synthesis definition literature example

Literature Syntheis 101

How To Synthesise The Existing Research (With Examples)

By: Derek Jansen (MBA) | Expert Reviewer: Eunice Rautenbach (DTech) | August 2023

One of the most common mistakes that students make when writing a literature review is that they err on the side of describing the existing literature rather than providing a critical synthesis of it. In this post, we’ll unpack what exactly synthesis means and show you how to craft a strong literature synthesis using practical examples.

This post is based on our popular online course, Literature Review Bootcamp . In the course, we walk you through the full process of developing a literature review, step by step. If it’s your first time writing a literature review, you definitely want to use this link to get 50% off the course (limited-time offer).

Overview: Literature Synthesis

• What exactly does “synthesis” mean?
• Aspect 1: Agreement
• Aspect 2: Disagreement
• Aspect 3: Key theories
• Aspect 4: Contexts
• Aspect 5: Methodologies
• Bringing it all together

What does “synthesis” actually mean?

As a starting point, let’s quickly define what exactly we mean when we use the term “synthesis” within the context of a literature review.

Simply put, literature synthesis means going beyond just describing what everyone has said and found. Instead, synthesis is about bringing together all the information from various sources to present a cohesive assessment of the current state of knowledge in relation to your study’s research aims and questions .

Put another way, a good synthesis tells the reader exactly where the current research is “at” in terms of the topic you’re interested in – specifically, what’s known , what’s not , and where there’s a need for more research .

So, how do you go about doing this?

Well, there’s no “one right way” when it comes to literature synthesis, but we’ve found that it’s particularly useful to ask yourself five key questions when you’re working on your literature review. Having done so,  you can then address them more articulately within your actual write up. So, let’s take a look at each of these questions.

1. Points Of Agreement

The first question that you need to ask yourself is: “Overall, what things seem to be agreed upon by the vast majority of the literature?”

For example, if your research aim is to identify which factors contribute toward job satisfaction, you’ll need to identify which factors are broadly agreed upon and “settled” within the literature. Naturally, there may at times be some lone contrarian that has a radical viewpoint , but, provided that the vast majority of researchers are in agreement, you can put these random outliers to the side. That is, of course, unless your research aims to explore a contrarian viewpoint and there’s a clear justification for doing so. 

Identifying what’s broadly agreed upon is an essential starting point for synthesising the literature, because you generally don’t want (or need) to reinvent the wheel or run down a road investigating something that is already well established . So, addressing this question first lays a foundation of “settled” knowledge.

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2. Points Of Disagreement

Related to the previous point, but on the other end of the spectrum, is the equally important question: “Where do the disagreements lie?” .

In other words, which things are not well agreed upon by current researchers? It’s important to clarify here that by disagreement, we don’t mean that researchers are (necessarily) fighting over it – just that there are relatively mixed findings within the empirical research , with no firm consensus amongst researchers.

This is a really important question to address as these “disagreements” will often set the stage for the research gap(s). In other words, they provide clues regarding potential opportunities for further research, which your study can then (hopefully) contribute toward filling. If you’re not familiar with the concept of a research gap, be sure to check out our explainer video covering exactly that .

3. Key Theories

The next question you need to ask yourself is: “Which key theories seem to be coming up repeatedly?” .

Within most research spaces, you’ll find that you keep running into a handful of key theories that are referred to over and over again. Apart from identifying these theories, you’ll also need to think about how they’re connected to each other. Specifically, you need to ask yourself:

• Are they all covering the same ground or do they have different focal points  or underlying assumptions ?
• Do some of them feed into each other and if so, is there an opportunity to integrate them into a more cohesive theory?
• Do some of them pull in different directions ? If so, why might this be?
• Do all of the theories define the key concepts and variables in the same way, or is there some disconnect? If so, what’s the impact of this ?

Simply put, you’ll need to pay careful attention to the key theories in your research area, as they will need to feature within your theoretical framework , which will form a critical component within your final literature review. This will set the foundation for your entire study, so it’s essential that you be critical in this area of your literature synthesis.

If this sounds a bit fluffy, don’t worry. We deep dive into the theoretical framework (as well as the conceptual framework) and look at practical examples in Literature Review Bootcamp . If you’d like to learn more, take advantage of our limited-time offer to get 60% off the standard price.

4. Contexts

The next question that you need to address in your literature synthesis is an important one, and that is: “Which contexts have (and have not) been covered by the existing research?” .

For example, sticking with our earlier hypothetical topic (factors that impact job satisfaction), you may find that most of the research has focused on white-collar , management-level staff within a primarily Western context, but little has been done on blue-collar workers in an Eastern context. Given the significant socio-cultural differences between these two groups, this is an important observation, as it could present a contextual research gap .

In practical terms, this means that you’ll need to carefully assess the context of each piece of literature that you’re engaging with, especially the empirical research (i.e., studies that have collected and analysed real-world data). Ideally, you should keep notes regarding the context of each study in some sort of catalogue or sheet, so that you can easily make sense of this before you start the writing phase. If you’d like, our free literature catalogue worksheet is a great tool for this task.

5. Methodological Approaches

Last but certainly not least, you need to ask yourself the question: “What types of research methodologies have (and haven’t) been used?”

For example, you might find that most studies have approached the topic using qualitative methods such as interviews and thematic analysis. Alternatively, you might find that most studies have used quantitative methods such as online surveys and statistical analysis.

But why does this matter?

Well, it can run in one of two potential directions . If you find that the vast majority of studies use a specific methodological approach, this could provide you with a firm foundation on which to base your own study’s methodology . In other words, you can use the methodologies of similar studies to inform (and justify) your own study’s research design .

On the other hand, you might argue that the lack of diverse methodological approaches presents a research gap , and therefore your study could contribute toward filling that gap by taking a different approach. For example, taking a qualitative approach to a research area that is typically approached quantitatively. Of course, if you’re going to go against the methodological grain, you’ll need to provide a strong justification for why your proposed approach makes sense. Nevertheless, it is something worth at least considering.

Regardless of which route you opt for, you need to pay careful attention to the methodologies used in the relevant studies and provide at least some discussion about this in your write-up. Again, it’s useful to keep track of this on some sort of spreadsheet or catalogue as you digest each article, so consider grabbing a copy of our free literature catalogue if you don’t have anything in place.

Bringing It All Together

Alright, so we’ve looked at five important questions that you need to ask (and answer) to help you develop a strong synthesis within your literature review.  To recap, these are:

• Which things are broadly agreed upon within the current research?
• Which things are the subject of disagreement (or at least, present mixed findings)?
• Which theories seem to be central to your research topic and how do they relate or compare to each other?
• Which contexts have (and haven’t) been covered?
• Which methodological approaches are most common?

Importantly, you’re not just asking yourself these questions for the sake of asking them – they’re not just a reflection exercise. You need to weave your answers to them into your actual literature review when you write it up. How exactly you do this will vary from project to project depending on the structure you opt for, but you’ll still need to address them within your literature review, whichever route you go.

The best approach is to spend some time actually writing out your answers to these questions, as opposed to just thinking about them in your head. Putting your thoughts onto paper really helps you flesh out your thinking . As you do this, don’t just write down the answers – instead, think about what they mean in terms of the research gap you’ll present , as well as the methodological approach you’ll take . Your literature synthesis needs to lay the groundwork for these two things, so it’s essential that you link all of it together in your mind, and of course, on paper.

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 .

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Get Organized

• Lit Review Prep Use this template to help you evaluate your sources, create article summaries for an annotated bibliography, and a synthesis matrix for your lit review outline.

Synthesize your Information

Synthesize: combine separate elements to form a whole.

Synthesis Matrix

A synthesis matrix helps you record the main points of each source and document how sources relate to each other.

After summarizing and evaluating your sources, arrange them in a matrix or use a citation manager to help you see how they relate to each other and apply to each of your themes or variables.  

By arranging your sources by theme or variable, you can see how your sources relate to each other, and can start thinking about how you weave them together to create a narrative.

• Step-by-Step Approach
• Example Matrix from NSCU
• Matrix Template
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How to Synthesize Written Information from Multiple Sources

Shona McCombes

Content Manager

B.A., English Literature, University of Glasgow

Shona McCombes is the content manager at Scribbr, Netherlands.

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Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

On This Page:

When you write a literature review or essay, you have to go beyond just summarizing the articles you’ve read – you need to synthesize the literature to show how it all fits together (and how your own research fits in).

Synthesizing simply means combining. Instead of summarizing the main points of each source in turn, you put together the ideas and findings of multiple sources in order to make an overall point.

At the most basic level, this involves looking for similarities and differences between your sources. Your synthesis should show the reader where the sources overlap and where they diverge.

Unsynthesized Example

Franz (2008) studied undergraduate online students. He looked at 17 females and 18 males and found that none of them liked APA. According to Franz, the evidence suggested that all students are reluctant to learn citations style. Perez (2010) also studies undergraduate students. She looked at 42 females and 50 males and found that males were significantly more inclined to use citation software ( p < .05). Findings suggest that females might graduate sooner. Goldstein (2012) looked at British undergraduates. Among a sample of 50, all females, all confident in their abilities to cite and were eager to write their dissertations.

Synthesized Example

Studies of undergraduate students reveal conflicting conclusions regarding relationships between advanced scholarly study and citation efficacy. Although Franz (2008) found that no participants enjoyed learning citation style, Goldstein (2012) determined in a larger study that all participants watched felt comfortable citing sources, suggesting that variables among participant and control group populations must be examined more closely. Although Perez (2010) expanded on Franz’s original study with a larger, more diverse sample…

Step 1: Organize your sources

After collecting the relevant literature, you’ve got a lot of information to work through, and no clear idea of how it all fits together.

Before you can start writing, you need to organize your notes in a way that allows you to see the relationships between sources.

One way to begin synthesizing the literature is to put your notes into a table. Depending on your topic and the type of literature you’re dealing with, there are a couple of different ways you can organize this.

Summary table

A summary table collates the key points of each source under consistent headings. This is a good approach if your sources tend to have a similar structure – for instance, if they’re all empirical papers.

Each row in the table lists one source, and each column identifies a specific part of the source. You can decide which headings to include based on what’s most relevant to the literature you’re dealing with.

For example, you might include columns for things like aims, methods, variables, population, sample size, and conclusion.

For each study, you briefly summarize each of these aspects. You can also include columns for your own evaluation and analysis.

The summary table gives you a quick overview of the key points of each source. This allows you to group sources by relevant similarities, as well as noticing important differences or contradictions in their findings.

Synthesis matrix

A synthesis matrix is useful when your sources are more varied in their purpose and structure – for example, when you’re dealing with books and essays making various different arguments about a topic.

Each column in the table lists one source. Each row is labeled with a specific concept, topic or theme that recurs across all or most of the sources.

Then, for each source, you summarize the main points or arguments related to the theme.

The purposes of the table is to identify the common points that connect the sources, as well as identifying points where they diverge or disagree.

Step 2: Outline your structure

Now you should have a clear overview of the main connections and differences between the sources you’ve read. Next, you need to decide how you’ll group them together and the order in which you’ll discuss them.

For shorter papers, your outline can just identify the focus of each paragraph; for longer papers, you might want to divide it into sections with headings.

There are a few different approaches you can take to help you structure your synthesis.

If your sources cover a broad time period, and you found patterns in how researchers approached the topic over time, you can organize your discussion chronologically .

That doesn’t mean you just summarize each paper in chronological order; instead, you should group articles into time periods and identify what they have in common, as well as signalling important turning points or developments in the literature.

If the literature covers various different topics, you can organize it thematically .

That means that each paragraph or section focuses on a specific theme and explains how that theme is approached in the literature.

Source Used with Permission: The Chicago School

If you’re drawing on literature from various different fields or they use a wide variety of research methods, you can organize your sources methodologically .

That means grouping together studies based on the type of research they did and discussing the findings that emerged from each method.

If your topic involves a debate between different schools of thought, you can organize it theoretically .

That means comparing the different theories that have been developed and grouping together papers based on the position or perspective they take on the topic, as well as evaluating which arguments are most convincing.

Step 3: Write paragraphs with topic sentences

What sets a synthesis apart from a summary is that it combines various sources. The easiest way to think about this is that each paragraph should discuss a few different sources, and you should be able to condense the overall point of the paragraph into one sentence.

This is called a topic sentence , and it usually appears at the start of the paragraph. The topic sentence signals what the whole paragraph is about; every sentence in the paragraph should be clearly related to it.

A topic sentence can be a simple summary of the paragraph’s content:

“Early research on [x] focused heavily on [y].”

For an effective synthesis, you can use topic sentences to link back to the previous paragraph, highlighting a point of debate or critique:

“Several scholars have pointed out the flaws in this approach.” “While recent research has attempted to address the problem, many of these studies have methodological flaws that limit their validity.”

By using topic sentences, you can ensure that your paragraphs are coherent and clearly show the connections between the articles you are discussing.

As you write your paragraphs, avoid quoting directly from sources: use your own words to explain the commonalities and differences that you found in the literature.

Don’t try to cover every single point from every single source – the key to synthesizing is to extract the most important and relevant information and combine it to give your reader an overall picture of the state of knowledge on your topic.

Step 4: Revise, edit and proofread

Like any other piece of academic writing, synthesizing literature doesn’t happen all in one go – it involves redrafting, revising, editing and proofreading your work.

Checklist for Synthesis

•   Do I introduce the paragraph with a clear, focused topic sentence?
•   Do I discuss more than one source in the paragraph?
•   Do I mention only the most relevant findings, rather than describing every part of the studies?
•   Do I discuss the similarities or differences between the sources, rather than summarizing each source in turn?
•   Do I put the findings or arguments of the sources in my own words?
•   Is the paragraph organized around a single idea?
•   Is the paragraph directly relevant to my research question or topic?
•   Is there a logical transition from this paragraph to the next one?

Further Information

How to Synthesise: a Step-by-Step Approach

Help…I”ve Been Asked to Synthesize!

Learn how to Synthesise (combine information from sources)

How to write a Psychology Essay

Related Articles

Student Resources

How To Cite A YouTube Video In APA Style – With Examples

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APA References Page Formatting and Example

APA Title Page (Cover Page) Format, Example, & Templates

How do I Cite a Source with Multiple Authors in APA Style?

How to Write a Psychology Essay

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How to Write a Literature Review

• 6. Synthesize
• Literature Reviews: A Recap
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• 4. Manage Your References
• 5. Critically Analyze and Evaluate

Synthesis Visualization

Synthesis matrix example.

• 7. Write a Literature Review

• Synthesis Worksheet

About Synthesis

Approaches to synthesis.

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

How to Begin?

Read your sources carefully and find the main idea(s) of each source

Look for similarities in your sources – which sources are talking about the same main ideas? (for example, sources that discuss the historical background on your topic)

Use the worksheet (above) or synthesis matrix (below) to get organized

This work can be messy. Don't worry if you have to go through a few iterations of the worksheet or matrix as you work on your lit review!

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.

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Click on the example to view the pdf.

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Literature reviews: synthesis.

• Criticality

Synthesise Information

So, how can you create paragraphs within your literature review that demonstrates your knowledge of the scholarship that has been done in your field of study?  

You will need to present a synthesis of the texts you read.  

Doug Specht, Senior Lecturer at the Westminster School of Media and Communication, explains synthesis for us in the following video:  

Synthesising Texts  

What is synthesis? 

Synthesis is an important element of academic writing, demonstrating comprehension, analysis, evaluation and original creation.  

With synthesis you extract content from different sources to create an original text. While paraphrase and summary maintain the structure of the given source(s), with synthesis you create a new structure.  

The sources will provide different perspectives and evidence on a topic. They will be put together when agreeing, contrasted when disagreeing. The sources must be referenced.  

Perfect your synthesis by showing the flow of your reasoning, expressing critical evaluation of the sources and drawing conclusions.  

When you synthesise think of "using strategic thinking to resolve a problem requiring the integration of diverse pieces of information around a structuring theme" (Mateos and Sole 2009, p448). 

Synthesis is a complex activity, which requires a high degree of comprehension and active engagement with the subject. As you progress in higher education, so increase the expectations on your abilities to synthesise. 

How to synthesise in a literature review: 

Identify themes/issues you'd like to discuss in the literature review. Think of an outline.  

Read the literature and identify these themes/issues.  

Critically analyse the texts asking: how does the text I'm reading relate to the other texts I've read on the same topic? Is it in agreement? Does it differ in its perspective? Is it stronger or weaker? How does it differ (could be scope, methods, year of publication etc.). Draw your conclusions on the state of the literature on the topic.  

Start writing your literature review, structuring it according to the outline you planned.  

Put together sources stating the same point; contrast sources presenting counter-arguments or different points.  

Present your critical analysis.  

Always provide the references. 

The best synthesis requires a "recursive process" whereby you read the source texts, identify relevant parts, take notes, produce drafts, re-read the source texts, revise your text, re-write... (Mateos and Sole, 2009). 

What is good synthesis?  

The quality of your synthesis can be assessed considering the following (Mateos and Sole, 2009, p439):  

Integration and connection of the information from the source texts around a structuring theme. 

Selection of ideas necessary for producing the synthesis. 

Appropriateness of the interpretation.  

Elaboration of the content.  

Example of Synthesis

Original texts (fictitious): 

Synthesis: 

Animal experimentation is a subject of heated debate. Some argue that painful experiments should be banned. Indeed it has been demonstrated that such experiments make animals suffer physically and psychologically (Chowdhury 2012; Panatta and Hudson 2016). On the other hand, it has been argued that animal experimentation can save human lives and reduce harm on humans (Smith 2008). This argument is only valid for toxicological testing, not for tests that, for example, merely improve the efficacy of a cosmetic (Turner 2015). It can be suggested that animal experimentation should be regulated to only allow toxicological risk assessment, and the suffering to the animals should be minimised.   

Bibliography

Mateos, M. and Sole, I. (2009). Synthesising Information from various texts: A Study of Procedures and Products at Different Educational Levels. European Journal of Psychology of Education,  24 (4), 435-451. Available from https://doi.org/10.1007/BF03178760 [Accessed 29 June 2021].

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Video Transcripts: Analyzing & Synthesizing Sources: Synthesis: Definition and Examples

Analyzing & synthesizing sources: synthesis: definition and examples.

Last updated 11/8/2016

Video Length: 2:50

Visual: The screen shows the Walden University Writing Center logo along with a pencil and notebook. “Walden University Writing Center.” “Your writing, grammar, and APA experts” appears in center of screen. The background changes to the title of the video with open books in the background.

Audio: Guitar music plays.

Visual: Slide changes to the title “Moving Towards Synthesis” and the following:

Interpreting, commenting on, explaining, discussion of, or making connections between MULTIPLE ideas and sources for the reader.

Often answers questions such as:

• What do these things mean when put together?
• How do you as the author interpret what you’ve presented?

Audio : Synthesis is a lot like, I like to say it's like analysis on steroids. It's a lot like analysis, where analysis is you're commenting or interpreting one piece of evidence or one idea, one paraphrase or one quote. Synthesis is where you take multiple pieces of evidence or multiple sources and their ideas and you talk about the connections between those ideas or those sources. And you talk about where they intersect or where they have commonalities or where they differ. And that's what synthesis is. But really, in synthesis, when we have synthesis, it really means we're working with multiple pieces of evidence and analyzing them.

Visual: Slide changes to the title “Examples of Synthesis” and the following example:

Ang (2016) found that small businesses that followed the theory of financial management reduced business costs by 12%, while Sonfield (2015) found that this theory reduced costs by 17%. These studies together confirmed that adopting the theory of financial management reduces costs for U.S. small businesses.

Audio: So here's an example for you. In this eaxmple we have Ang (2016), that's source number 1, right? Then Sonfield (2015), that's source number 2. They are both using this theory and found that it reduced costs by both 12% and 17%. So this is my evidence, right?

I have one sentence, but two pieces of evidence, because we're working with two different sources, Ang and Sonfield, one and two. In my next sentence, my last sentence here, we have my piece of synthesis. Because I'm taking these two sources and saying that they both found something very similar. They confirmed that adopting the theory for financial management reduces costs for small businesses. So I'm showing the commonality between these two sources. So it's a very, sort of, not simple, but, you know, clean approach to synthesis. It's a very direct approach to kind of showing the similarities between these two sources. So that's an example of synthesis, okay.

Visual : The following example is added to the slide:

Sharpe (2016) observed an increase in students’ ability to focus after they had recess. Similarly, Barnes (2015) found that hands-on activities also helped students focus. Both of these techniques have worked well in my classroom, helping me to keep my students engaged in learning.

Audio: Another example here. So Sharpe found that one thing helps students. Barnes found another thing helps students focus. Two different sources, two different ideas. In the bold sentence of synthesis, I'm taking these two ideas together and talking about how they have both worked well in my classroom.

The synthesis that we have here kind of take two different approaches. The first example is more about how these studies confirm something. The second example is about how these two ideas can be useful in my own practice, I'm applying it to my own practice, or the author is applying it to their own practice in the classroom. But they both are examples of synthesis and taking different pieces of evidence showing how they work together or relate, okay.

I kind of like to think of synthesis as taking two pieces of a puzzle. So each piece of evidence is a piece of the puzzle. And you're putting together those pieces for the reader and saying, look, this is the overall picture, right? This is what we can see, when these two pieces--or three pieces--of the puzzle are put together. So it's kind of like putting together a puzzle.

Visual: “Walden University Writing Center. Questions? E-mail [email protected] ” appears in center of screen.

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Literature Reviews

• Introduction: What, Who & Why
• Define a topic
• Identify keywords
• More search tips
• Understand & Analyse

How to synthesise

Synthesis, a written example, synthesising tools.

• More resources
• Accessing help
• Systematic Style Reviews Guide

Synthesis & theme

Synthesising the content of your analysis means you need to explain and provide an original interpretation of what you've read by highlighting relationships (or lack thereof), between your sources.

Organise and categorise your content into themes or patterns. Examples of themes include:

• Chronological
• Geographical
• Theory, issue or question
• Importance (most to least); or
• Topical (general to specific).
• Synthesis Matrix
• 5 ways to tame the literature dragon
• Using a matrix to organise your notes

How not to write.

Smith (1970) reported that bilbies come out at night and eat chocolates. Jones (1972) described the variety of beetles eaten by bilbies on their daytime trips. Wheeler (1974) reported that bilbies eat only apples.

How to write.

The elusive bilby has provoked considerable disagreement over such essential facts as whether it is diurnal or nocturnal, and what constitutes its staple diet. Smith (1970) considered them to be nocturnal whereas Jones (1972) reported that they are daytime foragers. A similar disagreement about food preference can be observed in Smith (1970) who  reported bilbies had a fondness for chocolate, and in Jones (1974) who believed bilbies eat beetles and Wheeler (1974) who maintained that apples were the staple food. However, neither chocolate nor apples are indigenous to the bilby habitat, and it seems improbable that they are the main foodstuffs for bilbies.

Grouping papers by theme

Use this matrix to group papers according to themes you have identified in your topic.

• Literature review matrix by theme

Answering a specific question

Use this matrix to group papers according to the questions you asked when analysing your sources.

• Literature review matrix by question

 Remember, it is common to use more than one method to record your notes.

Evaluating or scoring resources as you go can be helpful, you may like to add a column to your matrix for recording some type of coding system such as a + or -  or numerical value.

Spreadsheets: Creating Matrixes using spreadsheets can be useful if you have a lot of resources and you need to sort the information you have collected.

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3.2 Synthesizing literature

Learning objectives.

• Connect the sources you read with key concepts in your research question and proposal
• Systematize the information and facts from each source you read

Putting the pieces together

Combining separate elements into a whole is the dictionary definition of synthesis. It is a way to make connections among and between numerous and varied source materials. A literature review is not an annotated bibliography, organized by title, author, or date of publication. Rather, it is grouped by topic and argument to create a whole view of the literature relevant to your research question.

Your synthesis must demonstrate a critical analysis of the papers you collected, as well as your ability to integrate the results of your analysis into your own literature review. Each source you collect should be critically evaluated and weighed based on the criteria from Chapter 2 before you include it in your review.

Begin the synthesis process by creating a grid, table, or an outline where you will summarize your literature review findings, using common themes you have identified and the sources you have found. The summary, grid, or outline will help you compare and contrast the themes, so you can see the relationships among them as well as areas where you may need to do more searching. A basic summary table is provided in Figure 3.2. Whichever method you choose, this type of organization will help you to both understand the information you find and structure the writing of your review. Remember, although “the means of summarizing can vary, the key at this point is to make sure you understand what you’ve found and how it relates to your topic and research question” (Bennard et al., 2014, para. 10).

As you read through the material you gather, look for common themes as they may provide the structure for your literature review. And, remember, writing a literature review is an iterative process. It is not unusual to go back and search academic databases for more sources of information as you read the articles you’ve collected.

Literature reviews can be organized sequentially or by topic, theme, method, results, theory, or argument. It’s important to develop categories that are meaningful and relevant to your research question. Take detailed notes on each article and use a consistent format for capturing all the information each article provides. These notes and the summary table can be done manually using note cards. However, given the amount of information you will be recording, an electronic file created in a word processing or spreadsheet (like this example Literature Search Template ) is more manageable. Examples of fields you may want to capture in your notes include:

• Authors’ names
• Article title
• Publication year
• Main purpose of the article
• Methodology or research design
• Participants
• Measurement
• Conclusions

Other fields that will be useful when you begin to synthesize the sum total of your research:

• Specific details of the article or research that are especially relevant to your study
• Key terms and definitions
• Strengths or weaknesses in research design
• Relationships to other studies
• Possible gaps in the research or literature (for example, many research articles conclude with the statement “more research is needed in this area”)
• Finally, note how closely each article relates to your topic. You may want to rank these as high, medium, or low relevance. For papers that you decide not to include, you may want to note your reasoning for exclusion, such as small sample size, local case study, or lacks evidence to support conclusions.

An example of how to organize summary tables by author or theme is shown in Table 3.1.

Here is an example summary table template .

Creating a topical outline

An alternative way to organize your articles for synthesis it to create an outline. After you have collected the articles you intend to use (and have put aside the ones you won’t be using), it’s time to extract as much as possible from the facts provided in those articles. You are starting your research project without a lot of hard facts on the topics you want to study, and by using the literature reviews provided in academic journal articles, you can gain a lot of knowledge about a topic in a short period of time.

As you read an article in detail, try copying the information you find relevant to your research topic in a separate word processing document. Copying and pasting from PDF to Word can be a pain because PDFs are image files not documents. To make that easier, use the HTML version of the article, convert the PDF to Word in Adobe Acrobat or another PDF reader, or use “paste special” command to paste the content into Word without formatting. If it’s an old PDF, you may have to simply type out the information you need. It can be a messy job, but having all of your facts in one place is very helpful for drafting your literature review.  Of course, you will not be using other authors’ words in your own literature review, but this is a good way to start compiling your notes.

You should copy and paste any fact or argument you consider important. Some good examples include definitions of concepts, statistics about the size of the social problem, and empirical evidence about the key variables in the research question, among countless others. It’s a good idea to consult with your professor and the syllabus for the course about what they are looking for when they read your literature review. Facts for your literature review are principally found in the introduction, results, and discussion section of an empirical article or at any point in a non-empirical article. Copy and paste into your notes anything you may want to use in your literature review.

Importantly, you must make sure you note the original source of that information. Nothing is worse than searching your articles for hours only to realize you forgot to note where your facts came from. If you found a statistic that the author used in the introduction, it almost certainly came from another source that the author cited in a footnote or internal citation. You will want to check the original source to make sure the author represented the information correctly. Moreover, you may want to read the original study to learn more about your topic and discover other sources relevant to your inquiry.

Assuming you have pulled all of the facts out of multiple articles, it’s time to start thinking about how these pieces of information relate to each other. Start grouping each fact into categories and subcategories as shown in Figure 3.3. For example, a statistic stating that homeless single adults are more likely to be male may fit into a category of gender and homelessness. For each topic or subtopic you identified during your critical analysis of each paper, determine what those papers have in common. Likewise, determine which ones in the group differ. If there are contradictory findings, you may be able to identify methodological or theoretical differences that could account for the contradiction. For example, one study may sample only high-income earners or those in a rural area. Determine what general conclusions you can report about the topic or subtopic, based on all of the information you’ve found.

Create a separate document containing a topical outline that combines your facts from each source and organizes them by topic or category. As you include more facts and more sources into your topical outline, you will begin to see how each fact fits into a category and how categories are related to each other. Your category names may change over time, as may their definitions. This is a natural reflection of the learning you are doing.

A complete topical outline is a long list of facts, arranged by category about your topic. As you step back from the outline, you should understand the topic areas where you have enough information to make strong conclusions about what the literature says. You should also assess in what areas you need to do more research before you can write a robust literature review. The topical outline should serve as a transitional document between the notes you write on each source and the literature review you submit to your professor. It is important to note that they contain plagiarized information that is copied and pasted directly from the primary sources. That’s okay because these are just notes and are not meant to be turned in as your own ideas. For your final literature review, you must paraphrase these sources to avoid plagiarism. More importantly, you should keep your voice and ideas front-and-center in what you write as this is your analysis of the literature. Make strong claims and support them thoroughly using facts you found in the literature. We will pick up the task of writing your literature review in section 3.3.

Additional resources for synthesizing literature

There are many ways to approach synthesizing literature. We’ve reviewed two examples here: summary tables and topical outlines. Other examples you may encounter include annotated bibliographies and synthesis matrices. As you are learning research, find a method that works for you. Reviewing the literature is a core component of evidence-based practice in social work at any level. See the resources below if you need some additional help:

Literature Reviews: Using a Matrix to Organize Research  / Saint Mary’s University of Minnesota

Literature Review: Synthesizing Multiple Sources  / Indiana University

Writing a Literature Review and Using a Synthesis Matrix  / Florida International University

Sample Literature Reviews Grid  / Complied by Lindsay Roberts

Killam, Laura (2013) . Literature review preparation: Creating a summary table . Includes transcript.

Key Takeaways

• It is necessary to take notes on research articles as you read. Try to develop a system that works for you to keep your notes organized, such as a summary table.
• Summary tables and topical outlines help researchers synthesize sources for the purpose of writing a literature review.

Image attributions

Pieces of the puzzle by congerdesign cc-0, adult diary by pexels cc-0.

• Figure 3.2 copied from Frederiksen, L. & Phelps, S. F. (2018). Literature reviews for education and nursing graduate students. Shared under a CC-BY 4.0 license. ↵
• This table was adapted from the work of Amanda Parsons ↵

Guidebook for Social Work Literature Reviews and Research Questions Copyright © 2020 by Rebecca Mauldin and Matthew DeCarlo is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Synthesizing Sources

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When you look for areas where your sources agree or disagree and try to draw broader conclusions about your topic based on what your sources say, you are engaging in synthesis. Writing a research paper usually requires synthesizing the available sources in order to provide new insight or a different perspective into your particular topic (as opposed to simply restating what each individual source says about your research topic).

Note that synthesizing is not the same as summarizing.  

• A summary restates the information in one or more sources without providing new insight or reaching new conclusions.
• A synthesis draws on multiple sources to reach a broader conclusion.

There are two types of syntheses: explanatory syntheses and argumentative syntheses . Explanatory syntheses seek to bring sources together to explain a perspective and the reasoning behind it. Argumentative syntheses seek to bring sources together to make an argument. Both types of synthesis involve looking for relationships between sources and drawing conclusions.

In order to successfully synthesize your sources, you might begin by grouping your sources by topic and looking for connections. For example, if you were researching the pros and cons of encouraging healthy eating in children, you would want to separate your sources to find which ones agree with each other and which ones disagree.

After you have a good idea of what your sources are saying, you want to construct your body paragraphs in a way that acknowledges different sources and highlights where you can draw new conclusions.

As you continue synthesizing, here are a few points to remember:

• Don’t force a relationship between sources if there isn’t one. Not all of your sources have to complement one another.
• Do your best to highlight the relationships between sources in very clear ways.
• Don’t ignore any outliers in your research. It’s important to take note of every perspective (even those that disagree with your broader conclusions).

Example Syntheses

Below are two examples of synthesis: one where synthesis is NOT utilized well, and one where it is.

Parents are always trying to find ways to encourage healthy eating in their children. Elena Pearl Ben-Joseph, a doctor and writer for KidsHealth , encourages parents to be role models for their children by not dieting or vocalizing concerns about their body image. The first popular diet began in 1863. William Banting named it the “Banting” diet after himself, and it consisted of eating fruits, vegetables, meat, and dry wine. Despite the fact that dieting has been around for over a hundred and fifty years, parents should not diet because it hinders children’s understanding of healthy eating.

In this sample paragraph, the paragraph begins with one idea then drastically shifts to another. Rather than comparing the sources, the author simply describes their content. This leads the paragraph to veer in an different direction at the end, and it prevents the paragraph from expressing any strong arguments or conclusions.

An example of a stronger synthesis can be found below.

Parents are always trying to find ways to encourage healthy eating in their children. Different scientists and educators have different strategies for promoting a well-rounded diet while still encouraging body positivity in children. David R. Just and Joseph Price suggest in their article “Using Incentives to Encourage Healthy Eating in Children” that children are more likely to eat fruits and vegetables if they are given a reward (855-856). Similarly, Elena Pearl Ben-Joseph, a doctor and writer for Kids Health , encourages parents to be role models for their children. She states that “parents who are always dieting or complaining about their bodies may foster these same negative feelings in their kids. Try to keep a positive approach about food” (Ben-Joseph). Martha J. Nepper and Weiwen Chai support Ben-Joseph’s suggestions in their article “Parents’ Barriers and Strategies to Promote Healthy Eating among School-age Children.” Nepper and Chai note, “Parents felt that patience, consistency, educating themselves on proper nutrition, and having more healthy foods available in the home were important strategies when developing healthy eating habits for their children.” By following some of these ideas, parents can help their children develop healthy eating habits while still maintaining body positivity.

In this example, the author puts different sources in conversation with one another. Rather than simply describing the content of the sources in order, the author uses transitions (like "similarly") and makes the relationship between the sources evident.

A Guide to Evidence Synthesis: What is Evidence Synthesis?

• Meet Our Team
• Our Published Reviews and Protocols
• What is Evidence Synthesis?
• Types of Evidence Synthesis
• Evidence Synthesis Across Disciplines
• Finding and Appraising Existing Systematic Reviews
• 0. Develop a Protocol
• 1. Draft your Research Question
• 2. Select Databases
• 3. Select Grey Literature Sources
• 4. Write a Search Strategy
• 5. Register a Protocol
• 6. Translate Search Strategies
• 7. Citation Management
• 8. Article Screening
• 9. Risk of Bias Assessment
• 10. Data Extraction
• 11. Synthesize, Map, or Describe the Results
• Evidence Synthesis Institute for Librarians
• Open Access Evidence Synthesis Resources

What are Evidence Syntheses?

What are evidence syntheses.

According to the Royal Society, 'evidence synthesis' refers to the process of bringing together information from a range of sources and disciplines to inform debates and decisions on specific issues. They generally include a methodical and comprehensive literature synthesis focused on a well-formulated research question.  Their aim is to identify and synthesize all  of the scholarly research on a particular topic, including both published and unpublished studies. Evidence syntheses are conducted in an unbiased, reproducible way to provide evidence for practice and policy-making, as well as to identify gaps in the research. Evidence syntheses may also include a meta-analysis, a more quantitative process of synthesizing and visualizing data retrieved from various studies. 

Evidence syntheses are much more time-intensive than traditional literature reviews and require a multi-person research team. See this PredicTER tool to get a sense of a systematic review timeline (one type of evidence synthesis). Before embarking on an evidence synthesis, it's important to clearly identify your reasons for conducting one. For a list of types of evidence synthesis projects, see the next tab.

How Does a Traditional Literature Review Differ From an Evidence Synthesis?

How does a systematic review differ from a traditional literature review.

One commonly used form of evidence synthesis is a systematic review.  This table compares a traditional literature review with a systematic review.

Video: Reproducibility and transparent methods (Video 3:25)

Reporting Standards

There are some reporting standards for evidence syntheses. These can serve as guidelines for protocol and manuscript preparation and journals may require that these standards are followed for the review type that is being employed (e.g. systematic review, scoping review, etc). ​

• PRISMA checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses.
• PRISMA-P Standards An updated version of the original PRISMA standards for protocol development.
• PRISMA - ScR Reporting guidelines for scoping reviews and evidence maps
• PRISMA-IPD Standards Extension of the original PRISMA standards for systematic reviews and meta-analyses of individual participant data.
• EQUATOR Network The EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network is an international initiative that seeks to improve the reliability and value of published health research literature by promoting transparent and accurate reporting and wider use of robust reporting guidelines. They provide a list of various standards for reporting in systematic reviews.

Video: Guidelines and reporting standards

PRISMA Flow Diagram

The  PRISMA  flow diagram depicts the flow of information through the different phases of an evidence synthesis. It maps the search (number of records identified), screening (number of records included and excluded), and selection (reasons for exclusion).  Many evidence syntheses include a PRISMA flow diagram in the published manuscript.

See below for resources to help you generate your own PRISMA flow diagram.

• PRISMA Flow Diagram Tool
• PRISMA Flow Diagram Word Template
• << Previous: Our Published Reviews and Protocols
• Next: Types of Evidence Synthesis >>
• Last Updated: May 6, 2024 12:12 PM
• URL: https://guides.library.cornell.edu/evidence-synthesis

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Definition of synthesis

• amalgamation
• combination
• intermixture

Examples of synthesis in a Sentence

These examples are programmatically compiled from various online sources to illustrate current usage of the word 'synthesis.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples.

Word History

Greek, from syntithenai to put together, from syn- + tithenai to put, place — more at do

1589, in the meaning defined at sense 1a

Phrases Containing synthesis

synthesis gas

Dictionary Entries Near synthesis

Cite this entry.

“Synthesis.” Merriam-Webster.com Dictionary , Merriam-Webster, https://www.merriam-webster.com/dictionary/synthesis. Accessed 16 May. 2024.

Kids Definition

Kids definition of synthesis, medical definition, medical definition of synthesis, more from merriam-webster on synthesis.

Nglish: Translation of synthesis for Spanish Speakers

Britannica English: Translation of synthesis for Arabic Speakers

Britannica.com: Encyclopedia article about synthesis

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Synthesis Examples

Synthesis means putting together separate parts to make a whole. When you are asked to synthesize something in a literary sense, it most commonly means taking information presented in multiple texts and putting it together to form one new text that includes information from separate sources.

Synthesis is more than summarizing. When you synthesize information, you put together information in a new way. Instead of just summarizing what different sources say on a topic, you pull together the information from the various sources to say something new and more complex than the original texts.

If you are asked to synthesize information, it is best to think about all of the things you have read and then develop a main idea or thesis for your own writing before you begin. This will help you to avoid just summarizing the different texts.

When scholars do a literature review as part of a dissertation study, they are engaging in synthesis . The research and read many different articles and studies pertaining to their topic and then determine what the current literature has to say about the topic. They must synthesize the current literature in order to say something meaningful about it.

Doctors engage in synthesis when they read various lab reports and data. For example, a doctor may review blood work or labs, review basic vital signs such as temperature and blood pressure, and also listen to what the patient is saying about how he or she feels. The doctor will synthesize information from all of these sources to determine a diagnosis and treatment plan.

Here is a brief example of synthesizing information given in several sentences.

Marissa saw a strange man enter the gym this morning. He was dressed in a suit.

Caroline was in the gym when a man came in and talked to Coach Carter for several minutes. They walked around the gym looking at some places where paint was chipped and where the bleachers were cracked.

Joseph overhead one of the secretaries in the front office saying that the superintendent would be visiting today to look at the building and any budget needs for the next year.

Synthesis: The superintendent visited the school today, and he went to the gym. He talked with Coach Carter, who showed him some areas in the gym that may need renovation or repairing as part of the budget process.

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Metasynthesis: An Original Method to Synthesize Qualitative Literature in Psychiatry

Jonathan lachal.

1 AP-HP, Cochin Hospital, Maison de Solenn, Paris, France

2 Université Paris Descartes, Sorbonne Paris Cité, Paris, France

3 CESP, Faculté de médecine, Université Paris-Sud, Faculté de médecine, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), INSERM, Université Paris-Saclay, Villejuif, France

Anne Revah-Levy

4 Service Universitaire de Psychiatrie de l’Adolescent, Centre Hospitalier Argenteuil, Argenteuil, France

5 ECSTRA Team, UMR-1153, INSERM, Paris Diderot University, Sorbonne Paris Cité, Paris, France

Massimiliano Orri

6 Université Paris-Sud, Paris, France

Marie Rose Moro

Metasynthesis—the systematic review and integration of findings from qualitative studies—is an emerging technique in medical research that can use many different methods. Nevertheless, the method must be appropriate to the specific scientific field in which it is used. The objective is to describe the steps of a metasynthesis method adapted from Thematic Synthesis and phenomenology to fit the particularities of psychiatric research.

We detail each step of the method used in a metasynthesis published in 2015 on adolescent and young adults suicidal behaviors. We provide clarifications in several methodological points using the latest literature on metasyntheses. The method is described in six steps: define the research question and the inclusion criteria, select the studies, assess their quality, extract and present the formal data, analyze the data, and express the synthesis.

Metasyntheses offer an appropriate balance between an objective framework, a rigorously scientific approach to data analysis and the necessary contribution of the researcher’s subjectivity in the construction of the final work. They propose a third level of comprehension and interpretation that brings original insights, improve the global understanding in psychiatry, and propose immediate therapeutic implications. They should be included in the psychiatric common research toolkit to become better recognized by clinicians and mental health professionals.

The use of qualitative research is proliferating in medical research ( 1 ). Over the past two decades, numerous studies in the field of psychiatry have used a qualitative protocol ( 2 , 3 ), and it has been recognized as a valuable way to “ obtain knowledge that might not be accessible by other methods and to provide extensive data on how people interpret and act upon their illness symptoms ” ( 4 ). What matters most is the respondent’s perspective and the joint construction by the respondent and the researcher of a context-dependent, multiple, and complex reality ( 5 ). In this respect, the qualitative approach is close to that of the psychiatrist: what is important is what the patient feels and experiences and what emerges during the interaction between the patient and the psychiatrist. Indeed, the subjective coconstruction inherent to most of qualitative methods seems especially close to the psychiatric clinical meeting. Both are useful for building up local theory that helps to increase two important aspects of theory: individually relevant theory for clinical work and field-specific general theory for research ( 6 ). Qualitative research offers a thick description (one that encompass all the complexity of the phenomenon, behavior, or context) of a phenomenon and attempts to document the complexity and multiplicity of its experience ( 6 ). Similarly, in their day-to-day clinical work, psychiatrists attribute great importance to complexity and try to place symptoms within the patient’s history, in all of its intricate context—which again plays a crucial role in therapeutic choices.

Some have expressed concern, however, that because qualitative studies are isolated and rarely used to contribute to practical knowledge, they do not play a significant role in the movement toward evidence-based medicine ( 5 ). To alleviate this concern and enable qualitative work to contribute to this movement, an increasing number of teams have worked to develop and apply synthesis methods to these data. Qualitative syntheses refer to a collection of different methods for systematically reviewing and integrating findings from qualitative studies ( 7 ). The aims of such methods are to capture the increasing volume of qualitative research, to facilitate the transfer of knowledge to improve healthcare, and to bring together a broad range of participants and descriptions ( 8 , 9 ). Qualitative syntheses require not only a systematic approach to collecting, analyzing, and interpreting results across multiple studies, but also to develop overarching interpretation emerging from the joint interpretation of the primary studies included in the synthesis ( 10 , 11 ). Therefore, it involves going beyond the findings of any individual study to make the “whole into something more than the parts alone imply” ( 12 ).

Qualitative syntheses are now recognized as valuable tools for examining participants’ meanings, experiences, and perspectives, both deeply (because of the qualitative approach) and broadly (because of the integration of studies from different healthcare contexts and participants). They have been shown to be particularly useful to identify research gaps, to inform the development of primary studies, and to provide evidence for the development, implementation, and evaluation of health interventions ( 13 ). Because of this growing importance, an important work has been done in the last ten years, in order to ensure the quality of qualitative syntheses, such as: describing the methods to ensure reproducibility, develop tools for assessing the quality of the primary articles, and establish reporting guidelines [see, for example, the ENTREQ statement ( 13 ), the GRADE-Cerqual protocol ( 14 ), and the Cochrane or EVIDENT works ( 15 , 16 )].

However, despite some qualitative syntheses have been successfully conducted in the field of mental health ( 2 , 3 , 17 – 20 ), no study considers the methodological specificities inherent to psychiatric epistemological stance ( 7 ). Filling this gap has been one of the aims of our team since 2011. In this methodological article, we aimed to discuss the challenge of implementing metasynthesis to improve the understanding of youths suicide. In this study, we adapted the Thematic Synthesis developed by Thomas and Harden and incorporate a phenomenological approach in order to deal with new rigor with general as well as psychiatric issues ( 21 ). We will present each step of the method (Figure ​ (Figure1) 1 ) and will propose methodological discussions. The detailed description of the findings can be found elsewhere ( 22 ).

Distribution in time for articles included in the metasynthesis.

Conducting a Metasynthesis

Before start—constitution of a research group.

The constitution of the research group and the definition of the study method are an important step before engaging in any synthesis work. The researcher must work in collaboration with researchers of diverse backgrounds ( 9 ). A collaborative approach improves quality and rigor and subjects the analytical process to group reflexivity ( 11 ). The research team should include members trained in qualitative synthesis as well as those expert in the topic being studied ( 23 ). As there are many ways to do qualitative syntheses, the research team will have to choose one of them adapted to the research question and to the expertise of the group ( 15 ).

Our team is composed of adolescent and child psychiatrists and psychologists from France and elsewhere (Italy, Chile, and Brazil) and focuses on developing qualitative research ( 24 – 26 ) and metasynthesis in adolescent psychiatry and related fields ( 22 , 27 , 28 ). Our method is adapted from thematic synthesis ( 21 ), which combines and adapts approaches from both metaethnography and grounded theory ( 10 ). Metaethnography, as well as Thematic Synthesis, takes place in six or seven steps from data collection to text coding and finally writing the synthesis. Original authors of metaethnography were trained in grounded theory, a qualitative method developed in the social sciences, laying on conceptual coding combine to construct a new theory. Thematic synthesis allows the researcher to include much more studies in the synthesis and to use tools coming from quantitative reviews, as systematic literature searches. This method perfectly suits to psychiatric research: user-friendliness for both researchers and readers; standardized in its most subjective steps but flexible, to make it adaptable to various patients or situations, such as children, patients with psychological disabilities or psychotic disorders, and to different researchers’ backgrounds (e.g., phenomenology, psychology, or psychoanalysis). We add a phenomenological perspective with a coding close to Smith’s interpretative phenomenological analysis (IPA) ( 29 ). IPA is also a qualitative method of coding a text, laying on phenomenology and hermeneutics. The level of coding is what makes sense to the reader (for example, a letter, a word, a sentence, the absence of a word, or a sentence). Phenomenology allows avoiding never-ending debates about theories of the psyche and focuses on the patient experience which is at the heart of psychiatric care. We understand that published manuscripts provide only thin data sets that are not eligible for a complete phenomenological analysis. Rather we tried to let ourselves guided by the impressions the text generated in us. It was like one article was assimilated as one participant, as it is mainly the voice of the main writer. We applied Smith’s tips on how reading and coding the data.

Define the Research Question and the Selection Criteria

Defining the research question is a crucial substep ( 9 ). This question must be broad enough to be of interest but small enough to be manageable ( 5 , 23 ) and has already been explored by enough studies ( 30 ). Inclusion and exclusion criteria may be fixed on methodological aspects, on participants selected, on thematic focuses or language specificities ( 9 , 31 ).

Youths suicide is a focus that were suitable for qualitative methods. We chose this subject because youth suicide is a major public health issue worldwide as well as a complex disorder that encompasses medical, sociological, anthropological, cultural, psychological, and philosophical issues. It has been widely explored by qualitative research. The lack of effectiveness of current care let us think that new insights could be expected by qualitative exploration. A first selection of articles, as well as an existing literature review on the topic, served to specify some starting information and enable initial decisions, including the definition of the research question, specification of the scope and the inclusion criteria. Then, the questions were constructed through reading and confronting these articles with our first qualitative study in the theme and our clinical knowledge of the theme.

As we wanted to study the therapeutic relationship and barriers to effective care, we decided to include research concerning not only the population being treated (the adolescents and young adults, and their parents), but also the healthcare professionals who care for these patients. A first screening of the literature showed us that optimal scope required a large range of ages, from 15 to 30 years old. The common thread linking all these youths was the importance of their parents in their everyday life. We chose to include only qualitative research, because it remains unclear how to deal with mixed method (combining qualitative and quantitative datasets) ( 23 ). Although databases contain articles in different languages, we chose to include only articles published in English (as most studies are now published in English) and French (as it is our first language) ( 22 , 27 ).

Study Selection

There is a debate on the choice of sampling method, some authors using an exhaustive sampling, some others, an expansive one ( 30 ). We privileged exhaustive systematic searches ( 32 ) since our method allowed large samples and because our target audience was the mental health community, which is accustomed to quantitative systematic reviews ( 9 ). Only journal articles were included, as most scientific data are published in this form ( 33 ). The first selection of articles served to specify the choice of keywords and databases for the electronic search. To ensure both sensitivity and specificity, we decided to use a combined approach of thesaurus terms and free-text terms. This technique maximizes the number of potentially relevant articles retrieved and ensures the highest level of rigor ( 34 ). Keywords were established during research team meetings, and were reported in the article or as supplemental material for more clarity ( 35 ). As each database has its own thesaurus terms, and as keywords encompasses different meanings in each discipline ( 36 ), the keywords were specific for each one.

We used four clusters of keywords: (i) those that concern the topic of interest (such as suicide, obesity, or anorexia nervosa), (ii) those that concern the participants (gender, age, profession, etc.), (iii) those that concern qualitative research (such as qualitative research, interviews, focus groups , or content analysis ), and (iv) those that concern perceptions and understanding, often called “views” ( 33 ) (such as knowledge, perception, self-concept, feeling , or attitude ). The last cluster takes all its importance in the phenomenological perspective of the analysis. An example of the final algorithm used (in the PubMed Web search) is provided in Table ​ Table1 1 .

Algorithm used in the PubMed Web search from Ref. ( 22 ).

Similar work was conducted to select the databases. After consulting reference articles ( 33 , 37 , 38 ), we decided to conduct the search in five electronic databases covering medical, psychological, social, and nursing sciences: MEDLINE, EMBASE, CINAHL, PsycINFO, and Social Science Citation Index (SSCI). Not long ago, CINAHL was the most important database for finding qualitative research, but as qualitative research proliferates in medical research, more and more qualitative articles are referenced in MEDLINE ( 33 ) and EMBASE. PsycINFO was a good database for finding qualitative articles with a psychological approach. We decided to add SSCI to broaden and complexity the outlook with a sociological point of view. We followed recommendations published on MEDLINE ( 39 ), CINAHL ( 40 ), EMBASE ( 41 ), and PsycINFO ( 42 ) for choosing search terms. Finally, we decided not to use the methodological databases’ filters for qualitative research, as these have undergone little replication and validation ( 43 ).

We decided to include articles published only in or after 1990. Two points impelled this decision: first, there was very little qualitative research on suicide before the year 2000 and even less before the 1990s (Figure ​ (Figure2). 2 ). Second, we chose to consider as outdated research findings and results published more than 20 years ago were outdated, given the evolution of medical practices ( 44 ). However, this choice must be adapted to the topic of metasynthesis.

Flowchart of the metasynthesis steps.

The results of database searches were entered into a bibliographic software program (Zotero©) for automatic removal of duplicates. Then, two authors independently screened all titles and abstracts and selected the studies according to our inclusion criteria (defined earlier). If the abstract was not sufficient, we read the full text. Disagreements were resolved during working group meetings. Full texts of potentially relevant articles were then examined, and a second selection was performed. At this phase, we also checked each article’s reference list looking for new articles we might have overlooked. The final selection represented from 2 to 3% of the total initially obtained. This rate is consistent with the findings of other metasyntheses ( 23 ). For clarity, the selection process was also presented in a flowchart (Figure ​ (Figure3). 3 ). We referred to STARLITE principles to report our literature search ( 45 ) (Table ​ (Table2 2 ).

Flowchart for selecting studies from Ref. ( 22 ).

STARLITE principles applied to the literature search report of Ref. ( 22 ).

Quality Assessment of Included Studies

There is no consensus about whether quality criteria should be applied to qualitative research, or, for those who think they should be, about which criteria to use and how to apply them. Nevertheless a growing number of researchers are choosing to appraise studies for metasyntheses ( 46 ) and some authors state that a good metasynthesis can no longer avoid this methodological step ( 7 ). The reasons and methods for quality assessment fit into three general approaches: assessment of study conduct, appraisal of study reporting, and an implicit judgment of the content and utility of the findings for theory development ( 13 ). There is certainly not one best appraisal tool, but rather a wide choice of good ones ( 8 ).

We chose the Critical Appraisal Skills Program (CASP) ( 47 ), which is the most frequently used instrument ( 46 ), addresses all the principles and assumptions underpinning qualitative research ( 13 ). It is one of the instruments recommended by the Cochrane Collaboration ( 48 ) and has been used in several important thematic analyses of medical topics. As proposed by Boeije et al., we weighted our assessment by applying a three-point scale to each criterion (0 = criterion not met; 1/P = criterion partially met; 2/T = criterion totally met) ( 49 ) (Table ​ (Table3 3 ).

Evaluation of the quality of the studies according to the Critical Appraisal Skill Programme (CASP) from Ref. ( 22 ).

a Number of studies .

We have not excluded any study on quality criteria. We think that the goal of the quality assessment is not to help selecting the more rigorous article. Either, this step is important to improve the overall rigor of the metasynthesis: by easily evaluating the quality of each article, the readers will have the possibility to make their own evaluation of the quality of the results of the metasynthesis ( 9 ). To enhance the rigor of the synthesis, we published the full results of this assessment ( 50 ).

Extracting and Presenting the Formal Data

To understand the context of each study, readers need the formal data about each study: the number and type of participants in each study, its location, and the method of data collection and of analysis. These data must be extracted and presented in a way that enables readers to form their own opinions about the studies included. We presented these data systematically, in a table with the following headings:

• – Identification of the study.
• – Summary of the study’s aim.
• – Country where the study took place.
• – Details about the participants: age, gender, type, and number.
• – Method of data collection (e.g., semistructured interviews or focus groups).
• – Analysis method (grounded theory, phenomenology, thematic, etc.).

Data Analysis

This step is probably the most subjective: its performance is highly influenced by the authors’ backgrounds ( 13 ). There are many ways to analyze, as many as there are authors. All researchers build on their personal knowledge and background for the analysis, sometimes described as bricolage , following Claude Levi-Strauss: “ the bricoleur combines techniques, methods, and materials to work on any number of projects and creations. Whereas a typical construction process might be limited by the history or original use of individual pieces, the bricoleur works outside of such limitations, reorganizing pieces to construct new meaning. In other words, unlike linear, step-by-step processes, the bricoleur steps back and works without exhaustive preliminary specifications ” ( 51 , 52 ). The synthesis will inevitably be only one possible interpretation of the data ( 9 ), as it depends on the authors’ judgment and insights ( 21 ). The qualitative synthesis does not result simply from a coding process, but rather from the researchers’ configuration of segments of coded data “ assembled into a novel whole ” ( 53 ).

In this process, the multidisciplinary team is essential to assess rigor and develop richer and more complex understandings. Triangulation of the analyses is enhanced when researchers with diverse background consider the same data set ( 11 ). “ Collaborative working not only improve quality and rigour, but subjects the analytical process to group reflexivity ” ( 54 ).

The first step of this process involved carefully reading and rereading each study ( 21 ). It is an active reading, with the intention of appraising, familiarizing, identifying, extracting, recording, organizing, comparing, relating, mapping, stimulating and verifying. In other words, it is reading with “ the intention of collating a synthesizable set of accounts ” ( 11 ).

The second step was coding: at least two different researchers coded each part of the data (whole manuscripts), performing a line-by-line coding, close to the phenomenological analysis described by Smith et al. ( 29 ).

In the third step, the codes were grouped and categorized into a hierarchical tree structure. This step is very close to the translation work described by Noblit and Hare ( 12 ). It involves comparing themes across articles to match themes from one article with those from another while ensuring that each key theme captured similar themes from different articles. We obtained a list of descriptive themes very close to the data.

In our example, we highlighted the sentence “You’re going to school, you’re getting an education, but you’re depressed” and coded it depressed . The code is then combined with others in a theme named “The experience of distress.”

Finally, in the last and most subjective step of the analysis, we generated analytical themes, which depended largely on the “judgment and insights of the reviewers” ( 21 ). This step is very similar the development of third-order interpretations—“ the synthesis of both first and second order constructs into a new model or theory about a phenomenon ” ( 23 )—and requires going beyond the content of original studies to achieve a higher level of interpretation and going beyond the descriptive synthesis to propose a more conceptual line-of-argument ( 21 , 23 ). This work has two types of underlying aims. The first type may be theoretical, by enabling a higher level of comprehension of a phenomenon; in medical science, this may be to better describe and understand a pathology. The second type may be to answer clinical questions about pathology and care directly.

In our example, we clearly fulfilled the second aim. The results leaded us to discuss new insights about suicidal youths’ care. The experience of incomprehension shared by all the protagonists of the care interferes with the capacity for empathy of both family members and professionals. We could use the concepts of intersubjectivity to witness the violence driven by the suicidal act.

Writing the Synthesis

Throughout the analysis process, the authors build themes that take place in the story they are telling about the participant’s experience ( 21 ). Then, the expression of the synthesis is our story of the studied phenomenon.

The results of the metasynthesis consist of the themes that we developed in the analysis. They are built by first and second order constructs. We did not define actual third-order themes; rather, third-order constructs helped us to build the synthesis into a story. We organized the themes into superordinate themes, which are interpretations of the themes and can be considered third-order interpretations.

For example, in one of the developed theme called the experience of distress we described that the young people experienced depressive symptoms. The participants described feelings of sadness, sorrow, mental pain, despair, detachment, anger, and irritability . The authors interpreted that as despair . We organized all these closed related feeling into the individual experience of distress . We decide not to speak about depression , first because some healthcare professionals repeated that they may diagnose depression “ but certainly not on a routine basis ” ( 22 ), then because we adopted a phenomenological approach and we felt that distress encompasses a broader and more complex experience.

Metasynthesis results prepare the framework for the discussion, the most interpretative part of the review, where hypothesis and proposals are presented. We offer our understanding of the participants’ experience. Both our presentation and our discourse are influenced by our aim: to answer clinical questions by suggesting specific actions or considerations for care; the discussion and the answers are intended to be useful for the readers of our article, as well as for us ( 23 ).

Our conclusion is that “ the violence of the message of a suicidal act and the fears associated with death lead to incomprehension and interfere with the capacity for empathy of both family members and professionals. The issue in treatment is to be able to witness this violence so that the patient feels understood and heard, and thus to limit recurrences ” ( 22 ). This issue is clear and simple and it leads to an immediate application to clinical practice which is described in the implication for practice chapter.

Finally, we discuss the limitation of the findings. The principal limitations were methodological (with our method, the access to participants’ data is partial), and in the sampling (we didn’t take in consideration the influence of gender on the experience of suicidal behavior). That exercise enhances the credibility of the publication, enabling readers to measure the importance and generalizability of the findings.

The written synthesis has to fulfill the standard for reporting synthesis of qualitative research. We chose to refer to Tong and al. ENTREQ statement ( 13 ) attached to the publication.

Our method is based on Thomas and Harden Thematic Synthesis ( 21 ). After a broad-scale review of literature on the topic of metasynthesis, we have decided to clarify the definition of some aspects of the method and modify or expand others, because we wanted both a medical and a psychological approach. For example, we opted to use a systematic search method and a weighted version of the CASP to assess quality.

Most metasynthesis authors argue that these reviews achieve a third-order level of interpretation, that is, that they are more than the sum of their results. If, as we think, qualitative research can achieve a moderate level of generalization with clinical implications, metasyntheses may transform these findings into more highly abstracted and generalizable theoretical frameworks. We “ push their findings toward the nomothetic end of the idiographic-nomothetic continuum ” ( 44 ). Qualitative specialists certainly do not shy away from stressing the importance of context in their studies, or from arguing that the context of one study may not be applicable to others. It is true that, in a way, metasyntheses decontextualize concepts to attain greater generalizability ( 44 ). But we can relate this act to the response of clinicians reading a qualitative article: they will try to apply the concepts to their own situations ( 21 ). Authors of metasyntheses are proposing their own interpretation of the concept and its generalizability. The scientific value of metasynthesis lies in its role as a summary of several studies and as the interpretation of varying context, as well as in its ability to weight each result and to propose greater generalizability.

Qualitative research is an invaluable method for gaining new insights into mental disorders ( 6 ). Its development in recent years requires that we improve methods for synthesizing their results. We think this way of doing metasynthesis is appropriate to psychiatric research in its intermediate position that stresses both progress in the general comprehension of disorders and direct clinical implications. It offers an appropriate balance between three components: an objective framework, which includes the selection, inclusion, and appraisal of studies; a rigorously scientific approach to data analysis; and the necessary contribution of the researcher’s subjectivity in the construction of the final work. The balance for a qualitative metasynthesis is, we think, very similar to the clinical approach to each patient. It necessitates a robust scientific background, a rigorous step-by-step—symptom by symptom—progression, and finally a part of art that depends on each clinician: the subjective part of therapy.

Finally, we think that metasyntheses enable insights that no other method can provide. Qualitative research sheds new light on scientific questions by emphasizing the participants’ subjective understanding and experience ( 6 ). Metasynthesis proposes a third level of comprehension and interpretation that brings original insights. In our study ( 22 ), we emphasized an original point in the relationship that was no found in any result from each primary study: the difficulty of professionals and parents to understand and cope with suicide as an obstacle to the care of the suicidal adolescent. Therefore, our study’s analysis went deeper and proposed original results.

Author Contributions

Conceived and designed the experiments and final approval: JL, AR-L, MO, and MM. Conducted the literature review: JL and MO. Performed the experiments: JL, MO, and AR-L. Wrote the article: JL (all the article), AR-L (analysis), MO (introduction and analysis), and MM (discussion).

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We would like to thank Jo Ann Cahn for revising our English.

Synesthesia

Synesthesia definition.

In literature, synesthesia refers to a technique adopted by writers to present ideas, characters, or places in such a manner that they appeal to more than one sense, like hearing, sight, smell, and touch at a given time.

Generally, the term synesthesia refers to a certain medical condition in which one of the five senses simultaneously stimulates another sense. A person with such a condition may not only see letters of the alphabet, but also associate them with particular scents. This happens when the different parts of the brain that are responsible in identifying color, sound, taste, and smell somehow get interlinked, and thus one sense triggers another sense.

Everyday Life Examples of Synesthesia

In everyday language, we find many examples of synesthesia, such as the frequently used adjective “cool.” This word is generally associated with temperature. However, in casual conversation, we hear phrases like “cool dress,”, “cool color,” or “you look cool,” wherein the visual sensation is blended with the sense of touch. Moreover, we commonly hear phrases like “loud colors,” “frozen silence ,” “warm colors,” and “bitter cold.”

Examples of Synesthesia in Literature

In literature, synesthesia is a figurative use of words that intends to draw out a response from readers by stimulating multiple senses.

Example #1: The Divine Comedy (By Dante Alighieri)

Dante Alighieri’s The Divine Comedy contains a good synesthesia example in literature. In the first canto , the poet tells us about a place called “ Inferno .” He says,

“Back to the region where the sun is silent .”

Here, Dante binds the sense of sight (sun) with the sense of hearing (silent).

Example #2: Ode to a Nightingale (By John Keats)

We notice synesthetic imageries in John Keats ’ Ode to a Nightingale :

“Tasting of Flora and the country green, Dance, and Provencal song, and sun burnt mirth!”

In the above example, Keats combines visual sensation with the sensations of taste and hearing. In the same poem , he further states:

“In some melodious plot , Of beechen green, Singest of summer in full throated ease.”

Keats associates the act of melodious singing with a plot covered with green beechen trees , and thus connects visual sense with the sense of hearing.

Example #3: King Lear (By William Shakespeare)

We see Shakespeare employing the synesthetic device in his play King Lear , Act 2, Scene 2:

“Thou art a lady: if only to go warm were gorgeous, Why nature needs not what thou gorgeous wear’st, Which scarcely keeps thee warm.”

In the above excerpt, King Lear makes fun of his daughter Goneril for wearing revealing attire. He associates the word “warm” with “gorgeous,” which is an attempt to blend the sense of touch with the sense of sight.

Example #4: A Tuft of Flowers (By Robert Frost)

Robert Frost , in his poem A Tuft of Flowers , uses synesthesia:

“ The butterfly and I had lit upon, Nevertheless, a message from the dawn, That made me hear the wakening birds around, And hear his long scythe whispering to the ground…”

In the above excerpt, the speaker reveals a blend of sensory experiences he is experiencing. The speaker’s visual sense and his sense of hearing make him aware of his surroundings.

Example #5: Dying (By Emily Dickinson)

Emily Dickinson , in her poem Dying , uses synesthesia:

“With blue, uncertain, stumbling buzz, Between the light and me; And then the windows failed, and then could not see to see.”

Here, the poetess added a visual element to the buzzing sound “buzz” by describing it as having a blue color.

Example #6: The Whole World Over (By Julia Glass)

The character Saga, in Julia Glass’ novel The Whole World Over , has a condition of synesthesia, in which she seems to sense colors in the words she reads, as illustrated below:

“The word would fill her mind for a few minutes with a single color: not an unpleasant sensation but still an intrusion… Patriarch: Brown, she thought, a temple of a word, a shiny red brown, like the surface of a chestnut.”

These lines are comments spoken by Duffy, who thinks that Saga’s synesthesia is a distraction.

Function of Synesthesia

Writers employ this device to be creative in communicating their ideas to the readers. It makes their ideas more vivid, and adds more layers of meaning to a text for the readers’ pleasure. By blending different senses, writers make their works more interesting and appealing.

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