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Literature reviews summarize and analyze what has been written on a particular topic and identify gaps or disagreements in the scholarly work on that topic.

Within a scholarly work, the literature review situates the current work within the larger scholarly conversation and emphasizes how that particular scholarly work contributes to the conversation on the topic. The literature review portion may be as brief as a few paragraphs focusing on a narrow topic area.

When writing this type of literature review, it's helpful to start by identifying sources most relevant to your research question. A citation tracking database such as Web of Science can also help you locate seminal articles on a topic and find out who has more recently cited them. See "Your Literature Search" for more details.

A literature review may itself be a scholarly publication and provide an analysis of what has been written on a particular topic without contributing original research. These types of literature reviews can serve to help keep people updated on a field as well as helping scholars choose a research topic to fill gaps in the knowledge on that topic. Common types include:

Systematic Review

Systematic literature reviews follow specific procedures in some ways similar to setting up an experiment to ensure that future scholars can replicate the same steps. They are also helpful for evaluating data published over multiple studies. Thus, these are common in the medical field and may be used by healthcare providers to help guide diagnosis and treatment decisions. Cochrane Reviews are one example of this type of literature review.

Semi-Systematic Review

When a systematic review is not feasible, a semi-systematic review can help synthesize research on a topic or how a topic has been studied in different fields (Snyder 2019). Rather than focusing on quantitative data, this review type identifies themes, theoretical perspectives, and other qualitative information related to the topic. These types of reviews can be particularly helpful for a historical topic overview, for developing a theoretical model, and for creating a research agenda for a field (Snyder 2019). As with systematic reviews, a search strategy must be developed before conducting the review.

Integrative Review

An integrative review is less systematic and can be helpful for developing a theoretical model or to reconceptualize a topic. As Synder (2019) notes, " This type of review often re quires a more creative collection of data, as the purpose is usually not to cover all articles ever published on the topic but rather to combine perspectives and insights from di ff erent fi elds or research traditions" (p. 336).

Source: Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research. 104. 333-339. doi: 10.1016/j.jbusres.2019.07.039

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A semi-systematic literature review, identifying the relationship between transit environments and women’s fear of victimization in transportation systems: a global perspective

• Original Research
• Published: 14 March 2024

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• Shamim Noor   ORCID: orcid.org/0000-0002-7609-9647 1 , 2 &
• Pawinee Iamtrakul 3  

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Female commuters across the globe face numerous constraints while using public transport (PT) systems. Unfortunately, the gender-specific needs and demands of women are often ignored while designing transportation settings, particularly in developing countries. Consequently, transit fear and victimization have become prevalent in such fragile transport systems. This study aims to shed light on the close association between transit fear, victimization, and the inadequacies of transportation systems. It also explores how these issues have been addressed in academic discourse over time. The study employs a combination of ‘narrative review’ and ‘systematic review’, commonly known as a ‘semi-systematic review’ process. To achieve its objectives, the study reviewed 88 papers, including relevant grey literature for narrative analysis, and conducted different themes and keywords analyses on 116 Scopus-indexed papers for a comprehensive systematic review. However, in the context of developing countries, the Scopus database reveals a scarcity of empirical studies that focus on women’s victimization during transit and gendered transport environment settings. This leads to a significant disparity in recognizing transit victimization, implementing effective mitigation measures, and understanding the patterns of reporting harassment varying substantially between developed and developing nations. While the narrative review provides detailed observations, the bibliometric analysis adds new insights and strengthens the understanding of the narrative review from different perspectives.

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Source: Based on Grant and Booth ( 2009 ), the authors modified the diagram

Source: The authors. *Note: SOCI (Social Sciences), ENGI (Engineering), ENVI (Environmental Science), DECI (Decision Sciences), MEDI (Medicine), PSYC (Psychology), ARTS (Arts and Humanities), HEAL (Health Profession), ar (Article), ch (Book Chapter), re (Review), bk (Book), cp (Conference Paper), Eng (English)

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Noor, S., Iamtrakul, P. A semi-systematic literature review, identifying the relationship between transit environments and women’s fear of victimization in transportation systems: a global perspective. Public Transp (2024). https://doi.org/10.1007/s12469-024-00350-1

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Literature review as a key step in research processes: case study of MA dissertations written on EFL of Saudi context

Saudi Journal of Language Studies

ISSN : 2634-243X

Article publication date: 1 June 2022

Issue publication date: 4 August 2022

The aim of this study is to find out the most common types of literature review and the accuracy of citing information related to topic in question among Saudi English as a Foreign Language (EFL) postgraduate students at Al-Baha University. This study also aims at revealing the quality of the literature review written by researchers.

Design/methodology/approach

This qualitative study used content analysis to investigate 15 unpublished Master of Arts (MA) dissertations written on EFL of Saudi context. They were analyzed qualitatively using criteria modified from Snyder's (2019) model which is considered a potential method for making theoretical and practical contributions of literature review.

The findings of the study showed that students favored the systematic review over the integrative. Additionally, data showed that students were lacking in paraphrasing and organizing cited information coherently and appropriately. Moreover, students' performance was better in design, conduct, and data abstraction and analysis criterion, whereas they seemed rather weak in structuring and writing the review criteria.

Originality/value

The significance of the study is to provide researchers with methodological guidance and reference to write a comprehensive and appropriate literature review. Based on the findings, this study concluded with some implications that aim to assist researchers in carrying out their studies professionally. Furthermore, the findings provide decision-makers in higher education institutions with important practical implications. In light of the study's findings, it is suggested to carry out further research investigating postgraduate students to find out their perceptions and attitudes regarding the quality standards of scientific research writing and the paraphrasing strategies.

• MA students
• Literature review

Integrative review

Semi-systematic review.

• Systematic review
• Literature review quality
• Paraphrasing

Alsalami, A.I. (2022), "Literature review as a key step in research processes: case study of MA dissertations written on EFL of Saudi context", Saudi Journal of Language Studies , Vol. 2 No. 3, pp. 153-169. https://doi.org/10.1108/SJLS-04-2022-0044

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Copyright © 2022, Ahmed Ibrahim Alsalami

Published in Saudi Journal of Language Studies . Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

Introduction

The way a researcher is building his/her research and linking it to current knowledge is like building a block of academic research activity, no matter which discipline it relates to, thus it is a priority step ( Snyder, 2019 ). In a definition by Liberati et al. (2009) cited in Snyder (2019) “ A systematic review can be explained as a research method and process for identifying and critically appraising relevant research, as well as for collecting and analyzing data from said research .” (p. 334). A literature review is an important part of any research as it is considered a foundation of the type of research.

As in Snyder (2019) , literature review is a written text of a published study that includes current knowledge and up-to-date information about the latest findings of science on a particular topic, including substantial discoveries as well as theoretical and practical contributions from scholarly research groups. A literature review as defined by Hart (1998) (Cronin et al ., 2008 cited in Ramdhani et al ., 2014 ) “ is an objective and thorough summary and critical analysis of the relevant, available research and non-research literature on the topic being studied ” (p. 48). A literature review requires a compound series of abilities to learn topics to explore and acquire and retrieve literature searching skills. Additionally, it requires the ability to develop, analyze and synthesize data to be keen on reporting and writing normally at a limited scale of time. Scholars divided the literature review into two types. The first is “Traditional or Narrative Literature Review”. This type of review criticizes and summarizes the body of the literature to draw conclusions about the topic under consideration. The basic aim of this review is to support a reviewer with a complete review to understand the knowledge and to show the implication of new inquiries. The second one is “Systematic Literature Review” which reviews the literature in a specific subject area to employ a more rigorous and well-defined approach. A systematic literature review is often used to solve a specific medical practice question ( Parahoo, 2006 ; Davis et al ., 2014 ; Almelhes, 2020 ). Some studies regard “meta-analysis” as a type of systematic review, which is primarily a statistical method that entails evaluating the research results among many studies on the very same topic using standardized statistical tests in drawing conclusions and identify patterns and trends between research results ( Polit and Beck, 2006 ; Dundar and Fleeman, 2017 ; Almelhes, 2020 ).

The most common types of literature review among Saudi EFL postgraduate students in Al-Baha University,

The accuracy of citing information related to the topic in question and

The quality of the literature review written by the MA researchers at Al-Baha University.

What are the most common types of literature review among Saudi EFL students at Al-Baha University?

To what extent is the accuracy of citing information related to the topic in question?

To what extent is the quality of the literature review written by the MA researchers at Al-Baha University?

Steps and phases of doing a literature review

Designing the review.

Why should this literature be reviewed? Do we really need literature in this area of our topic? And what literature review would be the great type for contribution? Indeed, these questions would be better borne in the mind of a researcher before starting to review the literature because they determine the likelihood of the review and the impact it might have on the research community ( Antons and Breidbach, 2018 ). As it is a hard work to conduct a literature review, the topic must interest both author and the reader. Hence, first of all, it is better to scan the points to relate to existing knowledge. Moreover, Palmatier et al . (2018) stated that any criterion related to the on-focus topic should be directed by the research questions.

Conducting the review

Conducting a review is required after deciding on the purpose, questions and type of approach that better suits the topic in question. Additionally, it is better to appropriately test the review process and protocol before performing the main review. To ensure the quality and reliability of the search protocol, it is important to use two reviewers to select articles depending on the nature and scope of the review ( Antons and Breidbach, 2018 ; Almelhes, 2020 ).

Analyzing the literature

To conduct appropriate analysis, it is important to consider how the articles will be used. Meanwhile, abstracting information needs to be professionally measured ( Palmatier et al ., 2018 ). They can be put into descriptive information (e.g. authors, year of publication, topic or type of study), or in effects and findings format, conceptualizations or theoretical perspective. Additionally, it is better to avoid any differences in coding and monitoring the data abstraction carefully during the review process in order to ensure quality and reliability. Researchers should ensure that their literature is appropriate to answer the selected research question.

Writing a review

The final review of any article depends on an approach that requires types of different information and different levels of details like standards and guidelines that explicitly address how literature reviews should be reported and structured (see Table 1 , below). Standards and guidelines for systematic narrative reviews ( Wong et al. , 2013 ) or guidelines for integrative reviews ( Torraco, 2005 ) should be considered in the final review too. Moreover, how literature was identified, analyzed, synthesized and reported by a researcher is necessary to describe transparently the process of designing the review literature. Literature reviews can result in a historical analysis of the development within a research field ( Carlborg et al ., 2014 ; Almelhes, 2020 ) or can be any agendas for further research ( McColl-Kennedy et al. , 2017 ), besides, conceptual model or categorization ( Snyder et al. , 2016 ; Witell et al ., 2016 ), or can be evidence of an effect ( Verlegh and Steenkamp, 1999 ).

The process of undertaking a literature review

Regardless of the method used to carry out the literature review, there seems to be a myriad of activities to be carried out and decisions made in order to build an assessment that satisfies the criteria for publication (for specific considerations with regards to each phase, as seen in Table 2 ). There are four phases that demonstrate and discuss the essential decisions and questions associated with conducting a literature review (as in Table 2 below): (1) designing the review, (2) conducting the review, (3) analysis and (4) structuring and writing the review ( Snyder, 2019 ). This procedure arose from real-world and practical experience and is a synthesis of and impact by diverse rules and specifications for literature reviews (e.g. Liberati et al. , 2009 ; Tranfield et al. , 2003 ; Wong et al. , 2013 ).

Types of literature review

Systematic literature review.

As described by Davis et al. , (2014) and later by Dundar and Fleeman (2017) , systematic reviews have first developed within medical sciences to synthesize research findings in a systematic, transparent and reproducible way. It can be a process for identifying and critically appraising relevant research for collecting and analyzing data from previous studies ( Liberati et al. , 2009 ; Almelhes, 2020 ). It aimed at identifying all empirical evidence that fits the pre-specified inclusion criteria to answer a particular research question or hypothesis. Bias can be minimized to provide reliable findings from conclusions and decisions ( Liberati et al. , 2009 ). Often statistical approaches are used to integrate the results of the topics in question. It combines results from different studies to evaluate and compare and identify patterns, disagreements or relationships ( Davis et al. , 2014 ) to assess them. It can be used to determine the continuity of effects across studies and to discover types of future studies that are required to be conducted to demonstrate the effect. Besides, techniques were used to discover which study-level or sample characteristics affect the phenomenon ( Davis et al. , 2014 ). The primary goal of a systematic review is to provide as comprehensive a list as possible of all studies whether published or unpublished, and these studies concerning a specific subject ( Ryan et al ., 2007 ; Dundar and Fleeman, 2017 ).

A systematic review needs to use standards as a roadmap for collecting studies ( Livinski et al ., 2015 ). Systematic review design has covered the following criteria: (1) studies related to students' attitudes; (2) the engagement of the learning process and (3) the outcomes of studies regarding speaking, writing and reading skills ( Antons and Breidbach, 2018 ; Almelhes, 2020 ).

The semi-systematic or narrative review approach hinders a full systematic review process. It is designed for different conceptualized and various studies that were studied by groups of researchers within various disciplines ( Wong et al. , 2013 ; Dundar and Fleeman, 2017 ).

Since it is hard to review every single article relevant to the topic, a different strategy must be developed ( McColl-Kennedy et al. , 2017 ). It aims at overviewing a topic and how research has progressed over time and developed. Generally, it seeks to identify and understand all potentially relevant research traditions and synthesize them by measuring effect size ( Wong et al. , 2013 ) and provides a considerate understanding of complex areas. It is potentially contributed to a useful analysis for detecting themes, and theoretical viewpoints of specific research disciplines as well as to identifying components of a theoretical concept ( Ward et al ., 2009 ). Thus, gain the ability to map a field of research, synthesize the state of knowledge and create an agenda for further research or the ability to provide a historical overview of a specific topic.

An integrative review is closely related to the semi-structured (integrative or critical review) approach. Usually, it has a different purpose from the semi-structured review which aims to assess, critique, and synthesize the literature in a way to develop new theoretical frameworks and perspectives ( Torraco, 2005 ). Generally, integrative literature reviews are intended to address mature or new topics. Additionally, seek to emerge topics to overview the knowledge base, critically review and potentially reconceptualize and expand on the theoretical foundation of the specific topic. It requires a more creative collection of data ( Whittemore and Knafl, 2005 ). A review of good literature does not summarize the sources, but rather analyzes, collects and evaluates them accurately to form a clear and general picture of existing knowledge or science on this topic.

Text borrowing skills

Text borrowing and incorporating other people's written ideas into one's own scholarly work are useful qualities to have in the world of academia, particularly for those pursuing higher education. Text borrowing expertise widely used in academic writing includes direct quoting, paraphrasing and summarizing. When contrasted to paraphrasing, directly quoting from the primary material is far more feasible, easier and less complex. There is really nothing inappropriate with integrating quotations; nevertheless, as Davis and Beaumont (2007) point out, overusing quotations does not really represent highly proficient writing. Rather, academic writing motivates the use of paraphrasing, drawing conclusions or synthesizing skill sets.

Paraphrasing is described as reiterating a statement in such a manner that both sentences are lexically and syntactically distinct whilst also remaining semantically equivalent ( Amoroso, 2007 ; Davis and Beaumont, 2007 ; McCarthy et al ., 2009 ). At least two echoes are implied by this description: reading process skills and writing ability. As a result, according to McCarthy et al . (2009) , paraphrasing is often used to aid comprehension, enhance previous knowledge and assist the development of writing skills.

According to cognitive psychology literature, paraphrasing is mentally demanding. As the content to be paraphrased has become more complicated, students are more likely to use simplified processing, resulting in patchwork written text (Marsh, Landau and Hick in Walker, 2008 ). Walker adds that just imagining about paraphrasing takes a substantial amount of cognitive vitality, and when the physical writing process starts, individuals have restricted opportunity to undertake thoughtful, systematic processing to ascertain if they paraphrased correctly. These complicated characteristics of paraphrasing cause some challenges. In the Japanese context, Iwasaki (1999) discovered four major areas of difficulty: varying behavioral patterns of parts of speech, subject limitation, context-specific paraphrasing and “blank” locating. There seems to be little proof, and data obtained from extensive research dedicated to examining paraphrasing-related concerns in the Indonesian context. Despite an abundance of survey participants, Kusumasondjaja's (2010) survey did not test students' paraphrasing abilities. It appears that paraphrasing is not represented, is described vaguely or is purely regarded as changing the existing source without stating the extent of adjustment.

In the Saudi context, Alaofi (2020) investigated the key problems that Saudi graduate students usually face when summarizing and paraphrasing source texts in EFL. Nine Saudi students attending university degrees in multiple fields were questioned using a qualitative approach. The study's findings revealed that a variety of barriers may exacerbate students' challenges with the skills under examination. These were students' insufficient English proficiency is the first root of complexities in summarizing and paraphrasing original text, followed by issues with students' writing styles and, finally, poor reading comprehension skillsets.

Methodology

As mentioned above, the purpose of this study is to analyze and synthesize findings from the content that is written in the literature review section of 15 unpublished MA studies. These studies were written in the Saudi context and conducted by MA postgraduate students of Al-Baha University. Additionally, to find out the most common types of literature review used by Saudi EFL postgraduate students in Al-Baha University, and to measure the accuracy of citing information related to topics in question, besides finding out the criteria and assess the quality of literature review written by MA researchers, to come out with rich findings that can guide undergraduate students in writing and reviewing knowledge related to their theses and research papers. Additionally, it can help postgraduates and other academic researchers to build a tidy content of literature and coherent procedures for research writing. Thus, this research is done qualitatively using content analysis taking into account the discipline, type of literature review, and contribution to see how successfully these researchers attract readers' attention and satisfy their needs, and in the long run, increase the quality of research and to develop better and more accurate hypotheses and questions.

To measure the research questions, 15 MA dissertations were selected randomly and carefully analyzed accordingly. The analysis of these 15 studies focused mainly on finding out the common types of literature review used by Saudi EFL students in Al-Baha University, and finding the accuracy of citing information, besides assessing the quality of the literature review of the selected MA research. Synder's (2019) model for assessing the quality of literature review is used as a criterion to analyze these MA studies. All are written in the field of English Language Teaching (ELT) settings. Therefore, it will be a potential step in making theoretical and practical contributions to literature review as a method to clarify what a literature review is, how it can be used and what criteria should be used to evaluate its quality. Thus, in this paper, the contribution differentiates between several types of literature review methodologies such as systematic, semi-systematic, and traditional/integrative approaches and how the procedures and the quality were shown (see Appendix ). Besides, presenting real practices that may be met when reviewing literature in EFL research. Additionally, it provides context and guidance to students and academics to use the literature review as a method to synthesize their research in question.

As in Appendix , the criteria used contained four phases: (1) design (includes 6 dimensions); (2) conduct (includes 5 dimensions); (3) data abstraction and analysis (includes 5 dimensions); and (4) structuring and writing the review (includes 5 dimensions). To show that the criterion has been met, the researcher used the symbol (√) as an indication system or vice versa (×) if it was not. The 15 kinds of research were coded using numbers (i.e. each research was given a number from 1 to 15). Then each research was checked according to the dimension of each criterion of each quality. These 15 unpublished MA studies were collected from the College of Arts and Humanities in Al Aqiq main campus, where the postgraduate dissertations were archived, and these studies were conducted during the period from 2013 to 2018. The reason for not selecting newer studies after 2018 is that this paid master's program has been discontinued and has resumed in mid-2021. To ensure the quality of the assessment and the analysis according to Synder's standard, the researcher got help from jury members of three PhD holders (voluntarily) who work in the Department of English at the College of Science and Arts in Qilwah. They had more than ten years of experience in the field of teaching and scientific research. The research took place in a round-held table for a number of meetings and asked them to review and evaluate the MA research according to Synder's criteria. The evaluation continued for three months, and each phase and its dimensions were discussed in separate sessions. The evaluation and discussion took place during the first term of the academic year 2021. Step by step the researcher continuously discussed with the jury members their evaluation (see Appendix ).

The analysis section was divided into two parts. The first part displayed the data gathered to measure the first and the second questions, whereas the second part displayed the third question.

Discovering common types of literature review and evaluating the accuracy of citing information

Part 1 : The main types of literature review (traditional or narrative, systematic, meta-analysis and meta-synthesis) were scrutinized and analyzed in light of their qualities and procedures. In this paper, three types are chosen to be judged accordingly. They are systematic, semi-systematic and traditional/integrative approaches. As mentioned above, the 15 MA projects were handed over to the reviewers (the researcher's colleagues). After long and regular sessions, they concluded their results to the researcher. They revealed that studies 1, 10 and 15 showed a masterpiece reflection of the systematic review approach. In this sense, these studies synthesized and compared evidence between the two studies. Another example is that these studies in the introduction section produced a clear and rationale connection between the topic and literature written in the same field of the study. These studies also showed that the information provided is reliable and based on proven facts. Additionally, the information is verified against other reliable sources. To be more realistic, we must evaluate all sources before deciding whether to incorporate what was found into the literature review ( Synder, 2019 ). Moreover, resources need to be evaluated to make sure that they contain information, which is valuable and pertinent, in this point, this study is consistent with what was found by other researchers ( Liberati et al. , 2009 ; Tranfield et al. , 2003 ; Wong et al. , 2013 ; Synder, 2019 ). These studies presented a rich literature that is displayed in various types of periodicals that include scholarly journals of high impact factors and intensive readability.

Generally, studies (1, 3, 4, 6, 8, 10, 11, 12, 13, 14 and 15) used systematic reviews to answer their highly structured and specific research questions. They undertook a more rigorous approach in reviewing the literature they presented in their research. In contrast, a traditional or narrative literature review usually adopts a critical approach in a way that analyzes and summarizes to address intensive information to shed light on new ideas, bridge gaps or/and cover weaknesses of previous research, studies endeavored a very high and accurate criterion of evaluating literature review Ryan et al. (2007) . On the other hand, studies (2, 5, 7 and 9) used both semi-systematic and integrative/traditional literature reviews. This clearly showed that the research questions were broad. On the other hand, in the introduction section, these studies used a semi-systematic literature review. For accuracy purposes, these studies presented a piece of reliable information. All the information displayed in these studies was error-free. Additionally, it is easy to say that the information shown was based on proven facts and can be verified against other reliable sources. All that cited in these studies in the literature review section was taken from famous and well-known periodicals. They can be completely described as facts shown without any bias. When looking back to what the researchers presented, it is easy to see that information presented was currently published to show the currency matter of the researchers' topics. The coverage of information has met in-depth the information needed to build up a literature review process. Accordingly, the researchers reviewed rich and accurate literature written about the focus topics to rationalize their objectives in conducting their research. All the information shown by researchers was presented without any bias. Thus, each study presented more than four references to show the accurateness of the literature. Additionally, the information presented is highly met and covered the needed information, and provided a basic and in-depth coverage. To meet the aims of systematic review (as in Dundar and Fleeman, 2017 ), to some extent, these studies provided a complete list of all possible published and unpublished studies relating to the researcher's subject matter.

To deal with the accuracy of citing information, in studies (2, 3, 4, 5, 9, 10, 11, 12, 14 and 15) one can find that, from the beginning, in the introduction section, these studies started citing from very recently published researches. Most interestingly, the researchers used the paraphrasing method to cite information related to the researchers' topic. However, they did not paraphrase appropriately. These studies used a paraphrasing method to make the information cited more reliable, error-free, based on proven facts and can be verified against other reliable sources. In this sense, these studies presented information that can be more accurate. But unexpectedly, those who used the paraphrasing method lacked professionality in treating the original text and formulating it using their own words (i.e. there is an apparent weakness in meaning between the original source and the paraphrased text). Again, the studies showed that researchers intended the purpose of the information in a precise way initiating that in the introduction. The studies also presented facts that were proven by famous writers.

Assessing the quality of a literature review

Part 2: As empirical research, literature reviews need assessment and evaluation ( Palmatier et al. , 2018 ). The literature review quality must have both depth and rigor to determine a suitable strategy for choosing topics and apprehending data and insights and to recite previous studies slightly. The quality of the literature review needs to be replicable to make the reader easily replicate the topic and reaches similar findings. Additionally, they must be useful for scholars and practitioners. Normally, the evaluation of different types of literature reviews is considered to be challenging. However, some guidelines could be used as a starting point to help researchers in evaluating literature reviews, to examine and to assess the review criteria for rigor and depth. To assess the literature review quality related to MA studies (the 15 selected samples) in question, Snyder (2019 , p. 338) suggested some guidelines as seen in Appendix .

Therefore, to find out a suitable step-by-step approach that can guide students and academics in undertaking a valid, comprehensive and helpful literature review, appropriate literature reviews have been gathered for this inquiry to investigate the criteria and quality of literature presented by selected MA studies (see Appendix ). Depending on the purpose of the topic, various literature studies may be highly useful to suggest which strategy may suit the analysis and synthesis stages that greatly help in the selection and writing of the literature review on EFL context, mainly Saudi context. Thus, the selected reviews were scrutinized and analyzed considering their qualities and procedures. In this paper, only 15 MA studies were chosen to be measured accordingly.

As in Appendix , the quality of these projects was checked and graded by the reviewers (the researchers' colleagues). Looking at the reviewers' evaluation of these dissertations, one can easily find that only one out of the 15 showed complete performance and was valuable in all criteria. Meanwhile, the others showed strength in the first and second dimensions of the design criteria. However, their performance in the other parameters deteriorated greatly. In total, seven out of them performed moderately in design criteria (i.e. they achieved in dimensions, 1, 2 and 6, whereas they failed in the other 3, 4 and 5); as the other seven researchers performed in four dimensions moderately. Concerning the conduct criteria, they did very well. Therefore, ten out of the fifteen researchers fulfilled perfectly in all dimensions, however, only five performed somehow moderately in only four out of the five dimensions in the conduct criteria. Additionally, seven out of the fifteen achieved in all dimensions in data abstraction and analysis, whereas three contented in only four dimensions, meanwhile other three of them fulfilled only three, while the other two achieved two dimensions. Although researchers did very well in design, conduct, and data abstraction and analysis criterion, they seemed very weak in structuring and writing the review. They only achieved in the fourth and fifth dimensions of this criteria. However, they got zero achievements in the first dimension. Additionally, only six out of the fifteen researchers fulfilled the third dimension, whereas only five achieved the second one.

Findings and discussion

As mentioned above, the purpose of this study is to find out the common types of literature review used by Saudi EFL postgraduate students in Al-Baha University; and to find out the accuracy of citing information related to the topics in question; as well as to assess the quality of the literature review written by selected researchers. From the analysis, it was found that most researchers (11 out of 15) used a systematic review of the literature. Systematic reviews are the thorough and openly transparent type of literature review. Moreover, the most reliable and comprehensive statement about what works is that systematic reviews embark on identification, synthesis and assessment of the available proof, or qualitative and/or quantitative, as a way of generating a well-researched, and empirically derived answer to a specified research question (Petrosino et al. , cited in van der Knaap, 2008 ). The analysis also showed that most researchers utilized paraphrasing in their citing information. Even though it eases work for the researcher, paraphrasing may poorly present information if not used well. As advised, it is better to understand the readings and put them in your own words to preserve the accuracy of the information. Thus, understanding information and then properly paraphrasing will make the work look more original and refined. In this study, the researchers in many parts of the research failed to do an accurate performance in paraphrasing (i.e. there is an apparent weakness in meaning between the original source and the paraphrased text). This demonstrated that there was no accuracy in the paraphrasing used to cite information on the topics in question.

Regarding the quality of the literature review written by selected researchers, the data were gathered using a checklist by the evaluators who voluntarily distributed it into the inquiry to help the researcher to rate the performance of the 15 MA students in their dissertations. Generally, the results showed that students (the MA researchers) were keen on the conduct phase and then to some extent on data abstraction and analysis. Therefore, they know how to conduct their research, especially they have proper measures to ensure quality data abstraction. Moreover, chose data analysis techniques appropriately concerning the overall research questions and the data abstracted. Thus, they accurately search the process for types of reviews, and they did the inclusion and exclusion processes of articles transparent which makes their sample appropriate and in concordance with the overall purpose of the review. Additionally, in the design, concerning the relationship to the overall research field, their literature review was needed, and it makes a substantial, practical and theoretical contribution; the motivation, the purpose and the research questions were clearly stated and motivated; the methodology and the search strategy were clearly and transparently described. On the other hand, they were weak in phase 1 (design), item 3 “Does the review account for the previous literature review and other relevant literature ?”, and they did not clearly state the approaches for the literature review. Finally, the study found that they showed a weak achievement in structuring and writing the review, especially they did not organize articles coherently about the overall approach and research question, and the overall method of conducting the literature review was not sufficiently described, thus their studies could not be replicated.

Therefore, as shown in the purpose of this research, the review of intellectual production is most often the introduction to various theses or peer-review research articles, before presenting the methods and results, and its use is common in most academic research. Thus, the literature review represents one of the important parts of the scientific research plan ( Baumeister and Leary, 1997 ; Torraco, 2005 ). It is the second part that is related to the theoretical framework of the presented research methodology. Meanwhile, it is directly and closely related to the topic. Additionally, it represents an information-rich ground for those who have the desire to know all aspects of the problem or hypothesis in question. It consumes time and requires strong analytical skills from the researchers to make a great contribution successfully as mentioned by other scholars ( Boyd and Solarino, 2016 ; Mazumdar et al. , 2005 , pp. 84–102; Rodell et al ., 2016 ). As in the study questions, and to rationalize the topic, the findings concluded in this paper showed that the analysis and criticism of the literature review may require personal experiences, and others depend on the methodological foundations. The analysis and the criticism should include various dimensions (content, methodology, the sample, reliability and results). This was evident in the performance of these students in analyzing, criticizing and citing the previous studies they refer to. Thus, a researcher should have appropriate insight and wisdom to comment on previous studies and critique them constructively through compelling scientific evidence as well as to be objective and distant from any internal ideologies or personal bias. Therefore, some ideas and techniques that contribute to the process of editing, analyzing and criticizing literature review must be known by researchers ( MacInnis, 2011 ). Additionally, more attention should be given to structuring and writing the review mainly the organization of the review in relation to the overall approach and research questions.

Implications

The study came up with some implications that can help researchers in conducting their studies skillfully. These implications were drawn from the study's findings which may be very important for practice or conducting a literature review.

First: How to criticize the literature?

When looking at the literature review, one should focus on five main points that a study can follow. They are (1) content, (2) methodology, (3) the study sample, (4) credibility and (5) results. Content criticism: in this case, the researcher must express his/her point of view that the content of the previous studies does not include the technical framework that must be followed, and in that case, the study loses the advantage of comprehensiveness and moves away from objectivity in the way it is refuted.

Criticism related to methodology

Here, the researcher must clarify the negative and positive points in the scientific method followed in previous studies, and it is not a requirement that the literature might be negative or positive in its entirety. Accordingly, this is subject to the researcher's opinion, which is an expression of his/her point of view, and he/she has to present this according to convincing evidence which varies from one researcher to another.

Criticism related to the study sample

The researcher must mention any deficiencies in the sample under study which may be ineffective in judging previous literature, and it was possible to increase the sample size. To clarify a matter related to the research problem, the sample may not be represented in an appropriate statistical way, etc.

Credibility criticism

The researcher must verify the reliability of previous studies, and the method of ascertaining. This differs according to the methodology followed by the review studies (i.e. there is the descriptive, experimental and historical approach. For example, the historical method is distinguished by its credibility from others, and the researcher must refute that matter and follow the precise criteria in judging that, etc.). To judge the reliability of literature, the researcher must be familiar with all scientific research methods, their advantages and disadvantages, and the research hypotheses and theories that are compatible with those approaches.

Results criticism

The researcher may disagree with the results shown in previous studies. Because there is an error in the method of analyzing and presenting the data, so, the researcher must clarify the comparison between his/her findings and what was presented in other studies and indicate the extent of objectivity in each of them ( Snyder et al ., 2016 ; Verlegh and Steenkamp, 1999 ; Witell et al. , 2016 ). Additionally, the researcher should address only the previous studies related to the research topic, and the link must be clear to the reader, so it makes no sense to refer to previous research or studies that do not touch the research problem from near or far.

Second: How to comment on literature?

Previous studies help clarify the theoretical foundations of the subject of the research to be carried out by the researcher.

They save time and effort for the researcher by choosing the framework for the topic of the research plan.

They are a wake-up call for the researcher when writing a paper by defining a method that would avoid the researcher making mistakes made by previous researchers.

Present the correct methodological approach to the topic of research in general.

They give the researcher an exemplary method to extract recommendations, findings and other proposals related to the research.

Literature helps the researcher in identifying references for his/her research and facilitates the process of writing.

They have an important role in the researcher's comparison process between the research he provides and those studies and sources.

As many EFL MA researchers find it difficult to choose and handle a suitable literature review that approves their writing quality, thus, this study was conducted to find out a suitable step-by-step approach that can help to undertake a valid, comprehensive and helpful literature review. In conclusion, EFL MA researchers need to search for the quality and trustworthiness of their reviews to build a rich and adequate literature review. As found in this paper, it is seen that most MA Saudi researchers favored using the systematic review rather than the integrative type. More or less, they try to avoid comparing the review rather than identifying and synthesizing, as it may seem a more complicated process. Obviously, reviewing any article that could be relevant to the topic is not a simple task; therefore, a different strategy must be developed and used carefully to fulfill the quality of literature review along with the topic in question. More interestingly and generally, the researcher found that a semi-systematic review method often possesses similarities to approaches used in qualitative research ( Dundar and Fleeman, 2017 ), but it can also be combined with a statistical meta-analysis approach. Due to the integrative approach liability to yield a creative collection of data, it is widely used to combine perspectives and insights from previous research. Thus, the integrative approach seems to be the best method that can be used in the field of EFL because its purpose is to compare and combine rather than cover all related topics. Additionally, as the study found that students did not accurately paraphrase/summarize appropriately from other sources, additional sessions impeding paraphrasing procedures and processes will have valuable benefits and will make students better at writing research in the future. Concerning the phases of the quality of conducting research, it is important to ensure the proper measurement that qualifies the quality of data abstraction and analysis techniques that deal with the overall research questions accurately. Furthermore, searching for proper types of reviews, article transparency and the appropriate sample should fit the purpose of the review. Finally, among the broader implications of the study, it is expected that the construction of master's programs (courses path) should be reviewed, and focus should be given to teach students the quality standards of research writing and how to analyze and critique them in a better way.

Approaches to literature reviews

Note(s): *Adopted from Snyder's (2019 , p. 338) model “Guidelines to assess the quality of a literature review”

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Global employability skills in the 21st century workplace: A semi-systematic literature review

Affiliations.

• 1 School of Human Resource Development, National Institute of Development Administration, Bangkok, Thailand.
• 2 College of Business Administration, IUBAT-International University of Business Agriculture and Technology, Dhaka, Bangladesh.
• PMID: 37954286
• PMCID: PMC10637906
• DOI: 10.1016/j.heliyon.2023.e21023

This study conducts a semi-systematic literature review of research pertaining to employability to identify essential employability skills that employers seek in recent graduates. The comprehensive analysis of the existing literature review aims to present a set of global employability skills, identify similarities, variations, or changes in these skills across time, and explore the most relevant existing employability skills for the 21st-century workplace. The review includes 30 years of research articles and government reports published in English and considers 25 studies based on the Scientific Procedures and Rationales for Systematic Literature Reviews (SPAR-4-SLR). After removing duplicates, 87 unique skills were identified and listed under three distinct temporal themes (the 1990s, 2000s, and 2010s), with problem-solving, communication, teamwork, adaptability, and willingness to learn among the most commonly reported skills over time. The study found a mismatch between employers' expectations and graduates' possessed skills. Therefore, the list of employability skills identified in this study can serve as a valuable tool for addressing this mismatch. The study's findings can also help educators and employers to better align their efforts to prepare students for the modern workplace.

Keywords: 21st-century workplace; Employability skills; Employers' expectations; SPAR-4-SLR.

© 2023 The Authors. Published by Elsevier Ltd.

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• v.15(1); 2018 Feb

Wound care evidence, knowledge and education amongst nurses: a semi‐systematic literature review

1 School of Health, Nursing and Midwifery, University of the West of Scotland, Paisley Scotland

The aims of this study were to determine the knowledge and skills of nurses involved in wound care, to provide a critical overview of the current evidence base underpinning wound care and to determine the extent of utilisation of existing evidence by nurses involved in the management of wounds in practice.

A semi‐systematic review of the literature was undertaken on Cinahl, Medline Science Direct and Cochrane using the search terms: wound, tissue viability, education, nurse, with limitations set for dates between 2009 and 2017 and English language.

Shortfalls were found in the evidence base underpinning wound care and in links between evidence and practice, prevalence of ritualistic practice and in structured education at pre‐ and post‐registration levels.

The evidence underpinning wound care practice should be further developed, including the conduction of independent studies and research of qualitative design to obtain rich data on both patient and clinician experiences of all aspects of wound management. More structured wound care education programmes, both at pre‐registration/undergraduate and professional development levels, should be established.

Introduction/background

The presence of a wound represents a considerable burden in terms of economic cost to health and social care providers and impact on patient quality of life (QoL). This is notably so for chronic wounds, the definition of which has not been universally agreed upon but is generally accepted to refer to wounds that do not follow the normal stages of healing and in which healing is consequently delayed 1 . Whilst chronic wounds were previously estimated to cost the National Health Service (NHS) between £2·5 and £3 billion p/a 2 , more recent data propose that the annual cost to manage wounds and associated comorbidities is between £4·5 and £5·1 billion 3 . In addition, Augustin et al. 4 found living with a wound to have a negative multifactorial impact on psychosocial health and well‐being. This impact is recognised to be worsening with changing demographics and a population that is living longer with multiple comorbidities and chronic conditions 5 . In the UK, the increasing decentralisation of health and social care means that the majority of the burden lies within the community setting where district nurses (DNs) and other community health and social care providers are responsible for wound management 6 . Indeed, wound care represents between 35% and 65% of community nurses' caseloads ( 7 , 8 ), which has significant implications for an increasingly overstretched and pressurised DN work force 6 , 9 , 10 .

The effective management of chronic wounds is complex, and in order to maximise outcomes for patients, it is recommended that those involved in their care and treatment should have the appropriate knowledge and skills (European Wound Management Association 11 , 12 . This includes an understanding of the anatomy and physiology of tissue repair and aetiology and also knowledge pertaining to the selection of appropriate products and interventions to support the achievement of positive outcomes. The most obvious of these is wound closure, which is reflected in the frequency with which it is measured in studies 12 ; however, those relating to patient QoL are increasingly regarded with equal importance as wounds negatively impact all aspects of an individual's life, and complete closure is not always the ultimate goal of care (e.g., in palliative care patients for whom maximisation of comfort and dignity often takes precedence over healing) 13 . Despite this, little is known about nurses' knowledge and skills in wound care, both in relation to formal evidence and education and that which is from gleaned from experiential learning and clinical practice 14 , 15 . There is also debate surrounding the quality of evidence, which seeks to confirm the proposed effectiveness of particular types of wound treatments and products and factors influencing their selection 5 , 16 . A significant shortfall of this evidence is that it is largely driven and funded by industry, which may have potential methodological and ethical implications. It is therefore crucial that a more developed understanding of the evidence base underpinning the care of wounds and its role in shaping nurses' knowledge, education and clinical practice is achieved so that outcomes can be maximised.

The aim of this literature review is to provide a critical overview of the current evidence base underpinning wound care and the extent of utilisation of existing evidence by nurses involved in the management of wounds in practice. It will also seek to determine the knowledge and skills of nurses in relation to wound care and the sources from which it arises, including those that are formal (i.e. empirical evidence and structured education) and those that are informal (i.e. experiential, clinical practice and knowledge gleaned from colleagues).

Search strategy

An initial literature search was carried out in February 2017 on health care and scientific databases, including Cinahl, Medline, Cochrane,; Science Direct and PubMed, with the following key words singularly and in various combinations: Wound*, knowledge, nurs*, tissue viability, evidence, education.

Inclusion criteria were as follows: original research studies with no restrictions on design or methodology, English language, date of publication between 2009 and 2017 to source contemporary literature and all age groups.

Exclusion criteria were as follows: review papers, publications in languages other than English, date of publication before 2009, publications not fitting specified methodologies, publications focusing upon specialist or novel approaches to wound management, studies published with industry support and funding and studies focussing on specific or specialist wound care skills and practice.

The original search yielded 201 papers, which were filtered to 193 with the removal of duplicates; 193 papers were screened, with 104 excluded by title and abstract, and a further 84 excluded following review of full text and reference lists. An additional search on Google Scholar was carried out, but no further studies were identified. Saved searches were re‐run on a weekly basis until March 2017, but no new studies were identified, leaving a final total of five papers that fit the inclusion criteria (Figure ​ (Figure1 1 ).

Search strategy algorithm. PRISMA 35 .

To assist with structured methodological appraisal, a summary table was used (Table ​ (Table1). 1 ). An appraisal tool was adapted from the Critical Appraisal Skills Programme (CASP) for quantitative studies to support the critique of each study using the checklist approach that is recommended by the Centre for Reviews and Dissemination 17 .

Summary appraisal table

Key findings

The findings of the literature review highlighted a number of shortfalls and limitations pertaining to wound care knowledge and practice, with the following common sub‐themes emerging:

• Limitations in the evidence base pertaining to wound care, including the domination of studies published for corporate interest;
• Poorly developed links between evidence and wound care in practice;
• Recognition of insufficient wound care knowledge amongst nurses;
• The frequency of ritualistic and historic practice;
• Recognition of the need for more structured wound care education programmes for nurses at pre‐ and post‐registration levels.

A number of generic ontological and methodological limitations were identified with the evidence sourced – most notably that all studies took a similar post‐positivist approach, adopting descriptive and quantitative methodologies. A key and significant flaw is, therefore, the absence of studies underpinned by a constructivist or interpretivist paradigm and an overlooking of knowledge formation from contextual, individualistic and socially developed perspectives 18 . This might be contested to particularly misalign with the ethos of the nursing profession, which is embedded in person centeredness and holism 19 . The absence of studies adopting a qualitative design also overlooks the importance of rich contextual data, for example, that pertaining to nurses' views on their wound care knowledge and patients' lived experiences of having a wound 18 . The uniform choice of questionnaire and survey design methods considerably limit the variety of data that shape the resulting evidence base and may not accurately represent wound care in the practice setting, particularly because all studies relied upon data that was self‐reported.

In terms of methodological weakness, only one study utilised a validated tool to collate data, whilst a number of the sample sizes were small, with only one study completing a power calculation and others having relatively poor participant response rates. For the majority of studies, the approach to sampling was convenience, which may not have led to results reflective of wider nursing practice. No studies declared whether researchers had been previously known to participants and in what capacity, which could have contributed to a researcher effect 20 . This is considered to be an important factor in maintaining reliability in studies of positivist, realist and, to a lesser degree, post‐positivist ontology as contextual factors, including relationships between researchers and participants, should be highly controlled 20 . Finally, four of the studies used participants from only acute clinical settings, which limits the generalisability of the findings to wider areas of practice. This is particularly relevant in the UK where the majority of wound care is carried out in the community setting and may consequently account for community nurses having more developed skills in wound management 6 . However, the representation of wound care practice in a variety of geographical settings might be argued to shape a global perspective and enable useful comparisons to be made.

Each of the emergent themes will now be explored in succession.

Evidence in wound care

Nursing has been historically criticised for the absence of a distinct profession‐specific evidence base, instead borrowing on those from professions such as medicine and the social sciences 21 . To some extent, the academisation and move from an apprenticeship model to a higher education model has raised the profile of the profession in this capacity; however, there is still a reluctance amongst nurses to fully embrace evidence‐based practice (EBP), most notably within the clinical context 22 . This trend has been particularly visible within wound care, which has been argued to lag behind other areas of practice due to the lack of robust empirical evidence 23 . All five of the publications reviewed acknowledged this shortfall and the need to establish a more scientific evidence base 23 , 24 , 25 , 26 , 27 . Whilst national clinical guidelines, such as those produced by National Centre for Health and Care Excellence (NICE) in the UK, employ strict criteria for development (e.g., the underpinning of empirical evidence that is high on the hierarchy of evidence such as clinical trials), it was also recognised that, within wound care, nurses often rely upon evidence that is lower on the traditional hierarchy to shape practice 26 . This was particularly noted in relation to a lack of evidence supporting the efficacy of specific dressings 26 . However, although empirical evidence was widely agreed to be a crucial component of EBP in relation to wound care, additional types of knowledge, such as that gleaned from informal sources (i.e., experience, clinical practice and learning through colleagues), were also recognised to be important 23 , 24 , 25 , 26 , 27 . Indeed, the Centres for Disease Prevention and Control [CDC] in the USA applies a combination of empirical evidence, theoretical knowledge and contextual knowledge to shape each of its recommendations 26 , which supports an increasing awareness of the role of informal sources of knowledge in EBP. Dugdall and Watson 23 additionally recognised shortfalls in evidence pertaining to the management of wounds for specific patient groups (e.g. paediatrics and neonates) and a subsequent need to adopt evidence from studies conducted on adults to shape practice. However, it should be noted that this challenge is not unique to wound care as it is ethically problematic to carry out trials using paediatric and neonatal participants in all areas of practice 28 . A final factor is that much wound care research is supported by industry, leading to potential conflicts of interest in relation to overall corporate aim and the opportunity for ethical misconduct.

Poorly developed links between evidence and practice

All five of the studies either directly or indirectly identified poor links or barriers to the implementation of EBP. Although McCluskey and McCarthy 27 recognised the importance of informal sources of knowledge, such as experiential learning and intuition, in shaping competence in wound care practice, the lack of a structured approach and barriers to the implementation of EBP were also identified. As such, nurses' knowledge was, in some cases, found to be sufficient, but poor application negatively affected competence in practice. Gillespie et al . 26 also recognised the role of experiential knowledge but found gaps between knowledge and practice and a failure of nurses to apply recommendations made by national clinical guidelines, whilst a high number of respondents in deFaria et al . 24 and Ferreira et al . 25 reported a lack of awareness of the existence of local protocols or guidelines pertaining to wound care in their clinical area at all. Dugdall and Watson 23 found statistically significant correlations between positive attitudes to EBP and a specific tissue viability role ( P = 0·002), a first degree ( P = 0·001) and a formal tissue viability qualification ( P = 0·001), which suggests that EBP is more positively received by those with structured education. However, shortfalls in partnerships and integration between higher education/academic institutions and clinical sectors were also noted, which are also recognised to negatively affect the implementation of EBP in the practice setting 23 , 24 .

Inadequate wound care knowledge amongst nurses

Nurses' knowledge in wound care was addressed by five of the studies, all of which acknowledged an insufficiency to some degree. deFaria et al . 24 and Ferreira et al . 25 noted a clear deficit in knowledge in a number of areas pertaining to wound care (e.g. pressure ulcer grading, awareness of clinical guidelines/protocols, dressing selection etc.), although it should be noted that both studies were conducted in the same acute hospital in Brazil, which may identify shortfalls pertaining to the particular setting rather than to nursing in the wider sense. McCluskey and McCarthy 27 found that whilst wound care knowledge was sufficient to inform practice overall and somewhat better than reported in a number of previous studies, this was distinct from competence, which was often negatively affected by nurses' poor application of knowledge in the clinical setting. This was supported by Gillespie et al . 26 who found that despite having a good theoretical knowledge of wound assessment, Australian nurses working in the acute sector demonstrated similar poor links between knowledge and practice and poor application of clinical guidelines. Dugdall and Watson 23 was the only study that did not explicitly explore knowledge; however, they did identify a link between higher and specialist wound care education and a positive attitude to EBP, which subsequently led to better wound care practice. Although findings from some of the studies also suggested that nurses often lack product‐specific knowledge, which is required to make evidence‐based decisions in the selection of dressings 24 , 26 , in other studies, some participants reported a degree of confidence in product selection 25 . deFaria et al . 24 found that 70% of respondents attested that there were no wound care guidelines or standards in their area of practice, whilst a further 6% were unable to respond due to lack of information. When questioned about their level of professional autonomy in the selection of wound care products, 63% also stated that authorisation from the doctor was required in this capacity. This is in contrast to the UK where nurses historically take the lead in the management of wounds; however, although this might be argued to be reflective of differences in the organisational and professional hierarchies in health care, nurses from those studies carried out in other areas also reported some lack of knowledge, which reveals a potential deficit in a range of geographical settings 26 , 27 . Finally, only McCluskey and McCarthy 27 explored the nature and types of knowledge nurses apply to shape wound care practice, including those that are empirical, formal and explicit and also those that are tacit, informal and contextual, the latter of which were perceived to be linked to competence and experiential learning in practice.

Ritualistic and historic practice in wound care

Four of the studies attributed much wound care practice to derive from historic and ritualistic practices ( 23 , 24 , 25 , 26 ). Ferreira et al . 25 reported that wound care practice was rooted in tradition and myth; with Gillespie et al . 26 using the concept of the “sterile field” as an example of wound care practice, which is ritualistic rather than underpinned by evidence. Gillespie et al . 26 and McCluskey and McCarthy 27 both acknowledged the contextual and individualised nature of knowledge applied to wound care practice and a lack of standardisation that varied both within and between organisations. Dugdall and Watson 23 attributed this partly to the increasing availability of wound care products and nurses' reluctance to change the types of dressings used in case it appeared that they were challenging colleagues, whilst Gillespie et al . 26 attested that the selection of product can also be limited by contextual factors such as senior clinician preference and stock availability. McCluskey and McCarthy 27 also recognised the increasing complexity of wound aetiologies as a potential factor affecting ritualistic practice, whilst Ferreira et al . 25 and deFaria et al . 24 acknowledged challenges associated with accessing updated information about wound care and reliance upon colleagues' knowledge and experience as a means to address this. This was echoed by Gillespie et al . 26 , who reported that 75% of respondents obtained wound care information from informal sources, such as local specialists, rather than from scientific journals. Although learning from colleagues may be argued to present an opportunity for the maintenance of historic and ritualistic practice, in contrast, McCluskey and McCarthy 27 found that wound care competence in practice improved in accordance with length of clinician experience, which supports a positive link between contextual learning and competence in wound management.

Shortfalls in wound education

Dugdall and Watson 23 acknowledged the need for better education in EBP and research and also specifically recognised shortfalls in tissue viability content in undergraduate nursing education. This was echoed by Ferreira et al . 25 and deFaria et al . (2016) 24 , who found that 71·4% and 67·3% of respondents, respectively, reported to having insufficient formal wound care education, and McCluskey and McCarthy 27 , who recommended the implementation of better wound care education programmes for nurses working in acute setting. Gillespie et al . 26 did not specifically comment on the existence or effectiveness of formal wound care education or that accrued in practice but did acknowledge the existence of a positive relationship between higher education or specific tissue viability training and favourable attitudes towards EBP, which suggest that education improves practice. This may be argued to be of particular importance within the primary care sector as in a number of areas (e.g. across the UK), complex care is increasingly delivered in the community, and ineffective wound management would have a significant impact 6 .

It is clear from the findings of this review and from additional studies that the existence of high‐quality evidence pertaining to wound management is limited. This was found to be the case both in the generic sense but also in more specific areas of wound care practice (e.g. paediatrics) and was particularly notable in relation to the perceived effectiveness of specific products. This has been proposed to be related to a number of potential factors, notable of which may be that wound care practice has been traditionally led by the nursing profession rather than the medical profession, the latter of whom are historically regarded as the dominant health care professional 29 . As such, this may lead to their domination of competing research activity and resources but also to a failure to prioritise wound care and continually regard it as being of lesser importance than many clinical activities traditionally associated with doctors. It may also be linked to the lesser overall production of nursing research as nurses are recognised for their lesser engagement and reluctance to participate in scholarly activity in comparison to their medical counterparts. All of the publications acknowledged the need to establish a more scientific evidence base; however; despite attempts to gain legitimacy by aligning itself with the post‐positivist approach favoured by medicine 20 , nursing might be argued to be more ontologically in tune with the interpretivist/relativist/constructionist paradigms, which continue to be regarded with lesser scientific value amongst academic and research bodies than both the positivist and post‐positivist paradigms 30 . A further consideration is the links between wound care research and industry, although this has been addressed to some extent by the development of ethical codes of conduct for those employed by public sector and industry 31 , 32 .

Although empirical evidence was recognised to be a key component of practice [e.g. shaping national clinical wound care guidelines, such as those produced by the Scottish Intercollegiate Guidelines Network (SIGN) in the UK], nurses were also found to rely on evidence that is lower on the traditional hierarchy, with additional types of knowledge gleaned from informal sources (i.e. experience, clinical practice and learning through colleagues) also being recognised as important in all five studies. However, all studies also identified barriers to the implementation of EBP, including poor application of knowledge, failure to apply recommendations made by clinical guidelines or lack of awareness of protocols and guidelines altogether. Shortfalls in partnerships and integration between higher education/academic institutions and clinical sectors were also recognised to negatively affect the implementation of EBP in the practice setting 23 , 24 .

One of the shortfalls pertaining to the application of wound care theory to practice was the deficit in structured tissue viability education, both at an undergraduate level and that accredited by continuing professional development, which may be linked to the lack of prioritisation of wound care in comparison to other areas of practice and a consequential failure to organise and deliver sufficient education programmes. A further issue may be the increasing complexity of health demographics, which has led to a call in some circles for the preference of the term complex wounds rather than chronic wounds as the latter is defined by an association with time whilst the former recognises the growing underlying comorbidities that have a more multifactorial impact on wound healing 33 . This highlights an additional challenge for clinicians who are ultimately accountable for ensuring correct diagnosis, treatment pathways and responsible use of resources; however, this may be further limited by local systems and protocols impacting product availability in particular clinical areas (i.e. local wound care formularies). Additionally, the reduction of funding in CPD courses by NHS England in the UK may have a detrimental impact on access for those nurses wishing to undertake tissue viability courses, a development that is likely to filter out to other areas of the UK over time 34 .

A final point to note is that the majority of research pertaining to wound care is of quantitative design, and there is a noted absence of qualitative studies exploring either patients' or nurses' views, experiences and knowledge surrounding wounds and their management. Although the formal evidence base pertaining to wound care is unwaveringly limited, evidence and knowledge from less formal sources were more challenging to define. This was reflected in mixed evidence amongst the studies supporting the use of experiential and tacit learning in the practice setting and the conflicting results that emerged (i.e. learning from colleagues but also passing on ritualistic practices); however, experiential knowledge has been long recognised to be an important component of nursing practice, and there is no theoretical reason to believe this to be any less so in the field of wound care 14 , 15 .

This work reviewed literature pertaining to wound management to determine the current evidence base underpinning wound care, the extent of utilisation of existing evidence by nurses involved in the management of wounds and the knowledge and skills of nurses in relation to wound care. The evidence base pertaining to wound care practice was found to be limited, with weak links between EBP and practice‐heavy reliance upon industry support and funding, which may have potential ethical implications. Nurses were found to rely upon both formal and informal sources of knowledge to shape wound care practice; however, this contributed to the culture of ritualistic practice that withstands the clinical setting. A further impacting factor was found to be the inadequacy of wound care education at all levels.

Recommendations for practice

• The commitment to the conduction of independent studies in an effort to build the evidence base on all aspects of wound management;
• The commitment to the conduction of wound care research of qualitative design to obtain rich data on both patient and clinician experiences of all aspects of wound management;
• The development of more structured wound care education programmes at both pre‐registration/undergraduate and professional development levels;
• The commitment from nurse leaders and managers to support innovation and best practice through ongoing governance and audit activity.

Acknowledgements

The authors acknowledge Professor Ruth Deery, School of Health, Nursing and Midwifery, University of the West of Scotland, Dr Stephen Day, Assistant Dean, School of Education, University of the West of Scotland, Dr Vivian Crispin, Lecturer, School of Health, Nursing and Midwifery, University of the West of Scotland.

No conflicts of interest declared.