literature review online tutorial

Literature Reviews

• Introduction
• Tutorials and resources
• Step 1: Literature search
• Step 2: Analysis, synthesis, critique
• Step 3: Writing the review

If you need any assistance, please contact the library staff at the Georgia Tech Library Help website . 

Literature review tutorials

There are many helpful Literature Review video tutorials online. Here is an excellent, succinct (10 min) introduction to how to succeed at a literature review:

Literature Reviews: An Overview for Graduate Students from NC State University Libraries on Vimeo .

For a longer, high quality in-depth look at how literature reviews come together, see this set of  literature review tutorials  from RMIT University.

Literature review resources

We recommend these resources for more information.

This literature review tutorial is from SAGE Research Methods, which has additional resources for learning about literature reviews.

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• Next: Step 1: Literature search >>
• Last Updated: Apr 2, 2024 11:21 AM
• URL: https://libguides.library.gatech.edu/litreview

How To Write An A-Grade Literature Review

3 straightforward steps (with examples) + free template.

By: Derek Jansen (MBA) | Expert Reviewed By: Dr. Eunice Rautenbach | October 2019

Quality research is about building onto the existing work of others , “standing on the shoulders of giants”, as Newton put it. The literature review chapter of your dissertation, thesis or research project is where you synthesise this prior work and lay the theoretical foundation for your own research.

Long story short, this chapter is a pretty big deal, which is why you want to make sure you get it right . In this post, I’ll show you exactly how to write a literature review in three straightforward steps, so you can conquer this vital chapter (the smart way).

Overview: The Literature Review Process

• Understanding the “ why “
• Finding the relevant literature
• Cataloguing and synthesising the information
• Outlining & writing up your literature review
• Example of a literature review

But first, the “why”…

Before we unpack how to write the literature review chapter, we’ve got to look at the why . To put it bluntly, if you don’t understand the function and purpose of the literature review process, there’s no way you can pull it off well. So, what exactly is the purpose of the literature review?

Well, there are (at least) four core functions:

• For you to gain an understanding (and demonstrate this understanding) of where the research is at currently, what the key arguments and disagreements are.
• For you to identify the gap(s) in the literature and then use this as justification for your own research topic.
• To help you build a conceptual framework for empirical testing (if applicable to your research topic).
• To inform your methodological choices and help you source tried and tested questionnaires (for interviews ) and measurement instruments (for surveys ).

Most students understand the first point but don’t give any thought to the rest. To get the most from the literature review process, you must keep all four points front of mind as you review the literature (more on this shortly), or you’ll land up with a wonky foundation.

Okay – with the why out the way, let’s move on to the how . As mentioned above, writing your literature review is a process, which I’ll break down into three steps:

• Finding the most suitable literature
• Understanding , distilling and organising the literature
• Planning and writing up your literature review chapter

Importantly, you must complete steps one and two before you start writing up your chapter. I know it’s very tempting, but don’t try to kill two birds with one stone and write as you read. You’ll invariably end up wasting huge amounts of time re-writing and re-shaping, or you’ll just land up with a disjointed, hard-to-digest mess . Instead, you need to read first and distil the information, then plan and execute the writing.

Step 1: Find the relevant literature

Naturally, the first step in the literature review journey is to hunt down the existing research that’s relevant to your topic. While you probably already have a decent base of this from your research proposal , you need to expand on this substantially in the dissertation or thesis itself.

Essentially, you need to be looking for any existing literature that potentially helps you answer your research question (or develop it, if that’s not yet pinned down). There are numerous ways to find relevant literature, but I’ll cover my top four tactics here. I’d suggest combining all four methods to ensure that nothing slips past you:

Method 1 – Google Scholar Scrubbing

Google’s academic search engine, Google Scholar , is a great starting point as it provides a good high-level view of the relevant journal articles for whatever keyword you throw at it. Most valuably, it tells you how many times each article has been cited, which gives you an idea of how credible (or at least, popular) it is. Some articles will be free to access, while others will require an account, which brings us to the next method.

Method 2 – University Database Scrounging

Generally, universities provide students with access to an online library, which provides access to many (but not all) of the major journals.

So, if you find an article using Google Scholar that requires paid access (which is quite likely), search for that article in your university’s database – if it’s listed there, you’ll have access. Note that, generally, the search engine capabilities of these databases are poor, so make sure you search for the exact article name, or you might not find it.

Method 3 – Journal Article Snowballing

At the end of every academic journal article, you’ll find a list of references. As with any academic writing, these references are the building blocks of the article, so if the article is relevant to your topic, there’s a good chance a portion of the referenced works will be too. Do a quick scan of the titles and see what seems relevant, then search for the relevant ones in your university’s database.

Method 4 – Dissertation Scavenging

Similar to Method 3 above, you can leverage other students’ dissertations. All you have to do is skim through literature review chapters of existing dissertations related to your topic and you’ll find a gold mine of potential literature. Usually, your university will provide you with access to previous students’ dissertations, but you can also find a much larger selection in the following databases:

• Open Access Theses & Dissertations
• Stanford SearchWorks

Keep in mind that dissertations and theses are not as academically sound as published, peer-reviewed journal articles (because they’re written by students, not professionals), so be sure to check the credibility of any sources you find using this method. You can do this by assessing the citation count of any given article in Google Scholar. If you need help with assessing the credibility of any article, or with finding relevant research in general, you can chat with one of our Research Specialists .

Alright – with a good base of literature firmly under your belt, it’s time to move onto the next step.

Need a helping hand?

Step 2: Log, catalogue and synthesise

Once you’ve built a little treasure trove of articles, it’s time to get reading and start digesting the information – what does it all mean?

While I present steps one and two (hunting and digesting) as sequential, in reality, it’s more of a back-and-forth tango – you’ll read a little , then have an idea, spot a new citation, or a new potential variable, and then go back to searching for articles. This is perfectly natural – through the reading process, your thoughts will develop , new avenues might crop up, and directional adjustments might arise. This is, after all, one of the main purposes of the literature review process (i.e. to familiarise yourself with the current state of research in your field).

As you’re working through your treasure chest, it’s essential that you simultaneously start organising the information. There are three aspects to this:

• Logging reference information
• Building an organised catalogue
• Distilling and synthesising the information

I’ll discuss each of these below:

2.1 – Log the reference information

As you read each article, you should add it to your reference management software. I usually recommend Mendeley for this purpose (see the Mendeley 101 video below), but you can use whichever software you’re comfortable with. Most importantly, make sure you load EVERY article you read into your reference manager, even if it doesn’t seem very relevant at the time.

2.2 – Build an organised catalogue

In the beginning, you might feel confident that you can remember who said what, where, and what their main arguments were. Trust me, you won’t. If you do a thorough review of the relevant literature (as you must!), you’re going to read many, many articles, and it’s simply impossible to remember who said what, when, and in what context . Also, without the bird’s eye view that a catalogue provides, you’ll miss connections between various articles, and have no view of how the research developed over time. Simply put, it’s essential to build your own catalogue of the literature.

I would suggest using Excel to build your catalogue, as it allows you to run filters, colour code and sort – all very useful when your list grows large (which it will). How you lay your spreadsheet out is up to you, but I’d suggest you have the following columns (at minimum):

• Author, date, title – Start with three columns containing this core information. This will make it easy for you to search for titles with certain words, order research by date, or group by author.
• Categories or keywords – You can either create multiple columns, one for each category/theme and then tick the relevant categories, or you can have one column with keywords.
• Key arguments/points – Use this column to succinctly convey the essence of the article, the key arguments and implications thereof for your research.
• Context – Note the socioeconomic context in which the research was undertaken. For example, US-based, respondents aged 25-35, lower- income, etc. This will be useful for making an argument about gaps in the research.
• Methodology – Note which methodology was used and why. Also, note any issues you feel arise due to the methodology. Again, you can use this to make an argument about gaps in the research.
• Quotations – Note down any quoteworthy lines you feel might be useful later.
• Notes – Make notes about anything not already covered. For example, linkages to or disagreements with other theories, questions raised but unanswered, shortcomings or limitations, and so forth.

If you’d like, you can try out our free catalog template here (see screenshot below).

2.3 – Digest and synthesise

Most importantly, as you work through the literature and build your catalogue, you need to synthesise all the information in your own mind – how does it all fit together? Look for links between the various articles and try to develop a bigger picture view of the state of the research. Some important questions to ask yourself are:

• What answers does the existing research provide to my own research questions ?
• Which points do the researchers agree (and disagree) on?
• How has the research developed over time?
• Where do the gaps in the current research lie?

To help you develop a big-picture view and synthesise all the information, you might find mind mapping software such as Freemind useful. Alternatively, if you’re a fan of physical note-taking, investing in a large whiteboard might work for you.

Step 3: Outline and write it up!

Once you’re satisfied that you have digested and distilled all the relevant literature in your mind, it’s time to put pen to paper (or rather, fingers to keyboard). There are two steps here – outlining and writing:

3.1 – Draw up your outline

Having spent so much time reading, it might be tempting to just start writing up without a clear structure in mind. However, it’s critically important to decide on your structure and develop a detailed outline before you write anything. Your literature review chapter needs to present a clear, logical and an easy to follow narrative – and that requires some planning. Don’t try to wing it!

Naturally, you won’t always follow the plan to the letter, but without a detailed outline, you’re more than likely going to end up with a disjointed pile of waffle , and then you’re going to spend a far greater amount of time re-writing, hacking and patching. The adage, “measure twice, cut once” is very suitable here.

In terms of structure, the first decision you’ll have to make is whether you’ll lay out your review thematically (into themes) or chronologically (by date/period). The right choice depends on your topic, research objectives and research questions, which we discuss in this article .

Once that’s decided, you need to draw up an outline of your entire chapter in bullet point format. Try to get as detailed as possible, so that you know exactly what you’ll cover where, how each section will connect to the next, and how your entire argument will develop throughout the chapter. Also, at this stage, it’s a good idea to allocate rough word count limits for each section, so that you can identify word count problems before you’ve spent weeks or months writing!

PS – check out our free literature review chapter template…

3.2 – Get writing

With a detailed outline at your side, it’s time to start writing up (finally!). At this stage, it’s common to feel a bit of writer’s block and find yourself procrastinating under the pressure of finally having to put something on paper. To help with this, remember that the objective of the first draft is not perfection – it’s simply to get your thoughts out of your head and onto paper, after which you can refine them. The structure might change a little, the word count allocations might shift and shuffle, and you might add or remove a section – that’s all okay. Don’t worry about all this on your first draft – just get your thoughts down on paper.

Once you’ve got a full first draft (however rough it may be), step away from it for a day or two (longer if you can) and then come back at it with fresh eyes. Pay particular attention to the flow and narrative – does it fall fit together and flow from one section to another smoothly? Now’s the time to try to improve the linkage from each section to the next, tighten up the writing to be more concise, trim down word count and sand it down into a more digestible read.

Once you’ve done that, give your writing to a friend or colleague who is not a subject matter expert and ask them if they understand the overall discussion. The best way to assess this is to ask them to explain the chapter back to you. This technique will give you a strong indication of which points were clearly communicated and which weren’t. If you’re working with Grad Coach, this is a good time to have your Research Specialist review your chapter.

Finally, tighten it up and send it off to your supervisor for comment. Some might argue that you should be sending your work to your supervisor sooner than this (indeed your university might formally require this), but in my experience, supervisors are extremely short on time (and often patience), so, the more refined your chapter is, the less time they’ll waste on addressing basic issues (which you know about already) and the more time they’ll spend on valuable feedback that will increase your mark-earning potential.

Literature Review Example

In the video below, we unpack an actual literature review so that you can see how all the core components come together in reality.

Let’s Recap

In this post, we’ve covered how to research and write up a high-quality literature review chapter. Let’s do a quick recap of the key takeaways:

• It is essential to understand the WHY of the literature review before you read or write anything. Make sure you understand the 4 core functions of the process.
• The first step is to hunt down the relevant literature . You can do this using Google Scholar, your university database, the snowballing technique and by reviewing other dissertations and theses.
• Next, you need to log all the articles in your reference manager , build your own catalogue of literature and synthesise all the research.
• Following that, you need to develop a detailed outline of your entire chapter – the more detail the better. Don’t start writing without a clear outline (on paper, not in your head!)
• Write up your first draft in rough form – don’t aim for perfection. Remember, done beats perfect.
• Refine your second draft and get a layman’s perspective on it . Then tighten it up and submit it to your supervisor.

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 .

You Might Also Like:

38 Comments

Thank you very much. This page is an eye opener and easy to comprehend.

This is awesome!

I wish I come across GradCoach earlier enough.

But all the same I’ll make use of this opportunity to the fullest.

Thank you for this good job.

Keep it up!

You’re welcome, Yinka. Thank you for the kind words. All the best writing your literature review.

Thank you for a very useful literature review session. Although I am doing most of the steps…it being my first masters an Mphil is a self study and one not sure you are on the right track. I have an amazing supervisor but one also knows they are super busy. So not wanting to bother on the minutae. Thank you.

You’re most welcome, Renee. Good luck with your literature review 🙂

This has been really helpful. Will make full use of it. 🙂

Thank you Gradcoach.

Really agreed. Admirable effort

thank you for this beautiful well explained recap.

Thank you so much for your guide of video and other instructions for the dissertation writing.

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Thank you the video was great – from someone that knows nothing thankyou

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It is timely

It is very good video of guidance for writing a research proposal and a dissertation. Since I have been watching and reading instructions, I have started my research proposal to write. I appreciate to Mr Jansen hugely.

I learn a lot from your videos. Very comprehensive and detailed.

Thank you for sharing your knowledge. As a research student, you learn better with your learning tips in research

I was really stuck in reading and gathering information but after watching these things are cleared thanks, it is so helpful.

Really helpful, Thank you for the effort in showing such information

This is super helpful thank you very much.

Thank you for this whole literature writing review.You have simplified the process.

I’m so glad I found GradCoach. Excellent information, Clear explanation, and Easy to follow, Many thanks Derek!

You’re welcome, Maithe. Good luck writing your literature review 🙂

Thank you Coach, you have greatly enriched and improved my knowledge

Great piece, so enriching and it is going to help me a great lot in my project and thesis, thanks so much

This is THE BEST site for ANYONE doing a masters or doctorate! Thank you for the sound advice and templates. You rock!

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I am doing two papers on my final year thesis, and I must stay I feel very confident to face both headlong after reading this article.

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if anyone is to get a paper done on time and in the best way possible, GRADCOACH is certainly the go to area!

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Good morning scholar. I’m delighted coming to know you even before the commencement of my dissertation which hopefully is expected in not more than six months from now. I would love to engage my study under your guidance from the beginning to the end. I love to know how to do good job

Thank you so much Derek for such useful information on writing up a good literature review. I am at a stage where I need to start writing my one. My proposal was accepted late last year but I honestly did not know where to start

Like the name of your YouTube implies you are GRAD (great,resource person, about dissertation). In short you are smart enough in coaching research work.

This is a very well thought out webpage. Very informative and a great read.

Very timely.

I appreciate.

Very comprehensive and eye opener for me as beginner in postgraduate study. Well explained and easy to understand. Appreciate and good reference in guiding me in my research journey. Thank you

Thank you. I requested to download the free literature review template, however, your website wouldn’t allow me to complete the request or complete a download. May I request that you email me the free template? Thank you.

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• Research Guides

Literature Review: A Self-Guided Tutorial

• Getting Started
• Literature Reviews: A Recap
• Peer Review
• Reading the Literature
• Using Concept Maps
• Developing Research Questions
• Considering Strong Opinions
• 2. Review discipline styles
• Super Searching
• Finding the Full Text
• Citation Searching This link opens in a new window
• When to stop searching
• Citation Management
• Annotating Articles Tip
• 5. Critically analyze and evaluate
• How to Review the Literature
• Using a Synthesis Matrix
• 7. Write literature review

What's a Literature Review?

A literature review (or lit review, for short) is an in-depth critical analysis of published scholarly research related to a specific topic. Published scholarly research (the "literature") may include journal articles, books, book chapters, dissertations and thesis, or conference proceedings. 

A solid lit review must:

• be organized around and related directly to the thesis or research question you're developing
• synthesize results into a summary of what is and is not known
• identify areas of controversy in the literature
• formulate questions that need further research

View the video below for a brief explanation of lit reviews. (It's not just for grad students!)

What is a Literature Review?

Credit: NCSU Libraries. Video 1 of Literature Reviews: An Overview for Graduate Students . Run Time: 3:12

• << Previous: Home
• Next: Literature Reviews: A Recap >>
• Last Updated: Feb 22, 2024 10:53 AM
• URL: https://libguides.williams.edu/literature-review

• University of Oregon Libraries
• Research Guides

How to Write a Literature Review

• 7. Write a Literature Review
• Literature Reviews: A Recap
• Reading Journal Articles
• Does it Describe a Literature Review?
• 1. Identify the Question
• 2. Review Discipline Styles
• Searching Article Databases
• Finding Full-Text of an Article
• Citation Chaining
• When to Stop Searching
• 4. Manage Your References
• 5. Critically Analyze and Evaluate
• 6. Synthesize

Write a Literature Review

Writing support on campus, need more help.

Photo Credit: UO Libraries

Some points to remember

• Include only the most important points from each source -- you want to digest, not quote from, the sources.
• The value of the review for you audience will consist in a clear, well-organized synopsis of what has been found so far on your topic. 
• Avoid plagiarism in your lit review. Consult this UO Libraries tutorial on Academic Integrity if you need some guidance.

If you would like more pointers about how to approach your literature review, this this handout from The Writing Center at UNC-Chapel Hill  suggests several effective strategies.

From UNC-Chapel Hill  and  University of Toronto

Note : Please check the websites below for availability of online or remote services:

• Writing Lab Service Customized academic assistance for all international students
• How to Write a Literature Review (UO Libraries tutorial)
• Exploring Academic Integrity in Your Research

If you have questions related to a field or discipline, consider reaching out to a Subject Librarian by email, phone, or by scheduling an appointment for a free consultation:

• Subject Librarians
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Library Tutorials

• Searching Tutorials
• Evaluation Tutorials
• STEM Tutorials
• Using Special Collections in Research

Conducting a Literature Review

• Women in STEM
• Additional Videos

Conducting a literature Review for the first time can be confusing.  These tutorials will provide you with tips and examples.

Source: Literature Review , video tutorial, by Emily Bongiovanni and Brianna Buljung

Source: Conducting a Literature Review , LibWizard tutorial, by Brianna Buljung

Conducting Lit Reviews Checklist and Slides

When you are conducting a literature review, or any substantial research project, you will want to be as comprehensive as possible in locating materials. 

Use this checklist to ensure you are considering:

• Your Keywords
• Research Guides and Databases that will be helpful
• Web and Other resources you should consider

The checklist is available in Word and PDF formats.

• Literature Review Workshop - Thesis Writers Retreat 2022
• Literature Review Checklist - Word
• Literature Review Checklist - PDF

How to Reuse these Tutorials

We highly encourage reuse and adaptation of our tutorials. Unless otherwise noted, all tutorials on this guide are licensed CC-BY-NC . Please use the following attribution format when reusing this content. Contact the librarians on this guide with any questions or feedback.

Attribution:

TUTORIAL NAME, TYPE, by AUTHOR, Colorado School of Mines Arthur Lakes Library, used under a  CC-BY-NC license.

Keyword Search Tips , LibWizard tutorial, by Brianna Buljung, Colorado School of Mines Arthur Lakes Library under a  CC-BY-NC license

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• Last Updated: Sep 8, 2023 3:08 PM
• URL: https://libguides.mines.edu/tutorials

Indiana University Indianapolis Indiana University Indianapolis IU Indianapolis

• Herron School of Art
• Ruth Lilly Law
• Ruth Lilly Medical
• School of Dentistry

Literature Review - A Self-Guided Tutorial

• Literature Reviews: A Recap
• Reading Journal Articles
• Does it describe a Literature Review?
• 1. Identify the question
• 2. Review discipline styles
• Searching article databases - video
• Finding the article full-text
• Citation chaining
• When to stop searching
• 4. Manage your references
• 5. Critically analyze and evaluate
• 6. Synthesize
• 7. Write literature review

Who's My Librarian?

Locate your University Library's subject librarian  for personalized assistance.

Students doing research in specific areas may also request assistance at other IUPUI libraries:

• IU School of Dentistry Library
• Ruth Lilly Law Library
• Ruth Lilly Medical Library  

Literature Review - A Self-Guided Tutorial was created by Kathleen Hanna, with contributions from Sara Lowe and Ted Polley (all with IUPUI University Library ) and is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License .

Content used in this tutorial adapted from Writing at the University of Toronto's "The Literature Review: A Few Tips On Conducting It"  and The Writing Center at UNC-Chapel Hill's "Literature Reviews."

This guide will help you to:

• Define a literature review.
• Recognize that different fields of study have their own way to perform and write literature reviews.
• Prepare to search the literature.
• Read critically -- analyze and synthesize.
• Prepare to write a literature review.

At the end of the tutorial, you will find a quiz that you can submit through Canvas for course credit. 

Graphic from Literature Review (2009) by Machi and McEvoy.

Detailed description of, Literature Review Process

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• Last Updated: Jun 15, 2023 8:24 AM
• URL: https://iupui.libguides.com/literaturereview

• Research guides

Writing a Literature Review

Useful guides/tutorials, guides/tutorials.

A search on Google will retrieve numerous guides and tutorials focused on researching and writing literature reviews. Some are general, i.e. not subject nor level-specific while others focus on literature reviews in a specific discipline and/or on a particular level, i.e. undergraduate, or graduate. Below are a few examples:

Literature Reviews: An Overview for Graduate Students  (NCSU Libraries) What is a literature review? What purpose does it serve in research? What should you expect when writing one? Find out here.

Writing the Literature Review in Three Parts (YouTube videos):

Part One: Step-by-Step Tutorial for Graduate Students

Part Two: Step-by-Step Tutorial for Graduate Students

Part Three: Outline and Write the Review of Literature

The Literature Review (Massey University) This video lecture explains how to write a Literature Review, and examines which elements are required in one.

Literature Reviews (The Writing Center, U. of North Carolina at Chapel Hill) Explains what literature reviews are and offer insights into the form and construction of literature reviews in the humanities, social sciences, and sciences.

Literature Review Advice This is a short talk about what should be in an academic literature review such as the one you might produce in a final year project. 

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• Next: Citation Management >>
• Last Updated: Dec 5, 2023 2:26 PM
• Subjects: Education , General
• Tags: literature_review , literature_review_in_education

How to Write a Literature Review - A Self-Guided Tutorial

• Literature Reviews: A Recap
• Reading Journal Articles
• Does it describe a Literature Review?
• 1. Identify the question
• 2. Review discipline styles
• Searching article databases - video
• Finding the article full-text
• Citation trails
• When to stop searching
• Citation Managers
• 5. Critically analyze and evaluate
• 6. Synthesize
• 7. Write literature review
• Additional Resources

You can meet with a librarian to talk about your literature review, or other library-related topics.

You can sort the literature in various ways, for example:

Synthesis Vizualization

Four examples of student writing.

In the four examples below, only ONE shows a good example of synthesis: the fourth column, or  Student D . For a web accessible version, click the link below the image.

Long description of "Four Examples of Student Writing" for web accessibility

• Download a copy of the "Four Examples of Student Writing" chart

Synthesis Matrix Example

From Jennifer Lim

Synthesis Templates

Synthesis grids are organizational tools used to record the main concepts of your sources and can help you make connections about how your sources relate to one another.

• Source Template Basic Literature Review Source Template from Walden University Writing Center to help record the main findings and concepts from different articles.
• Sample Literature Review Grids This spreadsheet contains multiple tabs with different grid templates. Download or create your own copy to begin recording notes.
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Video: Literature Reviews: An Overview for Graduate Students

What is a literature review? What purpose does it serve in research? What should you expect when writing one? Find out here

Writing a literature review is an inevitable part of being a graduate student. So, before spending hours of your time working on a project involving a literature review, it helps to understand what a "literature review" is, and why it is important. 

You may need to do a literature review as a part of a course assignment, a capstone project, or a master's thesis or dissertation. No matter the context, a literature review is an essential part of the research process. 

Some important functions of a literature review are that it helps you to understand a research topic and develop your own perspective on a problem. Not only that, it lets you show your instructor or thesis committee what you know about the topic. 

Your instructor or advisor may assume you know what a literature review is and that you understand what they are expecting from you. You might hear phrases like: "What does the literature show us?" "Connect your ideas to the literature." "Survey the literature on the topic." 

Well, before you can review the literature, you need to make sure you know what is meant by "the literature." A good definition of the literature is that it is a collection of all the scholarly writings on a topic. These writings can be in the form of scholarly, peer reviewed articles, books, and other sources like conference proceedings. These may be called annual meetings or conventions. The literature also includes dissertations written by other graduate students. Collectively, these make up the literature. 

Visually, the literature might look like this. Often there are major works that have been written on a topic, and then other, later, works that build on them. These later works tend to be extending or responding to the original papers in some way. Basically, the literature is a continuously evolving network of scholarly works that interact with each other. 

As you do your own research, you'll begin to understand the relationships in this evolving web and how your own ideas connect to it. 

I'm John Classen, Associate Professor of Biological and Agricultural Engineering at North Carolina State University. Research is about telling a story, kind of like a chain story where each writer starts with a partial story created by others and takes it where the imagination leads. The existing literature is the story so far. You have to know where you are before you can go forward. But research is not just one linear story; many different lines of study contribute to the story you are trying to write. 

Your job in the literature review is to see where all the loose ends are in the various fields that are most closely related to what you want to do and to figure out what needs to be done next. The background to any good story has to be explained carefully or the reader doesn't know why one thing is important and something else is not; the reader has to understand what's going on. 

In the same way, researchers need the background in the literature of their discipline to know what's going on in their field of study. So, how do you turn a network of articles into a cohesive review of the literature? How do you find and tell the "story" behind your research topic? 

Reviewing the literature is like participating in a conversation. As you read and evaluate articles you begin to understand how they are connected and how they form the story that the authors are telling. Then you start to formulate your own response or contribution. 

This process - discovering relationships in the literature and developing and connecting your own ideas to it - is what helps you turn a network of articles into a coherent review of the literature. 

So what does a literature review look like? There are different types of literature reviews that you may encounter, or be required to write, while in graduate school. Literature reviews can range from being selective to comprehensive. They can also be part of a larger work or stand alone. 

A course assignment is an example of a selective review. It focuses on a small segment of the literature on a topic and makes up the entire work. The literature review in a thesis or dissertation is an example of a comprehensive review that is part of a larger work. 

Most research articles begin with a selective literature review to establish the context for the research reported in the paper. Often this is part of the introduction. Other literature reviews are meant to be fairly comprehensive and also to stand alone. This means that the entire article is devoted to reviewing the literature. 

A literature review that introduces an article can look like this. Here is an article about cognitive behavioral therapy. Here is the literature review, in this article it is part of the introduction. You can tell that the introduction includes a literature review because it discusses important research that has already been published on this topic. 

Here is an example of a stand alone literature review article, in this case, about employment. The article's title states that this is a review of the literature on the topic. However, not all review articles will have the term 'literature review' in their title. In-depth review articles like this are an excellent starting place for research on a topic. 

So, at this point, you may be asking yourself just what's involved in writing a literature review? And how do I get started? 

Writing a literature review is a process with several key steps. Let's look at each part of this process in more detail. 

Your first step involves choosing, exploring, and focusing a topic. At this stage you might discover that you need to tweak your topic or the scope of your research as you learn more about the topic in the literature. Then, of course, you'll need to do some research using article databases, the library catalog, Google Scholar, and other sources to find scholarly information. 

All along you'll be using your brain. You'll want to evaluate what you find and select articles, books, and other publications that will be the most useful. Then, you will need to read through these articles and try to understand, analyze, and critique what you read. 

While researching and organizing your paper, you'll collect a lot of information from many different sources. You can use citation management software like RefWorks, EndNote, or Zotero to help you stay organized. Then, of course, you'll need to write and revise your paper and create your final bibliography. 

One more thing: Writing a literature review is a process, but it is not always a linear process. One step does lead to another, but sometimes your research or reading will point you back to earlier steps as you learn more about your topic and the literature. 

At this point you might be wondering how do I actually review the literature I find? Let's look at what it means to review the literature. 

In the most general sense it means that you collect and read all the relevant papers and other literature on your topic. You want to provide an overview but also highlight key concepts and important papers. As you read you may start by describing and summarizing each article. Then you can start to make connections by comparing and contrasting those papers. 

You will also need to evaluate, analyze, and organize the information from your reading. When you work with the literature you will read and critically examine articles and books to see what's important or out of scope and analyze arguments for strengths and weaknesses. 

When working with the literature it is important to look for relationships between publications. Some of the important relationships between publications that you discover might include major themes and important concepts, as well as critical gaps and disagreements. 

But don't fall into the trap of making your review a laundry list of summaries of the works you read. A literature review is not an annotated bibliography. 

Your goal should be to go one step further and integrate and synthesize what you find in the literature into something new. Ideally, you will create your own conceptual map or outline of the literature on your topic. 

For example, let's say as you read you discover three major concepts that are important in the literature and relevant to your research. You should then identify how the literature - that is, the content in individual articles, books, and other publications - relates to the concepts you discovered. Some publications may be relevant to several concepts; others may apply to only one concept. What's important is that you develop and present your own organization and understanding of the literature. 

Then, when you write your literature review you will end up with a document that is organized by the concepts and relationships you found and developed based on your reading and thinking. Your review will not only cover what's been published on your topic, but will include your own thoughts and ideas. You will be telling the specific story that sets the background and shows the significance of your research. 

Researching and writing a good literature review is a challenging and sometimes intimidating process. Don't be afraid to seek assistance, whether from your adviser or instructor, campus writing center, or your librarian. Many librarians have subject specialties and can be especially helpful in identifying valuable resources and showing you how to obtain relevant information.

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• Western Universities | Lit Review Tutorial This 43-second tutorial provides a brief description on literature reviews and how they might fit into a thesis or dissertation. The transcript is available below the embedded tutorial.
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A literature review: efficacy of online learning courses for higher education institution using meta-analysis

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• Volume 26 , pages 1367–1385, ( 2021 )

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• Mayleen Dorcas B. Castro   ORCID: orcid.org/0000-0002-6618-6958 1 , 2 &
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The Internet has made online learning possible, and many educators and researchers are interested in online learning courses to enhance and improve the student learning outcomes while battling the shortage in resources, facilities and equipment particularly in higher education institution. Online learning has become popular because of its potential for providing more flexible access to content and instruction at any time, from any place. It is imperative that the researchers consider, and examine the efficacy of online learning in educating students. For this study, the researchers reviewed literature through meta-analysis as the method of research concerning the use of ADDIE (Analysis, Design, Development, Implementation and Evaluation) framework for designing and developing instructional materials that can provide wider access to quality higher education. This framework can be used to list generic processes that instructional designers and training developers use (Morrison et al., 2010 ). It represents a descriptive guideline for building effective training and performance support tools in five phases, as follows: 1.) Analysis, 2.) Design, 3.) Development, 4.) Implementation, and 5.) Evaluation. The researchers collected papers relating to online learning courses efficacy studies to provide a synthesis of scientifically rigorous knowledge in online learning courses, the researchers searched on ERIC (Education Resources Information Center), ProQuest databases, PubMed, Crossref, Scribd EBSCO, and Scopus. The researchers also conducted a manual search using Google Scholar. Based on the analysis, three main themes developed: 1.) comparison of online learning and traditional face-to-face setting, 2.) identification of important factors of online learning delivery, and 3.) factors of institutional adoption of online learning. Based on the results obtained 50 articles. The researchers examine each paper and found 30 articles that met the efficacy of online learning courses through having well-planned, well-designed courses and programs for higher education institution. Also, it highlights the importance of instructional design and the active role of institutions play in providing support structures for educators and students. Identification of different processes and activities in designing and developing an Online Learning Courses for Higher Education Institution will be the second phase of this study for which the researchers will consider using the theoretical aspect of the ADDIE framework.

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Castro, M.D.B., Tumibay, G.M. A literature review: efficacy of online learning courses for higher education institution using meta-analysis. Educ Inf Technol 26 , 1367–1385 (2021). https://doi.org/10.1007/s10639-019-10027-z

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Data visualisation in scoping reviews and evidence maps on health topics: a cross-sectional analysis

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Scoping reviews and evidence maps are forms of evidence synthesis that aim to map the available literature on a topic and are well-suited to visual presentation of results. A range of data visualisation methods and interactive data visualisation tools exist that may make scoping reviews more useful to knowledge users. The aim of this study was to explore the use of data visualisation in a sample of recent scoping reviews and evidence maps on health topics, with a particular focus on interactive data visualisation.

Ovid MEDLINE ALL was searched for recent scoping reviews and evidence maps (June 2020-May 2021), and a sample of 300 papers that met basic selection criteria was taken. Data were extracted on the aim of each review and the use of data visualisation, including types of data visualisation used, variables presented and the use of interactivity. Descriptive data analysis was undertaken of the 238 reviews that aimed to map evidence.

Of the 238 scoping reviews or evidence maps in our analysis, around one-third (37.8%) included some form of data visualisation. Thirty-five different types of data visualisation were used across this sample, although most data visualisations identified were simple bar charts (standard, stacked or multi-set), pie charts or cross-tabulations (60.8%). Most data visualisations presented a single variable (64.4%) or two variables (26.1%). Almost a third of the reviews that used data visualisation did not use any colour (28.9%). Only two reviews presented interactive data visualisation, and few reported the software used to create visualisations.

Conclusions

Data visualisation is currently underused by scoping review authors. In particular, there is potential for much greater use of more innovative forms of data visualisation and interactive data visualisation. Where more innovative data visualisation is used, scoping reviews have made use of a wide range of different methods. Increased use of these more engaging visualisations may make scoping reviews more useful for a range of stakeholders.

Peer Review reports

Scoping reviews are “a type of evidence synthesis that aims to systematically identify and map the breadth of evidence available on a particular topic, field, concept, or issue” ([ 1 ], p. 950). While they include some of the same steps as a systematic review, such as systematic searches and the use of predetermined eligibility criteria, scoping reviews often address broader research questions and do not typically involve the quality appraisal of studies or synthesis of data [ 2 ]. Reasons for conducting a scoping review include the following: to map types of evidence available, to explore research design and conduct, to clarify concepts or definitions and to map characteristics or factors related to a concept [ 3 ]. Scoping reviews can also be undertaken to inform a future systematic review (e.g. to assure authors there will be adequate studies) or to identify knowledge gaps [ 3 ]. Other evidence synthesis approaches with similar aims have been described as evidence maps, mapping reviews or systematic maps [ 4 ]. While this terminology is used inconsistently, evidence maps can be used to identify evidence gaps and present them in a user-friendly (and often visual) way [ 5 ].

Scoping reviews are often targeted to an audience of healthcare professionals or policy-makers [ 6 ], suggesting that it is important to present results in a user-friendly and informative way. Until recently, there was little guidance on how to present the findings of scoping reviews. In recent literature, there has been some discussion of the importance of clearly presenting data for the intended audience of a scoping review, with creative and innovative use of visual methods if appropriate [ 7 , 8 , 9 ]. Lockwood et al. suggest that innovative visual presentation should be considered over dense sections of text or long tables in many cases [ 8 ]. Khalil et al. suggest that inspiration could be drawn from the field of data visualisation [ 7 ]. JBI guidance on scoping reviews recommends that reviewers carefully consider the best format for presenting data at the protocol development stage and provides a number of examples of possible methods [ 10 ].

Interactive resources are another option for presentation in scoping reviews [ 9 ]. Researchers without the relevant programming skills can now use several online platforms (such as Tableau [ 11 ] and Flourish [ 12 ]) to create interactive data visualisations. The benefits of using interactive visualisation in research include the ability to easily present more than two variables [ 13 ] and increased engagement of users [ 14 ]. Unlike static graphs, interactive visualisations can allow users to view hierarchical data at different levels, exploring both the “big picture” and looking in more detail ([ 15 ], p. 291). Interactive visualizations are often targeted at practitioners and decision-makers [ 13 ], and there is some evidence from qualitative research that they are valued by policy-makers [ 16 , 17 , 18 ].

Given their focus on mapping evidence, we believe that scoping reviews are particularly well-suited to visually presenting data and the use of interactive data visualisation tools. However, it is unknown how many recent scoping reviews visually map data or which types of data visualisation are used. The aim of this study was to explore the use of data visualisation methods in a large sample of recent scoping reviews and evidence maps on health topics. In particular, we were interested in the extent to which these forms of synthesis use any form of interactive data visualisation.

This study was a cross-sectional analysis of studies labelled as scoping reviews or evidence maps (or synonyms of these terms) in the title or abstract.

The search strategy was developed with help from an information specialist. Ovid MEDLINE® ALL was searched in June 2021 for studies added to the database in the previous 12 months. The search was limited to English language studies only.

The search strategy was as follows:

Ovid MEDLINE(R) ALL

(scoping review or evidence map or systematic map or mapping review or scoping study or scoping project or scoping exercise or literature mapping or evidence mapping or systematic mapping or literature scoping or evidence gap map).ab,ti.

limit 1 to english language

(202006* or 202007* or 202008* or 202009* or 202010* or 202011* or 202012* or 202101* or 202102* or 202103* or 202104* or 202105*).dt.

The search returned 3686 records. Records were de-duplicated in EndNote 20 software, leaving 3627 unique records.

A sample of these reviews was taken by screening the search results against basic selection criteria (Table 1 ). These criteria were piloted and refined after discussion between the two researchers. A single researcher (E.S.) screened the records in EPPI-Reviewer Web software using the machine-learning priority screening function. Where a second opinion was needed, decisions were checked by a second researcher (M.R.).

Our initial plan for sampling, informed by pilot searching, was to screen and data extract records in batches of 50 included reviews at a time. We planned to stop screening when a batch of 50 reviews had been extracted that included no new types of data visualisation or after screening time had reached 2 days. However, once data extraction was underway, we found the sample to be richer in terms of data visualisation than anticipated. After the inclusion of 300 reviews, we took the decision to end screening in order to ensure the study was manageable.

Data extraction

A data extraction form was developed in EPPI-Reviewer Web, piloted on 50 reviews and refined. Data were extracted by one researcher (E. S. or M. R.), with a second researcher (M. R. or E. S.) providing a second opinion when needed. The data items extracted were as follows: type of review (term used by authors), aim of review (mapping evidence vs. answering specific question vs. borderline), number of visualisations (if any), types of data visualisation used, variables/domains presented by each visualisation type, interactivity, use of colour and any software requirements.

When categorising review aims, we considered “mapping evidence” to incorporate all of the six purposes for conducting a scoping review proposed by Munn et al. [ 3 ]. Reviews were categorised as “answering a specific question” if they aimed to synthesise study findings to answer a particular question, for example on effectiveness of an intervention. We were inclusive with our definition of “mapping evidence” and included reviews with mixed aims in this category. However, some reviews were difficult to categorise (for example where aims were unclear or the stated aims did not match the actual focus of the paper) and were considered to be “borderline”. It became clear that a proportion of identified records that described themselves as “scoping” or “mapping” reviews were in fact pseudo-systematic reviews that failed to undertake key systematic review processes. Such reviews attempted to integrate the findings of included studies rather than map the evidence, and so reviews categorised as “answering a specific question” were excluded from the main analysis. Data visualisation methods for meta-analyses have been explored previously [ 19 ]. Figure  1 shows the flow of records from search results to final analysis sample.

Flow diagram of the sampling process

Data visualisation was defined as any graph or diagram that presented results data, including tables with a visual mapping element, such as cross-tabulations and heat maps. However, tables which displayed data at a study level (e.g. tables summarising key characteristics of each included study) were not included, even if they used symbols, shading or colour. Flow diagrams showing the study selection process were also excluded. Data visualisations in appendices or supplementary information were included, as well as any in publicly available dissemination products (e.g. visualisations hosted online) if mentioned in papers.

The typology used to categorise data visualisation methods was based on an existing online catalogue [ 20 ]. Specific types of data visualisation were categorised in five broad categories: graphs, diagrams, tables, maps/geographical and other. If a data visualisation appeared in our sample that did not feature in the original catalogue, we checked a second online catalogue [ 21 ] for an appropriate term, followed by wider Internet searches. These additional visualisation methods were added to the appropriate section of the typology. The final typology can be found in Additional file 1 .

We conducted descriptive data analysis in Microsoft Excel 2019 and present frequencies and percentages. Where appropriate, data are presented using graphs or other data visualisations created using Flourish. We also link to interactive versions of some of these visualisations.

Almost all of the 300 reviews in the total sample were labelled by review authors as “scoping reviews” ( n  = 293, 97.7%). There were also four “mapping reviews”, one “scoping study”, one “evidence mapping” and one that was described as a “scoping review and evidence map”. Included reviews were all published in 2020 or 2021, with the exception of one review published in 2018. Just over one-third of these reviews ( n  = 105, 35.0%) included some form of data visualisation. However, we excluded 62 reviews that did not focus on mapping evidence from the following analysis (see “ Methods ” section). Of the 238 remaining reviews (that either clearly aimed to map evidence or were judged to be “borderline”), 90 reviews (37.8%) included at least one data visualisation. The references for these reviews can be found in Additional file 2 .

Number of visualisations

Thirty-six (40.0%) of these 90 reviews included just one example of data visualisation (Fig.  2 ). Less than a third ( n  = 28, 31.1%) included three or more visualisations. The greatest number of data visualisations in one review was 17 (all bar or pie charts). In total, 222 individual data visualisations were identified across the sample of 238 reviews.

Number of data visualisations per review

Categories of data visualisation

Graphs were the most frequently used category of data visualisation in the sample. Over half of the reviews with data visualisation included at least one graph ( n  = 59, 65.6%). The least frequently used category was maps, with 15.6% ( n  = 14) of these reviews including a map.

Of the total number of 222 individual data visualisations, 102 were graphs (45.9%), 34 were tables (15.3%), 23 were diagrams (10.4%), 15 were maps (6.8%) and 48 were classified as “other” in the typology (21.6%).

Types of data visualisation

All of the types of data visualisation identified in our sample are reported in Table 2 . In total, 35 different types were used across the sample of reviews.

The most frequently used data visualisation type was a bar chart. Of 222 total data visualisations, 78 (35.1%) were a variation on a bar chart (either standard bar chart, stacked bar chart or multi-set bar chart). There were also 33 pie charts (14.9% of data visualisations) and 24 cross-tabulations (10.8% of data visualisations). In total, these five types of data visualisation accounted for 60.8% ( n  = 135) of all data visualisations. Figure  3 shows the frequency of each data visualisation category and type; an interactive online version of this treemap is also available ( https://public.flourish.studio/visualisation/9396133/ ). Figure  4 shows how users can further explore the data using the interactive treemap.

Data visualisation categories and types. An interactive version of this treemap is available online: https://public.flourish.studio/visualisation/9396133/ . Through the interactive version, users can further explore the data (see Fig.  4 ). The unit of this treemap is the individual data visualisation, so multiple data visualisations within the same scoping review are represented in this map. Created with flourish.studio ( https://flourish.studio )

Screenshots showing how users of the interactive treemap can explore the data further. Users can explore each level of the hierarchical treemap ( A Visualisation category >  B Visualisation subcategory >  C Variables presented in visualisation >  D Individual references reporting this category/subcategory/variable permutation). Created with flourish.studio ( https://flourish.studio )

Data presented

Around two-thirds of data visualisations in the sample presented a single variable ( n  = 143, 64.4%). The most frequently presented single variables were themes ( n  = 22, 9.9% of data visualisations), population ( n  = 21, 9.5%), country or region ( n  = 21, 9.5%) and year ( n  = 20, 9.0%). There were 58 visualisations (26.1%) that presented two different variables. The remaining 21 data visualisations (9.5%) presented three or more variables. Figure  5 shows the variables presented by each different type of data visualisation (an interactive version of this figure is available online).

Variables presented by each data visualisation type. Darker cells indicate a larger number of reviews. An interactive version of this heat map is available online: https://public.flourish.studio/visualisation/10632665/ . Users can hover over each cell to see the number of data visualisations for that combination of data visualisation type and variable. The unit of this heat map is the individual data visualisation, so multiple data visualisations within a single scoping review are represented in this map. Created with flourish.studio ( https://flourish.studio )

Most reviews presented at least one data visualisation in colour ( n  = 64, 71.1%). However, almost a third ( n  = 26, 28.9%) used only black and white or greyscale.

Interactivity

Only two of the reviews included data visualisations with any level of interactivity. One scoping review on music and serious mental illness [ 22 ] linked to an interactive bubble chart hosted online on Tableau. Functionality included the ability to filter the studies displayed by various attributes.

The other review was an example of evidence mapping from the environmental health field [ 23 ]. All four of the data visualisations included in the paper were available in an interactive format hosted either by the review management software or on Tableau. The interactive versions linked to the relevant references so users could directly explore the evidence base. This was the only review that provided this feature.

Software requirements

Nine reviews clearly reported the software used to create data visualisations. Three reviews used Tableau (one of them also used review management software as discussed above) [ 22 , 23 , 24 ]. Two reviews generated maps using ArcGIS [ 25 ] or ArcMap [ 26 ]. One review used Leximancer for a lexical analysis [ 27 ]. One review undertook a bibliometric analysis using VOSviewer [ 28 ], and another explored citation patterns using CitNetExplorer [ 29 ]. Other reviews used Excel [ 30 ] or R [ 26 ].

To our knowledge, this is the first systematic and in-depth exploration of the use of data visualisation techniques in scoping reviews. Our findings suggest that the majority of scoping reviews do not use any data visualisation at all, and, in particular, more innovative examples of data visualisation are rare. Around 60% of data visualisations in our sample were simple bar charts, pie charts or cross-tabulations. There appears to be very limited use of interactive online visualisation, despite the potential this has for communicating results to a range of stakeholders. While it is not always appropriate to use data visualisation (or a simple bar chart may be the most user-friendly way of presenting the data), these findings suggest that data visualisation is being underused in scoping reviews. In a large minority of reviews, visualisations were not published in colour, potentially limiting how user-friendly and attractive papers are to decision-makers and other stakeholders. Also, very few reviews clearly reported the software used to create data visualisations. However, 35 different types of data visualisation were used across the sample, highlighting the wide range of methods that are potentially available to scoping review authors.

Our results build on the limited research that has previously been undertaken in this area. Two previous publications also found limited use of graphs in scoping reviews. Results were “mapped graphically” in 29% of scoping reviews in any field in one 2014 publication [ 31 ] and 17% of healthcare scoping reviews in a 2016 article [ 6 ]. Our results suggest that the use of data visualisation has increased somewhat since these reviews were conducted. Scoping review methods have also evolved in the last 10 years; formal guidance on scoping review conduct was published in 2014 [ 32 ], and an extension of the PRISMA checklist for scoping reviews was published in 2018 [ 33 ]. It is possible that an overall increase in use of data visualisation reflects increased quality of published scoping reviews. There is also some literature supporting our findings on the wide range of data visualisation methods that are used in evidence synthesis. An investigation of methods to identify, prioritise or display health research gaps (25/139 included studies were scoping reviews; 6/139 were evidence maps) identified 14 different methods used to display gaps or priorities, with half being “more advanced” (e.g. treemaps, radial bar plots) ([ 34 ], p. 107). A review of data visualisation methods used in papers reporting meta-analyses found over 200 different ways of displaying data [ 19 ].

Only two reviews in our sample used interactive data visualisation, and one of these was an example of systematic evidence mapping from the environmental health field rather than a scoping review (in environmental health, systematic evidence mapping explicitly involves producing a searchable database [ 35 ]). A scoping review of papers on the use of interactive data visualisation in population health or health services research found a range of examples but still limited use overall [ 13 ]. For example, the authors noted the currently underdeveloped potential for using interactive visualisation in research on health inequalities. It is possible that the use of interactive data visualisation in academic papers is restricted by academic publishing requirements; for example, it is currently difficult to incorporate an interactive figure into a journal article without linking to an external host or platform. However, we believe that there is a lot of potential to add value to future scoping reviews by using interactive data visualisation software. Few reviews in our sample presented three or more variables in a single visualisation, something which can easily be achieved using interactive data visualisation tools. We have previously used EPPI-Mapper [ 36 ] to present results of a scoping review of systematic reviews on behaviour change in disadvantaged groups, with links to the maps provided in the paper [ 37 ]. These interactive maps allowed policy-makers to explore the evidence on different behaviours and disadvantaged groups and access full publications of the included studies directly from the map.

We acknowledge there are barriers to use for some of the data visualisation software available. EPPI-Mapper and some of the software used by reviews in our sample incur a cost. Some software requires a certain level of knowledge and skill in its use. However numerous online free data visualisation tools and resources exist. We have used Flourish to present data for this review, a basic version of which is currently freely available and easy to use. Previous health research has been found to have used a range of different interactive data visualisation software, much of which does not required advanced knowledge or skills to use [ 13 ].

There are likely to be other barriers to the use of data visualisation in scoping reviews. Journal guidelines and policies may present barriers for using innovative data visualisation. For example, some journals charge a fee for publication of figures in colour. As previously mentioned, there are limited options for incorporating interactive data visualisation into journal articles. Authors may also be unaware of the data visualisation methods and tools that are available. Producing data visualisations can be time-consuming, particularly if authors lack experience and skills in this. It is possible that many authors prioritise speed of publication over spending time producing innovative data visualisations, particularly in a context where there is pressure to achieve publications.

Limitations

A limitation of this study was that we did not assess how appropriate the use of data visualisation was in our sample as this would have been highly subjective. Simple descriptive or tabular presentation of results may be the most appropriate approach for some scoping review objectives [ 7 , 8 , 10 ], and the scoping review literature cautions against “over-using” different visual presentation methods [ 7 , 8 ]. It cannot be assumed that all of the reviews that did not include data visualisation should have done so. Likewise, we do not know how many reviews used methods of data visualisation that were not well suited to their data.

We initially relied on authors’ own use of the term “scoping review” (or equivalent) to sample reviews but identified a relatively large number of papers labelled as scoping reviews that did not meet the basic definition, despite the availability of guidance and reporting guidelines [ 10 , 33 ]. It has previously been noted that scoping reviews may be undertaken inappropriately because they are seen as “easier” to conduct than a systematic review ([ 3 ], p.6), and that reviews are often labelled as “scoping reviews” while not appearing to follow any established framework or guidance [ 2 ]. We therefore took the decision to remove these reviews from our main analysis. However, decisions on how to classify review aims were subjective, and we did include some reviews that were of borderline relevance.

A further limitation is that this was a sample of published reviews, rather than a comprehensive systematic scoping review as have previously been undertaken [ 6 , 31 ]. The number of scoping reviews that are published has increased rapidly, and this would now be difficult to undertake. As this was a sample, not all relevant scoping reviews or evidence maps that would have met our criteria were included. We used machine learning to screen our search results for pragmatic reasons (to reduce screening time), but we do not see any reason that our sample would not be broadly reflective of the wider literature.

Data visualisation, and in particular more innovative examples of it, is currently underused in published scoping reviews on health topics. The examples that we have found highlight the wide range of methods that scoping review authors could draw upon to present their data in an engaging way. In particular, we believe that interactive data visualisation has significant potential for mapping the available literature on a topic. Appropriate use of data visualisation may increase the usefulness, and thus uptake, of scoping reviews as a way of identifying existing evidence or research gaps by decision-makers, researchers and commissioners of research. We recommend that scoping review authors explore the extensive free resources and online tools available for data visualisation. However, we also think that it would be useful for publishers to explore allowing easier integration of interactive tools into academic publishing, given the fact that papers are now predominantly accessed online. Future research may be helpful to explore which methods are particularly useful to scoping review users.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Organisation formerly known as Joanna Briggs Institute

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

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Acknowledgements

We would like to thank Melissa Harden, Senior Information Specialist, Centre for Reviews and Dissemination, for advice on developing the search strategy.

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Both authors conceptualised and designed the study and contributed to screening, data extraction and the interpretation of results. ES undertook the literature searches, analysed data, produced the data visualisations and drafted the manuscript. MR contributed to revising the manuscript, and both authors read and approved the final version.

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Additional file 1..

Typology of data visualisation methods.

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References of scoping reviews included in main dataset.

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Spiritual nursing education programme for nursing students in Korea: a systematic review and meta-analysis

• Hyun-Jin Cho 1 ,
• Kyoungrim Kang 2 &
• Kyo-Yeon Park 1  

BMC Nursing volume  23 , Article number:  310 ( 2024 ) Cite this article

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Metrics details

This study conducts a systematic review and meta-analysis to understand the characteristics and contents of studies on spiritual nursing education programmes and their effects.

The literature search included five databases (RISS, KISS, DBpia, Science ON, and KmBase) published in South Korea until September 30, 2021. Nine studies were included in the final review, with six for the meta-analysis using the RevMan 5.4. 1 programme. The programmes targeted nursing students and nurses in the RN-BSN course and employed methods such as lecturing, discussions, and case presentations. The contents focused on self-spirituality awareness, spirituality-related concepts, understanding others’ spirituality, and the process and application of spiritual nursing.

The meta-analysis revealed statistically significant effects on spiritual nursing competencies, spirituality, spiritual well-being, existential well-being, and spiritual needs, except self-esteem. Spiritual nursing education was effective in enhancing spiritual nursing competencies.

The study confirmed that spiritual nursing education effectively improves spiritual nursing competency, indicating a need for increased focus and administrative and financial support for such education in schools and hospitals. Furthermore, future studies should employ randomised experimental designs to examine the effects of online education programmes with short training time on clinical nurses in hospitals.

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Introduction

Spiritual nursing involves providing care that recognises and responds to the spiritual needs of people in specific situations such as birth, trauma, illness, and loss [ 1 ]. It can provide answers to fundamental questions such as meaning of life, suffering, distress, and death through the person’s inner healing resources [ 2 ]. The physical, mental, social, and spiritual aspects of human beings dynamically interact with one another, with the spiritual aspect actively integrating and regulating all aspects [ 3 ]. The goal to enhance understanding and management of human health and disease has led to a growing interest in the spiritual aspect [ 4 ]. Spiritual nursing, as a trend, is reinforced as an essential obligation in modern nursing [ 5 ], which pursues holistic health management [ 6 ]. Therefore, spiritual nursing is considered an important core concept of holistic nursing [ 7 ].

Despite the importance of the spiritual aspect in health, most nurses have never received training in spiritual nursing and have little experience in utilizing it [ 8 ]. Nursing college students lack clinical practicum opportunities in spiritual nursing, hindering them to gain experience in this area [ 9 ]. Additionally, nurses often avoid spiritual nursing because they perceive it as a religious concept or as unscientific owing to the abstract nature of the spiritual aspect and their lack of knowledge [ 10 ]. Moreover, spiritual nursing can be challenging owing to lack of time, prioritisation of physical nursing tasks, and inadequate staff training [ 11 , 12 ].

Spiritual nursing education has been proposed as a solution to these problems, leading to the development of spiritual nursing education programmes [ 11 ]. Nurses must learn about spirituality and spiritual nursing to enhance patients’ quality of life, health, well-being, coping mechanisms, and decision-making [ 13 ]. Spiritual nursing education serves as means to integrate spiritual aspects into comprehensive patient care [ 14 ]. Previous studies have shown that spiritual nursing education increases nurses’ ability to assess spiritual needs, enhances their competency in spiritual care, and improves their performance in spiritual nursing [ 11 ]. Moreover, nurses’ positive attitudes towards spiritual nursing influence their intention to engage in spiritual nursing and provide spiritual care [ 4 ]. Therefore, spiritual nursing education should aim to improve nurses’ attitude towards spiritual nursing and promote the application of spiritual nursing [ 15 ].

Spiritual nursing education programmes apply various curricula, content, delivery, and evaluation methods [ 16 ]. The educational content varies and may include the definition of spirituality or spiritual nursing, personal spiritual awareness, understanding of spiritual anguish, communication skills, comparative religious studies, and spiritual nursing ethics. Similarly, the educational methods employed comprise lectures, online education, simulation, role-plays, videos, group discussions, individual reflections, and practice [ 11 , 13 , 14 ]. This diversity arises from the lack of consensus on the meaning of spirituality and the unclear content and evaluation methods for spiritual nursing education programmes [ 1 ]. However, it also offers the opportunity to learn different approaches to caring for individuals from different social, cultural, and spiritual backgrounds [ 13 ]. Furthermore, diverse education programmes can serve as foundation for applying the most effective approach in situations requiring spiritual nursing education. Therefore, a systematic review can help in identifying strategies for integrating spirituality and spiritual nursing by examining the contents and teaching and evaluation methods of spiritual nursing education programmes.

Although several studies abroad conducted systematic reviews of spiritual nursing education programmes [ 11 , 13 , 14 ], only one phenomenological study [ 17 ] examined the experiences that Korean nursing students could potentially gain through spiritual nursing practicum and only one randomised controlled trial (RCT) study [ 18 ] investigated the effectiveness of spirituality training programmes focusing solely on spirituality on Korean nurses. Thus, a systematic review of spiritual nursing education programmes in Korea is necessary. In particular, Christianity began as a medical mission in Korea, establishing Korea’s first modern hospital, and subsequently expanded [ 19 ]. Consequently, nurses confused spiritual nursing with medical mission and perceived spiritual nursing as a compulsion to a certain religion [ 20 ], or Christian evangelism [ 21 ]. Moreover, the Korean culture values dignity and the views of others rather than the personal factors of self-satisfaction. The pursuit of spirituality also values harmony with the absolute, others, ancestors, and society [ 3 ]. Therefore, a spiritual nursing education programme that considers Korea’s cultural practices is necessary [ 22 ] to implement spiritual nursing in the nursing field.

Thus, using previous studies’ results related to the spiritual nursing education programmes in Korea, this study aims to systematically and scientifically integrate the contents, methods, and effects of these programmes. It seeks to develop and apply an effective programme for evidence-based practice, providing evidence for enhancing spiritual nursing competency and guiding future research directions.

Study design

This study is a systematic review that aims to understand the characteristics and effects of spiritual nursing education programmes on nurses and nursing students in Korea. The study used the systematic review manual of the National Evidence-based Healthcare Collaborating Agency [ 23 ]. The protocol for this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO, ID: CRD42022326776).

Search strategy and study selection

Studies published up to September 30, 2021, were examined using electronic databases. Earlier studies [ 10 , 12 , 13 ] published in 2015, 2016, and 2021 conducted systematic literature reviews of spiritual nursing education programmes using foreign databases and did not search the domestic literature suitable for the eligibility criteria of this study. Therefore, this study utilized the five most used databases in Korea: the Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), DataBase Periodical Information Academic (DBpia), Science ON (formerly National Discovery for Science Library [NDSL]), and KmBase. There was no restriction on the search period, and all documents corresponding to related subject words were searched until the search date (September 30, 2021). To increase sensitivity of the literature search, grey literature was manually searched using Google Scholar. Furthermore, additional literature was searched by reviewing the reference lists of studies obtained through the database search. ‘Nurse’, ‘nursing student’, ‘spiritual nursing’, ‘education’, and ‘programme’ were used as literature search terms. Three researchers independently performed the literature selection process. Intervention studies on the effectiveness of spiritual nursing education programmes for nurses or nursing students were included, while review articles, conference abstracts, or unpublished manuscripts were excluded. The full inclusion and exclusion criteria are presented in Table  1 .

Data extraction and quality assessment

Relevant data were extracted using a standardised data collection form, which included information on authors, publication year, research design, study subjects (number, grade), programme characteristics (training place, type, session/time/period/evaluation time, education methods, conceptual framework, and contents), measurement tools, variable measurement results, limitations, and suggestions (Tables  2 and 3 ). The Cochran’s Risk of Bias (Cochrane’s RoB 1) tool was used to evaluate the quality of the selected literature as randomised study [ 24 ]. Cochrane’s RoB 1 assesses seven areas: randomisation order generation, random assignment order concealment, blinding of study participants and researchers, blinding of outcome evaluation, insufficient data, selective reporting, and other biases. Each area was rated as having low, high, or uncertain risk of bias in the literature. Non-randomised studies were evaluated using the Risk of Bias Assessment Tool for Non-randomised Studies (RoBANS) [ 25 ] developed by the National Evidence-based Healthcare Collaborating Agency [ 23 ]. RoBANS assesses six areas: subject group selection, confounding variables, intervention (exposure) measurement, blinding outcome evaluation, incomplete data, and selective outcome reporting. Each area was evaluated as having low, high, or uncertain risk of bias. In this study, the risk of bias is considered low for non-randomised studies if the subjects were similar in the experimental and control groups and were prospectively and continuously recruited. The risk of bias is considered low also if the intervention was made after confirmation of exposure to spiritual nursing-related education, a questionnaire with confirmed reliability and validity was used, blinding to the outcome evaluator was reported, dropouts and reasons were reported or missing values did not affect the outcome, or the outcome value for the pre-defined outcome variable was reported. Three researchers independently evaluated each piece of literature, and any disagreements were resolved through discussion.

Data synthesis and meta-analysis

For studies where quantitative synthesis was possible, we conducted a meta-analysis using the RevMan 5.4.1 programme from the Cochrane Library. This was performed when the same outcome variables could be analysed, or when pre- and post-mean and standard deviation values for the outcome variables were available. Subgroup meta-analysis was performed when at least two studies had the same outcome variables. In calculating the effect size, the result variables of each synthesised study were analysed as continuous variables, with mean and standard deviation. The Standardised Mean Difference (SMD) was selected as the analysis method for effect size of the same outcome variable. The statistical significance level for effect size was set at 0.05, and the confidence interval was set at 95%. Heterogeneity between studies was assessed for the common part in the confidence interval and effect estimate using a meta-analysis forest plot, a visual method. Heterogeneity was quantitatively evaluated using Cochrane’s chi-square test and Higgins’ I 2 statistic value. The I 2 value is 0% when there is no heterogeneity, 30-60% when there is moderate heterogeneity, and more than 75% when there is large heterogeneity [ 23 ].

Analysis was conducted using a random-effects model, which adjusts weights to account for intersubject variation and heterogeneity between the studies used in meta-analysis. Given the diversity in samples, intervention methods, intervention period, and measurement tools across studies, the random-effects model was used when the heterogeneity was I 2  = 50% or higher. When inputting data, if the outcome variables were measured twice, only the value calculated immediately after training was included. If the standard deviation for the difference before and after education was missing, the correlation coefficient calculated in another study was used and the missing standard deviation was replaced using the correlation coefficient [ 23 ].

Study selection and characteristics

Literature was obtained using electronic databases, and a literature review was conducted according to the reporting guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We then carried out a literature search and identified 612 studies: 425 from RISS, 19 from KISS, 95 from DBpia, 64 from Science ON, and nine from KmBase. After removing 318 duplicate papers using RefWorks, we reviewed the titles and abstracts of 294 papers based on the inclusion and exclusion criteria; 280 studies that did not fit the study purpose were excluded. After a detailed review of the full texts of the remaining 14 studies in detail, one study with unverifiable original text, two studies focusing solely on spirituality rather than spiritual nursing, and three theses duplicating academic papers were excluded. Eight studies were thus included. Additionally, two studies found in the reference lists of the selected studies were reviewed, with one meeting the inclusion criteria. The original text of the other study could not be confirmed. Finally, nine articles were selected for the systematic review (see Additional file 1 ). Among these, six studies suitable for quantitative synthesis were meta-analysed. Disagreements among the three researchers were resolved through discussion. The exclusion of literature at each selection stages was recorded, and the document selection process was described using the systematic review flow chart [ 26 ] from the Preferred Reporting Items for Systematic Reviews and Meta Analysis 2020 (Fig.  1 ).

Flow diagram of study selection process

Characteristics of selected literature

All nine studies considered were published in journals in Korea. Two studies each were published in 2016 and 2019, and one study each was published in 1999, 2011, 2014, 2018, and 2021. The study designs were as follows: three were single-group pre-post-quasi experimental studies, three were quasi-experimental studies with non-equivalent control groups, two were pre- and post-non-synchronised quasi-experimental studies with non-equivalent control groups, and one was a randomised control pre- and post-experimental study. Seven studies focused on nursing students, while two targeted nurses in a bachelor’s degree programme (Registered Nurse-Bachelor of Science in Nursing, RN-BSN). Among the nine studies, six included 80 to 99 participants, and three included 60 to 79 participants. Four studies targeted junior students, two targeted senior students, two targeted students in first and second semesters of the RN-BSN course, and one targeted sophomore students. All training sessions were conducted in university classrooms. Five programmes utilised non-formal education, while four were operated through regular education courses. The training session durations were as follows: four studies conducted training sessions for 120 min each, two studies for 60 min each, two studies for 90 min each, and one for 150 min. As for the number of sessions, three studies have had seven sessions each, while the remaining six studies have had eight, nine, 10, 12, 14, and 16 sessions, respectively.

Characteristics of spiritual nursing education programmes

1) Teaching methods and content of spiritual nursing education programmes.

All nine studies in the review conducted lectures as a teaching method. Eight studies incorporated presentations, seven used discussions, three employed case studies, two featured practice sessions, and two included role-play. Additionally, relaxation techniques, action learning, and various tests were used. As for evaluation methods, four studies used reports and two used paper-written exams. Among the nine studies that provided lectures using PowerPoint (PPT) as an educational medium, seven also used various videos. Furthermore, one study presented photos, and another utilized sound equipment for relaxation. Six studies employed the conceptual framework, with three utilizing the Actioning Spirituality and Spiritual Care Education and Training in nursing (ASSET) model, two employing the textbook ‘Spiritual Nursing Module: Completion of Holistic Care’, one using the Analysis, Design, Development, Implementation, Evaluation (ADDIE) model, one applying the Psychological Empowerment Theory, and one implementing the Rogers Human-Centred Theory. Three studies did not mention any conceptual framework.

The content of spiritual nursing education was categorised into self-awareness, concepts related to spirituality, understanding of others, spiritual nursing process, and spiritual nursing applications. As for self-awareness, eight studies focused on examining the ego state to revise self-image through positive objective self-recognition in the first and second sessions of the programme. Each study included self-reflection in the third and ninth sessions. Four studies used tests such as ego-gram, MBTI, and enneagram tests, while five applied a holistic understanding of humans. The spiritual nursing process (assessment, diagnosis, planning, intervention, and evaluation) was included in all nine studies. Spiritual nursing intervention methods included therapeutic self-use such as being present together, attentive listening, touch, massage, lettering, poetry, laughter therapy, music therapy, occupational therapy, horticultural therapy, walking, meditation, use of the Bible, prayer, hymns using, support for religious activities, spiritual counselling, clergy referral, and offering support groups. The spiritual nursing process was covered in sessions 3 to 11 of the programme for training in spiritual nursing practice.

Eight studies applied spiritual nursing in various contexts: they targeted general, surgical, cancer, elderly, paediatric, and end-of-life patients, employed spiritual nursing in clinical situations, and explored spiritual nursing case studies and presentations. One study conducted a practicum at facilities for single mothers, the disabled, orphanages, and hospitals. Another study focused on nurses in bachelor’s degree programmes, asking them to apply their spiritual nursing education in practice by selecting patients themselves. The application of spiritual nursing was typically introduced in the latter part of the programme for practical use in clinical settings. Additionally, some studies included Nightingale’s nursing philosophy as educational content, while others explored the meaning of life and death.

2) Effects of spiritual nursing education programmes.

The effectiveness of spiritual nursing education programmes was confirmed using measures such as spiritual care competency (eight studies), spiritual well-being (six studies), spirituality (four studies), spiritual needs (three studies), existential well-being (two studies), self-esteem (two studies), self-identity (one study), life satisfaction (one study), empathy (one study), communication ability (one study), and attitude towards death (one study). All surveys were conducted using self-report questionnaires. Measurements were taken before and after training in eight studies, and before, after, and five weeks after training in one study.

In eight studies that measured spiritual care competency as a major variable, all spiritual care competency levels showed significant increase after intervention in the spiritual nursing education programme. However, for the sub-domains of spiritual care competency, one study did not demonstrate any significant difference in ‘professionalisation and improving the quality of spiritual care’ and ‘referral to professionals’, while another study did not show significant difference in ‘communication’. Three studies did not specify subdomain, and some studies measured only the ‘assessment and implementation of spiritual care’, ‘professionalisation and improving the quality of spiritual care’, and ‘personal support and patient counselling’ among the elements of spiritual care competency.

Among the six studies focusing on spiritual well-being, four showed a significant increase in spiritual well-being, one found no significant difference in religious well-being in the subdomain, and another showed no significant difference in existential well-being. Regarding the four studies that measured spirituality as a major variable, three showed a significant increase in the degree of spirituality, while one showed no significant change in transcendence in the subdomain. In studies measuring spiritual need as the main variable, all three studies showed significant differences, although one reported a significant decrease in spiritual need. Two studies reported a significant increase in spiritual need, with one showing no significant difference in the subdomains of ‘love and peace’ and ‘the meaning and purposes of life’.

Both studies that measured existential well-being as the main variable showed a significant increase in its degree. However, only one of the two studies measuring self-esteem as a major variable showed a significant increase in the degree of self-esteem. The studies measuring self-identity, life satisfaction, and empathy as the main variables showed significant increases, while one study measuring communication ability showed no significant difference. One study measured attitude towards death as a major variable. A significant increase was found in the need for prolonging the life of terminally ill patients and for an organisation dedicated to protection facilities, dedicated personnel, and the elderly problem. However, no significant differences were found in response to dying patient’s needs, death notice, attitude towards the dying, general attitude towards death, and dying patient’s family problems before and after education.

Evaluation of the quality of included literature

The quality evaluation of a randomised study using Cochrane’s RoB tool showed a low risk of bias. Random numbers were assigned using a random numbering programme to ‘generate random assignment order’, and the allocation table was covered in an opaque envelope to ‘hide allocation order’. For the items ‘blind for research participants and researcher’ and ‘blind for outcome evaluation’, the assignment table was managed by an assistant involved in the curriculum, thus preventing exposure of the order to the experimental and control groups until the start of spiritual education. As for ‘insufficient result data’, dropouts occurred in both groups for similar causes, and the risk of bias was rated as low in ‘selective reporting’ and ‘other bias’.

Of the eight non-randomised studies evaluated using the RoBANS tool, for the ‘subject group selection’ item, four studies confirmed that the experimental and control groups were the same or from the same period, and as the subjects did not receive spiritual nursing education at the time of study participation, it resulted in a low risk of bias. However, in one study, it was unclear whether there was an intervention in the study participants during the study participation. Additionally, in three studies, participants were not continuously recruited, leading to a high risk of bias. In terms of the ‘confounder variable’ items, five studies identified and appropriately considered the confounding variables, resulting in a low risk of bias, but the risk was uncertain in three studies. All eight studies used self-response for the ‘intervention exposure measurement’ item. Seven studies used the tools verified in previous studies, suggesting low risk of bias due to tool reliability. One study developed a tool by extracting from the literature, but as its validity and reliability were not presented, the risk of bias was high. The information reported in all eight studies was insufficient for the item ‘blindness for outcome evaluation’. ‘Incomplete outcome data’ showed low risk of bias in seven studies, except for one study with large difference in missing values between the groups. One study was evaluated as having high risk of bias for the ‘selective outcome report’ item owing to undefined results, while seven studies had low risk of bias by including all expected results (Fig.  2 ).

Risk of bias graph for non-randomized controlled studies

Outcome variables and effect size of the included literature

Of the nine studies, six compared the effects of a spiritual nursing education programme that included the control group that did not receive treatment. These studies presented the pre- and post-mean and standard deviation of the outcome variables, enabling effect size analysis (Fig.  3 ).

Forest plot of meta analysis on effects of spiritual care education

The examination of six studies measuring spiritual care competency as a major variable showed no homogeneity in the homogeneity test (Higgins I²=94%). As for effect size between the experimental and control groups of the programmes, the experimental group exhibited a 1.56 increase in spiritual care competency compared to the control group ( n  = 460, SMD = 1.56, 95% CI 0.70 to 2.43), indicating a statistically significant difference (Z = 3.56, p  = .0004).

The examination of four studies measuring spirituality as a major variable showed no homogeneity in the homogeneity test (Higgins I²=90%). As for effect size, the experimental group showed a 0.82 increase in spirituality compared to the control group ( n  = 317, SMD = 0.82, 95% CI 0.08 to 1.55), indicating a statistically significant difference (Z = 2.18, p  = .03).

The examination of four papers measuring spiritual well-being as a major variable showed no homogeneity in the homogeneity test (Higgins I²=85%). As for effect size, the experimental group exhibited a 0.65 increase in spiritual well-being compared to the control group ( n  = 317, SMD = 0.65, 95% CI 0.07 to 1.24), indicating a statistically significant difference (Z = 2.18, p  = .03).

The examination of two studies measuring existential well-being as a major variable showed no homogeneity in the homogeneity tests (Higgins I²=72%). As for effect size, the experimental group showed a 0.76 increase in existential well-being compared to the control group ( n  = 143, SMD = 0.76, 95% CI 0.11 to 1.40), indicating a statistically significant difference (Z = 2.31, p  = .02).

The examination of two studies measuring spiritual needs as a major variable showed no homogeneity in the homogeneity tests (Higgins I²=0%). As for effect size, the experimental group exhibited a 0.51 increase in spiritual need compared to the control group ( n  = 153, SMD = 0.51, 95% CI 0.19 to 0.83), indicating a statistically significant difference (Z = 3.11, p  = .002).

The examination of two studies measuring self-esteem as a major variable showed no homogeneity in the homogeneity tests (Higgins I²=94%). As for effect size, the experimental group showed a 1.06 increase in self-esteem compared to the control group ( n  = 143, SMD = 1.06, 95% CI − 0.43 to 2.55), indicating no statistically significant difference (Z = 1.40, p  = .16).

The systematic review and meta-analysis aimed to confirm the characteristics and contents of spiritual nursing education programme research, identify the effect of the spiritual nursing education programme, develop a spiritual nursing education programme by integrating education content and methods, and provide evidence for interventions strengthening the spiritual care competency.

This study confirmed that although interest and attempts in interventional research in spiritual nursing education are increasing, research on spiritual nursing education programmes in Korea is still not actively conducted. These results are similar to those of previous systematic reviews in other countries that showed increasing focus on spiritual nursing education for healthcare professionals [ 11 , 14 ]. However, compared to the increase in observational studies on spiritual nursing [ 22 ], intervention studies on spiritual nursing education were insufficient and required comprehensive implementation.

As for the study participants, seven studies were conducted on nursing students, including those in the RN-BSN course. Nursing students are easier to recruit than nurses, as education for students is implemented in a classroom setting, eliminating the need for an intervention environment. However, in a systematic review of spiritual nursing education, Jones and Paal [ 11 ] identified 13 studies on nursing students and 14 studies on nurses conducted over the past ten years. Unlike in Korea, researchers in other countries actively conduct studies on intervention in educational programmes targeting nurses. Six studies included in this review also suggested that research on clinical nurses be conducted [ 6 , 8 , 10 , 27 , 28 , 29 ]. It is crucial to explore whether spiritual nursing education programmes for nurses can affect the provision of spiritual nursing intervention to patients. Therefore, developing and actively applying practical spiritual nursing education programmes at the hospital level is necessary to enable the practice of spiritual nursing.

In terms of study design, eight out of nine studies were quasi-experimental ones, with three [ 27 , 28 , 30 ] among them using a one-group pre-post design. Difficulties could arise in designing a randomised controlled experimental study because students could not choose a class in regular course education, and time and psychological constraints pose challenges for students in special lecture-type education [ 31 ]. Limited availability of randomised controlled experimental studies led to the inclusion of quasi-experimental studies, which is a limitation of this study. Future studies should consider an RCT design to prevent subject selection bias and to clearly measure the effect of spiritual nursing education. Additionally, only one study performed a follow-up evaluation after five weeks of education [ 29 ], suggesting the need to consider a follow-up period to confirm continuity of the study results.

The duration of training sessions ranged from 60 to 150 min, with 120 min being the most common. This duration was likely based on the form of regular education or special lectures for nursing students and organised according to the average credits per class for bachelor’s degrees. Previous systematic review studies conducted abroad reported varying teaching hours, ranging from 30-minute to an all-day lectures [ 11 ]. This may be because, as found in a study on nurses, training was provided to them during lunch breaks or in the form of workshops, depending on the situation [ 32 ]. Previous studies have reported that spiritual nursing education was effective even in a short curriculum [ 11 ]. Therefore, when planning future research for three-shift nurses, it is necessary to consider short training duration to secure sufficient time for education.

In most studies, educational programmes were conducted in the form of general lectures, which is the most common educational method. However, research on nurses must address the shortcomings of face-to-face education considering the difficulty in adjusting nurses’ schedules owing to shift work. As previous international studies have proven the effectiveness of online spiritual nursing education [ 33 , 34 , 35 , 36 ], it is necessary to consider online non-face-to-face education. Additionally, field practice for spiritual nursing application was conducted in only one study [ 28 ], while two studies suggested research to combine theory and practice [ 10 , 37 ]. As field practice prepare nurses to function in real situations [ 38 ], more studies should conduct field practices. Furthermore, for research targeting nursing students, considering that practicum is currently limited due to COVID-19, education through simulation must be applied as it is effective as actual clinical practicum in increasing confidence in nursing performance [ 39 ].

Regarding the content of spiritual nursing education, most programmes were based on the ASSET model, consisting of self-awareness, spirituality, understanding of others, and the spiritual nursing process and application. Most studies approached spirituality from a cross-religious perspective, with spiritual nursing intervention providing education focused on existential and religious well-being. This result is consistent with previous systematic review studies [ 11 ], where spirituality was taught not as part of religion, but comprehensively. Many people in Korea believe that spiritual nursing is related to a specific religion [ 20 ]. However, since Korea has various religions such as shamanism, Buddhism, Confucianism, and Christianity [ 3 ], spirituality was approached from various perspectives. Moreover, most of the spiritual nursing education programmes in Korea showed a holistic rather than religious approach [ 8 ]. This trend is also reflected in the definition of the multidimensional domain of spirituality and spiritual nursing adopted by the European Education Project for the Development of Standards for Spiritual Nursing Education [ 1 ]. Therefore, future studies should approach spirituality and spiritual nursing as multidimensional educational content meant to provide meaning and purpose to life beyond religion.

Studies in Korea focused on teaching communication skills to broaden the understanding of the spiritual needs of others and training on enhancing empathy and providing hope. The effectiveness of spiritual nursing education was measured by its relationship with the subject as a spiritual nursing provider, including communication, empathy, spiritual needs, and spiritual care competency. In contrast, previous international systematic reviews [ 11 , 13 , 14 ] focused more on recognising one’s own spirituality, training on self-reflection to broaden the understanding of individual spirituality, and measuring the changes in viewpoint, knowledge, and attitude towards individual spirituality and spiritual nursing. This difference may be attributed to the socio-cultural characteristics of Korea, which value harmony with family and community rather than individuals [ 3 ]. Thus, the educational content on spirituality and spiritual nursing in Korea focuses more on understanding others and performing spiritual nursing for the spiritual well-being of patients rather than on self-awareness or personal spirituality. Particularly, therapeutic communication skills are required to broaden the understanding of the spiritual needs of others, assess their spiritual needs, and support patients with a professional competency that improves spiritual nursing quality [ 8 ]. Therefore, a spiritual nursing education applicable to nursing practice, such as scenarios related to therapeutic communication and communication skills for certain situations, is necessary [ 8 ].

This systematic review found that spiritual nursing education programme improves spiritual care competency. This finding is consistent with the results of previous systematic reviews from other countries [ 11 , 13 , 14 ] and confirms the need for spiritual nursing education to address the challenges faced in related practice. All eight studies in this review used tools developed by Van Leeuwen and Tiesinga [ 40 ], but one study did not show any significant difference in ‘professionalisation and improving the quality of spiritual care’ and ‘referral to professionals’ from among the subfields of spiritual care competency [ 37 ]. Multidisciplinary collaboration between nurses and hospital clergy is necessary for a religious approach to the transcendental relationship of spirituality in performing spiritual nursing. As professional referrals are an important area of spiritual care competency that addresses the spiritual needs of the subject beyond the role of a nurse [ 40 ], a specific multidisciplinary approach in spiritual nursing education is necessary.

Studies measuring the effect of spiritual nursing education on spiritual well-being and spirituality showed different results, especially when checking the subdomains. No significant differences were found between the ‘religious well-being’ subdomains of spiritual well-being and the ‘transcendence’ subdomains of spirituality. This could be due to difficulties in reflecting the level of spirituality and spiritual well-being of subjects with no religion when measuring the ‘religious well-being’ subdomain of spiritual well-being or in the ‘transcendence’ subdomain of spirituality. Therefore, studies should revise and supplement the tools for measuring spirituality and spiritual well-being by reflecting the meaning of the changing concepts.

Some studies examined the effects of spiritual nursing education on spiritual needs. One study reported a decrease in spiritual needs after implementation of spiritual nursing education, suggesting ways to meet the spiritual needs of nurses through self-awareness and application of learnings [ 28 ]. However, two studies reported that increase in spiritual needs can be considered as increased sensitivity to one’s spiritual needs through spiritual nursing education and would help understand the spiritual needs of patients [ 6 , 12 ]. These contradictory findings indicate that the reliability and validity of the measurement tool should be checked to confirm the effectiveness of spiritual nursing education and that presenting clear standards is necessary for result interpretation.

Studies in Korea used eleven variables to confirm the effectiveness of the spiritual nursing education programme. Systematic review studies [ 11 , 14 ] from other countries used various variables such as the Spirituality and Spiritual Care Rating Scale, Spiritual Transcendence Scale, Spiritual Perspective Scale, Spiritual Care Inventory, and Spiritual Care in Practice Survey to confirm the effectiveness of spiritual nursing education. To meet the spiritual needs of nursing students, self-awareness to understand one’s spirituality is crucial [ 11 ]. Future studies examining the effectiveness of spiritual nursing education should consider other variables, such as evaluating nurses’ perceptions of spirituality and spiritual nursing [ 41 ] and measuring the effect of spiritual nursing performance on nurses [ 42 ]. The studies included in this study have limitations in subjective evaluation because all measurements of the effectiveness of spiritual nursing education were measured using self-reported questionnaires. Prior studies from other countries showed that the objectivity of the effect measurement of spiritual nursing education increased after providing spiritual nursing education for nurses [ 43 ]. One study objectified the effect of spiritual nursing education by examining the number of spiritual nursing interventions before and after spiritual nursing education [ 44 ]. For objective evaluation, evaluation checklists, in which the evaluation criteria are objectively presented not only for self-evaluation, can be used for head nurses or patients. Various other methods can be considered for more objective evaluation by using standardised measurements for the subject’s spiritual nursing intervention skill level, number of executions, performance accuracy, and knowledge level [ 45 ]. Therefore, future studies should confirm the effectiveness of spiritual nursing education by using more objective, reliable, and valid measurement methods and tools.

The meta-analysis showed that the spiritual nursing education programme increased spiritual nursing competency, spirituality, spiritual well-being, existential well-being, and spiritual needs. Understanding one’s spirituality helps in understanding the spiritual needs of others by reflecting on one’s own spiritual beliefs in the process of identifying individual spirituality and spiritual needs through self-awareness at the beginning of the spiritual nursing education programme. Spiritual nursing education [ 14 ] aim to develop sensitivity to spiritual nursing, clarify the importance of spirituality and spiritual nursing in healthcare, and present a spiritual nursing intervention method. Thus, it can affect the acknowledgement of individual spirituality and the integration of spirituality in clinical practice and communication with patients [ 14 ].

However, the quality of studies included may pose the risk of randomisation-related bias because of the minimal number of randomised trials used, with the possibility of the effect estimates of the outcome variables being overestimated when interpreting the results. Moreover, the study had limitations in explaining the effect as only six studies were included in the meta-analysis, most results showed large heterogeneity, and moderation effect analysis was not conducted because less than ten studies were selected.

Nevertheless, this study can be meaningful in a few aspects. We tried to comprehensively and scientifically synthesise individual study results confirming the effectiveness of spiritual nursing education programmes for nurses and nursing students in Korea. In particular, we aim to contribute to the planning of the future directions of spiritual nursing education intervention research by providing the content and teaching methods of programmes. Furthermore, diverse outcome variables were explored and integrated to estimate the significance of the effects of spiritual nursing education programmes.

Conclusions

This study examined the teaching methods and contents of spiritual nursing education programmes for nurses and nursing students and confirmed their effectiveness. The teaching methods included lectures, discussions, and case presentations, while the contents included self-spiritual awareness, spirituality-related concepts, understanding the spirituality of others, and the spiritual nursing process and application. To confirm the effects of education programmes, we mainly used variables related to spiritual care competency. Spiritual nursing education increased spiritual care competency and individual spirituality. The meta-analysis showed statistically significant effects on spiritual nursing competency, spirituality, spiritual well-being, existential well-being, and spiritual demand, but not on self-esteem. This study’s findings on the characteristics of spiritual nursing education programmes in Korea can help develop and apply programmes for nursing students and nurses. Given the improvement in spiritual nursing competency, more attention and administrative and financial support for spiritual nursing education programmes in schools and hospitals should be provided. To further advance this science, more randomised experimental studies on the effectiveness of spiritual nursing education on clinical nurses is necessary. Furthermore, future studies should examine whether short online training is effective and verify its continued effects through a long-term follow-up study. We also recommend developing and applying spiritual nursing education programmes considering Korean practices, such as spiritual nursing interventions that addresses spiritual needs arising from relationships with others and promoting existential well-being full of meaning and purpose in life.

Data availability

The supplementary material used for this study can be found in Additional file 1 . The datasets used or analysed for the current study are available from the corresponding author on reasonable request.

Abbreviations

Analysis Design Development Implementation Evaluation

Actioning, Spirituality and Spiritual Care Education and Training in nursing

Cochrane’s Risk of Bias

DataBase Periodical Information Academic

International Council of Nurses

Korean Studies Information Service System

National Discovery for Science Library

Participants, Intervention, Comparison, Outcome, and Study Design

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Randomised Controlled Trial

Research Information Sharing Service

Registered Nurse-Bachelor of Science in Nursing

Risk of Bias Assessment Tool for Non-randomised Studies

Standardised Mean Difference

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Hyun-Jin Cho & Kyo-Yeon Park

College of Nursing, Research Institute of Nursing Science, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, South Korea

Kyoungrim Kang

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HJC and KK were involved in the conception and design of the study. All authors discussed inclusion and exclusion criteria. HJC and KYP searched databases, screened articles, and all authors discussed inclusion of articles. All authors were involved in data collection, and data analysis plans, as well as drafting the manuscript. HJC performed meta-analysis, and KK supervised the research. All authors were involved in the critical review of the article, writing, drafting, and editing the final document for publication. All authors have read and agreed with the final version of the manuscript.

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Cho, HJ., Kang, K. & Park, KY. Spiritual nursing education programme for nursing students in Korea: a systematic review and meta-analysis. BMC Nurs 23 , 310 (2024). https://doi.org/10.1186/s12912-024-01961-6

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Received : 02 March 2023

Accepted : 22 April 2024

Published : 07 May 2024

DOI : https://doi.org/10.1186/s12912-024-01961-6

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