example of a literature review conclusion

The Guide to Literature Reviews

• What is a Literature Review?
• The Purpose of Literature Reviews
• Guidelines for Writing a Literature Review
• How to Organize a Literature Review?
• Software for Literature Reviews
• Using Artificial Intelligence for Literature Reviews
• How to Conduct a Literature Review?
• Common Mistakes and Pitfalls in a Literature Review
• Methods for Literature Reviews
• What is a Systematic Literature Review?
• What is a Narrative Literature Review?
• What is a Descriptive Literature Review?
• What is a Scoping Literature Review?
• What is a Realist Literature Review?
• What is a Critical Literature Review?
• Meta Analysis vs. Literature Review
• What is an Umbrella Literature Review?
• Differences Between Annotated Bibliographies and Literature Reviews
• Literature Review vs. Theoretical Framework
• How to Write a Literature Review?
• How to Structure a Literature Review?
• How to Make a Cover Page for a Literature Review?
• How to Write an Abstract for a Literature Review?
• How to Write a Literature Review Introduction?
• How to Write the Body of a Literature Review?

How to Write the Conclusion of a Literature Review?

How to write a literature review conclusion, important reminders when writing a conclusion.

• How to Make a Literature Review Bibliography?
• How to Format a Literature Review?
• How Long Should a Literature Review Be?
• Examples of Literature Reviews
• How to Present a Literature Review?
• How to Publish a Literature Review?

Writing an effective conclusion for a literature review is a vital aspect of academic writing. It summarizes the key points and insights gained from analyzing literature review articles. An effective conclusion synthesizes existing knowledge and highlights the critical analysis of key concepts and theories. A good literature review conclusion ties together the findings from the research journey. It identifies gaps in the literature and suggests how further research can address important unanswered questions. This section demonstrates how the reviewed literature contributes to the broader context of the research area. In the social sciences, a strong conclusion emphasizes the importance of the research. It provides new insights and situates the findings within existing theories. This approach shows the relevance of the study and its implications for further research.

An effective conclusion also evaluates the current state of research. It reflects on the source material, offering a summary that connects key terms and ideas. This part of the literature review, found in the literature review section, not only reviews existing studies but also advances academic knowledge by proposing new areas for inquiry and exploration.

For example, in a few sentences, a literature review conclusion might summarize key points, highlight new ideas, and identify gaps in existing research. An introductory paragraph and a strong conclusion provide a comprehensive overview and set the stage for future directions in the field. Writing a good literature review involves crafting a conclusion that encapsulates the critical analysis and key concepts discussed, bringing the review to a thoughtful and informative close.

There are important aspects that conclusions need to have to be useful and close a literature review successfully. Use clear and concise language to convey key messages. Avoid ambiguity and vagueness in your conclusion. Focus on the significance and impact of the research, and highlight the key findings and implications of the literature review. Here are some important steps you can take when writing a literature review conclusion:

Summarize key findings . Briefly summarize the most important findings from your literature review. Highlight the major themes, patterns, and trends that emerged from the literature. This summary should encapsulate the core ideas without introducing new information.

Highlight research gaps . Identifying gaps in the existing literature is a crucial aspect of the conclusion. Point out areas that have not been thoroughly explored and clearly explain why it is important to address these unanswered questions. This helps establish the relevance and necessity of further investigation in your field of study.

Review your research question and objectives . Restate your research question and objectives in a concise and clear way, using different words than in the introduction. Briefly summarize the main themes or categories that you have discussed in the body of your literature review, and how they relate to your research question and objectives.

Discuss the implications. Discuss the broader implications of the findings. Explain how the insights gained from the literature review can impact your specific field or topic. This discussion should connect the reviewed literature to the larger academic or practical context, demonstrating the significance of your work. Synthesize your main findings to identify patterns and gaps. Integrate and compare the results and arguments of the different sources that you have reviewed, and show how they support or contradict each other. Highlight the most important or relevant points that you have made in the body of your literature review, and explain how they inform your research question or meet your objectives.

Reflect on the research process . Reflect on the methodology and approach used in your literature review, especially when you are writing a review as a full research paper. Consider any limitations encountered during the review process and how they might have influenced your findings. This reflection adds a layer of transparency and critical evaluation to your work.

Provide a final thought . End the conclusion with a final thought that encapsulates the overall importance of your literature review. This could be a call to action, a statement on the importance of ongoing research, or a prediction about future developments in your area of study. Focus on the significance and impact of the research. Explain how your literature review contributes to the advancement of knowledge in the field, and how it informs or guides your own research project. Identify any gaps or limitations that still exist in the literature, and propose some possible directions or questions for further investigation.

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Use a logical structure to present your findings . Use a logical structure to present your findings , and organize your conclusion in a way that flows smoothly from the introduction and body of your literature review.

Use transitions to connect your ideas and paragraphs . Use transitions to connect your ideas and paragraphs, and make sure your conclusion is well-organized and easy to follow.

Avoid ambiguity and vagueness in your conclusion . Use clear and concise language to convey key messages, and avoid ambiguity and vagueness in your conclusion.

Steer clear of overly broad or general statements . Steer clear of overly broad or general statements, and focus on the specific key findings and implications of your literature review. Avoid introducing new information in your conclusion, and stick to summarizing the main points and findings of your literature review.

Discuss the limitations and gaps in the existing research . Discuss the limitations and gaps in the existing research, and identify areas for future research in your literature review. Explain how your literature review contributes to the advancement of knowledge in the field, and how it informs or guides your own research project.

Identify areas for future research in your literature review . Propose some possible directions or questions for further investigation and discuss the limitations and gaps in the existing research. Explain how your research addresses these gaps and limitations.

Edit and revise your conclusion carefully . Make sure it is well-organized and easy to follow. Ensure consistency with the rest of your research paper, and check for grammar, punctuation, and spelling errors.

Review your conclusion in the context of your entire literature review . Make sure it accurately reflects the content and significance of your research. Ensure your conclusion effectively summarizes your research findings, and provides a clear direction for future research.

The literature review conclusion is important because it synthesizes findings, highlights research gaps, establishes the review's significance, provides a coherent end, reflects on the research process , informs future research, and enhances academic rigor . These functions collectively ensure that the literature review is a valuable and impactful academic contribution. In a literature review conclusion, you should briefly summarize the most important findings from your literature review. Highlight the major themes, patterns, and trends that emerged from the literature. This summary should encapsulate the core ideas without introducing new information. Identifying gaps in the existing literature is a crucial aspect of the conclusion. Point out areas that have not been thoroughly explored and suggest potential directions for future research. This helps establish the relevance and necessity of further investigation in your field of study.

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What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

What is the purpose of literature review , a. habitat loss and species extinction: , b. range shifts and phenological changes: , c. ocean acidification and coral reefs: , d. adaptive strategies and conservation efforts: .

• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• How to write a literature review faster with Paperpal? 

Frequently asked questions 

What is a literature review .

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

1. Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 

2. Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field.

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3. Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 

4. Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 

5. Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 

6. Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example 

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:  

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

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How to write a good literature review 

Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

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Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review 

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:  

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:  

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:  

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:  

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:  

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:  

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

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• Cite with Confidence: Paperpal makes it easy to incorporate relevant citations and references in 10,000+ styles into your writing, ensuring your arguments are well-supported by credible sources. This translates to a polished, well-researched literature review. 

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A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

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How to Conclude a Literature Review

By Laura Brown on 6th March 2019

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

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

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

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

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

How To Write A Literature Review Conclusion

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

1. Enlist Key Points

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

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

2. Summarise The Key Features Briefly

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

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

3. Educational Implications Of The Reviewed Literature

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

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4. Indicating Room For Future Research

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

Tips That Can Enlighten Your Conclusion

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

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

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

Get Help to Conclude Your Literature Review

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

Looking At Literature Review Conclusion Example

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

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

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

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

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

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

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

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

What basically is a literature review?

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

There are four primary objectives of writing a literature review:

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

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

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

Why is a literature review conclusion necessary?

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

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

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

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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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

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

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

Download Word doc Download Google doc

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

For each publication, ask yourself:

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

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

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

Take notes and cite your sources

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

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

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

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

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

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

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

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

As you write, you can follow these tips:

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

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

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

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

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

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

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

 Statistics

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

Research bias

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

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

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

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

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

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

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

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

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

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Writing a Literature Review

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

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

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

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

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

What are the parts of a lit review?

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

Introduction:

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

Conclusion:

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

How should I organize my lit review?

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

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

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

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

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

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

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

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

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Writing: Literature Review Basics

• What is Synthesis?
• Organizing Your Research
• Paraphrasing, Summary, or Direct Quotation?
• Introductions
• Conclusions
• All Writing Guides: Home
• CORE Library Home

The Job of the Conclusion

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

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

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

Here is an easy checklist for writing a conclusion:

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

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

  What recommendations do you have?

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

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

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

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

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

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

 Did you avoid presenting any new information?

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

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

Now let's break that down.

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

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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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

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

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

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

Download Word doc Download Google doc

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

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

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

For each publication, ask yourself:

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

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

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

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

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

Take notes and cite your sources

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

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

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

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

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

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

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

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

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

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

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

As you write, make sure to follow these tips:

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

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

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

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

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

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

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

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

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

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Literature Reviews for Medical Sciences

• Introduction
• Headings and subheadings

The following adheres to APA style formatting:

• Do not begin on a new page (begin where the Body section ends)
• Start with a Level 1 Heading (ex: Conclusion, Results, etc)
• Depending on the complexity of your paper, you may need to use subheadings in this section

A strong conclusion section will seek to achieve the following:

• Summarize your paper
• What worked? What was lacking? How are they similar/different?
• How did the evidence you found support your thesis? How has your research added to the existing discourse around this topic?
• What are the main takeaways? What do you want your readers to remember most from your paper?
• Highlight gaps in the existing literature

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How to Write a Literature Review

What is a literature review.

• What Is the Literature
• Writing the Review

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

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

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

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

Types of Literature Reviews

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

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

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

Examples of Literature Reviews

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

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

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

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

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

This article has a standard breakdown of sections:

• Introduction
• Literature Review
• Some discussion sections

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

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

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• Last Updated: Jan 11, 2024 9:48 AM
• URL: https://libguides.wesleyan.edu/litreview

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

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

WRITING THE REVIEW 

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

The actual review generally has 5 components:

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

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

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

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

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

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

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

Conclusion :  In the conclusion, you should:

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

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

• Writing a Literature Review: Wesleyan University
• Literature Review: Edith Cowan University
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• Last Updated: Aug 22, 2023 1:35 PM
• URL: https://libguides.eastern.edu/literature_reviews

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

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

Importance of a Good Literature Review

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

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

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

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

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

Types of Literature Reviews

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

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

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

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

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

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

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

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

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

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

Structure and Writing Style

I.  Thinking About Your Literature Review

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

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

The critical evaluation of each work should consider :

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

II.  Development of the Literature Review

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

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

III.  Ways to Organize Your Literature Review

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

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

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

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

IV.  Writing Your Literature Review

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

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

V.  Common Mistakes to Avoid

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

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

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

Writing Tip

Break Out of Your Disciplinary Box!

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

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

Another Writing Tip

Don't Just Review for Content!

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

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

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

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

Yet Another Writing Tip

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

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

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

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

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Learn how to write a review of literature

What is a review of literature.

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

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

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

Writing the introduction

In the introduction, you should:

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

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

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

Writing the body

In the body, you should:

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

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

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

Writing the conclusion

In the conclusion, you should:

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

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

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

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

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

Sample Literature Reviews

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

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

Academic and Professional Writing

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A Short Guide to Close Reading for Literary Analysis

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Incorporating Interview Data

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Planning and Writing a Grant Proposal: The Basics

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Job Materials and Application Essays

Writing Personal Statements for Ph.D. Programs

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15 Literature Review Examples

Chris Drew (PhD)

Dr. Chris Drew is the founder of the Helpful Professor. He holds a PhD in education and has published over 20 articles in scholarly journals. He is the former editor of the Journal of Learning Development in Higher Education. [Image Descriptor: Photo of Chris]

Learn about our Editorial Process

Literature reviews are a necessary step in a research process and often required when writing your research proposal . They involve gathering, analyzing, and evaluating existing knowledge about a topic in order to find gaps in the literature where future studies will be needed.

Ideally, once you have completed your literature review, you will be able to identify how your research project can build upon and extend existing knowledge in your area of study.

Generally, for my undergraduate research students, I recommend a narrative review, where themes can be generated in order for the students to develop sufficient understanding of the topic so they can build upon the themes using unique methods or novel research questions.

If you’re in the process of writing a literature review, I have developed a literature review template for you to use – it’s a huge time-saver and walks you through how to write a literature review step-by-step:

Get your time-saving templates here to write your own literature review.

Literature Review Examples

For the following types of literature review, I present an explanation and overview of the type, followed by links to some real-life literature reviews on the topics.

1. Narrative Review Examples

Also known as a traditional literature review, the narrative review provides a broad overview of the studies done on a particular topic.

It often includes both qualitative and quantitative studies and may cover a wide range of years.

The narrative review’s purpose is to identify commonalities, gaps, and contradictions in the literature .

I recommend to my students that they should gather their studies together, take notes on each study, then try to group them by themes that form the basis for the review (see my step-by-step instructions at the end of the article).

Example Study

Title: Communication in healthcare: a narrative review of the literature and practical recommendations

Citation: Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., … & Vogelaers, D. (2015). Communication in healthcare: a narrative review of the literature and practical recommendations. International journal of clinical practice , 69 (11), 1257-1267.

Source: https://onlinelibrary.wiley.com/doi/pdf/10.1111/ijcp.12686  

Overview: This narrative review analyzed themes emerging from 69 articles about communication in healthcare contexts. Five key themes were found in the literature: poor communication can lead to various negative outcomes, discontinuity of care, compromise of patient safety, patient dissatisfaction, and inefficient use of resources. After presenting the key themes, the authors recommend that practitioners need to approach healthcare communication in a more structured way, such as by ensuring there is a clear understanding of who is in charge of ensuring effective communication in clinical settings.

Other Examples

• Burnout in United States Healthcare Professionals: A Narrative Review (Reith, 2018) – read here
• Examining the Presence, Consequences, and Reduction of Implicit Bias in Health Care: A Narrative Review (Zestcott, Blair & Stone, 2016) – read here
• A Narrative Review of School-Based Physical Activity for Enhancing Cognition and Learning (Mavilidi et al., 2018) – read here
• A narrative review on burnout experienced by medical students and residents (Dyrbye & Shanafelt, 2015) – read here

2. Systematic Review Examples

This type of literature review is more structured and rigorous than a narrative review. It involves a detailed and comprehensive plan and search strategy derived from a set of specified research questions.

The key way you’d know a systematic review compared to a narrative review is in the methodology: the systematic review will likely have a very clear criteria for how the studies were collected, and clear explanations of exclusion/inclusion criteria. 

The goal is to gather the maximum amount of valid literature on the topic, filter out invalid or low-quality reviews, and minimize bias. Ideally, this will provide more reliable findings, leading to higher-quality conclusions and recommendations for further research.

You may note from the examples below that the ‘method’ sections in systematic reviews tend to be much more explicit, often noting rigid inclusion/exclusion criteria and exact keywords used in searches.

Title: The importance of food naturalness for consumers: Results of a systematic review  

Citation: Roman, S., Sánchez-Siles, L. M., & Siegrist, M. (2017). The importance of food naturalness for consumers: Results of a systematic review. Trends in food science & technology , 67 , 44-57.

Source: https://www.sciencedirect.com/science/article/pii/S092422441730122X  

Overview: This systematic review included 72 studies of food naturalness to explore trends in the literature about its importance for consumers. Keywords used in the data search included: food, naturalness, natural content, and natural ingredients. Studies were included if they examined consumers’ preference for food naturalness and contained empirical data. The authors found that the literature lacks clarity about how naturalness is defined and measured, but also found that food consumption is significantly influenced by perceived naturalness of goods.

• A systematic review of research on online teaching and learning from 2009 to 2018 (Martin, Sun & Westine, 2020) – read here
• Where Is Current Research on Blockchain Technology? (Yli-Huumo et al., 2016) – read here
• Universities—industry collaboration: A systematic review (Ankrah & Al-Tabbaa, 2015) – read here
• Internet of Things Applications: A Systematic Review (Asghari, Rahmani & Javadi, 2019) – read here

3. Meta-analysis

This is a type of systematic review that uses statistical methods to combine and summarize the results of several studies.

Due to its robust methodology, a meta-analysis is often considered the ‘gold standard’ of secondary research , as it provides a more precise estimate of a treatment effect than any individual study contributing to the pooled analysis.

Furthermore, by aggregating data from a range of studies, a meta-analysis can identify patterns, disagreements, or other interesting relationships that may have been hidden in individual studies.

This helps to enhance the generalizability of findings, making the conclusions drawn from a meta-analysis particularly powerful and informative for policy and practice.

Title: Cholesterol and Alzheimer’s Disease Risk: A Meta-Meta-Analysis

Citation: Sáiz-Vazquez, O., Puente-Martínez, A., Ubillos-Landa, S., Pacheco-Bonrostro, J., & Santabárbara, J. (2020). Cholesterol and Alzheimer’s disease risk: a meta-meta-analysis. Brain sciences, 10(6), 386.

Source: https://doi.org/10.3390/brainsci10060386  

O verview: This study examines the relationship between cholesterol and Alzheimer’s disease (AD). Researchers conducted a systematic search of meta-analyses and reviewed several databases, collecting 100 primary studies and five meta-analyses to analyze the connection between cholesterol and Alzheimer’s disease. They find that the literature compellingly demonstrates that low-density lipoprotein cholesterol (LDL-C) levels significantly influence the development of Alzheimer’s disease.

• The power of feedback revisited: A meta-analysis of educational feedback research (Wisniewski, Zierer & Hattie, 2020) – read here
• How Much Does Education Improve Intelligence? A Meta-Analysis (Ritchie & Tucker-Drob, 2018) – read here
• A meta-analysis of factors related to recycling (Geiger et al., 2019) – read here
• Stress management interventions for police officers and recruits (Patterson, Chung & Swan, 2014) – read here

Other Types of Reviews

• Scoping Review: This type of review is used to map the key concepts underpinning a research area and the main sources and types of evidence available. It can be undertaken as stand-alone projects in their own right, or as a precursor to a systematic review.
• Rapid Review: This type of review accelerates the systematic review process in order to produce information in a timely manner. This is achieved by simplifying or omitting stages of the systematic review process.
• Integrative Review: This review method is more inclusive than others, allowing for the simultaneous inclusion of experimental and non-experimental research. The goal is to more comprehensively understand a particular phenomenon.
• Critical Review: This is similar to a narrative review but requires a robust understanding of both the subject and the existing literature. In a critical review, the reviewer not only summarizes the existing literature, but also evaluates its strengths and weaknesses. This is common in the social sciences and humanities .
• State-of-the-Art Review: This considers the current level of advancement in a field or topic and makes recommendations for future research directions. This type of review is common in technological and scientific fields but can be applied to any discipline.

How to Write a Narrative Review (Tips for Undergrad Students)

Most undergraduate students conducting a capstone research project will be writing narrative reviews. Below is a five-step process for conducting a simple review of the literature for your project.

• Search for Relevant Literature: Use scholarly databases related to your field of study, provided by your university library, along with appropriate search terms to identify key scholarly articles that have been published on your topic.
• Evaluate and Select Sources: Filter the source list by selecting studies that are directly relevant and of sufficient quality, considering factors like credibility , objectivity, accuracy, and validity.
• Analyze and Synthesize: Review each source and summarize the main arguments  in one paragraph (or more, for postgrad). Keep these summaries in a table.
• Identify Themes: With all studies summarized, group studies that share common themes, such as studies that have similar findings or methodologies.
• Write the Review: Write your review based upon the themes or subtopics you have identified. Give a thorough overview of each theme, integrating source data, and conclude with a summary of the current state of knowledge then suggestions for future research based upon your evaluation of what is lacking in the literature.

Literature reviews don’t have to be as scary as they seem. Yes, they are difficult and require a strong degree of comprehension of academic studies. But it can be feasibly done through following a structured approach to data collection and analysis. With my undergraduate research students (who tend to conduct small-scale qualitative studies ), I encourage them to conduct a narrative literature review whereby they can identify key themes in the literature. Within each theme, students can critique key studies and their strengths and limitations , in order to get a lay of the land and come to a point where they can identify ways to contribute new insights to the existing academic conversation on their topic.

Ankrah, S., & Omar, A. T. (2015). Universities–industry collaboration: A systematic review. Scandinavian Journal of Management, 31(3), 387-408.

Asghari, P., Rahmani, A. M., & Javadi, H. H. S. (2019). Internet of Things applications: A systematic review. Computer Networks , 148 , 241-261.

Dyrbye, L., & Shanafelt, T. (2016). A narrative review on burnout experienced by medical students and residents. Medical education , 50 (1), 132-149.

Geiger, J. L., Steg, L., Van Der Werff, E., & Ünal, A. B. (2019). A meta-analysis of factors related to recycling. Journal of environmental psychology , 64 , 78-97.

Martin, F., Sun, T., & Westine, C. D. (2020). A systematic review of research on online teaching and learning from 2009 to 2018. Computers & education , 159 , 104009.

Mavilidi, M. F., Ruiter, M., Schmidt, M., Okely, A. D., Loyens, S., Chandler, P., & Paas, F. (2018). A narrative review of school-based physical activity for enhancing cognition and learning: The importance of relevancy and integration. Frontiers in psychology , 2079.

Patterson, G. T., Chung, I. W., & Swan, P. W. (2014). Stress management interventions for police officers and recruits: A meta-analysis. Journal of experimental criminology , 10 , 487-513.

Reith, T. P. (2018). Burnout in United States healthcare professionals: a narrative review. Cureus , 10 (12).

Ritchie, S. J., & Tucker-Drob, E. M. (2018). How much does education improve intelligence? A meta-analysis. Psychological science , 29 (8), 1358-1369.

Roman, S., Sánchez-Siles, L. M., & Siegrist, M. (2017). The importance of food naturalness for consumers: Results of a systematic review. Trends in food science & technology , 67 , 44-57.

Sáiz-Vazquez, O., Puente-Martínez, A., Ubillos-Landa, S., Pacheco-Bonrostro, J., & Santabárbara, J. (2020). Cholesterol and Alzheimer’s disease risk: a meta-meta-analysis. Brain sciences, 10(6), 386.

Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., … & Vogelaers, D. (2015). Communication in healthcare: a narrative review of the literature and practical recommendations. International journal of clinical practice , 69 (11), 1257-1267.

Wisniewski, B., Zierer, K., & Hattie, J. (2020). The power of feedback revisited: A meta-analysis of educational feedback research. Frontiers in Psychology , 10 , 3087.

Yli-Huumo, J., Ko, D., Choi, S., Park, S., & Smolander, K. (2016). Where is current research on blockchain technology?—a systematic review. PloS one , 11 (10), e0163477.

Zestcott, C. A., Blair, I. V., & Stone, J. (2016). Examining the presence, consequences, and reduction of implicit bias in health care: a narrative review. Group Processes & Intergroup Relations , 19 (4), 528-542

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Literature Review: Conducting & Writing

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Please contact Britt McGowan at [email protected] for inclusion in this guide. All disciplines welcome and encouraged.

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How To Structure Your Literature Review

3 options to help structure your chapter.

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

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

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

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

But wait – is this the right time?

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

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

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

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

Need a helping hand?

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

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

1: The Introduction Section

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

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

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

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

2: The Body Section

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

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

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

Option 1: Chronological (according to date)

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

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

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

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

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

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

Option 2: Thematic (grouped by theme)

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

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

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

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

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

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

Option 3: Methodological

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

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

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

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

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

3: The Conclusion Section

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

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

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

Example: Thematically Structured Review

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

Let’s Recap

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

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

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

Psst… there’s more!

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

29 Comments

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

I agree with you Marin… A great piece

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

Awesome article for my research.

I thank you immensely for this wonderful guide

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

Very educative and good time to get guide. Thank you

Great work, very insightful. Thank you.

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

Thank you very much, very helpful

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

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

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

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

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

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

Beautifully clear.nThank you!

Lucid! Thankyou!

Brilliant work, well understood, many thanks

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

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

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

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

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

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

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

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

Asking questions are actually fastidious thing if you are not understanding anything fully, but this article presents good understanding yet.

thank you SOOO much it is really helpful ..

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39 Best Literature Review Examples (Guide with Samples)

A literature review is a compilation of current knowledge on a particular topic derived from the critical evaluation of different scholarly sources such as books, articles, and publications, which is then presented in an organized manner to relate to a specific research problem being investigated.

It highlights the methods, relevant theories, and gaps in existing research on a particular subject. It can be both a summary and synthesis of information on a specific topic. A summary reiterates key information from scholarly sources, while synthesis is a new interpretation or combination of new and old material. 

As a synthesis, it can outline the intellectual progression of knowledge in a particular field or topic, which might involve stating key debates throughout the advancement period.  

Literature Review Examples

Purpose of Literature Review

Literature reviews have different purposes in scholarly articles, research papers , and books, depending on the discipline at hand. First and foremost, reviews are generally meant to showcase the extensive research carried out by an author on a particular topic and their findings, which will form the foundation of the research. It then summarizes the information to show the author’s familiarity with the topic in question.

The review also demonstrates the relationship between the topic being investigated and other topics that were under consideration. Finally, it outlines the gaps in the previous works of other scholars, which create areas of research.

Literature reviews provide a new interpretation of previous scholarly publications and aim to resolve conflicting studies done in the past. In addition, identifying existing gaps in a particular research area illustrates the starting point of the research.

Literature Review vs. Academic Research Paper

A research paper presents new ideas, arguments, and approaches toward a particular topic. The conclusions of a research paper will be based on the analysis and interpretation of raw data collected by the author and an original study. On the other hand, a literature review is based on the findings of other publications. Thus, the review highlights the author’s understanding of a topic based on the previously conducted research. It is part of a research paper.

Where, When, and Why

The need for a literature review in a publication will vary from one situation to the other and the field/discipline of research. These two factors determine what is expected from the lit review. For example, a scientific review will be more analytical on the methods and results of previous research. In contrast, a philosophical review will be more argumentative, highlighting the discrepancies and correspondences between scholars.

It can either be part of a publication or a stand-alone document. As part of a research publication, it is often placed after the introduction to the topic outlining knowledge about a particular topic and critical sources that formed the foundation of the research. As an individual document, it is prepared by students as part of course study to aid the students in familiarizing themselves with different topics in their field of study.

Lit reviews also guide students to help them synthesize theoretical methodologies and frameworks to adopt in academic research . As a publication, literature reviews are used to document existing information about a topic for readers (other scholars) to go through for whatever reasons they may have. Published studies are essentially helpful to new scholars getting into any field of research.

Types of Literature Review

Before looking into how to write a literature review, it is vital to understand the different types. The type will usually depend on the objective approach of the author.

Common types are:  

Argumentative review

An argumentative review is adopted when the research paper or publication is meant to take a contrarian viewpoint on a particular subject. The review analyses an existing argument, philosophical problem, assumption, or conclusion outlined in different studies with an objective to either support or oppose the argument. 

Integrative review

An integrative review integrates secondary data to develop new perspectives and frameworks on a topic. This is more prevalent in research that does not involve primary data. In addition, integrative reviews are more familiar with social sciences.       

Historical review

Historical reviews are used when scholars or authors place a particular idea, concept, theory, or research in a historical context. It examines the idea, theory, or issue from the first time it was discussed and outlines its evolution throughout a given period.  

Methodological review

Methodological reviews look at how a specific theory, concept, results, or findings were developed. Therefore, methodological reviews will analyze the different methods used by different scholars to arrive at conclusions or knowledge about the topic being investigated.

Some of the methods scholars use in different disciplines to obtain information are interviewing, sampling, practical experiments/data collection, research approaches, critical thinking, social experiments, etc.

Methodological reviews are hence used to discuss tested methods of research and ethics that a researcher should be aware of before undertaking their investigations.  

Systematic review

A systematic review is a more detailed and comprehensive review compared to other types of lit reviews. It highlights any existing research evidence associated with a clearly defined research problem or question. The evidence is collected, analyzed, and reported in a summarized but detailed manner. Systematic reviews are popularly presented as a cause-and-effect structure.

Theoretical review

A theoretical review delves into the different theories regarding a particular issue, challenge, concept, or theory. It identifies their inadequacy in explaining the issue or concept at hand. The review then identifies the relationships between the identified theories, and the degree of research done and poses novel hypotheses to be investigated.

Organization of a Literature Review

How an author organizes a literature review will depend on what they aim to achieve. As a consequence, there are multiple ways of organizing it which are discussed below:

Chronological 

A chronological format outlines knowledge on a particular topic based on when the scholarly source of information was published. Starting with the earliest followed up to the most recent chronological order. This format should be used if there is a clear chronological order in the development of the information; therefore, it will not be applicable in some cases. Instead, key turning points, patterns, and events that impacted the direction of the knowledge should be outlined.  

By publication

It can be organized in the scholarly publications reviewed by the author, scholar, or student. The by-publication format should only improve the review and facilitate what the author aims to accomplish. 

Scholars or students can adopt a dominant trend in research, such as history, developmental stages, steps involved in a process, etc.

Methodological

A methodological format is based on the methods used by the researcher. Thus, the order of contents in the lit review will depend on the method they will use to carry out their research, knowledge obtained from the first method appears first, and the rest of the information follows in the same order according to the methods used by the author.  

Literature reviews organized in a thematic format revolve around the subject being investigated in no order. It is, therefore, ordinarily up to the researcher or author to determine how they intend to outline the information. A thematic format will crossover from one period and publication to another, but can sometimes incorporate a chronological order.

Theoretical

Literature reviews organized in a theoretical format have their contents organized in an abstract framework established by the author to discuss different concepts, theories, and concepts and how they relate to the research at hand.

Additional sections

Depending on the objective, other sections do not fit under conventional lit review formats that one may need to add. Below are some of the sections that authors or students can include in the lit review:

• Current situation: The review can have information about the current state of things regarding the topic at hand to facilitate further understanding.
• History: Researchers can summarize the subject under investigation, literature, or concept if the review is not already in chronological format.
• Selection methods: Lit reviews are known to outline the methods or criteria used in selecting the way to present information and scholarly sources referenced in the review.
• Standards: it can also include the standards used in choosing the format to present information in the review and the scholarly literature used in the research.
• Further questions for research: The review can include questions emanating from the review and how the researcher will further explore their research to address the queries raised.

Literature Review Samples

Considerations Before Writing a Literature Review

Preparation is essential when it comes to writing. The objective should be to come up with a review that satisfactorily explores the topic being discussed. The following considerations are steps towards that if incorporated into the writing process:

Authors should seek clarification from mentors or supervisors before commencing the writing process. First, determine what is expected from the lit review. The type and number of sources to be used, the assignment (summarize, synthesize, or critique), and the type of information provided should be clear.

Find models

You should review literature from other authors in the same discipline and evaluate how those authors presented their lit reviews. Previous lit reviews can be used as guides that point authors in the right direction when writing their lit reviews.

Narrow your topic

It is always advantageous to narrow down the research topic to a specific area of research; that way, the number of sources can also be reduced. Even though conducting research will usually involve extensive research on all available materials about a particular topic, having a well-defined topic simplifies the task at hand.

Current sources

Determine if the research project or discipline ought to be based on the most recent findings or information. It is common for knowledge to become obsolete, especially in disciplines where discoveries and new inventions are made fast. If the lit review should be based on current knowledge, limit the sources to the most recent literature. Some disciplines will typically have a limit on how old the sources should be.  

How to Write a Literature Review (Expert Guide)

Once all pre-writing considerations have been taken into account, it is time to write the document. At this point, you should already be aware of what you wish to accomplish with the literature review, and the steps to writing an exemplary lit review are mentioned below:

Problem formulation

First and foremost, clearly define the topic (research area) to be investigated. For students, this will sometimes be given as an assignment. However, the research could be an academic project, which means that the author has to come up with the problem and define it themselves.

Search for relevant studies

Once the problem is clearly expressed, you should search for studies related to the topic, concept, theory, or idea and questions surrounding the topic. Most stand-alone lit reviews will generally attempt to answer a more concentrated question. On the internet, literature can be searched using keywords related to the research area. In addition to keywords, include vital variables such as synonyms and associated terms. The inclusion of Boolean operators and, or not, is also used to narrow down results to more specific publications.

Familiar sources for publications are:

• Google Scholar
• Library catalogue
• Econ lit (economics)
• Project Muse (humanities and social sciences)
• Inspec (physics, engineering, and computer science )
• Medline (life sciences and biomedicine)

Before selecting relevant studies, go through their abstract and determine if they fit the scope needed in the investigation. Use a list to note down any chosen works. Select landmark sources in the discipline.

Evaluation of sources/data

The next step is the evaluation stage . Evaluation involves a lot of reading. Evaluation can be done in two stages; overall skimming and thorough reading. During the second stage of this step, be critical, ask questions, and take many notes.

Some of the questions authors or researchers should ask themselves are:

• What is the author’s objective? What problem, concept, or theory are they putting across?
• What are the main concepts?
• What are the methodologies used by the author to arrive at the results and conclusions?
• What are the strengths and weaknesses of the results and conclusions?

Use credible sources. Most cited sources are preferred as they indicate their influence in the field. Also, keep track of the citations to be later incorporated.

Identify themes, debates, and gaps

While reading the sources, identify key patterns, themes, debates/arguments, and gaps in each literature. These elements help tie the literature to the topic under investigation. Look for consistent patterns, themes, questions, challenges, methods, and inconsistencies in the same. Consistencies present critical information for consideration, while inconsistencies present opportunities for research areas.

Outline the structure

Formatting is part and parcel of a well-written work. Selecting the structure should start by creating an outline with all the information that will go into the lit review, then consider the different types of structures and select the most suitable. Next, take the basic structure of the introduction, body, and conclusion into consideration and start work from there. 

Analysis and interpretation 

Lastly, perform an in-depth analysis and interpretation of the information obtained from the scholarly research and put it into writing. The summarized, synthesized, and critically evaluated information is then written down in well-structured paragraphs that follow the chosen structure. Transition words are used to draw comparisons, connections, and contrasts.

Format 

Ordinarily, a literature review will have three key components: introduction, body, and conclusion. These components should appear in the document in the following order:

Introduction

An introduction should inform the reader which topic is being studied. It gives the reader an overall idea of the purpose and focus of the document. The introduction lets the reader know beforehand the key things that will be highlighted in the document. Therefore, the introduction should be brief and precise.

The next item is the body, where the primary purpose of the lit review is fulfilled. The body should take critical information from all the sources used and comprehensively present them. This is where the author reports the extensive analysis and interpretation results that they gathered from all the sources they reviewed. The body should be categorized into themes, ideas, and concepts within the main topic.

Lastly, a summary of what the lit review entails should be provided as a conclusion. The critical points obtained from examining the sources should be written down and linked to the primary subject of the review. Key points are those that have the most outstanding contribution to the research.

Studies used should be screened based on provenance (author’s credentials or credibility), methodology, objectivity, persuasiveness, and value related to the topic at hand.

Guidelines for Writing a Literature Review

To improve the delivery of information, there are certain elements that authors can incorporate. They are:

Use evidence

The lit review’s findings, interpretations, and general contents should be based on actual evidence or credible literature. Using citations is evidence of authentic information.

Be selective

There will always be a lot of information available from the reviewed sources. Authors should therefore be selective and discuss the key points that focus on the topic. Not all information must be included in the review.  

Word-for-word quotes are acceptable . This is even more so if a critical point or author-specific terminology or knowledge cannot be paraphrased. Quotes should, however, be used sparingly.

Summarize and synthesize

The information obtained from the sources should be summarized, and the author should use it to synthesize new arguments, concepts, or ideas related to their research.

Keep your voice

The literature review should reflect the author’s voice as it is a review of other people’s works. This can be done by starting and ending the paragraphs with an original voice, ideas, and wordings.

Use caution while paraphrasing

Any paraphrased information should be conveyed accurately and in the author’s words. A citation must always be done, even when paraphrasing has been done.

Proofread before submitting or publishing. Go through the document a few times and make the necessary changes. The review should be within the applicable guidelines. Check for language and any other errors and edit accordingly.

Do’s and Don’ts for a Literature Review 

Every researcher wants to introduce their readers to a particular topic in an informative and engaging manner. Below are tips that can be used to this effect.

The following things should be opted by the researcher when writing a lit review:

• Find a focus: Authors should take a direction, idea, concept, or argument and stick to it. The information conveyed should then be made to align with the chosen point of focus. Thus, the review is not simply a list of analyzed sources, but a detailed summary of how different sources have a focal point (intertwined).
• Well-chosen sources: The quality of the information will, to a great extent, be determined by the quality of sources used. Therefore, take time to select suitable sources and more value will be added to the review.
• Create an annotated bibliography: Creating an annotated bibliography is recommended as one reads their sources. The bibliography keeps track of sources and takes notes. This information can be used when writing the final lit review.
• Synthesize research: Information obtained from the relevant studies should be combined to come up with new or original ideas. You should present a new domain based on previous sources’ knowledge, not just restating the information.
• Argumentative approach: Well-written literature reviews will often argue to support an author’s stance on a particular topic. The author can choose to address how the author’s work is filling a particular gap or support one of the scholar’s arguments and perception towards a particular topic. However, this argumentative approach will not work in all situations; it is usually discipline-specific. 
• Convey it to the reader: It should let the reader know the document’s main idea, concept, or argument. This can be done by including a simple statement that compels the reader to think precisely and know what to expect.
• Break out your disciplinary box: The research will often be multi-disciplinary. Literature reviews should then collect interdisciplinary information from multiple sources as they add novel dynamics to the topic under investigation. It should be noted that this does not imply that the researcher should substitute the literature from the topic’s discipline with that from other disciplines. This is usually an improvement strategy that adds substance to the review.
• Look for repeated patterns: Be attentive to pick out repeated ideas, findings, and concepts from different scholars as they will often illustrate agreed research dead-end or a scholarly conclusion.
• Don’t just review for content: When reviewing the literature, examine the content and other writing and presentation techniques. Look out for unique ways information has been presented, methods used, consistent citations, and non-textual elements such as graphs, and figures used to present information. In addition, the researcher identifies theories used to predict, explain, or understand phenomena within the discipline.
• Search Web of Science and Google Scholar: Conduct citation tracking about the leading scholars already identified in the search process. Scholars cited by multiple scholars outside the principal discipline will generally indicate that there are no new publications on the topic.

The following don’ts should be avoided:

• Do not select studies that are not directly related to the topic being investigated.
• Avoid rushing when identifying and selecting sources to use to research the problem.
• Avoid the use of secondary analytical sources. Instead, opt to use sources with primary research studies or data. Secondary analytical sources will often cite primary analytical sources; research should refer to them instead.
• Do not accept other scholarly findings, theories, or interpretations without critically examining and critiquing them.
• Researchers should not outline the search procedures used to identify scholarly sources for reviewing purposes.
• Avoid including isolated statistical findings without illustrating how they were arrived at using chi-squared or meta-analytic methods.
• Do not review studies that only validate the assumptions, stances, and concepts of your thesis; consider contradicting works with alternative and conflicting stances.

Frequently Asked Questions

It is written by researchers, authors, and students who must study literature to gather knowledge on a particular topic they are interested in.

It should be placed right after the introduction of the dissertation. It places the research in a scholarly context by summarizing existing knowledge on the particular topic.

Researchers and authors are not limited in terms of how many sources they can review. Students will usually have a given number of sources to review as an assignment. However, the number of sources referenced in a lit review will vary from one topic or discipline to the other. Some topics have a vast catalog of available sources, while others have minimal sources, especially emerging issues. It is, however, advised that each key point discussed should have at least 2-3 references/sources. For example, a 10-page lit review will have an average of 30 references.

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A literature review is an essential part of any academic research paper, thesis, or dissertation. It provides a thorough examination of existing research on a particular topic, allowing the researcher to identify gaps, areas of agreement or disagreement, and emerging trends in the field. In this post, we’ll delve into the definition of a literature review, explore the different types of literature reviews, and provide examples of literature review structures that can guide your own work. Additionally, we’ll offer tips on how to craft a compelling literature review that strengthens the foundation of your research.

Literature Review Meaning

The term "literature review" refers to a comprehensive survey of the scholarly works, books, journal articles, and other sources relevant to a particular research topic. Its primary purpose is to offer a critical evaluation of the existing body of knowledge. The literature review helps set the context for the research question, showing what has already been explored and where gaps in knowledge or methodological limitations may exist. By examining various sources, you can assess how your research fits into the broader conversation within your field. The literature review also provides the foundation for your argument, helping to justify the importance of your research and explain how it contributes to the ongoing academic discussion.

Why Is a Literature Review Important?

A literature review is not just a summary of previous research but a critical analysis of the work that has been done in a particular area of study. It helps demonstrate your understanding of the topic and situates your work within the existing academic landscape. By conducting a literature review, you ensure that your research is not redundant and identify the unique contributions your study can make. Furthermore, the literature review informs your methodology, highlighting which methods have been successful in previous studies and which have encountered limitations. By understanding what has worked before, you can avoid potential pitfalls and build upon the successes of earlier researchers.

Literature Review Structure

The structure of a literature review can vary depending on the nature of your research and the field of study. However, the most common literature review structure includes several key components:

• Introduction :This section outlines the scope of the literature review, defines the key terms, and states the overall purpose of the review. It provides the reader with an understanding of what the review will cover.
• Thematic Organisation : The literature is often organised thematically, grouping together works that address similar aspects of the research topic. Themes can relate to theoretical approaches, methodologies, or different interpretations of key issues.
• Critical Evaluation : The body of the literature review should not only summarise the existing research but also critically evaluate it. This might involve identifying strengths and weaknesses in methodologies, assessing the reliability of findings, and discussing how well the research supports the claims made.
• Conclusion : The conclusion should summarise the main findings of the review, restate the key themes, and highlight gaps in the research that your study will address. It should also reflect on how the literature review has shaped your own research design.

Types of Literature Reviews

There are several different forms of literature reviews, each with a distinct focus and structure. Understanding these types can help you choose the approach that best fits your research needs. Here are some of the most common types of literature reviews:

• Narrative Literature Review : This is the most traditional form of literature review. It provides a comprehensive summary and analysis of the literature on a particular topic. Narrative reviews are often broad in scope and provide an overview of key themes and trends.
• Systematic Literature Review : This type of review involves a rigorous, structured process that aims to identify all relevant studies on a specific research question. Systematic reviews follow a clearly defined methodology, including specific criteria for selecting and analysing studies. They are commonly used in fields such as healthcare, where a comprehensive synthesis of evidence is needed.
• Scoping Review : Clearly outline your main argument or position. This should guide the direction of your essay.
• Scoping Review : A scoping review is used to map the key concepts, sources, and evidence in a research area. It is often the first step before a systematic review and is useful for identifying gaps in the literature and guiding further research.
• Meta-Analysis : This is a form of literature review that uses statistical techniques to combine the results of multiple studies. Meta-analyses are typically used to provide an overall estimate of the effect size for a particular intervention or phenomenon.
• Integrative Review : An integrative review synthesises qualitative and quantitative data to provide a more holistic view of the research on a particular topic. It aims to generate new perspectives by integrating findings from different types of studies.
• Critical Review : This type of literature review goes beyond merely describing the literature. A critical review analyses and synthesises the research, evaluating its strengths and weaknesses and offering new insights and perspectives on the topic.

Short Example of a Literature Review

Below is an example of the literature review from a dissertation on climate change policies. The example demonstrates how to structure a literature review and critically engage with the literature:

Introduction of the Literature Review

Climate change has been a topic of growing concern over the past few decades, with numerous policies introduced globally to mitigate its effects. This review examines the existing literature on climate change policies, focusing on the effectiveness of carbon pricing, renewable energy subsidies, and regulatory approaches. The review aims to highlight the strengths and limitations of these policies and identify gaps in the research that future studies should address.

Thematic Organisation

The literature is organised into three main themes: carbon pricing mechanisms, renewable energy subsidies, and regulatory approaches to emissions reduction. Each theme is analysed in detail, examining the key findings of previous research and assessing the impact of these policies on greenhouse gas emissions.

Critical Evaluation

The review finds that while carbon pricing mechanisms have been effective in reducing emissions in some contexts, their success is heavily dependent on political and economic factors. Renewable energy subsidies have contributed to significant increases in renewable energy capacity, but their long-term sustainability remains in question. Regulatory approaches, while often politically contentious, have proven to be effective in certain jurisdictions.

The literature review concludes that although significant progress has been made in the development of climate change policies, further research is needed to evaluate the long-term impacts of these policies and to explore new approaches that may be more effective in reducing emissions.

Key Considerations

Writing a literature review can be a complex task, but it is a vital part of the research process. By understanding the meaning of a literature review, familiarising yourself with different forms of literature reviews, and following a clear structure, you can create a review that enhances your research project and demonstrates your knowledge of the field.

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Literature Reviews

• What is a Literature Review?
• Steps for Creating a Literature Review
• Providing Evidence / Critical Analysis
• Challenges when writing a Literature Review
• Systematic Literature Reviews

Developing a Literature Review

1. Purpose and Scope

To help you develop a literature review, gather information on existing research, sub-topics, relevant research, and overlaps. Note initial thoughts on the topic - a mind map or list might be helpful - and avoid unfocused reading, collecting irrelevant content.  A literature review serves to place your research within the context of existing knowledge. It demonstrates your understanding of the field and identifies gaps that your research aims to fill. This helps in justifying the relevance and necessity of your study.

To avoid over-reading, set a target word count for each section and limit reading time. Plan backwards from the deadline and move on to other parts of the investigation. Read major texts and explore up-to-date research. Check reference lists and citation indexes for common standard texts. Be guided by research questions and refocus on your topic when needed. Stop reading if you find similar viewpoints or if you're going off topic.

You can use a "Synthesis Matrix" to keep track of your reading notes. This concept map helps you to provide a summary of the literature and its connections is produced as a result of this study. Utilizing referencing software like RefWorks to obtain citations, you can construct the framework for composing your literature evaluation.

2. Source Selection

Focus on searching for academically authoritative texts such as academic books, journals, research reports, and government publications. These sources are critical for ensuring the credibility and reliability of your review. 

• Academic Books: Provide comprehensive coverage of a topic.
• Journal Articles: Offer the most up-to-date research and are essential for a literature review.
• Research Reports: Detailed accounts of specific research projects.
• Government Publications: Official documents that provide reliable data and insights.

3. Thematic Analysis

Instead of merely summarizing sources, identify and discuss key themes that emerge from the literature. This involves interpreting and evaluating how different authors have tackled similar issues and how their findings relate to your research.

4. Critical Evaluation

Adopt a critical attitude towards the sources you review. Scrutinize, question, and dissect the material to ensure that your review is not just descriptive but analytical. This helps in highlighting the significance of various sources and their relevance to your research.

Each work's critical assessment should take into account:

Provenance:  What qualifications does the author have? Are the author's claims backed up by proof, such as first-hand accounts from history, case studies, stories, statistics, and current scientific discoveries? Methodology:  Were the strategies employed to locate, collect, and evaluate the data suitable for tackling the study question? Was the sample size suitable? Were the findings properly reported and interpreted? Objectivity : Is the author's viewpoint impartial or biased? Does the author's thesis get supported by evidence that refutes it, or does it ignore certain important facts? Persuasiveness:  Which of the author's arguments is the strongest or weakest in terms of persuasiveness? Value:  Are the author's claims and deductions believable? Does the study ultimately advance our understanding of the issue in any meaningful way?

5. Categorization

Organize your literature review by grouping sources into categories based on themes, relevance to research questions, theoretical paradigms, or chronology. This helps in presenting your findings in a structured manner.

6. Source Validity

Ensure that the sources you include are valid and reliable. Classic texts may retain their authority over time, but for fields that evolve rapidly, prioritize the most recent research. Always check the credibility of the authors and the impact of their work in the field.

7. Synthesis and Findings

Synthesize the information from various sources to draw conclusions about the current state of knowledge. Identify trends, controversies, and gaps in the literature. Relate your findings to your research questions and suggest future directions for research.

Practical Tips

• Use a variety of sources, including online databases, university libraries, and reference lists from relevant articles. This ensures a comprehensive coverage of the literature.
• Avoid listing sources without analysis. Use tables, bulk citations, and footnotes to manage references efficiently and make your review more readable.
• Writing a literature review is an ongoing process. Start writing early and revise as you read more. This iterative process helps in refining your arguments and identifying additional sources as needed.  

Brown University Library (2024) Organizing and Creating Information. Available at: https://libguides.brown.edu/organize/litreview (Accessed: 30 July 2024).

Pacheco-Vega, R. (2016) Synthesizing different bodies of work in your literature review: The Conceptual Synthesis Excel Dump (CSED) technique . Available at: http://www.raulpacheco.org/2016/06/synthesizing-different-bodies-of-work-in-your-literature-review-the-conceptual-synthesis-excel-dump-technique/ (Accessed: 30 July 2024).

Study Advice at the University of Reading (2024) Literature reviews . Available at: https://libguides.reading.ac.uk/literaturereview/developing (Accessed: 31 July 2024).

Further Reading

Frameworks for creating answerable (re)search questions  How to Guide

Literature Searching How to Guide

• << Previous: Steps for Creating a Literature Review
• Next: Providing Evidence / Critical Analysis >>
• Last Updated: Sep 4, 2024 11:43 AM
• URL: https://library.lsbu.ac.uk/literaturereviews

How to write a literature review introduction (+ examples)

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

Why you need an introduction for a literature review

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

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

When you need an introduction for a literature review

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

What to include in a literature review introduction

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

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

Academic literature review paper

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

Regular literature review section in an academic article or essay

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

In some cases, you might include:

Introduction to a literature review chapter in thesis or dissertation

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

Examples of literature review introductions

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

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

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

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

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

Examples 3-5: Effective introductions to literature review chapters

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

Master’s thesis literature review introduction

Phd thesis literature review chapter introduction, phd thesis literature review introduction.

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

Steps to write your own literature review introduction

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• Published: 10 September 2024

When urban poverty becomes a tourist attraction: a systematic review of slum tourism research

• Tianhan Gui   ORCID: orcid.org/0000-0001-6069-3046 1 &
• Wei Zhong 1  

Humanities and Social Sciences Communications volume  11 , Article number:  1178 ( 2024 ) Cite this article

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• Business and management

Over the last two decades, the phenomenon of “slum tourism” and its academic exploration have seen considerable growth. This study presents a systematic literature review of 122 peer-reviewed journal articles, employing a combined approach of bibliometric and content analysis. Our review highlights prominent authors and journals in this domain, revealing that the most cited journals usually focus on tourism studies or geography/urban studies. This reflects a confluence of travel motivations and urban complexities within slum tourism. Through keyword co-occurrence analysis, we identified three primary research areas: the touristic transformation of urban informal settlements, the depiction and valorization of urban poverty, and the socio-economic impacts of slum tourism. This study not only maps the current landscape of research in this area but also identifies existing gaps. It suggests that the economic, social, and cultural effects of slum tourism are areas that require more in-depth investigation in future research endeavors.

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Introduction.

“Slums” are defined by UN-Habitat ( 2006 ) as underdeveloped urban areas lacking in a durable housing, adequate living space, safe water access, sanitation, and tenure security. Emerging from urban growth disparities, these informal settlements have proliferated since the latter half of the 20th century, especially in the Global South’s cities. Despite progress in urban planning and poverty reduction, UN-Habitat ( 2020 ) reports that over a billion people, with 80% in developing regions, still live in such conditions.

Slums undeniably “represent one of the most enduring faces of poverty, inequality, exclusion and deprivation” (UN-Habitat, 2020 , p. 25), necessitating policy intervention. However, the term “slum” is controversial among scholars as it often carries negative connotations, conflating poor housing conditions with the identities of residents (Gilbert, 2007 ). Beyond poverty and disease, it suggests crime and immorality, contributing to a narrative of fear and fascination (Davis, 2006 ; Mayne, 2017 ).

Recent decades have seen a surge in “slum tours” in the Global South, attracting tourists from the affluent North. Driven by complex motives that “consist of a mix of adventurous inquiry and humanitarian ambitions” (Dürr, 2012b , p. 707), tourists from the affluent North desire to glimpse “the other side of the world” (Steinbrink, 2012 , p. 232). This trend has turned guided tours in informal settlements into a booming business in cities like Mumbai, Rio de Janeiro, Cape Town, and Nairobi, drawing approximately one million tourists annually (Frenzel, 2016 ).

Modern slum tourism has deep historical roots, originating as “slumming” in Victorian England and early 20th-century America. Rapid urbanization in cities like London and New York created neglected areas, which, to middle and upper-class observers, represented a mysterious and chaotic “other world” (Steinbrink, 2012 ). This perception of danger and uncivilization paradoxically attracted bourgeois curiosity (Frenzel et al. 2015 ).

By the late 1970s, with the surge in international tourism, this localized “slumming” transformed into a global phenomenon. Affluent residents from the Global North began exploring underprivileged urban pockets in the Global South, making these areas tourism hotspots (Freire-Medeiros, 2009 ; Iqani, 2016 ). This trend marked the beginning of modern slum tourism, a practice that took a significant turn in the 1990s in South Africa. Initially focusing on anti-apartheid landmarks in townships like Soweto, Johannesburg (Steinbrink, 2012 ), these tours diversified to other cities, including Rio de Janeiro, Mumbai, and Manila (Frenzel et al. 2015 ). The once sporadic visits to informal settlements have now metamorphosed into well-orchestrated tours, often recommended by travel guidebooks. Today’s travelers can dine at local eateries, visit schools, interact with residents, or even step inside their homes (Frenzel, 2017 ; Frenzel and Blakeman, 2015 ). The industry has professionalized, with cities in the Global South attracting tourists mainly from the United Kingdom, United States, Germany, and Scandinavia (Frenzel, 2012 ; Frenzel and Blakeman, 2015 ; Steinbrink, 2012 ).

The burgeoning interest in slum tourism has sparked significant scholarly discourse, particularly in the new millennium. Research in this realm predominantly orbits around the ethical implications of such tourism, its role in mitigating poverty, and the duties of governing bodies in these scenarios. Slum tourism research encompasses various disciplines, including urban studies, tourism and hospitality, and human geography, with a significant proliferation of publications in recent years.

The surge in research has also led to several evaluative studies scrutinizing the breadth and depth of the subject. Frenzel’s ( 2013 ) thematic review, for instance, probed the nexus between slum tourism and poverty alleviation. Given that most slum tours proclaim poverty alleviation as their core intent, Frenzel’s inquiry into the intersection of this mission with tourism was insightful. He also championed the need for a rigorous exploration of the multifaceted valorization of poverty within tourism dynamics. A more expansive review by Frenzel et al. ( 2015 ) delved into various research focuses like the evolution of slum tourism, tourist experiences, operational aspects, economic implications, and so on. Their assessment underscored existing research voids, emphasizing the necessity for more nuanced, comparative studies. Tzanelli ( 2018 ) examined the socio-cultural and political drivers behind tourists’ inclinations towards informal settlements, critically analyzing the epistemological frameworks employed by scholars.

While these reviews have significantly sketched the contours of the discipline, many leaned heavily on conventional literature review techniques—predicated on selected, and at times, circumscribed resources (Petticrew and Roberts, 2008 ). Such manual methodologies, albeit insightful, are prone to biases “during the identification, selection, and synthesis of included studies” (Haddaway et al. 2015 , p. 1956). A systematic literature review, which adheres to rigorous protocols and curtails subjective inclinations, would be more enriching. Such a methodological shift not only offers a panoramic view of pivotal research arguments and deliberations but also illuminates evolving trends and perspectives. The surge in slum tourism literature recently underscores its dynamic nature, necessitating a renewed scrutiny of nascent discussions eluding preceding reviews.

Addressing this research exigency, our current endeavor undertakes a comprehensive examination of a gamut of articles illuminating diverse research angles on slum tourism. Employing both bibliometric and qualitative content analysis techniques, our study dissects 122 journal articles published over the past twenty years. We endeavor to spotlight seminal authors and journals, delineate prevailing themes in slum tourism studies, and carve out prospective trajectories for forthcoming research endeavors.

Methodology

Search process and sample selection.

A systematic review requires researchers to thoroughly examine all existing studies in a certain research area. This ensures a replicable, scientific, and transparent approach with minimal bias (Denyer and Tranfield, 2009 ). We adopt the “Preferred Reporting Items for Systematic Reviews and Meta-Analysis” (PRISMA) guideline (Moher et al. 2009 ) to identify eligible articles. The screening process is presented in Fig. 1 . We consulted an advanced keyword search on Google Scholar to retrieve literature on slum tourism. We chose Google Scholar because it provides broader access to a diverse range of scholarly articles, including those from various regions and disciplines that may not be indexed in databases like Web of Science or Scopus. Furthermore, since this study aims to review research articles on slum tourism, which is pertinent in the Global South, many journals or articles published or authored in the Global South are not indexed in Web of Science or Scopus but can be found on Google Scholar. This accessibility is vital for ensuring the inclusion of relevant studies that reflect the diverse contexts of slum tourism.

The systematic workflow and results.

For our subject search, we used the keywords “slum tourism.” We consciously omitted country-specific terms like barrios, township, and favela to prevent a regional bias (Baffoe and Kintrea, 2023 ). Google Scholar Advanced Search provides the choice to locate keywords either “in the title of the article” or “anywhere in the article.” We chose the latter, ensuring the inclusion of articles that might employ regional terms synonymous with “slum” in their titles. This approach also considered the potential cross-referencing of slum tourism literature in these articles. Conducted in August 2023 without time constraints, our search yielded 2690 materials.

To uphold the literature’s quality, only peer-reviewed scientific articles were chosen, excluding “grey literatures” such as reports, theses, conference proceedings, and other similar outputs. Books and book chapters were not incorporated into our review because our focus extended to trends in slum tourism research. The accelerated pace of academic publishing in journals, as compared to the longer timelines associated with books, means they often house the most current findings and trends. Utilizing a bibliometric analysis approach, we found the standardized structure of journal articles particularly beneficial, allowing for a more straightforward process in extracting, comparing, and synthesizing data. Books and their chapters, given their varied formats, might not always provide this level of consistency. Recognizing that a systematic review cannot encompass all languages, we confined our study to English-written articles.

After the initial screening, 148 articles closely related to slum tourism were identified. Our perspective on slum tourism aligns with Frenzel’s ( 2018 , p. 51) definition, describing it as “tourism where poverty and associated signifiers become central themes and (part of the) attraction of the visited destination.” Upon a thorough review of the full texts, it became apparent that some articles, while mentioning “slum tourism,” did not primarily focus on it. For instance, the work of Jones and Sanyal ( 2015 ) discusses the portrayal of Dharavi—India and Asia’s largest informal settlement—in slum tours, arts, and documentaries. Although their article addresses how Dharavi is represented in slum tours, its primary focus is on the depiction of informal settlements and urban poverty across various media, not slum tourism per se. Consequently, this article was excluded from our dataset. We also eliminated editorials, short commentaries, research notes, and prior literature reviews. This filtering narrowed our selection to 107 peer-reviewed articles. An exhaustive examination of their references added another 15 articles, giving a total of 122 articles. Figure 1 visualizes the selection process.

Data analysis

This study utilized both bibliometric and qualitative content analyses. Bibliometric analysis is crucial for identifying both established and emerging research themes as well as influential authors, key studies, and prominent journals (Hajek et al. 2022 ). We employed VOSviewer, a leading bibliometric analysis software, to undertake co-citation and keyword co-occurrence analyses, examining slum tourism research. Co-citation analysis pinpoints influential authors, studies, and journals, leveraging citations as pivotal indicators of scientific impact (De Bellis, 2009 ). Meanwhile, keyword co-occurrence analysis highlights prominent keywords and their relationships, signposting research field hotspots (Wang and Yang, 2019 ).

Augmenting the bibliometric approach, our qualitative content analysis delved deeper into the primary themes of slum tourism research. The keyword co-occurrence analysis supplied a broad view of research themes and trending topics. Emerging nodes and clusters helped pinpoint dominant research themes. By meticulously analyzing each article’s content, we executed a critical review of every theme. We also broached prospective research trajectories in the article’s conclusion.

Overview of slum tourism research

Figure 2 illustrates the evolving research landscape of slum tourism. The journey began in 2004 with two seminal papers by Kaplan ( 2004 ) and Rogerson ( 2004 ). Both delved into Johannesburg’s township tourism, emphasizing tourism’s potential in poverty mitigation and the region’s economic upliftment. Post-2004, the domain attracted escalating scholarly interest, evidenced by a notable publication upswing from 2012 onward.

Publishing trends of slum tourism research.

Two pivotal discursive events in Bristol (2010) and Potsdam (2014) further catalyzed the field’s evolution. Gathering global experts on slum tourism, these events spurred foundational texts that have since informed the discipline. The post-Bristol momentum produced a special Tourism Geographies issue in 2012, curated by Frenzel and Koens. Successive publications, like the “Slum Tourism” special issue of Die Erde 144 (2) in 2013, and the themed “Slum Tourism” issue of Tourism Review International in 2015, further cemented the field’s prominence. Undoubtedly, these seminal conferences and publications have been instrumental in surging scholarly endeavors in slum tourism research.

We conducted a co-citation analysis to pinpoint the leading authors and journals in the realm of slum tourism research. A co-citation refers to the simultaneous citation of two documents (Small, 1973 ). Such analysis aids scholars in organizing scientific literature and grasping the evolution of specific research domains (Surwase et al. 2011 ).

Figure 3 illustrates the outcomes of our author co-citation analysis. We established a threshold of 40 citations to identify the most influential authors within our dataset of 4229 authors. Only 11 authors met this threshold, allowing for a focused examination of the core contributors in the field. Their significant scholarly impact is reflected by their extensive citations, with node size in the visualization representing co-citation strength. Rogerson, Frenzel, and Steinbrink emerged as the most frequently cited authors, with the highest link strengths of 3978, 3173, and 2734, respectively. Rogerson’s work delved into the economic ramifications of tourism in South African townships, highlighting the part slum tourism plays in poverty reduction and sustainable community economic growth (Booyens and Rogerson, 2019 a, 2019b ; Rogerson, 2014 ). He also discussed urban tourism’s influence on small and medium-sized enterprises (Rogerson, 2004 , 2008 ). In contrast, Frenzel and Steinbrink examined the commercialization of urban informal settlements and the portrayal and appreciation of poverty (Frenzel, 2017 ; Frenzel and Blakeman, 2015 ; Steinbrink, 2012 , 2013 ).

Author co-citation network.

Other notable authors in this field include Freire-Medeiros, who discussed the transformation of Brazilian favelas into tourist attractions (Freire-Medeiros et al. 2013 ; Freire-Medeiros, 2007 , 2009 , 2011 ), Koens, who probed the growth of small and medium-sized businesses in South African townships (Koens and Thomas, 2015 , 2016 ) and local perceptions of slum tourism in India (Slikker and Koens, 2015 ), and Booyens, who primarily focused on responsible tourism in South African townships (Booyens, 2010 ; Booyens and Rogerson, 2019b , 2018). Rolfes also made a significant contribution by studying the ethical aspects of slum tourism (Burgold and Rolfes, 2013 ; Rolfes, 2010 ).

Intriguingly, although not a slum tourism specialist, Urry stands among the eleven most-cited authors. He is renowned for introducing “the tourist gaze” concept (Urry, 1990 ), suggesting that tourist experiences and choices are more influenced by the tourism industry, societal norms, and cultural factors than by personal autonomy. This theory offers a crucial framework for understanding how poverty is portrayed in slum tourism and the dynamics between tourists and local residents.

Figure 4 presents the map of journal co-citations, illuminating the academic areas focused on the topic of “slum tourism.” A journal co-citation analysis, conducted with a threshold of 40 citations, identified 11 key journals from a pool of 3013 in our dataset, underscoring their central roles in the discourse of the field. Notably, the Annals of Tourism Research occupies a central position on the map with the highest link strength of 2608, highlighting its prominence as the most-cited journal in slum tourism research. These journals are categorized into two primary clusters: tourism studies and geography/urban studies. This categorization reflects the dual scholarly interest in slum tourism, which intertwines travel motivations with the complexities of urban environments. On one hand, tourism researchers probe the allure of these regions, the ensuing cultural interactions, and the ethical debates surrounding poverty as an attraction. Conversely, geography and urban studies scholars explore the spatial structures of informal settlements, underlying socio-economic drivers, and the reciprocal impact between tourism and urban evolution. Collectively, these disciplines provide a nuanced view of slum tourism’s multifaceted nature. Notably, Development Southern Africa does not align strictly with these categories, but as a multidisciplinary journal emphasizing policy and practice in Southern Africa—a hub for modern slum tourism—it garners frequent citations.

Journal co-citation network.

After meticulously reviewing the 122 publications, we pinpointed the locations that are focal points for slum tourism research. As presented in Table 1 , South Africa, India, and Brazil emerge as the most extensively researched countries in this domain. They are closely followed by Kenya, Mexico, Colombia, Egypt, and Indonesia.

Township tourism in South Africa, deeply rooted in the country’s complex history, is a significant topic in slum tourism research. This form of tourism, which emerged in post-apartheid South Africa (Steinbrink, 2012 ), focuses on areas historically designated as “black only” zones, where disparities still exist (Iqani, 2016 ). Originating in Soweto, Johannesburg, it has since spread to other major cities. The 2010 FIFA World Cup, hosted by South Africa, notably boosted its popularity (Marschall, 2013 ). Today, Cape Town is a key destination for township tourism, with townships like Langa and Khayelitsha attracting tourists due to their historical significance (Rolfes, 2010 ).

Similar to South Africa, favela tourism in Brazil has political roots. These favelas, initially informal settlements for the formerly enslaved (Iqani, 2016 ), gained international attention after the 1992 Earth Summit, when delegates visited Rio de Janeiro’s favelas (Frenzel, 2012 ). Their prominence increased further during the 2014 FIFA World Cup and the 2016 Olympics (Steinbrink, 2013 ). Despite their cultural richness, favelas face challenges like crime and drug trafficking (Freire-Medeiros, 2009 ). Rio’s favelas, especially Rocinha and Santa Marta, attract numerous tourists each year (Frenzel and Blakeman, 2015 ).

In India, the scenario of slum tourism is notably different, with Mumbai’s Dharavi, one of the world’s largest informal settlement, being a key focus of India-specific studies. Other informal settlements in cities like Kolkata and Delhi have also attracted scholarly attention (Holst, 2015 ; Sen, 2008 ). These informal settlements are characterized by their micro-industries and recycling efforts, showcasing the resilience and entrepreneurial spirit of the residents (Gupta, 2016 ). Although a relatively new trend compared to its counterparts, India’s slum tourism industry has burgeoned, spawning numerous tour operators (Frenzel and Blakeman, 2015 ).

Over time, slum tourism has gained traction, spreading to nations across the Global South, including Kenya, Colombia, Mexico, Egypt, and the Philippines. In our study, while most articles were location-specific, ten adopted a holistic approach, discussing the overarching theme of slum tourism.

Prominent areas of slum tourism research

We conducted a keyword co-occurrence analysis on our slum tourism research dataset to identify and visualize the most significant themes by examining the frequency and relationships of keywords. This method facilitated the identification of central research clusters and thematic hotspots within the topic. Figure 5 illustrates the network of keywords that frequently co-occur in slum tourism studies. To refine our data, we consolidated similar keywords, for example, pairing “township” with “townships” and “developing countries” with “developing world.” For this analysis, we set a threshold to include keywords that appeared at least three times, leading to the selection of 44 out of 322 keywords, thereby emphasizing their significance within the field. In the network, each node represents a keyword; larger nodes indicate higher frequencies of occurrence. Our analysis revealed six distinct clusters, each differentiated by a unique color.

Network visualization of the keywords co-occurrence.

The red cluster focuses on “slum tourism,” examining the development of tourism in informal settlements and its wide-ranging socio-economic impacts. This cluster covers aspects such as “branding” and the role of “tour guides,” and emphasizes key socio-economic factors including “residents’ perceptions” and “poverty alleviation.” Simultaneously, the green cluster, highlighting terms such as “township tourism” and “economic development,” shifts focus to the growth of local, often small-to-medium-sized, tourism businesses, particularly spotlighting township tourism in South Africa. Meanwhile, the light blue cluster examines the impact of slum tourism on local communities, with a special focus on “community-based tourism” and favela tourism in Brazil. The yellow cluster delves into the portrayal of poverty as a key draw in slum tourism, questioning its classification as “poverty tourism” and exploring the shift towards more ethical, “pro-poor,” and responsible tourism practices. Concurrently, the purple cluster critically examines the portrayal and perception of poverty in slum tourism, focusing on tourist perspectives influenced by the “tourist gaze” and social media. Lastly, the dark blue cluster analyzes how globalization and rising consumer culture have spurred the growth of slum tourism, integrating themes like “globalization,” “space,” and “consumption,” and underscoring poverty’s central role in this phenomenon.

In our thematic analysis of publications, we integrated clusters with similar themes. The red, green, yellow, and light blue clusters, which focus on the socio-economic impacts of slum tourism on local communities, were merged. The red and dark blue clusters, addressing the transformation of urban informal settlements into tourist destinations and their driving factors, were also combined into a single theme. Furthermore, the purple and yellow clusters, centered on the portrayal and perception of poverty in slum tourism, were grouped together. Our review systematically examines these unified themes, as illustrated in Table 2 .

Touristic transformation of urban informal settlements

The transformation of urban informal settlements into tourist destinations has been extensively discussed in earlier literature on slum tourism. This transformation hinges significantly on cultural and historical heritage. As previously mentioned, Brazil’s favelas and South Africa’s townships attracted visitors with political and cultural interests (Frenzel, 2012 ; Steinbrink, 2012 ). Gradually, with the globalization that stimulated global mobility and the rise of consumer culture, these locales became spaces of interaction, juxtaposing mobility and immobility on a global scale (Dürr, 2012a ). As many informal settlements in the Global South were represented in global media, they gained increasing touristic attention. For instance, after the success of the film “The City of God” in 2003, the number of foreign visitors to favelas in Rio grew significantly (Freire-Medeiros, 2011 ). As Freire-Medeiros ( 2009 , p. 582) mentioned in another article that tours in these informal settlements “are equally indebted to the phenomenon of circulation and consumption, at a global level, of the favela as a trademark.”

In the touristic transformation of informal settlements, policy plays a pivotal role. For instance, local governments in South Africa actively encouraged township tourism by creating museums, developing historical and political heritage sites, and promoting township upgrading programs (Booyens, 2010 ; Booyens and Rogerson, 2019b ; Marschall, 2013 ). In Brazil, favela tourism served as a means to enhance its image in the context of preparations for mega-events in Rio, a strategy dubbed “Festifavelasation” (Steinbrink, 2013 ). South Africa pursued a similar path after securing the 2010 FIFA World Cup (Marschall, 2013 ). In Colombia, a policy known as “social urbanism” led Medellin, previously known for its drug barons and criminal activities, to undergo social and economic transformation, attracting both interest and tourists (Hernandez‐Garcia, 2013 ).

In analyzing our dataset’s articles, it is evident that slum tours primarily occur in well-known informal settlements of the Global South, such as Mumbai’s Dharavi, Rio de Janeiro’s Rocinha, and Johannesburg’s Soweto. These locations are preferred due to the factors previously mentioned. However, this growing industry often overlooks numerous lesser-known and more impoverished communities (Koens, 2012 ). Issues such as insufficient infrastructure, the absence of tourist attractions, and poor security hinder the growth of tourism in informal urban settlements. This situation is clearly seen in areas like Harare, Zimbabwe (Mukoroverwa and Chiutsi, 2018 ), and certain townships in Durban, South Africa (Chili, 2015 ).

A significant barrier is also the lack of awareness of pro-poor tourism in these lesser-known areas. Munyanyiwa et al.’s ( 2014 ) research in Harare’s townships revealed that many residents were unaware of township tourism, compounded by insufficient infrastructure and community involvement to support it. Moreover, residents were unsure of how to benefit from such initiatives, with historical tourism activities largely unknown to them. Similarly, Attaalla’s ( 2016 ) study in Egypt highlighted the minimal awareness of pro-poor tourism, the absence of a comprehensive government policy to develop this tourism type, and the scarcity of specialized Egyptian tour operators and travel agencies in the pro-poor tourism market. For successful tourism in these areas, it’s vital to enhance infrastructure, safety, and offer innovative tourism experiences (Mukoroverwa and Chiutsi, 2018 ). Additionally, improved information dissemination and increased stakeholder engagement are essential (Munyanyiwa et al. 2014 ).

The transition of informal settlements into tourist destinations brings several challenges. Notably, the commercialization of these marginalized areas can aestheticize deprivation and social inequality, turning them into themed spaces that reinforce stereotypes and maintain informal settlements as attractions shaped by tourist expectations (e.g. Altamirano, 2022b ; Dürr, 2012a ). Building on this point, Dürr et al. ( 2020 ) highlighted that marketing urban poverty and violence as a city brand could exacerbate existing inequalities. Research also shows that in many touristic informal settlements, local residents often do not fully engage with or benefit from tourism (Koens and Thomas, 2015 ; Marschall, 2013 ). Furthermore, public policies aimed at transforming these settlements sometimes lack consistency, creating insecurity among locals (Altamirano, 2022b ). Addressing these issues requires enhanced policies and increased community involvement in tourism, posing significant challenges for local governments.

Valorization and representation of urban poverty

In 2010, the term “poverty tourism” was recognized in slum tourism research, casting a spotlight on the intricate connection between poverty and this type of tourism (Rolfes, 2010 ). This tourism variant is not without controversy, interrogating the confluence of poverty, power, and ethical dilemmas (see Chhabra and Chowdhury, 2012 ; Korstanje, 2016 ; Outterson et al. 2011 ). This dynamic between the commodification of impoverished settlements and their portrayal within the tourism spectrum has ignited fervent academic debate.

Frenzel ( 2014 ) critically observed that within the paradigm of slum tourism, poverty transcends its role as a mere backdrop, ascending to the primary spectacle. Consequently, this leads to the commodification of urban impoverishment, turning it into a tourism commodity with tangible monetary value (Rolfes, 2010 ). Scholars have extensively dissected this juxtaposition. While some examine the framing, representation, and marketing dimensions (Dürr et al. 2020 ; Meschkank, 2011 ; Rolfes, 2010 ), others argued that poverty becomes romanticized, perceived more as a cultural artifact rather than an urgent societal issue (Crossley, 2012 ; Huysamen et al. 2020 ; Nisbett, 2017 ).

In this tapestry, both tourists and tour operators play pivotal roles in framing the narrative. Operators, tapping into the tourists’ quest for the “authenticity” embedded in the narratives of global urbanization, exert significant influence in shaping perceptions (Meschkank, 2012 ; Rolfes, 2010 ). Studies have observed that in an attempt to counteract the inherently negative perceptions surrounding informal settlements (Dyson, 2012 ), operators often position these spaces as beacons of hope, underlining the tenacity, optimism, and aspirations of the residents (Crossley, 2012 ; Dürr et al. 2020 ; Huysamen et al. 2020 ; Meschkank, 2011 ). Moreover, to navigate the moral complexities that tourists might grapple with, operators design their offerings as ethical enterprises, promising both enlightenment for the tourists and tangible economic upliftment for the communities (Muldoon and Mair, 2016 ; Nisbett, 2017 ).

However, such strategies face intellectual scrutiny for their potential to obfuscate the palpable suffering that underpins these urban landscapes. Several studies affirm that poverty dominates the observational narratives across tours in global cities from Mumbai to Rio de Janeiro (Crossley, 2012 ; Dürr et al. 2020 ; Meschkank, 2012 ). As Clini and Valančiūnas ( 2023 ) observed, such sanitized representations, while better than negative stereotypes, could unintentionally normalize the systemic inequalities associated with poverty. This approach not only risks reducing the perceived need for urgent poverty alleviation efforts but also may leave existing societal inequalities unchallenged. This has prompted critiques that label the phenomenon as commercial “voyeurism, and exploitation for commercial ends” (Burgold and Rolfes, 2013 , p. 162).

For tourists, their motivation often orbits around the pursuit of “authenticity” when they consider visiting informal settlements (see Clini and Valančiūnas, 2023 ; Crossley, 2012 ; Gupta, 2016 ; Meschkank, 2011 ; Steinbrink, 2012 ). Marketed as unvarnished encounters with reality, informal settlements are often depicted as bastions of culture, diversity, and authenticity (Frenzel et al. 2015 ). This category of slum tourism is, thus, situated within the broader realm of “reality tourism,” promising participatory experiences in socio-economically challenged urban landscapes (Wise et al. 2019 ). However, this approach, despite aligning with general tourism patterns, is not devoid of problems. The very essence of this touristic venture, which is to experience urban impoverishment, inherently establishes an imbalanced dynamic between tourists and inhabitants, leading to its characterization as a form of voyeurism. (Dürr et al. 2020 ; Meschkank, 2011 ).

In the last decade, slum tourism has diversified with new tours offered by locals and NGOs, aiming to challenge stereotypes and present a more complex picture of informal settlements. Frenzel ( 2014 ) noted that guides can empower communities by focusing on often-ignored aspects of these areas. While motivations vary, with some guides driven by profit and others by community welfare and resisting gentrification effects, the role of guides is crucial. Angelini’s ( 2020 ) examination of favela tours accentuated the nuanced challenges faced by these guides, as they attempt to strike a balance between authentic representation and the commodification of their environments. Further, Dürr et al. ( 2021 ) in their ethnographic study in Mexico City’s Tepito, showed how guides can positively portray deprived areas without depoliticizing them, contextualizing local achievements within city politics and using historical narratives to emphasize the area’s significance.

In the digital era, social media significantly influences the slum tourism narrative (Sarrica et al. 2021 ). The Internet is vital for operators to market and sell tours and provide information to potential travelers (Privitera, 2015 ). Many studies have analyzed slum tourism portrayals in online reviews and media, exploring how these areas and experiences are represented (Huysamen et al. 2020 ; Nisbett, 2017 ; Sarrica et al. 2021 ; Shang et al. 2022 ; Wise et al. 2019 ). For instance, Nisbett ( 2017 ) highlighted concerns about reviews that often gloss over poverty’s complexities, focusing instead on the tours’ economic aspects. Similarly, Huysamen et al. ( 2020 ) observed that tourist narratives tend to paint these areas as “slums of hope,” ignoring the disparity between wealthy tourists and impoverished locals. Ekdale and Tuwei ( 2016 ) studied texts from Kibera visitors, noting that while tourists claim to gain authentic understanding of global inequality, their privileged perspective remains unexamined. These “ironic encounters” often reinforce global inequalities, serving more as self-validation for tourists than a true engagement with local challenges.

On the flip side, social media’s role in depicting informal settlements is not always reductive. Some academics posit that these platforms can provide a counter-narrative to skewed representations by offering avenues to disseminate a diverse array of authentic stories and perspectives (Sarrica et al. 2021 ). Crucially, social media can amplify local residents’ voices, allowing them to share concerns about slum tourism, including privacy, potential exploitation, and daily life disruptions (Crapolicchio et al. 2022 ). The digital era thus presents both opportunities and challenges for slum tourism, underscoring the need for ethical and respectful interactions that honor and authentically represent these communities’ narratives.

Social and economic impact of slum tourism to local communities

The economic and social impacts of tourism in these informal settlements are prominent themes in slum tourism research. Across various countries, including Egypt, South Africa, Brazil, and Indonesia, tourism has spurred urban development and improved living conditions in informal settlements (Anyumba, 2017 ; Booyens and Rogerson, 2019a ; Mekawy, 2012 ; Sulistyaningsih et al. 2022 ; Torres, 2012 ). Developments like aerial cable cars in Brazil’s favelas and minibus-taxis in South African townships have evolved local transportation systems (Freire-Medeiros and Name, 2017 ; Rietjens et al. 2006 ). These advancements facilitate social transformation, such as increased security investments in Brazilian favelas (Freire-Medeiros et al. 2013 ) and “social urbanism” in Colombian barrios, integrating marginalized communities and improving education and security (Hernandez‐Garcia, 2013 ). A comparative study of the touristification of Gamcheon Culture Village (Busan, South Korea) and Comuna 13 (Medellin, Colombia) highlighted that effective governance can create community networks and stakeholder partnerships, fostering entrepreneurial opportunities (Escalona and Oh, 2022 ).

Tourism holds potential as a means to reduce poverty by creating employment opportunities in impoverished urban areas (Aseye and Opoku, 2015 ; Cardoso et al. 2022 ; Paul, 2016 ). Slum tourism, in particular, fosters entrepreneurship, allowing residents to start their own tour companies or bed and breakfasts. However, challenges for local entrepreneurs include limited market access, stiff competition, low marketing budgets, poor business locations, and lack of support from established firms, often leading to the marginalization of smaller operators in a market dominated by larger companies (see Chili, 2018 ; Hikido, 2018 ; Mokoena and Liambo, 2023 ; Mtshali et al. 2017 ; Nemasetoni and Rogerson, 2005 ). Further, small business owners frequently lack essential education and marketing skills (see Leonard and Dladla, 2020 ; Letuka and Lebambo, 2022 ; Rogerson, 2004 ). Mokoena and Liambo ( 2023 ) observed that only a minority of entrepreneurs adopt competitive strategies in their businesses.

Scholars have also observed that the profits from slum tourism are insufficient for significant poverty alleviation (Freire-Medeiros, 2009 , 2012 ). Koen and Thomas’ study of South Africa townships ( 2015 ) highlighted the challenge to the idea that small business owners reinvest their profits locally for economic development. Successful entrepreneurs often leave their townships due to a lack of local ties, leading to economic benefits being concentrated among a small, predominantly male, privileged group, while marginalized groups’ businesses yield lower gains. Moreover, most slum tour companies depend heavily on foreign support, resulting in substantial economic leakage (Frenzel and Blakeman, 2015 ; Meschkank, 2012 ; Rolfes, 2010 ).

The social implications of slum tourism form a major focus in recent academic studies, particularly regarding how local residents perceive this tourism form. Surveys and interviews with inhabitants of informal settlements have uncovered a range of reactions, including positive, negative, skeptical, and indifferent attitudes toward slum tourism (Amo et al. 2019 ; Auala et al. 2019 ; Freire-Medeiros, 2012 ; Marschall, 2013 ; Slikker and Koens, 2015 ).

In Rio, Mumbai, and Nairobi, some studies reveal that residents feel embarrassed by slum tourism, as certain operators emphasize negative community aspects to cater to tourists seeking “real” poverty experiences, leading to privacy issues (Freire-Medeiros, 2012 ; Kieti and Magio, 2013 ; Slikker and Koens, 2015 ). Conversely, slum tourism is also viewed positively in many areas. Slikker and Koens’ ( 2015 ) study in Mumbai and Amo et al. ( 2019 ) research in Medellin found residents believe it counters negative stereotypes and raises community visibility. In Nairobi and Cape Town, locals welcome it as a source of income and jobs (Chege and Mwisukha, 2013 ; Potgieter et al. 2019 ). Additionally, Muldoon et al.’s South African studies suggest slum tourism empowers residents by bringing international attention to townships, giving them more control over their narratives and a sense of importance (Muldoon, 2020 ; Muldoon and Mair, 2022 ).

Indeed, the social impact of tourism is dualistic. As Altamirano ( 2022a ) pointed out, while tourism can establish new material and symbolic frameworks, providing residents with chances for counter-hegemonic actions, it does not uniformly support the cultural empowerment of impoverished communities. Instead, it can result in neoliberal development and increased surveillance. This underscores the necessity for thoughtful policymaking in slum tourism, advocating for policies that prioritize the well-being and cultural richness of communities over mere profit generation, particularly in environments marked by urban disparities and complex power dynamics.

Booyens and Rogerson ( 2019 b) suggested that slum tourism ought to function as a type of “creative tourism,” fostering solidarity and mutual understanding between tourists and local residents, stimulating economic growth in communities, and increasing awareness of the North-South disparity in the postcolonial context. The transition to pro-poor tourism heavily relies on effective policy implementation. Therefore, numerous scholars have advocated for policy instruments to enhance safety and infrastructure, and to facilitate effective coordination among various stakeholders, alongside strengthening institutional frameworks (e.g. Aseye and Opoku, 2015 ; Booyens, 2010 ; Chege and Mwisukha, 2013 ; Rusata et al. 2023 ).

Furthermore, the success of slum tourism largely depends on local community engagement (Duarte and Peters, 2012 ). Yet, in many cases, such as in India (Slikker and Koens, 2015 ), Kenya (Kieti and Magio, 2013 ), Brazil (Freire-Medeiros, 2012 ), and elsewhere, local residents’ participation is limited. Various factors contribute to this, including inadequate business knowledge and skills, and social and financial barriers (Dzikiti and Leonard, 2016 ; Hammad, 2021 ; Leonard and Dladla, 2020 ). Addressing this, researchers emphasize the need for tourism-specific training and resources for local entrepreneurs, particularly focusing on youth (Dzikiti and Leonard, 2016 ; Mbane and Ezeuduji, 2022 ; Nkemngu, 2014 ). To leverage slum tourism for community development, equipping locals with the skills and tools for effective tourism participation is crucial, though it remains a challenging goal.

Conclusion and future research agenda

Over the past two decades, “slum tourism” and its academic study have expanded significantly. Our systematic review of 122 peer-reviewed journal articles sheds light on key authors and journals in this field. The most cited journals typically specialize in tourism studies or geography/urban studies, underscoring the blend of travel motivations and urban complexities in slum tourism. Our findings show that South Africa, India, and Brazil are the most researched countries, with others like Kenya, Mexico, Colombia, Egypt, and Indonesia also being significant. The keyword co-occurrence analysis identified three primary research areas: the touristic transformation of urban informal settlements, the portrayal and valorization of urban poverty, and the socio-economic impacts of slum tourism. This study not only outlines the scope of current research but also points out gaps, suggesting that the economic, social, and cultural effects of slum tourism warrant further exploration in future studies.

The economic aspects of slum tourism, widely debated in academic circles, pose unanswered questions about the actual financial benefits for local residents and communities. Frenzel and Koens ( 2012 ) noted a lack of quantitative evaluations, leaving the impact of slum tours on poverty reduction and urban development uncertain. Existing research, primarily qualitative involving interviews, ethnography, media content analysis, and stakeholder surveys, fails to adequately measure the economic impact on informal settlements. Although studies like those by Chege and Mwisukha ( 2013 ) and Potgieter et al. ( 2019 ) indicated resident perceptions of slum tourism as a source of income and employment, these lack concrete statistical backing. The financial dynamics of slum tourism, including the economic leakage stemming from reliance on external and foreign support (Frenzel and Blakeman, 2015 ; Meschkank, 2012 ; Rolfes, 2010 ), warrant more in-depth investigation. Future research should focus on tracing profit distribution in slum tourism and assessing its real effects on the communities, considering the prominent role of local guides and their relationships with tour operators.

The intangible impacts of slum tourism, including social, political, and cultural aspects, are a fertile area for future research. Shifting focus to local residents’ views, recent studies have shown slum tourism’s broad influence beyond just economic factors, notably in changing perceptions of poverty. However, as Koens ( 2012 ) pointed out, evaluating these impacts is complex due to the deep social and historical contexts within these communities. Advocates for authentic local engagement, like Slikker and Koens ( 2015 ) and Freire-Medeiros ( 2012 ), emphasized the importance of giving local residents a voice. Muldoon’s research ( 2020 ; Muldoon and Mair, 2022 ) in South Africa demonstrates how township tourism allows locals to redefine their identities and interactions with tourists. On the other hand, Freire-Medeiros ( 2012 ) noted in Brazil’s Rocinha the possibility of residents altering narratives for tourist appeal. This highlights the need to integrate the genuine experiences of locals into slum tourism research to fully grasp its diverse impacts.

The potential for slum tourism to either reinforce or challenge existing power dynamics and stereotypes represents a dynamic area of ongoing debate, ripe for further theoretical exploration. Slum tourism is emblematic of neoliberal capitalist practices, where the lived experiences of marginalized communities are commodified and consumed predominantly by Western tourists. This pattern aligns with David Harvey’s concept of “accumulation by dispossession,” where the exploitation and aestheticization of poverty serve to reinforce global economic disparities (Harvey, 2003 ). By transforming informal settlements into tourist attractions, slum tourism becomes a mechanism of cultural commodification, packaging poverty-stricken environments for sale and perpetuating a global hierarchy that privileges affluent tourists while marginalizing local residents.

The representation of informal settlements within this tourism framework often involves selective storytelling, echoing Edward Said’s notion of “Orientalism.” This process portrays the “Other” in ways that reinforce Western superiority and exoticize non-Western realities, contributing to the perpetuation of stereotypes and obscuring the systemic causes of poverty (Said, 2003 ). Such portrayals often sanitize the harsh realities of poverty, presenting informal settlements as exotic and intriguing destinations, thus skewing the understanding of global inequalities and framing poverty more as a cultural artifact than an urgent social issue.

Conversely, slum tourism holds potential to challenge and subvert these entrenched power dynamics and stereotypes. When approached through the lens of ethical representation, it becomes a platform that amplifies marginalized voices and promotes more equitable narratives. This approach is deeply rooted in theories of participatory development and empowerment, which argue that local communities should be active agents in shaping their own narratives, rather than passive subjects (Dürr et al. 2021 ; Frenzel, 2014 ). Employing local guides and focusing on authentic narratives that highlight both the challenges and resilience of informal settlement residents can provide a counter-narrative to dominant discourses, promoting a more nuanced and respectful understanding of these communities.

The role of social media in slum tourism highlights the significance of digital globalization in shaping narratives. Social media platforms provide avenues for local residents to share their perspectives, thereby democratizing the discourse and challenging stereotypical representations (Sarrica et al. 2021 ). This aligns with the ethics of representation, advocating for portrayals that respect the dignity and agency of marginalized communities (Crapolicchio et al. 2022 ). By enabling a more participatory and inclusive approach, social media can help mitigate the voyeuristic tendencies of slum tourism and foster a more ethical engagement with these communities.

Another prominent takeaway from this systematic literature review is the observation that the practice, perception, and success of slum tourism vary significantly across different cultural and geographical contexts. In Brazil, for instance, the favelas of Rio de Janeiro have been transformed into tourist destinations, influenced not only by their portrayal in internationally acclaimed films but also by the mega-events hosted in the city. This phenomenon has led to a form of tourism that often celebrates the cultural vibrancy of these areas, despite underlying issues of poverty and inequality. Conversely, in India, Mumbai’s Dharavi is marketed as a hub of entrepreneurship and industry, attracting tourists more interested in the economic dynamics of informal settlement life than in cultural spectacle alone. These differences illustrate how local contexts shape the thematic emphasis of slum tours.

However, the ability to develop slum or pro-poor tourism is not uniformly distributed. Many areas lack the necessary infrastructure, adequate security, or appealing tourist attractions, which impedes their ability to attract and sustain tourism. For instance, some townships in Durban, South Africa, and informal settlements in Harare, Zimbabwe, contend with issues such as poor security and insufficient infrastructure, making them less appealing to tourists and challenging to market as destinations (Chili, 2015 ; Mukoroverwa and Chiutsi, 2018 ). This disparity highlights the uneven impacts of global tourism trends on local communities and points to the necessity for ethical and sustainable tourism practices in urban settings marked by significant socio-economic divides.

To enhance our understanding of slum tourism dynamics and to devise more effective interventions, it is crucial to undertake further comparative studies. These studies should delve into why certain areas are successful in developing tourism that benefits local communities while others falter, considering both global influences and local conditions. Such research is imperative for uncovering the potential of tourism as a tool for social and economic improvement in marginalized urban areas and contributes significantly to the broader discourse on globalization, urban inequality, and sustainable development.

In this vein, a pivotal area for future research is transforming “slum tourism” into a form of responsible tourism that transcends the poverty-centric narrative often associated with terms like “slum,” “township,” and “favela” (Burgold and Rolfes, 2013 ; Rolfes, 2010 ; Steinbrink et al. 2012 ). While it is valuable to highlight the cultural and historical aspects of these communities, such portrayals frequently overlook the entrenched structural inequality and violence that pervade these areas. Furthermore, tourism often concentrates only on well-known locations, ignoring the most impoverished and lesser-known settlements, thus raising questions about the applicability of sustainable development strategies in these marginalized areas (Frenzel, 2013 ). It is essential that future research explores how slum tourism can truly benefit residents and address broader socio-economic challenges, ensuring it evolves into a form of responsible tourism.

This shift towards responsible slum tourism necessitates a comprehensive emphasis on ethical considerations, community involvement, and sustainable economic benefits for local residents. Ethical considerations must encompass respect for the dignity and agency of the communities involved, eschewing exploitative practices that commodify poverty for tourist consumption. Community involvement is imperative, as it enables residents to influence how their neighborhoods are portrayed and ensure their central participation in both managing and benefiting from tourism initiatives. This might include training local guides, engaging residents in creating tour content, and allocating a substantial share of tourism revenues back into the community.

Furthermore, ensuring sustainable economic benefits for residents is fundamental to responsible slum tourism. This involves fostering tourism that generates reliable income opportunities for locals, such as through establishing small businesses or cooperative ventures tailored to the tourism industry. Potential enterprises could include local eateries, souvenir shops, and accommodation services, all managed and operated by community members. Investment in infrastructure improvements that support tourism activities and simultaneously enhance resident quality of life is also crucial. Additionally, it is essential to implement mechanisms to track the flow of financial benefits to ensure that the revenue generated by tourism is indeed benefiting the local communities as intended.

The data collection for this study, completed in August 2023, revealed a notable gap: the lack of research on the impact of the COVID pandemic on slum tourism, despite the pandemic lasting three years. The pandemic has disproportionately affected informal settlement dwellers, as evidenced by Seddiky et al. ( 2023 ). For instance, Bangkok’s informal settlement residents have suffered significant economic hardships (Pongutta et al. 2021 ), and containment measures have led to widespread business closures, impacting low-income, daily wage earners in impoverished communities (Solymári et al. 2022 ). This absence of academic focus on COVID’s specific impact on slum tourism marks a limitation in current literature. The pandemic’s disruption of travel presents an opportunity to reassess and develop more sustainable tourism practices that could benefit residents in impoverished areas.

Additionally, this study’s focus on slum tourism in the Global South overlooks the re-emerging field of slum or poverty tourism in the Global North. For instance, Burgold ( 2014 ) explored guided walking tours in Berlin-Neukölln, an area known for poverty and social issues, contrasting them with traditional tourism and highlighting their role in changing perceptions and aiding local residents’ societal integration. Similarly, “homeless experience” tours in cities like Toronto, London, Amsterdam, and Seattle offer insights into the lives of homeless individuals (Haven Toronto, 2018 ; Kassam, 2013 ). These tours, as controversial in the Global North as in the South, raise ethical concerns about commodifying poverty. Proponents see them as empathy-building, while critics view them as exploitative. The dynamics of poverty tours vary between developed and less developed countries, presenting a potential area for future comparative research.

“Slum tourism,” a relatively new research field, reflects the complexities of rapid urbanization and the North-South power dynamics in a globalized era. The current study offers a comprehensive, longitudinal perspective on slum tourism research, charting future directions for scholarly inquiry. It also provides valuable insights for practitioners to reassess the role of tourism in poverty alleviation within urban informal settlements in the Global South. For public policy, this research is instrumental in shaping strategies for urban development, poverty alleviation, and sustainable tourism, advocating for the integration of informal settlements into wider economic frameworks. Academically, it enriches the existing body of knowledge, spurring interdisciplinary research and delving into lesser-explored aspects of slum tourism. Additionally, by shedding light on the effects of tourism in these communities, the study promotes more informed, respectful, and responsible tourist behavior, encouraging travelers to adopt a more empathetic and culturally sensitive approach.

Data availability

The data supporting the findings of this study are available in an uploaded CSV file.

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Developing a process for assessing the safety of a digital mental health intervention and gaining regulatory approval: a case study and academic’s guide

• Rayan Taher 1 ,
• Charlotte L. Hall 2 ,
• Aislinn D Gomez Bergin 2 , 3 ,
• Neha Gupta 4 ,
• Clare Heaysman 5 ,
• Pamela Jacobsen 6 ,
• Thomas Kabir 7 ,
• Nayan Kalnad 4 ,
• Jeroen Keppens 8 ,
• Che-Wei Hsu 9 ,
• Philip McGuire 10 ,
• Emmanuelle Peters 11 ,
• Sukhi Shergill 12 ,
• Daniel Stahl 13 ,
• Ben Wensley Stock 14 &
• Jenny Yiend   ORCID: orcid.org/0000-0002-1967-6292 1  

Trials volume  25 , Article number:  604 ( 2024 ) Cite this article

Metrics details

The field of digital mental health has followed an exponential growth trajectory in recent years. While the evidence base has increased significantly, its adoption within health and care services has been slowed by several challenges, including a lack of knowledge from researchers regarding how to navigate the pathway for mandatory regulatory approval. This paper details the steps that a team must take to achieve the required approvals to carry out a research study using a novel digital mental health intervention. We used a randomised controlled trial of a digital mental health intervention called STOP (Successful Treatment of Paranoia) as a worked example.

The methods section explains the two main objectives that are required to achieve regulatory approval (MHRA Notification of No Objection) and the detailed steps involved within each, as carried out for the STOP trial. First, the existing safety of digital mental health interventions must be demonstrated. This can refer to literature reviews, any feasibility/pilot safety data, and requires a risk management plan. Second, a detailed plan to further evaluate the safety of the digital mental health intervention is needed. As part of this we describe the STOP study’s development of a framework for categorising adverse events and based on this framework, a tool to collect adverse event data.

We present literature review results, safety-related feasibility study findings and the full risk management plan for STOP, which addressed 26 possible hazards, and included the 6-point scales developed to quantify the probability and severity of typical risks involved when a psychiatric population receives a digital intervention without the direct support of a therapist. We also present an Adverse Event Category Framework for Digital Therapeutic Devices and the Adverse Events Checklist—which assesses 15 different categories of adverse events—that was constructed from this and used in the STOP trial.

Conclusions

The example shared in this paper serves as a guide for academics and professionals working in the field of digital mental health. It provides insights into the safety assessment requirements of regulatory bodies when a clinical investigation of a digital mental health intervention is proposed. Methods, scales and tools that could easily be adapted for use in other similar research are presented, with the expectation that these will assist other researchers in the field seeking regulatory approval for digital mental health products.

Peer Review reports

The field of digital mental health interventions (DMHIs) has followed an exponential growth trajectory in recent years [ 1 ]. DMHIs typically involve mental health interventions, such as cognitive behavioural therapy, delivered via digital technologies, such as smartphones, and can either be completed as self-directed interventions or blended alongside synchronous (e.g., face-to-face or videoconference) or asynchronous (e.g., email or text message) clinical support [ 2 ]. The main benefit of these interventions is delivering evidence-based care to a large number of people with limited clinical resources [ 3 ]. While the evidence base has increased significantly, the adoption of these interventions within health and care services has been slowed by several challenges, including a lack of knowledge from researchers regarding how to navigate the pathway for mandatory regulatory approval. In the UK, DMHIs must meet the standard of evidence set by the National Institute of Health and Care Excellence (NICE) for adoption within the National Health Service (NHS) [ 4 ]. For DMHIs that are developed to diagnose, prevent, monitor, treat, or alleviate a mental health condition, this may include regulation as a “Software as a Medical Device” (SaMD) by the Medicines and Healthcare products Regulatory Agency (MHRA) [ 5 ]. The regulatory process ensures that devices used within the health and social care context are safe and effective.

In some cases, research will involve digital therapeutics that are already in use and carry a CE or UKCA mark. In this case, the therapeutic’s safety and effectiveness has already been established (and is maintained either through self-certification by the manufacturer or, for higher risk devices, through the use of a “Notified Body”: a government-approved organisation that ensures the device continues to conform to the required standards). However, early-stage digital therapeutics will not yet bear a CE/UKCA mark and are therefore required to obtain a specific form of regulatory approval from the MHRA (called “Notification of No Objection”; NoNO) before being used in research, in addition to the usual ethical approvals [ 6 ]. The NoNO regulatory process requires that safety and effectiveness data collection are the primary purpose of a clinical investigation, with the overall aim being to establish whether the benefits of the device outweigh its risks. This places a number of constraints and requirements upon how researchers design their investigations and write their protocols, the most obvious being that rigorous safety assessment is paramount. The present paper is intended to help academics who are interested in digital therapeutics, but unfamiliar with medical device safety assessment, to navigate a course through this complex regulatory field.

Although the research proposal for which NoNO is sought will, as already explained, need to have safety as a primary outcome, obtaining NoNO also requires the research team to demonstrate the safety of their device before the proposed investigation can be approved [ 6 ]. To understand this apparent contradiction, it is crucial to appreciate that safety assessment is considered an inherently iterative process: preliminary safety data must be presented in order to justify collecting more detailed safety data. This can be done by providing a summary of the existing device safety information using all possible sources (e.g. prototypes, user testing, pilot or feasibility data, qualitative information); a risk management plan (identifying all possible hazards, their potential impact and mitigations) and a detailed plan for safety assessment in the proposed clinical investigation (such as collecting and assessing any untoward medical occurrences [ 7 ], usually called adverse events (AEs)) [ 6 ].

However, researchers investigating DMHIs face specific challenges when proposing a safety assessment plan. Notably, MHRA guidance was developed in consideration of medical devices used in clinical contexts such as surgery and pharmacological interventions and was not designed to accommodate the unique safety considerations relevant to DMHIs. Additionally, the guidelines used in research for assessing the safety of DMHIs are borrowed from the medical and pharmaceutical fields, such as the “International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use—Good Clinical Practice” (ICH-GCP) guidelines [ 8 ]. These medical guidelines do not transfer well to assessing the safety of both digital and non-digital psychological interventions because of the fundamental differences between pharmacological and psychological approaches to treatment [ 8 ]. For example, biological responses to medicines usually occur rapidly and can be objectively measured, whereas psychological responses to therapy rely heavily on patients’ self-reported symptoms, can be hard to disentangle from other contextual factors, and intervention effects can take days, weeks or even months to emerge. As others have also identified, using medical definitions and processes to assess the safety of non-medical interventions such as DMHIs and behaviour change interventions can be unhelpful. It can overcomplicate the process of safety assessment, and lead to missing important harms [ 8 , 9 , 10 ].

These concerns have already been raised in trials assessing the safety of behaviour change interventions [ 8 ]. For example, in a qualitative study on recording harms in RCTs for behaviour change interventions, experts emphasised the need for harm recording to be proportionate and focused on harms that are plausibly linked (i.e. related) to the intervention under study [ 34 ]. It is likely that medical processes are being used to assess the safety of DMHIs, because there are no regulatory or standard safety assessment processes in place for face-to-face mental health interventions [ 9 ]. This is surprising given that most adverse events/side effects are common to both face-to-face mental health interventions and DMHIs (e.g. short-term deterioration, novel symptoms, and non-response) [ 10 , 11 , 12 ]. The one area that differs is, of course, technical and device-related harms.

Two recent reviews found that the identification and categorisation of AEs in DMHI trials was inconsistent and often inadequate [ 3 , 11 ]. This was similar to findings of a review on safety assessment in non-pharmacological psychological, behavioural and lifestyle interventions [ 8 ]. It is essential that harmonised standards tailored specifically to the needs of DMHIs are developed. Support mechanisms can then be implemented to assist manufacturers and researchers to understand and adhere to these guidelines . In the absence of these, the purpose of this paper is to share a worked example of how our clinical trial team successfully applied and received the MHRA’s NoNO for STOP (Successful Treatment for Paranoia).

STOP is a mobile app DMHI that uses Cognitive Bias Modification for paranoia (CBM-pa) to reduce symptoms of paranoia [ 12 , 13 ]. STOP consists of 12 weekly sessions of about 40 min each. In each session, the user is presented with 40 ambiguous scenarios that could be interpreted in a paranoid manner. Users are then guided to reevaluate each scenario in a non-paranoid way by completing words and answering questions designed to suggest alternative meanings. The goal is to gradually retrain the brain to assume non-paranoid meanings of ambiguous situations that occur in daily life, which has been shown to reduce paranoid symptoms. More information about STOP and its development is provided elsewhere [ 13 ]. Using STOP as our example, we aimed to provide valuable insights to other research teams undertaking clinical investigations of DMHIs, particularly those requiring regulatory (e.g., MHRA) approval and guidance in the assessment of safety in DMHI research.

Participants

The work presented in this paper was collaboratively completed by academics and clinicians in the field of digital mental health, an expert regulatory consultant, device manufacturers (Avegen), a clinical trials unit at a university, and representatives from an organisation working with experts by experience (the McPin Foundation). Participants varied at each stage; more detail is provided below per task. See Appendix A for the full list of participants.

To assess the safety of STOP (ISRCTN17754650) and obtain the MHRA’s NoNO the STOP team needed to achieve two main objectives:

Demonstrate existing safety.

Evaluate safety within the proposed research for which approval was being sought.

Demonstrating existing safety

This objective was achieved by completing three separate tasks; an empirical feasibility study; relevant literature searches and the creation of a comprehensive Risk Management Plan.

Feasibility study

The research team needed to present current safety data relevant to STOP such as previous publications, feasibility or pilot studies from the same or similar devices/ interventions. To achieve this, the team referred to a previously conducted study that had assessed the intervention’s feasibility and safety as a desktop intervention [ 12 ]. The feasibility study included two arms: treatment (CBM-pa which is a 6-session version of the therapeutic intervention used in STOP but delivered using a desktop computer) and an active control (a version of the same 6 session desktop programme with the same design and format as CBM-pa, except the content was neutral and should not trigger paranoid thoughts) [ 12 ]. CBM-pa works in the same way as STOP (see “ Background ”) by presenting users with a scenario that could be interpreted in a paranoid way and then, using word tasks and questions, helping participants to interpret the scenario in a nonparanoid, benign way [ 12 ]. Sixty-three outpatients with clinically significant paranoia participated in the feasibility study and were randomised to either the treatment or control group [ 12 ].

The feasibility study assessed safety by measuring whether presenting participants with these potentially paranoia-inducing scenarios was distressing or provoking for them, using visual analogue scales (VAS) completed before and after every session and measuring state anxiety, sadness, paranoia and friendliness. These data were used as proxy safety data relevant to STOP because STOP uses the same content and procedures as CBM-pa but delivered in a different format (mobile app vs. desktop) and the sample size of the feasibility studies are usually small [ 12 , 13 ].

Literature searches and regulatory databases

Second, three members of the research team (RT, CH, JY) conducted two literature searches to identity any published safety data that might be relevant to STOP or any equivalent intervention. These literature reviews are different to those used in academia and thus follow a different structure [ 14 ]. The team worked with an independent regulatory consultant on these to make sure we followed industry and regulatory standards. See Appendix B for more details around the methodology used in these two separate literature reviews. As part of this review, FDA databases were also searched for similar devices and any reported adverse events.

Risk management plan

The risk management plan was created collaboratively by key members of the STOP trial academic team and other project stakeholders, including members from a Lived Experience Advisory Panel, members of the software manufacturer and a regulatory consultant (see Appendix A, column 1, for full details).

Under this step, and by using the knowledge that arose from the feasibility study and the review, we developed a risk management plan. This step is required to demonstrate to regulators that the research team has listed all possible hazards, documented what harms might result from each hazard and identified actions or changes that will mitigate every risk entry as far as possible. Regulators require a comprehensive risk analysis specific to the product, showing a clear understanding of the following stepwise process: hazard, harm, initial risk rating, risk controls/ mitigations, revised risk ratings, identification of residual risks and final demonstration that the expected product benefits outweigh the identified residual risks, which should have been reduced as far as possible. In STOP’s case, a residual risk matrix (likelihood × severity) demonstrated that there were no residual medium or high risks.

The risk management plan described above was implemented by carrying out the following activities:

Hazard identification

To develop a risk management plan, the team first needed to develop a list of all potential hazards that participants taking part in the trial could be exposed to and articulate the harms that could result. Based on ISO 14971, which is a standard for risk management for medical devices, hazards are defined as “a potential source of harm” and harms are defined as “injury or damage to the health of people, or damage to property or the environment” [ 15 ]. This was done during a 1-h consensus meeting with an expert regulatory consultant, two representatives from the manufacturer, two clinicians, two academics, and one representative of a user organisation. During the consensus meeting all participants brainstormed possible hazards and articulated, through discussion, the harm it could lead to. The meeting resulted in a comprehensive spreadsheet of hazards and corresponding harms. The spreadsheet was compiled and circulated for members to review, revise and populate with any further suggestions.

Hazard analysis

After identifying hazards, a hazard analysis needs to be performed. While manufacturers may be experienced in providing this for the technical side of their products, the majority of hazards for DMHIs will be related to clinical risks. Most manufacturers will be unable to assess these and will require the clinical and academic team to become conversant with applying and interpreting risk assessment procedures. To this end, the STOP clinical and academic team received training in risk assessment from a regulatory consultant who worked with them to implement the process outlined below.

The first step in a hazard analysis is to quantify the probability (likelihood) and severity (impact) of each identified hazard. First, one must assess the probability that each hazard will lead to the specified harm. One must assume that the hazard has occurred and then ask oneself “how likely is the harm to now happen?”. Some of these may be fairly standard assessments or known within the digital industry, for example, should a participant stare at the screen for longer than advised, how likely is it that they will experience physical side effects such as eyestrain, fatigue or headache? However, in many cases nuanced clinical judgements are required to make this assessment. For example, how likely is it that the participant’s condition will worsen in the short term as a result of engaging with the content of the therapy? Second, one must assess the severity and impact, should that harm occur. For example, were eye strain, fatigue or headache to occur as a result of using the device how severe could those effects be at their worst? Severity in risk assessment can be operationalised in these terms:

The duration of harmful effects.

The level of intervention or support needed in response to the effects.

The possibility and extent of any long-lasting or permanent impact.

Central to the STOP hazard analysis was the need to create bespoke probability and severity scales relevant to the clinical therapeutic context. These were carefully devised by consensus discussion between the regulatory expert consultant and members of the clinical academic team to agree the most appropriate exact thresholds and wording for both dimensions. The application of the preliminary hazard analysis for STOP was a quantitative assessment of each individual risk entry (i.e., hazard and corresponding harm) against the criteria for probability and severity outlined above. The product of these two scores yields a “risk score”. It is important to note that these risk scores were based on expert consensus estimations derived from their knowledge of the literature and field experience. In line with standard practice in the field of risk analysis, no formal validation was conducted.

Risk control and re-evaluation

In common with all risk assessments, the next stage was to work through each of the identified risks outlining all the “risk control” actions (i.e., mitigations) that could be taken to reduce the identified risk to participants as far as possible. Each risk is then re-evaluated in terms of its probability and severity yielding a revised (“post risk control”) risk score. Finally, a risk acceptability management plan is implemented where various actions are specified for any residual risks that cannot be reduced any further, for example adding “warnings” and “cautions” to device details and labelling. These serve to alert the user to important residual risks that cannot be addressed in any other way. One residual risk that is common to mental health interventions is the possibility of users being distressed when presented with information that relates to the mental health condition they are living with.

In the case of STOP, residual risks were managed using a variety of processes, depending on the nature of the risk. This included, for example, warnings (e.g. “If negative feelings or symptoms worsen as result of using this app for more than a day, please contact your support team and cease use of the STOP app until advised further”), fortnightly check-in phone calls with researchers; a dedicated, in-app 24-h study helpline number and use of an inbuilt mood-tracking algorithm to trigger researcher alerts. Further details of these are provided below.

Evaluating the safety of a DMHI within the proposed research study

After demonstrating the current safety of STOP as seen in section A of this paper, the team needed to demonstrate how the safety of STOP would be assessed in the proposed clinical trial. Any assessment of safety will involve collecting data about the occurrence of adverse events, both related and unrelated, to the trial. For STOP, we planned to do this proactively and regularly in line with recent recommendations [ 11 ]. We therefore needed an overarching framework to organise and classify the large quantity of adverse event information that was likely given the larger sample size (273) and length of time each participant would spend in the trial (6 months). We therefore devised an adverse event classification framework as follows.

AE classification framework development

Literature review

First a brief narrative literature review (conducted within the limited, 60-day time window of the regulatory approval pathway) was carried out to identify any publications in the last 10 years [03/23/2012–03/23/2022] that discussed how adverse events were assessed, coded or categorised in psychiatric populations receiving psychological interventions (digital or non-digital). We combined the categories and definitions identified in the outputs of the literature review to create a first working draft of a classification framework.

Expert consultation

We then carried out an expert consultation involving key members of the STOP trial academic team and other project stakeholders. This included the McPin Foundation, key members of the software manufacturer, a regulatory consultant and key external members of the trial committees. Full details are given in Appendix A. The classification framework working draft was shared with this group to review and comment upon. The group was invited to edit, remove or add categories or examples. Where any conflicts or differences of opinion emerged, these were resolved by group discussion and consensus using virtual meeting and/or email communications. This resulted in a finalised ‘Adverse Event Category Framework for Digital Therapeutic Devices’ which is provided in the “ Results ” section.

Proposed safety plan for the trial

To appropriately and sufficiently assess the safety of a DMHI, regulators expect to see safety positioned as the primary outcome in the proposed study, alongside efficacy. In the STOP trial, this was done by adjustment of the protocol in three ways.

First, we built-in proactive, fortnightly collection of AE data for each participant throughout the entire trial (including throughout the follow-up period) in both arms, using a custom designed checklist based upon the Adverse Events Category Framework for digital devices described above. Even though collecting AE data in both arms is resource-intensive, it is important, as shown in a recent systematic review [ 11 ]. These data enable researchers to statistically compare the prevalence of AEs in the treatment and control arms, allowing for conclusions about the safety of the DMHI. The checklist was developed from the framework, customised to the STOP trial and designed to be administered by researchers during a 10-min phone or video interview with participants. Customisation included adding introductory scripting, one or more prompt questions under each adverse event category, examples of typical events for researchers’ reference and reordering/ grouping categories and questions to optimise efficiency and acceptability of the delivery. According to the ICH-GCP guidelines, all AE data need to be categorised based on seriousness, severity, relatedness and expectedness [ 16 ]. This was done following standard guidance widely available across clinical trials units (see Appendix C for further details). The checklist was devised to incorporate the first three of these evaluations (seriousness, severity, relatedness). By definition, any event that fell within one of the listed Adverse Event Categories was considered “expected” (i.e. anticipated). Items that had not been foreseen and were therefore classed as “unexpected” were listed under the “Other” category heading. The resulting Adverse Events Checklist for the STOP trial is presented in the “ Results ” section.

In response to regulatory safety concerns, the frequency of AE data collection calls was increased to once a week for any participants identified as high risk. High-risk participants were identified at baseline using a cut-off score on a Persuadability/Suggestibility scale [ 17 ] (higher suggestibility can lead to higher risk, as the intervention aims to foster nonparanoid and trusting thoughts) and a suicide risk assessment, and throughout the trial using a suicide assessment that was administered on a weekly/biweekly basis. In addition, researchers recorded any AE that was spontaneously reported by the participant at any other contact. Note that it is crucial to collect AE data using identical methods for both the intervention and control groups even if the trial is unblinded as the control group serves as an important baseline for adverse event occurrences.

Second, we built in safety monitoring within the device. An algorithm was used to trigger an alert to researchers whenever a participant had a worsening of state mood on self-reported levels of paranoia, anxiety or sadness across a weekly treatment session (using visual analogue scale in-app pre/post session assessments; see Supplementary File 1) on 3 consecutive occasions. Researchers would then make a follow-up call to check in on the participant, collect further information and safety data and decide if follow-up action was needed (for example alerting a GP or clinical care team).

Third, we added a specific outcome measure relevant to safety, namely the Negative Effects Questionnaire (NEQ) administered once at the end of the intervention (end of treatment). The NEQ is a 20-item self-report measure [ 18 ]. It was developed using the results from Rozental et al., (2014)’s consensus statement on the negative effects of internet interventions [ 18 ], and studies aimed at investigating the negative effects of psychotherapy [ 18 , 19 ]. It is used to collect data on the negative effects experienced by patients/users during treatment, their severity and whether they were related to the intervention or other circumstances [ 19 ]. The NEQ is a reliable and valid measure with an internal consistency of α  = 0.95 [ 19 ].

Demonstrating the existing safety of the DMHI

The feasibility study main outcome paper reported no adverse events or serious adverse events and an “absence of evidence of any harmful effects on state mood and the practicality of the protocol as delivered” [ 12 ] The results from the VAS showed that there was no evidence of significant short-term detrimental effects on anxiety, sadness, paranoia or friendliness in the intervention group compared to the control group, suggesting that the intervention did not exacerbate negative mood, or pose any risk of harm to patients with distressing paranoia [ 12 ]. These data are provided in Supplementary File 1. The STOP study team used these combined findings to argue in support of the safety of STOP based on its similarity in therapeutic content to CBM-pa.

Literature search and regulatory databases

Results of literature review 1 (Device use or experience):

The search for the first literature review resulted in 14 included studies. See Appendix D for the respective PRISMA flowchart. Results showed evidence that cognitive impairment in this population does not affect engagement with digital interventions [ 20 ]. There was evidence suggesting that digital interventions are effective at improving social functioning [ 21 ], memory [ 22 ], educational and vocational attainment [ 23 ], personal recovery [ 24 ], and alleviating loneliness [ 25 ] in psychotic disorders. Some digital interventions used in this population aimed to monitor symptoms such as sleep [ 26 ], and psychotic symptoms [ 24 ]. The results of a previous literature search [ 27 ] showed that there were three digital mental health interventions that have been developed to improve symptoms in individuals struggling with psychosis [ 21 , 23 , 25 ]. The review included eight papers on smartphone-based interventions for psychosis, of which three were protocols, two were feasibility studies, two were pilot RCTs and only one was an RCT with a sample of 36 participants. This RCT found that participants who used Actissit (a Cognitive Behavioural Therapy based app for psychosis) plus treatment as usual experienced better improvements psychotic symptoms compared to those who used a symptom monitoring app plus treatment as usual [ 28 ].

The data on the use or experience of digital therapies to monitor, reduce symptoms or improve recovery in this population were promising but still limited. Larger randomised controlled trials are needed. There was no study on the use or experience of digital mental health interventions in a sample specifically defined by paranoid symptomatology except for the feasibility study precursor to the STOP [ 11 ]. For that, the literature search criteria was expanded to include devices that address psychosis in general to find comparable studies.

Results of literature review 2 (Device safety):

The search for the second literature review resulted in five included studies. See Appendix D for the respective PRISMA flowchart. Although the literature on the safety of digital mental health interventions targeting paranoia/psychosis is limited, all the current studies demonstrated positive safety outcomes [ 21 , 23 ]. A number of studies assessed the safety of the Horyzons—an online social media-based intervention that was designed to enhance social functioning in individuals with a first episode of psychosis; the studies found Horyzons safe to use (no incidents) and Horyzons users reported feeling safe and empowered [ 23 , 29 , 30 ]. A social media-based intervention called (MOMENTUM), which aims to improve social functioning in “at high-risk mental state” young individuals, was found to be safe to use [ 29 , 30 ]. A randomised controlled trial ( N  = 36) of Actissit—a CBT-informed mobile phone app for people who have experienced psychosis—found it safe to use (no serious adverse events) [ 28 ]. Finally, a randomised clinical trial ( N  = 41) assessing the EMPOWER app (Early signs Monitoring to Prevent relapse in psychosis and prOmote Wellbeing, Engagement and Recovery) reported 9 adverse events that were related to the app such as increased feelings of paranoia, increased fear of relapse and technical issues [ 31 ]. Findings were in line with those of a systematic review on the digital interventions for early psychosis where all eight smartphone-based interventions under study were found to be safe [ 27 ].

The clinical data appraisal tools for both literature reviews are provided in Appendix C.

Regulatory databases

There were no safety concerns raised from the review of the regulatory databases.

In total 26 unique hazards and their corresponding harms were identified, which are listed in full in Appendix E.

The team defined likelihood/probability and severity for the proposed study as explained in the “ Methods ” section. Table 1 shows the final operationalised definition of probability and Table  2 shows the equivalent for severity.

Afterwards, the team used these definitions to rate the probability and severity of every identified hazard. Probability refers to the likelihood that the identified hazardous situation will lead to the specified harm . A risk score was calculated for each hazard entry by multiplying the probability and severity scores.

Under this step, the study team identified all measures they could take to reduce each risk entry as much as possible, listing these as “risk controls”. They then recalculated new probability, severity and risk scores under the assumption that the stated risk controls were effective. Before implementing risk-control strategies, the highest risk score was 20 out of 36. After applying these strategies, the highest risk score was reduced to 9 out of 36. These quantitative ratings and products are shown in Appendix F, which constitutes the final STOP Hazard Analysis, and was a key requirement of the submission for regulatory approval. One new insight that emerged from the consultation was the need for a product recall feature that could operate at either an individual or entire cohort level. This requirement was a crucial safety attribute, for use in the unlikely event that access to the app had to be immediately terminated. At the individual level access could be revoked by account deactivation. At the cohort level, the technical team implemented a “recall switch” feature in the app to enable the recall, and a corresponding participant facing message. Footnote 1

The literature review and the expert consultation that we conducted as described in the “ Methods ” section resulted in a finalised “Adverse Event Category Framework for Digital Therapeutic Devices” (See Table  3 ) . This framework was informed by three key publications arising from the literature review that discussed a range of classes of negative effects in psychotherapy [ 18 , 32 , 33 ]. Our framework was then used to identify the “anticipated” AEs for the STOP trial. As such, it might be applicable to all DMHIs that are in the form of a mobile app. The AEs collected are not exclusive to STOP but might not all be relevant or be comprehensive of all possible AEs for another DMHI. Professionals testing a DMHI delivered in a different format (virtual reality for example) and/or targeting a different population would need to make suitable adjustments and might even wish to incorporate additional AE categories specific to their device’s safety profile. However, this framework is recommended as a potentially useful starting point for any DMHI.

Some of the categories such as technical malfunction might be less clear to clinicians, as they do not directly relate to the therapeutic component of the device. When assessing adverse events (AEs), it is essential to evaluate the entire device, not just the treatment component. This includes potential risks from using any mobile app. Furthermore, the MHRA approval mandates monitoring all aspects of the approved research for safety, covering study procedures, intervention and the device. One learning that came out of discussions during the development of the AE framework with other professionals was the need to have a separate AE category for “device deficiency” that is distinct from “technical malfunction”. Device deficiency is defined as “an inadequacy of a medical device related to its identity, quality, durability, reliability, safety or performance, such as malfunction, misuse or use error and inadequate labelling” [ 34 ]. This differentiation was highlighted by some of the academics on the team with experience in other DMHIs, to align with the requirements and terminology used by the regulatory framework.

The trial is still ongoing at the time of writing and a full report of the STOP safety evaluation will be published as part of the trial outcomes. Here we present the tools we developed to aid STOP safety data collection, as described in the “ Methods ” sections of this paper. We also outline the final STOP safety analysis plan, which was subject to rigorous review and revision as part of the regulatory approval process.

Safety data collection

The Adverse Events Checklist used by researchers to proactively collect fortnightly (or weekly for more vulnerable participants) AE data is presented in Appendix G. Participants were asked each prompt question in turn to identify and record details of any adverse that had happened since the last researcher contact. For every event recorded researchers completed the remaining columns of the checklist to record a free text event description and to determine its seriousness, relatedness, expectedness and severity. The checklist will be administered every week rather than fortnightly with high-risk patients to mitigate any risks. It is likely that administering the checklist in these patients more than the rest might lead to a higher number of reported AEs. This will be taken into account in the analyses using sensitivity analyses.

Safety data analysis

The complete statistical analysis plan (SAP) for the STOP trial underwent a number of iterations in review with the regulators before approval was achieved. In terms of safety specifically, the approved plan included the following. Any AE/SAE involving the target clinical symptoms (paranoia) will be analysed separately from other AE/SAEs, due to the assessed (small) likelihood that the device could trigger these symptoms. This risk was singled out for separate analysis because it was the one of most concern to clinicians and regulators. Formal statistical analyses are unlikely due to small numbers of observations but the incidence rate of AEs (total number of those having the event divided by the person-months at risk) and the ratio of incidence rates of AEs between the two treatment arms per time period will be reported to allow detection of any safety concerns within the treatment arm.

Analysis of the checklist data will produce a list of adverse events along with frequencies, seriousness, relatedness and possible methods of prevention/mitigation. Additionally, demographic and clinical characteristics of those who experienced adverse events will identify patients who might be at a higher risk. Comparative statistical tests will be used to analyse the NEQ data between the treatment and control arms using a linear regression approach.

An overview of the pathway followed by the STOP team from start to finish is provided in Table  4 . This shows the purpose of each step, some brief details on what it included and pointers allowing the reader to more easily navigate to relevant sections of the present paper and associated resources.

This paper details the steps that the STOP study team took to thoroughly assess the safety of a DMHI and achieve regulatory approval to conduct an RCT (MHRA’s NoNO). The example shared in this paper serves as a guide for academics and other professionals in the field. It provides a roadmap for the essential prerequisites, requirements and expectations regarding safety when seeking regulatory approval to conduct research with DMHIs. A fuller understanding of this pathway will significantly benefit research teams, clinicians and developers involved in the process of developing and delivering novel DMHIs.

There are various key concepts and practical takeaways outlined in this paper. The overarching requirement is to compile an evidence-based argument that the benefit of the proposed device outweighs its risk to users, and this can only be done convincingly by the fullest consideration and quantification of that risk. The process by which one might do this can be broken down into various discrete steps. Figure  1 demonstrates the process model presented in this paper.

The process model of “How to demonstrate the safety of as-yet untested DMHI?

First, it is important to establish the safety of the DMHI even before testing its efficacy. This could be done by looking at the safety data of “equivalent” interventions that have been used in a similar population, studying the literature and/or conducting a feasibility/pilot study to assess the preliminary safety of the intervention. It is noteworthy that in the UK devices exclusively developed and used (either clinically or for research) within a single institution are exempt from formal regulatory approval requirements [ 35 ] which can provide an appropriate setting for gathering early-stage safety data. Second, conducting a comprehensive risk analysis specific to each DMHI is crucial [ 36 ]. This involves identifying all the potential hazards that are relevant to that DMHI, assessing any potential harm (likelihood and severity), calculating a risk rating per identified hazard, implementing risk control measures, reassessing risk, calculating a final post-risk score, denoting and reporting any residual risk and finally demonstrating that the expected benefits outweigh the identified risks in a quantifiable manner. Third, the safety of a new and untested DMHI needs to be evaluated as a primary outcome within the proposed research. It needs to hold the same importance as efficacy/effectiveness, irrespective of the academic research agenda. A safety evaluation plan needs to be integrated within the study protocol or presented separately as a standalone study.

Fourth, a helpful component of any safety evaluation is the use of a framework for organising the data to be collected, given the likely breadth of possible adverse events. The Adverse Event Category Framework for Digital Therapeutic Devices provides one such possibility. At a more practical level, this must be supplemented by a structured approach to collecting and evaluating individual adverse events. The Adverse Events Checklist (provided in appendices) received regulatory approval for use in the STOP trial and could usefully serve as a guide for others. By incorporating categorisation of each entry on the key dimensions of seriousness, severity, relatedness and expectedness, it allows a research team to more easily demonstrate their intended compliance with reporting requirements. It also facilitates gathering a richer dataset around negative effects that will go on to permit a more comprehensive analysis than previous traditional practices [ 11 ]. A scoping review on the recording of harms in RCTs of behaviour change interventions has mapped out the categories of harms found in that literature [ 35 ]. As might be expected, there is some overlap with our AE category framework, such as physical and psychological harms, which is reassuring and validatory. In contrast, group-level harms (such as the impact of a behaviour change intervention on culture, environment or health equity) feature strongly in the scoping review but are absent from our framework, which focused exclusively on individual participant-level harms data. It will be important for future studies to consider whether macro-level harms relevant to behaviour change interventions might also be relevant to DMHI interventions.

It is important to highlight the time involved in the processes summarised in this paper. In the present worked example acquiring regulatory approval (MHRA NoNO) took approximately 6 months and the authors’ recommendation is to allow a timeframe of up to 9 months, if working from a position of relatively little prior knowledge and experience. This timeline is necessary to allow for the involvement of clinical and technical experts, patient groups and regulatory consultants. In the present worked example employing a regulatory consultant played a vital role in ensuring compliance with all regulatory requirements and smooth passage through regulatory review. Their knowledge of the complex regulatory landscape provided a key interface between software developers and the academic team to ensure that the requisite information was compiled and presented in a manner compliant with the appropriate national and international standards [ 37 ]. Academic teams are advised to routinely cost such expertise into research projects involving medical devices, unless equivalent institutional support is already available.

Limitations

It is important to be aware that this paper provides an example of how one DMHI assessed safety and achieved regulatory approval. The experiences of other DMHIs will most likely differ. Thus, it is important to view this process flexibly and adapt it to each DMHI. Furthermore, this example is UK-centric. Even though the process described might be helpful for DMHIs applying for regulatory approval outside the UK, professionals need to be aware of the needs of their specific regulatory environment.

The example provided in this paper can be adapted by other professionals in the digital mental health field to help them navigate complex regulatory processes. Prioritising and emphasising safety and regulatory compliance allows researchers to contribute to the responsible development of DMHIs. Ensuring that the benefit of these interventions outweighs any risks that they carry is important for building confidence and trust among clinicians, patients and academics. The systematic approach to safety evaluation outlined here sets a valuable precedent for assessing the safety of DMHIs.

Availability of data and materials

All data generated or analysed during this study are included in this published article in the form of tables and appendices.

“ You can no longer use STOP as the product has been withdrawn. You will shortly be contacted by a member of the research team who will explain and offer further support if required. In the meantime, if you require more urgent assistance, please contact the study helpline at 020 784 80,425 or clinical support email at [email protected]”.

Abbreviations

Adverse event

Digital mental health intervention

International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use—Good Clinical Practice

Medicines and Healthcare products Regulatory Agency

Negative Effects Questionnaire

National Health Service

National Institute of Health and Care Excellence

• Notification of No Objection

Preferred Reporting Items for Systematic Reviews and Meta-Analyses RCT: randomised controlled trial

Randomised controlled trial

Serious adverse event

Software as a Medical Device

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Acknowledgements

We acknowledge the contributions made to this work by the McPin Foundation. We thank Andrew Gumley, Alex Kenny, Caroline Murphy, Sumiti Saharan, Carolina Sportelli and Chris Taylor for their input to consultations carried out as part of the work reported here.

This work was supported by the Medical Research Council Biomedical Catalyst: Developmental Pathway Funding Scheme (DPFS), MRC Reference: MR/V027484/1. We would also like to express our gratitude to the National Institute for Health and Care Research (NIHR) Biomedical Research Centre hosted at South London and Maudsley NHS Foundation Trust in partnership with King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care, the ESRC or King’s College London. For the purposes of open access, the author has applied a Creative Commons Attribution (CC, BY) licence to any Accepted Author Manuscript version arising from this submission.

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RT, CH and JY conducted the literature reviews. CWH, TK, CH, PM, EP, SS, BW, DS and JY were involved in the development of the risk management plan. RT, CWH, TK, CH, PM, EP, SS, BW, DS and JY were involved in the development of the Adverse Events Checklist. RT, AB, CH and JY wrote up this paper. All the authors read and approved the final manuscript.

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Taher, R., Hall, C.L., Bergin, A.D.G. et al. Developing a process for assessing the safety of a digital mental health intervention and gaining regulatory approval: a case study and academic’s guide. Trials 25 , 604 (2024). https://doi.org/10.1186/s13063-024-08421-1

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2. materials and methods, 2.1. subjects, 2.2. brain imaging, 2.3. genetic analysis, 2.4 literature review, 3.1. clinical report, 3.2. genetic findings, 3.3. spectrum of brain malformation in prenatal cases and postnatal patients affected by sino, 4. discussion, 5. conclusions, supplementary materials, author contributions, institutional review board statement, informed consent statement, data availability statement, acknowledgments, conflicts of interest.

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Bonati, M.T.; Baldoli, C.; Taurino, J.; Marchetti, D.; Larizza, L.; Finelli, P.; Iascone, M. A Novel KIDINS220 Pathogenic Variant Associated with the Syndromic Spastic Paraplegia SINO: An Expansion of the Brain Malformation Spectrum and a Literature Review. Genes 2024 , 15 , 1190. https://doi.org/10.3390/genes15091190

Bonati MT, Baldoli C, Taurino J, Marchetti D, Larizza L, Finelli P, Iascone M. A Novel KIDINS220 Pathogenic Variant Associated with the Syndromic Spastic Paraplegia SINO: An Expansion of the Brain Malformation Spectrum and a Literature Review. Genes . 2024; 15(9):1190. https://doi.org/10.3390/genes15091190

Bonati, Maria Teresa, Cristina Baldoli, Jacopo Taurino, Daniela Marchetti, Lidia Larizza, Palma Finelli, and Maria Iascone. 2024. "A Novel KIDINS220 Pathogenic Variant Associated with the Syndromic Spastic Paraplegia SINO: An Expansion of the Brain Malformation Spectrum and a Literature Review" Genes 15, no. 9: 1190. https://doi.org/10.3390/genes15091190

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The Role of Technology Maturity Level in the Occurrence of University Technology Transfer

• Published: 10 September 2024

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• Malcolm S. Townes   ORCID: orcid.org/0000-0002-9106-3634 1  

This paper presents the results of a study aimed at understanding how technology maturity level influences the incidence of university technology transfer to the private sector. The study examined the topic from the perspective of private sector organizations. It used data from a random sample of patent applications filed with the United States Patent and Trademark Office and a theoretically guided sampling of multiple cases of private sector organizations that contemplated obtaining and assimilating technologies created at universities in the United States. The patent application data were analyzed using nonparametric statistical techniques and the case data were analyzed using qualitative comparative analysis (QCA). The findings of the study suggest that the typical maturity level of technologies created at U.S. universities is a TRL-5 or lower on the NASA technology readiness level (TRL) scale. A technology maturity level of TRL-6 or higher is likely an insufficient but necessary part of at least one unnecessary but sufficient configuration of conditions that tends to result in the occurrence of university technology transfer. However, under certain circumstances, a technology maturity level of at least TRL-6 could be a sufficient but unnecessary condition for the occurrence of university technology transfer. These findings have several important implications. First, they provide support for the notion that university technology transfer is subject to causal complexity. Moreover, it may be possible to increase the incidence of university technology transfer in the United States by implementing public policy and practices that explicitly take technology maturity level into consideration.

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Data Availability

Most of the data generated or analyzed during this study are included in this article. All other data generated or analyzed during the study that are not included in this article are available from the corresponding author on reasonable request.

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Acknowledgements

I would like to acknowledge Mr. Brian Eller of North Carolina State University who provided case data used in this study. I would also like to thank Dr. Robert A. Cropf and Dr. James F. Gilsinan of Saint Louis University and Eric W. Anderson, J.D. of the University of Missouri–Kansas City, who served on the advisory committee for my dissertation research on which this work is based.

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Townes, M.S. The Role of Technology Maturity Level in the Occurrence of University Technology Transfer. J Knowl Econ (2024). https://doi.org/10.1007/s13132-024-02171-w

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Designing and psychometric evaluation of safe nursing care instrument in intensive care units

• Mozhdeh Tajari 1 ,
• Tahereh Ashktorab 2 ,
• Abbas Ebadi 3 &
• Farid Zayeri 4  

BMC Nursing volume  23 , Article number:  629 ( 2024 ) Cite this article

Metrics details

Providing safe care in a sensitive and high-risk unit such as the ICU is one of the most crucial tasks for nurses. One way to establish the criteria for safe care is by creating a instrument to assess it. Therefore, this study was conducted with the aim of designing and psychometrically evaluating an instrument for safe nursing care in the ICU.

The current study employed a sequential-exploratory mixed-method approach with two qualitative and quantitative phases. Based on the results of qualitative phase and the literature review, the primary instrument was designed. In the quantitative phase, the designed instrument underwent psychometric evaluation. Face, content and construct validity were assessed. Face validity was assessed by 20 nurses, and content validity was assessed by 26 experts. In the construct validity stage, the sample size for the exploratory factor analysis (EFA) included 300 nurses, and for the confirmatory factor analysis (CFA) included 200 nurses who work full-time in the ICUs of hospitals affiliated with Kermanshah University of Medical Sciences in western Iran. EFA sampling was conducted in three hospitals, encompassing six ICUs, while CFA sampling was carried out in two hospitals, covering four ICUs. Sampling was done using the convenience method. The reliability of the instrument was also assessed. Finally, the interpretability, feasibility, weighting, and scoring of the instrument were evaluated.

The qualitative phase identified three themes, including professional behavior (with categories: Implementation of policies, organizing communication, professional ethics), holistic care (with categories: systematic care, comprehensive care of all systems), and safety-oriented organization (with categories: human resource management and safe environment). The primary instrument was designed with 107 items rated on a five-point Likert scale. In the quantitative phase, the psychometrics of the instrument were conducted. First, the face and content validity were assessed, and the average scale content validity index (S-CVI) was 0.94. Then, a preliminary test was conducted to assess the initial reliability (α = 0.92) and the correlation of each item with the total score. After completing these steps, the number of items in the instrument was reduced to 52. The results of the EFA explained 58% of the total variance, with 4 factors identified: professional behavior by following guidelines, comprehensive care, accurate documentation, and pressure ulcer care. At the CFA stage, the results of the calculation of indices and goodness of fit showed that the model had a good fit. The reliability of the relative stability by examining the intraclass correlation coefficient (ICC) for the whole instrument in 20 samples was 0.92 with a confidence interval of 0.97 − 0.81. To measure absolute stability and determine the responsiveness of the instrument, the standard error of measurement (SEM) was 4.39 and the minimum detectable change (MDC) was 12.13.

The instrument for safe nursing care in the ICU has favorable psychometric properties.

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As recently defined by the World Health Organization (WHO) in 2021, patient safety is a framework of organized activities that create cultures, processes, behaviors, technologies, climates, and environments in healthcare organizations. This framework aims to continuously and sustainably identify risks, preventable harm, and reduce the likelihood of their occurrence [ 1 ]. According to this organization, unsafe care is a significant contributor to serious medical errors globally and ranks among the top ten causes of death worldwide [ 2 ]. According to available reports, 134 million serious incidents of unsafe care have been recorded in low- and middle-income countries. These incidents resulted in 2.6 million deaths per year [ 3 ]. There is evidence that patient safety is a global health issue that affects patients worldwide, including both developed and developing countries [ 4 ]. Researchers are evaluating interventions, designing health systems, and exploring creative methods to ensure patient safety. At a global level, the World Health Organization has implemented safety interventions in underdeveloped and developing countries [ 5 ].

In addition to the importance of safety in hospitals, this aspect becomes even more crucial in intensive care settings [ 6 ]. Intensive care units (ICUs) are specialized hospital units that care for critically ill patients. These patients require constant monitoring and specialized care due to their complex medical conditions [ 7 ]. The role of ICU nurses is crucial in ensuring patient safety and delivering quality care [ 8 ]. They are responsible for providing practical care, monitoring vital signs, administering medications, and assisting with medical procedures [ 9 ]. In addition to the acute condition of patients, nurses in these units are also required to deal with the emotional and psychological stress of caring for critically ill patients and their families [ 10 ]. However, providing safe care in these units can be challenging due to a number of factors [ 11 ]. One of the main challenges for nurses in these units is the requirement for high precision and the management of complex care needs [ 12 ]. The special conditions of patients hospitalized in ICUs, the equipment available in these units, and the care techniques used increase the risk of medical errors [ 13 ], but development and application of safe care criteria lead to increased patient survival, cost savings, and a reduction in preventable deaths [ 14 ]. One way to identify safe care criteria is by developing an instrument to review them. The utilization of patient safety review and assessment criteria not only enhances nurses’ and managers’ recognition and awareness of the current status of nurses’ safe care qualifications but also helps identify their skill and cognitive deficits and deficiencies [ 15 ].

Despite the availability of certain instruments for evaluating safe care in Iran [ 15 ] and other countries [ 16 , 17 , 18 , 19 ], these instruments are generic and lack specificity, failing to consider the variations among different care settings. Rashvand et al. (2016) conducted a study in Iran to develop and psychometrically evaluate a safety care instrument. The tool they developed consisted of 41 items with factors including assessment of nursing skills, assessment of psychological needs, assessment of physical needs, assessment of teamwork, and assessment of ethics [ 20 ]. Although this study is valuable, the instrument designed is a general tool to assess the safety of hospitalized patients, and it does not specifically address the care of patients in the ICU. Furthermore, since the tool’s design, there have been numerous changes in Iran’s health system structure and safe care standards. Instruments designed in other countries can be useful, but due to differences in the health system, facilities, and equipment, they may not always be compatible. For these reasons and due to the absence of a specific instrument thorough review of previous studies the researchers conducted this study with the aim of designing and psychometrically evaluating a safe nursing care instrument in the ICU.

Study design

The present study is a sequential-exploratory mixed-methods study conducted with the aim of designing and psychometrically evaluating a safe nursing care instrument in the ICU in Iran from October 2019 to October 2021. This study was conducted in two qualitative and quantitative phases. In the first phase, a qualitative approach was used to provide a comprehensive definition of the concept of safe nursing care in the ICU. In the next phase, a quantitative approach was used to design and psychometrically assess the safe nursing care instrument in these departments [ 21 ].

Qualitative phase and item generation

In the first phase of the study, conventional content analysis was utilized to gain a comprehensive understanding of the concept of safe nursing care and its dimensions. Through purposive sampling, in-depth and semi-structured interviews were conducted with 21 participants, including 7 nurses, 2 head nurses, 1 clinical supervisor, 1 nurse responsible for patient safety, 5 intensivists, 2 patients, 1 patient’s family member (patient’s son), 1 patient safety officer in the Ministry of Health, Treatment, and Medical Education, and 1 paramedic. The inclusion criteria for the healthcare personnel involved having a minimum of two years of professional experience in the ICU or in units associated with patient safety. The selection of the two-year threshold was based on the completion of the mandatory manpower plan course and the acquisition of sufficient experience and knowledge. Patients were included if they had a Glasgow Coma Score (GCS) of 15, demonstrated clear speech abilities, and received approval from the ICU intensivist to participate in the interview. Data collection persisted until data saturation was achieved, and no new codes emerged. A concluding interview was carried out to confirm data saturation.

Examples of interview questions for treatment staff include:

During each shift, what do you do for your patients?

How do you prioritize your nursing care?

What measures do you take to ensure patient safety?

What unsafe behaviors have you observed during your shift?

Qualitative data analysis was then carried out according to the steps suggested by Lindgeren et al. in 2020 [ 22 ]. First, decontextualization was carried out as follows. First, the text of the interviews was transcribed and read multiple times to grasp the main idea. The semantic units were then identified and coded. For recontextualization, the generated codes were compared and grouped into subcategories based on their similarities and differences. In the next step, the categories were extracted from the integration of subcategories, and finally, themes were extracted from the integration of categories. The first author conducted the data analysis, while the other authors reviewed and revised the codes, subcategories, and categories. A definition of the concept under study and its structures was then presented. The initial item pool was extracted by the first author and contained 130 items, 5 of which were extracted from other instruments. The item pool was refined several times by the research team, and a number of items were dropped. Finally, 107 items remained in the item pool.

At the end, the initial instrument was developed by establishing a 5-point Likert scale, with 1 = never, 2 = rarely, 3 = sometimes, 4 = often, 5 = always.

Quantitative phase and item reduction

In the quantitative phase of the study, the psychometric properties of the instrument were assessed according to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria. Face validity, content validity, construct validity, and reliability were evaluated. The number of samples in each stage varied, and this is detailed separately in the respective sections.

Face validity

To assess face validity, two qualitative and quantitative methods were used. In this stage, the participants consisted of 20 nurses (10 nurses in qualitative and 10 nurses in quantitative method) from the ICU departments of hospitals affiliated with Kermanshah University of Medical Sciences in western Iran, who met the inclusion criteria. The inclusion criteria required participants to hold a bachelor’s degree in nursing and have less than two years of work experience. These criteria were chosen to ensure that nurses with minimal nursing education and work experience could comprehend the items. The samples were selected using the convenience sampling method.

For qualitative face validity ten nurses were asked to rate the items of the instrument in terms of difficulty, relevance, and ambiguity. For quantitative face validity, another 10 nurses were asked to rate the appropriateness of each item by responding to a Likert scale (completely appropriate = 5, somewhat appropriate = 4, moderately appropriate = 3, slightly appropriate = 2, not appropriate at all = 1). Quantitative face validity was assessed by calculating the items impact score (IIS). The formula (impact score = frequency (%) × suitability) was used to determine the impact score [ 23 ]. The acceptable impact score is greater than 1.5.

Content validity

To assess content validity, two qualitative and quantitative methods were used. At this stage, there were 26 expert participants (14 experts in qualitative and 12 experts in quantitative method), including head nurses, nurses in charge of the ICUs, intensivists, and faculty members with experience in working or teaching ICU courses at universities affiliated with Kermanshah University of Medical Sciences in western Iran, who met the inclusion criteria. The inclusion criteria required more than two years of work experience in the ICU department. Sampling was conducted using the convenience method.

Qualitative content validity was assessed with the participation of 14 experts. Adjustments were made to the item arrangement and recommendations were provided for deleting, modifying, and integrating several items. Quantitative investigation of content validity involved 12 experts. The content validity ratio (CVR) was calculated to assess the necessity of the item, while the content validity index (CVI), average content validity index (S-CVI), and adjusted kappa coefficient (K*) were used to evaluate the relevance of the items. The CVR of each item was calculated based on a 3-point Likert scale, which included not necessary = 1, useful but not necessary = 2, and necessary = 3. Considering the number of experts, the cut-off point of the minimum value of the acceptable index in the Lawshe table was 0.56, and items with CVR values less than 0.56 could be removed [ 24 ]. To determine the Content Validity Index (CVI) of each item, experts provided feedback on a four-point Likert scale as follows: not relevant = 1, somewhat relevant = 2, relevant but needs revision = 3, and completely relevant = 4. The minimum acceptable level of CVI was considered to be 0.80 according to Waltz and Basel [ 25 ]. The SCVI/average approach was used to calculate the SCVI. A value of 0.9 was established as an excellent criterion, while a value of 0.8 was designated as the minimum threshold for SCVI acceptance [ 23 ]. To determine the adjusted kappa coefficient, experts provided comments by selecting one of the options: relevant = 1 or not relevant = 0. An adjusted kappa statistic greater than 0.74 was considered excellent, between 0.60 and 0.74 good, and less than 0.60 poor [ 26 ]. In the quantitative content validity stage, decisions about the items were made based on the kappa statistic.

In both qualitative and quantitative content validity, experts provided feedback on the comprehensiveness of items using a five-point Likert scale as follows: Not comprehensive at all = 1, Not comprehensive = 2, Somewhat comprehensive = 3, Sufficiently comprehensive = 4, and Very comprehensive = 5.

Item analysis

This stage involves the initial evaluation of the instrument in the target community and is conducted before assessing construct validity. In the item analysis stage, each item was examined to check the initial reliability, the correlation between the items, and the correlation of each item with the total score. In this stage the samples included 50 nurses of the ICU departments of hospitals affiliated with Kermanshah University of Medical Sciences in western Iran and paper questionnaires were prepared and distributed to head nurses and charge nurses to complete the performance of the nurses under their supervision in ICUs. Sampling was conducted using the convenience method.

Construct validity

Samples in the construct validity stage consisted of nurses from ten ICU departments of five hospitals affiliated with Kermanshah University of Medical Sciences in western Iran. Exploratory factor analysis sampling (EFA) was conducted in three hospitals, encompassing six ICUs, while confirmatory factor analysis (CFA) sampling was carried out in two hospitals, covering four ICUs. The inclusion criteria were full-time employment in the ICU, not partial. Sampling was conducted using the convenience method.

The instrument developed in this study is designed to assess the performance of nurses in delivering safe care in ICUs. In most cases, the responsibility of evaluating nurses’ performance lies with head nurses and charge nurses. Therefore, the questionnaires are completed by head nurses and charge nurses about nurses under their supervision.

During the exploratory factor analysis stage, the online instrument was developed using Google Forms. Participants were then sent the URL link to access the scale through email or various social media platforms like WhatsApp or Telegram. Due to the non-completion of some samples and the prolonged sampling process at this stage, paper questionnaires were prepared to conduct confirmatory factor analysis.

At construct validity stage, the instrument used had two parts. The first part focused on the demographic characteristics of the participants, including age, gender, marital status, education, and work experience, particularly in the ICU. The second part also included 42 items related to assessment of nurses safe care in the ICU.

Construct validity was tested using exploratory and confirmatory factor analysis. The five-step guide by Williams et al. in 2010 was used to conduct the exploratory factor analysis (EFA). The sample size in factor analysis depends on the number of items in the designed instrument, and different sources consider at least 3–10 samples per item as acceptable [ 27 ]. The sample size in the EFA included 300 nurses of three hospitals, encompassing six ICUs. Initially, 300 online questionnaires were sent to head nurses and charge nurses. After one month and several follow-ups, 230 feedback responses were received, resulting in a response rate of 76.6%. To reach the desired sample size, an additional 70 online questionnaires were sent out, and the required sample was achieved. The questionnaires data were entered into SPSS software version 26.

The appropriateness of the sample was assessed using the Kaiser-Meyer-Olkin (KMO) sampling index, and KMO values above 0.9 were deemed excellent. The operability of the data was checked using Bartlett’s sphericity test. Experts have considered the significance of Bartlett’s sphericity test to indicate the factorability of the data [ 28 ]. The maximum likelihood method was also used to conduct factor analysis and extract factors [ 29 ]. For factor extraction, the Kaiser criterion, the scree plot, the percentage of variance of each factor, and the cumulative variance explained by all extracted factors were used. Factors with an eigenvalue greater than one, factors beyond the horizontal line indicated by the scree plot, and factors that account for at least 50% of the variance in the desired concept by the extracted factors were considered for evaluation [ 28 ]. The four-factor model with promax rotation also generated factors that offered the most accurate interpretation and aligned with the qualitative findings of the study. In addition, 58% of the variance in the desired concept was explained by the extracted factors. The minimum acceptable factor loading for the items was considered to be 0.3. Finally, the factors were named according to the common meaning of the items within them.

In the next step, the instrument was evaluated using CFA. The sample size in the CFA stage included 200 nurses of two hospitals, covering four ICUs. In this stage, 200 Paper questionnaires were distributed among head nurses and charge nurses. The aims of the study were explained, and written consent was obtained. After one week, 182 completed questionnaires were collected, resulting in a response rate of 91%. To reach the calculated sample size of 200, 18 additional questionnaires were completed. The questionnaires data was entered into SPSS software version 26 and LISREL version 8.8 software was used.

The most common indicators used to check model fit in CFA include Goodness of Fit Index (GFI), Adjusted Goodness of Fit Index (AGFI), Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), Incremental Fit Index (IFI), Non-Normed Fit Index (NNFI), Normed Fit Index (NFI), Relative Fit Index (RFI), and Parsimony Normed Fit Index (PNFI) were also calculated.

Reliability

The reliability of the instrument was assessed by examining internal consistency and stability (both relative and absolute). Internal consistency was evaluated by calculating the Cronbach’s alpha coefficient in a sample of 300 individuals (EFA samples). Cronbach’s alpha was computed for the entire instrument and individually for each factor. Although an alpha value of 0.7 is acceptable, some experts have recommended an alpha value of 0.8 and above [ 30 ]. In the present study, alpha values greater than 0.8 were considered.

Relative stability was assessed by calculating the intraclass correlation coefficient (ICC). The developed instrument was administered to 20 head nurses and charge nurses, and the same sample completed it again after two weeks for calculating the Intraclass Correlation Coefficient (ICC). The closer the ICC is to one, the greater the reliability [ 24 ]. In this study, the Intraclass Correlation Coefficient (ICC) was considered to be 0.8–0.9, indicating good reliability [ 30 ] .

Absolute stability was assessed by calculating the standard error of measurement (SEM) and the minimum detectable change (MDC); these two indicators also reflect the responsiveness of the instrument. The SEM was calculated using the formula SEM = SD × √(ICC-1), and the MDC was calculated using the formula MDC = SEM × z × √2 [ 31 ]. The preparation steps are shown in Fig.  1 .

Steps in the development and psychometric evaluation of safe nursing care instrument in ICUs

Interpretability

To determine interpretability, the researchers used the following criteria: the percentage of unanswered items, the adequacy of the sample size, the distribution of total scores in the samples, and the identification of ceiling and floor effects [ 32 ]. The feasibility of the instrument was assessed by calculating two criteria: response time to the instrument and the percentage of forgotten items. To rank the instrument, the items were weighted, and the final instrument was scored.

Data analysis

Data analysis was conducted using SPSS version 26 software and LISREL version 8.8 software .

Ethical considerations

Written permission to conduct the research and approval from the ethics committee were obtained from Tehran Islamic Azad University of Medical Sciences with the code IR.IAU.TMU.REC.1399.481. The research objectives were explained to the participants, written informed consent was obtained from all participants and samples studied. Participants were informed of their voluntary participation in the research and their right to withdraw from the study. The research was conducted with respect for individuals, justice, and responsibility.

The mean age of the participants was 37.47 years, and the mean experience of the healthcare professionals was 17.23 years. Half of the participants were female. The mean duration of the interviews was 36.42 min. The maximum interview duration was 80 min, and the minimum interview duration was 20 min.

After analyzing the data and reviewing the codes multiple times, the research team removed duplicates and merged similar cases. As a result, the number of codes extracted from the interviews decreased from 1997 to 1770, which were then categorized into 43 subcategories. In the next step, seven categories were merged, resulting in three themes derived from the merging of the categories. These themes include professional behavior (with categories: Implementation of policies, organizing communication, professional ethics), holistic care (with categories: systematic care, comprehensive care of all systems), and safety-oriented organization (with categories: human resource management and safe environment). In addition to utilizing the results of the qualitative section, patient safety instruments were also employed to compile the items. The initial pool of items was extracted by the first author, which included 130 items, of which 5 items were taken from other instruments related to patient safety. The pool of items was reviewed by the second author, and based on the comments provided, 17 items were removed due to similarities and inadequacy. Then the remaining items were reviewed by the third author, who suggested removing a number of other items. Finally, 107 items remained in the item pool, 102 items were taken from interviews and 5 items were taken from patient safety tools. Regarding the items taken from patient safety tools, 3 items were related to the subcategory of professional ethics and 2 items were related to the subcategory of organizing communication.

In the qualitative face validity stage, the items were assessed for ease of understanding and the potential for misunderstanding or ambiguity in the wording. Fortunately, the participants encountered no issues, and the items did not require any modifications. At the quantitative face validity stage, all items had an IIS greater than 1.5. Thus, all items were retained.

During the qualitative content validity phase, the order of the items was adjusted based on the suggestions of the experts. At this stage, some items were modified, 20 items were merged and 2 items were eliminated due to overlap with other items and the number of items was reduced from 107 to 85. In the quantitative content validity phase, after calculating the CVR, 25 items were excluded. Also, in relation to the CVI values, since all items had a CVI greater than 0.8, no items were excluded and the number of items was reduced to 60. The average Scale Content Validity Index (S-CVI) was 0.94. Finally, an instrument with 60 items was obtained.

A preliminary test was conducted. At this stage, the instrument was administered to 50 head nurses and charge nurses in ICUs. The data analysis showed that the Cronbach’s alpha of the entire list was 0.92. Then, the correlation of the items with the entire instrument was checked using the correlation loop method, and the correlation between the items was examined using the correction factor method. At the end of this stage, 8 items were removed and a safe nursing care instrument with 52 items was prepared for construct validity.

Demographic characteristics of the participants

300 nurses, with a mean age of 31.35 ± 4.61 years and a mean work experience of 9.43 ± 5.59 years, participated in the exploratory factor analysis of this study. More of the sample had a bachelor’s degree (80.7%). In addition, the majority of them were female (73.3%) [Table  1 ].

In the confirmatory factor analysis 200 nurses participated with a mean age of 30.16 ± 5.89 years and a mean work experience of 6.33 ± 3.34 years. Like exploratory factor analysis more of the sample had a bachelor’s degree (84.8%) and the majority of them were female (69.7%) [Table  2 ].

At the exploratory factor analysis stage, the KMO index was 0.970, and Bartlett’s sphericity test (BT) was statistically significant ( p  < 0.001). Four factors extracted from the factor analysis using the maximum likelihood method with Promax orthogonal rotation, with eigenvalues greater than 1, explaining 58% of the total variance. The first factor accounted for 50.43%, the second for 3.69%, the third for 2.48%, and the fourth for 1.73% of the total variance. This resulted in an instrument with 42 items and four factors [Table  3 ].

Factors were named according to the common meaning of the items in each factor. For example, the first factor was named “Professional behavior by following guidelines “, the second “comprehensive care”, the third “accurate documentation” and the fourth “pressure ulcer care”. Based on the results of the EFA stage, a large number of items from the implementation of policies category led to the formation of a factor that the researchers named professional behavior by following the guidelines. The second factor was named comprehensive care. Despite the fact that a large number of the items in this factor were taken from the implementation of policies category and some from the holistic care theme, this name was chosen for this factor because of the breadth of the concept of comprehensive care. The third factor is accurate documentation. This factor has 5 items. 4 items are taken from the category of organizing communication, and the item that was related to providing information to the patient and the patient’s family before obtaining informed consent is related to the category of the implementation of policies. However, it can be said that the allocation of items to categories is based on the opinion of the researchers and is selective. Moreover, in the qualitative phase of this study, many items could be changed and moved to other categories. In relation to the fourth factor, Pressure Ulcer Care, the items in this factor relate to the prevention, care and treatment of pressure ulcers. These items are derived from the category of policy compliance and comprehensive care of systems, but the formation of a specific factor shows the importance of pressure ulcers in ICUs.

At the CFA stage, the results of the calculation of indices and goodness of fit indicated that the model had a good fit. The Chi-square index was 2499.13 with 813 degrees of freedom ( P  < 0.001). The indices used to assess the model fit and their corresponding values are listed in Table  4 .

According to Jaccard and Wan (1996), if at least three indicators have acceptable values, we can conclude that the model fit is acceptable [ 33 ]. Based on this, and according to the values reported in Table  3 , the minimum value of three indicators is appropriate, and therefore, the model fit is acceptable.

Cronbach’s alpha coefficient was used to assess the internal consistency. The alpha value for the entire instrument was 0.97, for the first factor 0.94, for the second factor 0.94, for the third factor 0.89, and for the fourth factor 0.86, indicating a high level of internal consistency for both the instrument and all its factors. The ICC for the entire instrument was 0.92, with a confidence interval of 0.81–0.97. To measure the absolute stability and determine the responsiveness of the instrument, the SEM was 4.39 and the MDC was 12.13.

The ceiling and floor effect index was zero for the entire instrument and for factors 1, 2, and 4, and only 10% for factor 3. Examining the distribution of scores in various sample groups also demonstrated the instrument’s capability to detect differences between different groups in relation to the measured construct.

Feasibility

The average response time for the designed instrument was approximately 5.35 min in a sample of ten participants. The minimum response time was 4 min, and the maximum was 8.40 min. Considering the number of items in the list (42 items), the response time to the instrument appears reasonable. Moreover, since the questionnaire was distributed to the participants online via an electronic link, most of them managed to answer all the items. Only five questionnaires were answered, but they were considered biased because a large number of questions were left unanswered. These questionnaires were excluded from the study, and supervisors completed five new questionnaires.

The ranking of the instrument was determined by assigning weights to the items. The results showed that the items with the highest weight were placed in the ‘comprehensive care’ dimension, indicating that this dimension was the most significant among the dimensions of the instrument in explaining the factors of safe nursing care.

Finally, the instrument was scored using a 5-point Likert scale, which included the options of never, rarely, sometimes, often, and always. The scoring system ranged from 0 to 100, with the score for each option being never 1, rarely 2, sometimes 3, often 4, and always 5. With a total of 42 items, the total points achievable range from a minimum of 42 (if all items are answered as never) to a maximum of 210 (if all items are answered as always). A higher score on the scale indicated safer nursing care.

Based on the results of the qualitative part of this study, the concept of safe nursing care in intensive care comprises three themes: professional behavior, holistic care, and safety-oriented organization. After completing the design and psychometric procedures, an instrument with 42 items and four factors was obtained. The factors extracted from the exploratory factor analysis using Promax rotation, explaining 58% of the total variance, were professional behavior by following guidelines, holistic care, accurate documentation, and pressure ulcer care. Internal consistency was assessed using Cronbach’s alpha coefficient, which was 0.97 for the entire instrument. The ICC for the entire instrument was 0.92, with a confidence interval of 0.81–0.97. In order to measure the absolute stability and determine the responsiveness of the instrument, the SEM was 4.39, and the MDC was 12.13. These values indicate the desirable psychometric properties of this instrument.

In this instrument, the first factor is referred to as professional behavior, which involves adhering to the guidelines. Based on the results of this study, this factor was identified as the most important aspect of safe nursing care in the ICU, consisting of 17 items. In the ICU, there are several procedures that must be performed correctly. Neglecting or making mistakes in performing these procedures seriously endangers the patient’s safety. Many patients admitted to these units are dependent on ventilators, and numerous procedures are performed on them. All these procedures are complex and require a high level of mental ability and skill on the part of the nurse. Based on the results of current research, safe procedures require adherence to the guidelines designed for them. However, many nurses rely on their personal skills and experience, which may compromise patient safety. The results of the research by Al-Omar et al. in Saudi Arabia in 2019 showed that nurses’ reliance on personal experience may compromise patient safety [ 34 ].

The results of Baccolini et al.‘s research in 2019 in Italy showed that the implementation of procedures to adhere to health standards in special care units was significantly influenced by following the established policies [ 35 ]. In this regard, Bignami et al. have argued, based on the results of their research in 2023 in Italy, that adhering to the policy is a secure approach to delivering clinical care, ensuring patient safety, and enhancing the quality of care in intensive care units [ 36 ]. Williams et al., in their study in the United States, concluded that adherence to guidelines can also result in a quicker diagnosis of sepsis [ 37 ]. However, it has been argued that adhering to guidelines may compromise the autonomy of the nurse, and that the nurse may not be able to effectively manage situations that were not anticipated in the guidelines [ 38 ]. For this reason, it seems that the nurse should be able to recognize and prepare for possible cases outside the procedure, in addition to following the guidelines set for the implementation of each procedure.

The second factor is comprehensive care, which also includes 17 items. The results of this study highlight the significance of advocating for safe nursing care in ICUs through a comprehensive care approach. These findings support previous research emphasizing the importance of systems thinking and safe care in enhancing patient safety and overall quality of care [ 39 ]. The results of this study emphasize that comprehensive care, which includes addressing the physical, emotional, social, and spiritual needs of patients, is valuable in ICUs. Implementing a comprehensive care model can lead to improved outcomes and patient satisfaction, as well as increased nurse satisfaction and reduced job burnout [ 40 ]. By focusing on the whole person, nurses can provide more personalized and effective care, ultimately contributing to a safer environment for patients and staff [ 41 ].

The third factor is accurate documentation, which consists of 5 items. The registration of accurate reports is essential for evaluating treatment and care measures. It is also the most effective document for judicial authorities, research affairs, supervisory affairs, and educating students. According to studies, out of every four cases of professional negligence, one case is related to incorrect registration of nursing reports and only 21.4% of nurses demonstrated proficiency in report writing [ 42 ]. A review study by McCarthy et al. found that the utilization of electronic reporting and documentation systems in acute care hospitals not only saves time but also reduces errors, as well as the risk of patient falls and infections [ 43 ].

The fourth factor is pressure ulcer care. Nurses are responsible for providing continuous and direct care in the prevention and management of pressure ulcers. To achieve quality and optimal care, they need to have evidence-based knowledge and practice. Risk assessment is recommended as the initial step in preventing pressure ulcers in nursing care. The reason for the poor quality of care regarding pressure ulcers is attributed to nurses’ lack of knowledge, absence of accountability, and inadequate monitoring of their performance. It is recommended that a systematic assessment be conducted at the patient’s bedside upon admission or whenever a change is feasible. The patient’s condition should be observed using a validated instrument [ 44 ]. In the current instrument, three items, which constitute the fourth factor of this instrument, pertain to assessment and nursing interventions regarding pressure ulcers.

In addition, the following table briefly compares patient safety instruments with the instrument designed and psychometrically tested in the present study based on the COSMIN criteria [Table  5 ].

In the table, the abbreviation SNCI-ICU (Safe Nursing Care Instrument in the ICU) refers to the instrument designed in the present study.

Comparing the process and methods of instruments

It is a sequential exploratory combined study comprising two qualitative and quantitative phases. In the qualitative phase, researchers utilized studies on patient safety, Reason’s human error model, and the curriculum of the Columbia University School of Nursing in New York to extract items. However, the process of extracting items from the human error model, studies, and curriculum is not detailed, including the number of items extracted from each source and the methodology used. Additionally, no information is provided about the human error model.

In this study, researchers extracted items and designed new tools utilizing PS ASK and HPPSACS instruments.

It is a sequential exploratory mixed-methods study comprising two phases - qualitative and quantitative. In the qualitative phase, the researchers solely relied on a literature review for data collection.

Safe nursing care evaluation questionnaire

This study is a sequential exploratory combined research comprising two phases - qualitative and quantitative. The qualitative phase involved interviews and literature review.

A sequential exploratory combined study with two qualitative and quantitative phases was utilized in the qualitative phase for literature review and observation of nurses’ performance.

In the design of the SNCI-ICU tool, a sequential exploratory combined method was carried out in two qualitative and quantitative stages. In addition to qualitative interviews with nurses, doctors, staff related to patient safety, patients, and patients’ family, the researcher also benefited from an extensive literature review. This review enriched the subject pool and covered all aspects of safe nursing care in the ICU department.

Comparison of Subscales of instruments

It is a self-report instrument on knowledge, attitudes and skills and has 7 subscales and 26 items. Attitude subscales include error detection (4 items), time saving (2 items), and safety culture (3 items). Skill subscales include error analysis (6 items), threat to patient safety (3 items), and decision support technology (4 items). The knowledge subscales include 4 items. It seems that the number of 24 items is not sufficient to assess knowledge, skills and attitudes and that more items may be more useful. Despite the usefulness of self-report insruments for checking knowledge and attitudes, they do not seem to be as effective for checking skills.

This tool is a self-report instrument and has two subscales and 24 items. The subscales include skill (7 items) and attitude (17 items).

It has 4 subscales and 64 items. The subscales include protection through communication (5 items), protection through risk management (11 items), protection through correct prescription of medications and solutions (4 items), and protection through the implementation of policies (4 items).

This instrument consists of 5 subscales and 41 items. The subscales include assessment of nursing skills (16 items), assessment of psychological needs (8 items), assessment of the patient’s physical needs (8 items), assessment of nurses’ teamwork (5 items), and assessment of ethics (4 items).

This insrument comprises 5 subscales and 25 items. The subscales consist of organization (6 items), tools and equipment (5 items), transfer duties (4 items), environment (5 items), and teamwork (4 items). These subscales align with the dimensions outlined in the theoretical model of innovative engineering for patient safety, which the researchers utilized during the qualitative phase for concept definition and item generation.

In the present study, the SNCI-ICU comprises 42 items and 4 subscales. These subscales consist of professional performance following policies (17 items), comprehensive care (17 items), accurate documentation (5 items), and pressure ulcer care (3 items).

Comparison of psychometric properties based on COSMIN’s Criteria

In this study, a Cronbach’s alpha value of 0.86 was reported in the internal consistency review, but no information was provided regarding the SEM and interpretability. Therefore, based on Cosmin’s criteria, the tool designed in the present study exhibits more comprehensive psychometric properties.

In this study, the researchers only investigated content validity and internal consistency. Cronbach’s alpha values were reported as 0.67 for the attitude items, 0.71 for the skill items, and 0.73 for the entire instrument. The reliability of the attitude items is at an average level, indicating a need for item revision. Other measures of COSMIN, such as construct validity, criterion validity, stability and SEM have not been explored.

Content validity and construct validity have been assessed through EFA. The internal consistency review reported a Cronbach’s alpha value of 0.91. However, no information was provided regarding other criteria such as stability, SEM and responsiveness.

In this study, content validity was assessed first, followed by structural validity using exploratory factor analysis. The internal consistency check reported a Cronbach’s alpha value of 0.97, and the tool stability check showed an ICC of 0.77.

In this study, content validity cross cultural validity and structural validity were assessed using exploratory factor analysis. Cronbach’s alpha ranged from 0.72 to 0.82 for each subscale, but no information was provided regarding measurement error and responsiveness.

In the present study, after establishing content validity, construct validity was assessed through EFA and CFA. Internal consistency was evaluated using Cronbach’s alpha, which was found to be 0.97. The relative stability was assessed by examining the ICC for the entire instrument and individually for each factor. The ICC for the entire instrument was 0.92, with a confidence interval of 0.81–0.97. To measure the absolute stability and determine the responsiveness of the instrument, the SEM and the MDC were calculated. They were found to be 4.39 and 12.13, respectively, for the entire instrument. All these features demonstrate that the instrument designed in the present study is not only specific for evaluating safe nursing care in the ICU but also possesses desirable psychometric properties.

Implications for practice

The use of a safe nursing care instrument is effective and practical not only for nursing assessors but also for nurses working in ICU departments. It can serve as a guide. In the field of education, utilizing the factors identified in this instrument, which are specific to ICU departments, can lead to more effective training for students and nurses. Additionally, it is beneficial in the field of management and can be used by nursing managers as a valid and reliable tool to assess safe nursing care in ICU departments. The evaluations generated can pinpoint areas where nurses may need improvement. Furthermore, researchers can use this instrument to assess safe nursing care in the ICU in descriptive studies. The results from the evaluations can provide fundamental data for decision-making by policymakers and safety planners.

The instrument for safe nursing care in the ICU has favorable psychometric properties based on the studies conducted using the Consensus based standards for the selection of health measurement instrument (COSMIN) criteria. The items in this instrument are derived from the results of a qualitative study and an extensive literature review. The outstanding feature of this instrument is its exclusivity to the ICU. On this basis, it can be said that this instrument is valid for evaluators and nurse managers to assess safe nursing care in the ICU.

Research limitations

In the present study, certain types of validity like convergent, divergent, comparison in known groups and experimental were not conducted, but they could be explored in future studies. Convergent validity was not achievable due to the absence of specific tools related to safe care in the ICU. However, this study has paved the way for other researchers to utilize this tool in their own studies.

Another limitation is the design of the instrument in the Persian language, which would necessitate translation and validation for cross-cultural applicability if it is intended for international use.

Due to the special conditions of the patients and the complexity of care measures, the interview process was interrupted several times during the patient interviews. The researcher’s experience of working in the ICU and familiarity with unsafe care in the ICU created a risk of bias in the researcher’s work. In the qualitative phase, to avoid bias during the interview, the researcher aimed to act as a listener and pose questions in accordance with the interview guide. Throughout this project, the researcher encountered numerous challenges. In the qualitative phase, many interviews were cancelled and rescheduled due to the concurrent interviews during the coronavirus epidemic. In the quantitative phase, it took 2 months to complete the questionnaires because they were submitted online to supervisors and nurses, and some questionnaires were not completed.

Data availability

Due to university policies, the datasets generated and utilized for the present study are not publically accessible but are available from the corresponding author upon justifiable request.

Abbreviations

World Health Organization

Intensive Care Units

Consensus based standards for the selection of health measurement instrument

Item Impact Score

Content Validity Ratio

Content Validity Index

CVI)-Scale Content Validity Index

Adjusted kappa coefficient

Exploratory Factor Analysis

Kaiser-Meyer-Olkin

Bartlett’s sphericity Test

Confirmatory Factor Analysis

Goodness of Fit Index

Adjusted Goodness of Fit Index

Root Mean Square Error of Approximation

Comparative Fit Index

Incremental Fit Index

Non-Normed Fit Index

Normed Fit Index

Relative Fit Index

Parsimony Normed Fit Index

Intraclass Correlation Coefficient

Standard Error of Measurement

Minimum Detectable Change

ICU)-Safe Nursing Care Instrument in the ICU

ASK)-Patient safety attitudes, skills, knowledge

Nurses attitudes and skill around updated safety concepts

Nursing Performance for Patient Safety Scale

Intrahospital Transport

Systems Engineering Initiative for Patient Safety

Health Professions Patient Safety Assessment Curriculum Survey

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Acknowledgements

The present study is an excerpt from a nursing doctoral thesis, which was completed after obtaining the necessary permissions from Tehran Islamic Azad University of Medical Sciences. The research team would like to thank the staff of this university and all the participants in this research.

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Nursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, IR, Iran

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Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

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M.T, T.A and A.E contributed in study design. M.T contributed in data collection and wrote the manuscript. T.A, A.E and F.Z analyzed the data and revised the manuscript. All of the authors proved the final version of manuscript.

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Tajari, M., Ashktorab, T., Ebadi, A. et al. Designing and psychometric evaluation of safe nursing care instrument in intensive care units. BMC Nurs 23 , 629 (2024). https://doi.org/10.1186/s12912-024-02322-z

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