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Research Paper – Structure, Examples and Writing Guide

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Research Paper

Definition:

Research Paper is a written document that presents the author’s original research, analysis, and interpretation of a specific topic or issue.

It is typically based on Empirical Evidence, and may involve qualitative or quantitative research methods, or a combination of both. The purpose of a research paper is to contribute new knowledge or insights to a particular field of study, and to demonstrate the author’s understanding of the existing literature and theories related to the topic.

Structure of Research Paper

The structure of a research paper typically follows a standard format, consisting of several sections that convey specific information about the research study. The following is a detailed explanation of the structure of a research paper:

The title page contains the title of the paper, the name(s) of the author(s), and the affiliation(s) of the author(s). It also includes the date of submission and possibly, the name of the journal or conference where the paper is to be published.

The abstract is a brief summary of the research paper, typically ranging from 100 to 250 words. It should include the research question, the methods used, the key findings, and the implications of the results. The abstract should be written in a concise and clear manner to allow readers to quickly grasp the essence of the research.

Introduction

The introduction section of a research paper provides background information about the research problem, the research question, and the research objectives. It also outlines the significance of the research, the research gap that it aims to fill, and the approach taken to address the research question. Finally, the introduction section ends with a clear statement of the research hypothesis or research question.

Literature Review

The literature review section of a research paper provides an overview of the existing literature on the topic of study. It includes a critical analysis and synthesis of the literature, highlighting the key concepts, themes, and debates. The literature review should also demonstrate the research gap and how the current study seeks to address it.

The methods section of a research paper describes the research design, the sample selection, the data collection and analysis procedures, and the statistical methods used to analyze the data. This section should provide sufficient detail for other researchers to replicate the study.

The results section presents the findings of the research, using tables, graphs, and figures to illustrate the data. The findings should be presented in a clear and concise manner, with reference to the research question and hypothesis.

The discussion section of a research paper interprets the findings and discusses their implications for the research question, the literature review, and the field of study. It should also address the limitations of the study and suggest future research directions.

The conclusion section summarizes the main findings of the study, restates the research question and hypothesis, and provides a final reflection on the significance of the research.

The references section provides a list of all the sources cited in the paper, following a specific citation style such as APA, MLA or Chicago.

How to Write Research Paper

You can write Research Paper by the following guide:

• Choose a Topic: The first step is to select a topic that interests you and is relevant to your field of study. Brainstorm ideas and narrow down to a research question that is specific and researchable.
• Conduct a Literature Review: The literature review helps you identify the gap in the existing research and provides a basis for your research question. It also helps you to develop a theoretical framework and research hypothesis.
• Develop a Thesis Statement : The thesis statement is the main argument of your research paper. It should be clear, concise and specific to your research question.
• Plan your Research: Develop a research plan that outlines the methods, data sources, and data analysis procedures. This will help you to collect and analyze data effectively.
• Collect and Analyze Data: Collect data using various methods such as surveys, interviews, observations, or experiments. Analyze data using statistical tools or other qualitative methods.
• Organize your Paper : Organize your paper into sections such as Introduction, Literature Review, Methods, Results, Discussion, and Conclusion. Ensure that each section is coherent and follows a logical flow.
• Write your Paper : Start by writing the introduction, followed by the literature review, methods, results, discussion, and conclusion. Ensure that your writing is clear, concise, and follows the required formatting and citation styles.
• Edit and Proofread your Paper: Review your paper for grammar and spelling errors, and ensure that it is well-structured and easy to read. Ask someone else to review your paper to get feedback and suggestions for improvement.
• Cite your Sources: Ensure that you properly cite all sources used in your research paper. This is essential for giving credit to the original authors and avoiding plagiarism.

Research Paper Example

Note : The below example research paper is for illustrative purposes only and is not an actual research paper. Actual research papers may have different structures, contents, and formats depending on the field of study, research question, data collection and analysis methods, and other factors. Students should always consult with their professors or supervisors for specific guidelines and expectations for their research papers.

Research Paper Example sample for Students:

Title: The Impact of Social Media on Mental Health among Young Adults

Abstract: This study aims to investigate the impact of social media use on the mental health of young adults. A literature review was conducted to examine the existing research on the topic. A survey was then administered to 200 university students to collect data on their social media use, mental health status, and perceived impact of social media on their mental health. The results showed that social media use is positively associated with depression, anxiety, and stress. The study also found that social comparison, cyberbullying, and FOMO (Fear of Missing Out) are significant predictors of mental health problems among young adults.

Introduction: Social media has become an integral part of modern life, particularly among young adults. While social media has many benefits, including increased communication and social connectivity, it has also been associated with negative outcomes, such as addiction, cyberbullying, and mental health problems. This study aims to investigate the impact of social media use on the mental health of young adults.

Literature Review: The literature review highlights the existing research on the impact of social media use on mental health. The review shows that social media use is associated with depression, anxiety, stress, and other mental health problems. The review also identifies the factors that contribute to the negative impact of social media, including social comparison, cyberbullying, and FOMO.

Methods : A survey was administered to 200 university students to collect data on their social media use, mental health status, and perceived impact of social media on their mental health. The survey included questions on social media use, mental health status (measured using the DASS-21), and perceived impact of social media on their mental health. Data were analyzed using descriptive statistics and regression analysis.

Results : The results showed that social media use is positively associated with depression, anxiety, and stress. The study also found that social comparison, cyberbullying, and FOMO are significant predictors of mental health problems among young adults.

Discussion : The study’s findings suggest that social media use has a negative impact on the mental health of young adults. The study highlights the need for interventions that address the factors contributing to the negative impact of social media, such as social comparison, cyberbullying, and FOMO.

Conclusion : In conclusion, social media use has a significant impact on the mental health of young adults. The study’s findings underscore the need for interventions that promote healthy social media use and address the negative outcomes associated with social media use. Future research can explore the effectiveness of interventions aimed at reducing the negative impact of social media on mental health. Additionally, longitudinal studies can investigate the long-term effects of social media use on mental health.

Limitations : The study has some limitations, including the use of self-report measures and a cross-sectional design. The use of self-report measures may result in biased responses, and a cross-sectional design limits the ability to establish causality.

Implications: The study’s findings have implications for mental health professionals, educators, and policymakers. Mental health professionals can use the findings to develop interventions that address the negative impact of social media use on mental health. Educators can incorporate social media literacy into their curriculum to promote healthy social media use among young adults. Policymakers can use the findings to develop policies that protect young adults from the negative outcomes associated with social media use.

References :

• Twenge, J. M., & Campbell, W. K. (2019). Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Preventive medicine reports, 15, 100918.
• Primack, B. A., Shensa, A., Escobar-Viera, C. G., Barrett, E. L., Sidani, J. E., Colditz, J. B., … & James, A. E. (2017). Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among US young adults. Computers in Human Behavior, 69, 1-9.
• Van der Meer, T. G., & Verhoeven, J. W. (2017). Social media and its impact on academic performance of students. Journal of Information Technology Education: Research, 16, 383-398.

Appendix : The survey used in this study is provided below.

Social Media and Mental Health Survey

• How often do you use social media per day?
• Less than 30 minutes
• 30 minutes to 1 hour
• 1 to 2 hours
• 2 to 4 hours
• More than 4 hours
• Which social media platforms do you use?
• Others (Please specify)
• How often do you experience the following on social media?
• Social comparison (comparing yourself to others)
• Cyberbullying
• Fear of Missing Out (FOMO)
• Have you ever experienced any of the following mental health problems in the past month?
• Do you think social media use has a positive or negative impact on your mental health?
• Very positive
• Somewhat positive
• Somewhat negative
• Very negative
• In your opinion, which factors contribute to the negative impact of social media on mental health?
• Social comparison
• In your opinion, what interventions could be effective in reducing the negative impact of social media on mental health?
• Education on healthy social media use
• Counseling for mental health problems caused by social media
• Social media detox programs
• Regulation of social media use

Thank you for your participation!

Applications of Research Paper

Research papers have several applications in various fields, including:

• Advancing knowledge: Research papers contribute to the advancement of knowledge by generating new insights, theories, and findings that can inform future research and practice. They help to answer important questions, clarify existing knowledge, and identify areas that require further investigation.
• Informing policy: Research papers can inform policy decisions by providing evidence-based recommendations for policymakers. They can help to identify gaps in current policies, evaluate the effectiveness of interventions, and inform the development of new policies and regulations.
• Improving practice: Research papers can improve practice by providing evidence-based guidance for professionals in various fields, including medicine, education, business, and psychology. They can inform the development of best practices, guidelines, and standards of care that can improve outcomes for individuals and organizations.
• Educating students : Research papers are often used as teaching tools in universities and colleges to educate students about research methods, data analysis, and academic writing. They help students to develop critical thinking skills, research skills, and communication skills that are essential for success in many careers.
• Fostering collaboration: Research papers can foster collaboration among researchers, practitioners, and policymakers by providing a platform for sharing knowledge and ideas. They can facilitate interdisciplinary collaborations and partnerships that can lead to innovative solutions to complex problems.

When to Write Research Paper

Research papers are typically written when a person has completed a research project or when they have conducted a study and have obtained data or findings that they want to share with the academic or professional community. Research papers are usually written in academic settings, such as universities, but they can also be written in professional settings, such as research organizations, government agencies, or private companies.

Here are some common situations where a person might need to write a research paper:

• For academic purposes: Students in universities and colleges are often required to write research papers as part of their coursework, particularly in the social sciences, natural sciences, and humanities. Writing research papers helps students to develop research skills, critical thinking skills, and academic writing skills.
• For publication: Researchers often write research papers to publish their findings in academic journals or to present their work at academic conferences. Publishing research papers is an important way to disseminate research findings to the academic community and to establish oneself as an expert in a particular field.
• To inform policy or practice : Researchers may write research papers to inform policy decisions or to improve practice in various fields. Research findings can be used to inform the development of policies, guidelines, and best practices that can improve outcomes for individuals and organizations.
• To share new insights or ideas: Researchers may write research papers to share new insights or ideas with the academic or professional community. They may present new theories, propose new research methods, or challenge existing paradigms in their field.

Purpose of Research Paper

The purpose of a research paper is to present the results of a study or investigation in a clear, concise, and structured manner. Research papers are written to communicate new knowledge, ideas, or findings to a specific audience, such as researchers, scholars, practitioners, or policymakers. The primary purposes of a research paper are:

• To contribute to the body of knowledge : Research papers aim to add new knowledge or insights to a particular field or discipline. They do this by reporting the results of empirical studies, reviewing and synthesizing existing literature, proposing new theories, or providing new perspectives on a topic.
• To inform or persuade: Research papers are written to inform or persuade the reader about a particular issue, topic, or phenomenon. They present evidence and arguments to support their claims and seek to persuade the reader of the validity of their findings or recommendations.
• To advance the field: Research papers seek to advance the field or discipline by identifying gaps in knowledge, proposing new research questions or approaches, or challenging existing assumptions or paradigms. They aim to contribute to ongoing debates and discussions within a field and to stimulate further research and inquiry.
• To demonstrate research skills: Research papers demonstrate the author’s research skills, including their ability to design and conduct a study, collect and analyze data, and interpret and communicate findings. They also demonstrate the author’s ability to critically evaluate existing literature, synthesize information from multiple sources, and write in a clear and structured manner.

Characteristics of Research Paper

Research papers have several characteristics that distinguish them from other forms of academic or professional writing. Here are some common characteristics of research papers:

• Evidence-based: Research papers are based on empirical evidence, which is collected through rigorous research methods such as experiments, surveys, observations, or interviews. They rely on objective data and facts to support their claims and conclusions.
• Structured and organized: Research papers have a clear and logical structure, with sections such as introduction, literature review, methods, results, discussion, and conclusion. They are organized in a way that helps the reader to follow the argument and understand the findings.
• Formal and objective: Research papers are written in a formal and objective tone, with an emphasis on clarity, precision, and accuracy. They avoid subjective language or personal opinions and instead rely on objective data and analysis to support their arguments.
• Citations and references: Research papers include citations and references to acknowledge the sources of information and ideas used in the paper. They use a specific citation style, such as APA, MLA, or Chicago, to ensure consistency and accuracy.
• Peer-reviewed: Research papers are often peer-reviewed, which means they are evaluated by other experts in the field before they are published. Peer-review ensures that the research is of high quality, meets ethical standards, and contributes to the advancement of knowledge in the field.
• Objective and unbiased: Research papers strive to be objective and unbiased in their presentation of the findings. They avoid personal biases or preconceptions and instead rely on the data and analysis to draw conclusions.

Advantages of Research Paper

Research papers have many advantages, both for the individual researcher and for the broader academic and professional community. Here are some advantages of research papers:

• Contribution to knowledge: Research papers contribute to the body of knowledge in a particular field or discipline. They add new information, insights, and perspectives to existing literature and help advance the understanding of a particular phenomenon or issue.
• Opportunity for intellectual growth: Research papers provide an opportunity for intellectual growth for the researcher. They require critical thinking, problem-solving, and creativity, which can help develop the researcher’s skills and knowledge.
• Career advancement: Research papers can help advance the researcher’s career by demonstrating their expertise and contributions to the field. They can also lead to new research opportunities, collaborations, and funding.
• Academic recognition: Research papers can lead to academic recognition in the form of awards, grants, or invitations to speak at conferences or events. They can also contribute to the researcher’s reputation and standing in the field.
• Impact on policy and practice: Research papers can have a significant impact on policy and practice. They can inform policy decisions, guide practice, and lead to changes in laws, regulations, or procedures.
• Advancement of society: Research papers can contribute to the advancement of society by addressing important issues, identifying solutions to problems, and promoting social justice and equality.

Limitations of Research Paper

Research papers also have some limitations that should be considered when interpreting their findings or implications. Here are some common limitations of research papers:

• Limited generalizability: Research findings may not be generalizable to other populations, settings, or contexts. Studies often use specific samples or conditions that may not reflect the broader population or real-world situations.
• Potential for bias : Research papers may be biased due to factors such as sample selection, measurement errors, or researcher biases. It is important to evaluate the quality of the research design and methods used to ensure that the findings are valid and reliable.
• Ethical concerns: Research papers may raise ethical concerns, such as the use of vulnerable populations or invasive procedures. Researchers must adhere to ethical guidelines and obtain informed consent from participants to ensure that the research is conducted in a responsible and respectful manner.
• Limitations of methodology: Research papers may be limited by the methodology used to collect and analyze data. For example, certain research methods may not capture the complexity or nuance of a particular phenomenon, or may not be appropriate for certain research questions.
• Publication bias: Research papers may be subject to publication bias, where positive or significant findings are more likely to be published than negative or non-significant findings. This can skew the overall findings of a particular area of research.
• Time and resource constraints: Research papers may be limited by time and resource constraints, which can affect the quality and scope of the research. Researchers may not have access to certain data or resources, or may be unable to conduct long-term studies due to practical limitations.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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What Is a Research Paper?

• An Introduction to Punctuation

Olivia Valdes was the Associate Editorial Director for ThoughtCo. She worked with Dotdash Meredith from 2017 to 2021.

• B.A., American Studies, Yale University

A research paper is a common form of academic writing . Research papers require students and academics to locate information about a topic (that is, to conduct research ), take a stand on that topic, and provide support (or evidence) for that position in an organized report.

The term research paper may also refer to a scholarly article that contains the results of original research or an evaluation of research conducted by others. Most scholarly articles must undergo a process of peer review before they can be accepted for publication in an academic journal.

Define Your Research Question

The first step in writing a research paper is defining your research question . Has your instructor assigned a specific topic? If so, great—you've got this step covered. If not, review the guidelines of the assignment. Your instructor has likely provided several general subjects for your consideration. Your research paper should focus on a specific angle on one of these subjects. Spend some time mulling over your options before deciding which one you'd like to explore more deeply.

Try to choose a research question that interests you. The research process is time-consuming, and you'll be significantly more motivated if you have a genuine desire to learn more about the topic. You should also consider whether you have access to all of the resources necessary to conduct thorough research on your topic, such as primary and secondary sources .

Create a Research Strategy 

Approach the research process systematically by creating a research strategy. First, review your library's website. What resources are available? Where will you find them? Do any resources require a special process to gain access? Start gathering those resources—especially those that may be difficult to access—as soon as possible.

Second, make an appointment with a reference librarian . A reference librarian is nothing short of a research superhero. He or she will listen to your research question, offer suggestions for how to focus your research, and direct you toward valuable sources that directly relate to your topic.

Evaluate Sources

Now that you've gathered a wide array of sources, it's time to evaluate them. First, consider the reliability of the information. Where is the information coming from? What is the origin of the source? Second, assess the  relevance  of the information. How does this information relate to your research question? Does it support, refute, or add context to your position? How does it relate to the other sources you'll be using in your paper? Once you have determined that your sources are both reliable and relevant, you can proceed confidently to the writing phase. 

Why Write Research Papers? 

The research process is one of the most taxing academic tasks you'll be asked to complete. Luckily, the value of writing a research paper goes beyond that A+ you hope to receive. Here are just some of the benefits of research papers. 

• Learning Scholarly Conventions:  Writing a research paper is a crash course in the stylistic conventions of scholarly writing. During the research and writing process, you'll learn how to document your research, cite sources appropriately, format an academic paper, maintain an academic tone, and more.
• Organizing Information: In a way, research is nothing more than a massive organizational project. The information available to you is near-infinite, and it's your job to review that information, narrow it down, categorize it, and present it in a clear, relevant format. This process requires attention to detail and major brainpower.
• Managing Time: Research papers put your time management  skills to the test. Every step of the research and writing process takes time, and it's up to you to set aside the time you'll need to complete each step of the task. Maximize your efficiency by creating a research schedule and inserting blocks of "research time" into your calendar as soon as you receive the assignment. 
• Exploring Your Chosen Subject:  We couldn't forget the best part of research papers—learning about something that truly excites you. No matter what topic you choose, you're bound to come away from the research process with new ideas and countless nuggets of fascinating information. 

The best research papers are the result of genuine interest and a thorough research process. With these ideas in mind, go forth and research. Welcome to the scholarly conversation!

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Reference management. Clean and simple.

What is a research paper?

A research paper is a paper that makes an argument about a topic based on research and analysis.

Any paper requiring the writer to research a particular topic is a research paper. Unlike essays, which are often based largely on opinion and are written from the author's point of view, research papers are based in fact.

A research paper requires you to form an opinion on a topic, research and gain expert knowledge on that topic, and then back up your own opinions and assertions with facts found through your thorough research.

➡️ Read more about  different types of research papers .

What is the difference between a research paper and a thesis?

A thesis is a large paper, or multi-chapter work, based on a topic relating to your field of study.

A thesis is a document students of higher education write to obtain an academic degree or qualification. Usually, it is longer than a research paper and takes multiple years to complete.

Generally associated with graduate/postgraduate studies, it is carried out under the supervision of a professor or other academic of the university.

A major difference between a research paper and a thesis is that:

• a research paper presents certain facts that have already been researched and explained by others
• a thesis starts with a certain scholarly question or statement, which then leads to further research and new findings

This means that a thesis requires the author to input original work and their own findings in a certain field, whereas the research paper can be completed with extensive research only.

➡️ Getting ready to start a research paper or thesis? Take a look at our guides on how to start a research paper or how to come up with a topic for your thesis .

Frequently Asked Questions about research papers

Take a look at this list of the top 21 Free Online Journal and Research Databases , such as ScienceOpen , Directory of Open Access Journals , ERIC , and many more.

Mason Porter, Professor at UCLA, explains in this forum post the main reasons to write a research paper:

• To create new knowledge and disseminate it.
• To teach science and how to write about it in an academic style.
• Some practical benefits: prestige, establishing credentials, requirements for grants or to help one get a future grant proposal, and so on.

Generally, people involved in the academia. Research papers are mostly written by higher education students and professional researchers.

Yes, a research paper is the same as a scientific paper. Both papers have the same purpose and format.

A major difference between a research paper and a thesis is that the former presents certain facts that have already been researched and explained by others, whereas the latter starts with a certain scholarly question or statement, which then leads to further research and new findings.

Related Articles

Research Paper

29 December 2023

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A research paper is a product of seeking information, analysis, human thinking, and time. Basically, when scholars want to get answers to questions, they start to search for information to expand, use, approve, or deny findings. In simple words, research papers are results of processes by considering writing works and following specific requirements. Besides, scientists research and expand many theories, developing social or technological aspects of human science. However, in order to write relevant papers, they need to know a definition of the research, structure, characteristics, and types.

Definition of What Is a Research Paper and Its Meaning

A research paper is a common assignment. It comes to a situation when students, scholars, and scientists need to answer specific questions by using sources. Basically, a research paper is one of the types of papers where scholars analyze questions or topics , look for secondary sources , and write papers on defined themes. For example, if an assignment is to write a research paper on some causes of global warming or any other topic, a person must write a research proposal on it, analyzing important points and credible sources . Although essays focus on personal knowledge, writing a research paper means analyzing sources by following academic standards. Moreover, scientists must meet the structure of research papers. Therefore, writers need to analyze their research paper topics , start to research, cover key aspects, process credible articles, and organize final studies properly.

The Structure of a Research Work

The structure of research papers depends on assignment requirements. In fact, when students get their assignments and instructions, they need to analyze specific research questions or topics, find reliable sources , and write final works. Basically, the structure of research papers consists of the abstract , outline , introduction , literature review , methodology, results , discussion, recommendations, limitations, conclusion , acknowledgments , and references. However, students may not include some of these sections because of assigned instructions that they have and specific types of research papers. For instance, if instructions of papers do not suppose to conduct real experiments, the methodology section can be skipped because of the data’s absence. In turn, the structure of the final work consists of:

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🔸 The First Part of a Research Study

Abstract or an executive summary means the first section of a research paper that provides the study’s purpose, research questions or suggestions, main findings with conclusions. Moreover, this paragraph of about 150 words should be written when the whole work is finished already. Hence, abstract sections should describe key aspects of studies, including discussions about the relevance of findings.

Outline serves as a clear map of the structure of a research study.

Introduction provides the main information on problem statements, the indication of methodology, important findings, and principal conclusion. Basically, this section of a research paper covers rationales behind the work or background research, explanation of the importance, defending its relevance, a brief description of experimental designs, defined research questions, hypotheses, or key aspects.

🔸 Literature Review and Research or Experiment

Literature Review is needed for the analysis of past studies or scholarly articles to be familiar with research questions or topics. Hence, this section summarizes and synthesizes arguments and ideas from scholarly sources without adding new contributions. In turn, this part is organized around arguments or ideas, not sources.

Methodology or Materials and Methods covers explanations of research designs. Basically, techniques for gathering information and other aspects related to experiments must be described in a research paper. For instance, students and scholars document all specialized materials and general procedures. In this case, individuals may use some or all of the methods in further studies or judge the scientific merit of the work. Moreover, scientists should explain how they are going to conduct their experiments.

Results mean the gained information or data after the research or experiment. Basically, scholars should present and illustrate their findings. Moreover, this section may include tables or figures.

🔸 Analysis of Findings

Discussion is a section of a research paper where scientists review the information in the introduction part, evaluate gained results, or compare it with past studies. In particular, students and scholars interpret gained data or findings in appropriate depth. For example, if results differ from expectations at the beginning, scientists should explain why that may have happened. However, if results agree with rationales, scientists should describe theories that the evidence is supported.

Recommendations take its roots from a discussion section where scholars propose potential solutions or new ideas based on obtained results in a research paper. In this case, if scientists have any recommendations on how to improve this research so that other scholars can use evidence in further studies, they must write what they think in this section.

Limitations mean a consideration of research weaknesses and results to get new directions. For instance, if researchers found any limitations of studies that could affect experiments, scholars must not use such knowledge because of the same mistakes. Moreover, scientists should avoid contradicting results, and, even more, they must write it in this section.

🔸 The Final Part of a Conducted Research

Conclusion includes final claims of a research paper based on findings. Basically, this section covers final thoughts and the summary of the whole work. Moreover, this section may be used instead of limitations and recommendations that would be too small by themselves. In this case, scientists do not need to use headings for recommendations and limitations. Also, check out conclusion examples .

Acknowledgments or Appendix may take different forms, from paragraphs to charts. In this section, scholars include additional information on a research paper.

References mean a section where students, scholars, or scientists provide all used sources by following the format and academic rules.

Research Characteristics

Any type of work must meet some standards. By considering a research paper, this work must be written accordingly. In this case, the main characteristics of research papers are the length, style, format, and sources. Firstly, the length of research work defines the number of needed sources to analyze. Then, the style must be formal and covers impersonal and inclusive language. In turn, the format means academic standards of how to organize final works, including its structure and norms. Finally, sources and their number define works as research papers because of the volume of analyzed information. Hence, these characteristics must be considered while writing research papers.

Types of Research Papers

In general, the length of assignments can be different because of instructions. For example, there are two main types of research papers, such as typical and serious works. Firstly, a typical research paper may include definitive, argumentative, interpretive, and other works. In this case, typical papers are from 2 to 10 pages, where students analyze research questions or specific topics. Then, a serious research study is the expanded version of typical works. In turn, the length of such a paper is more than 10 pages. Basically, such works cover a serious analysis with many sources. Therefore, typical and serious works are two types of research papers.

Typical Research Papers

Basically, typical research works depend on assignments, the number of sources, and the paper’s length. So, a typical research paper is usually a long essay with the analyzed evidence. For example, students in high school and colleges get such assignments to learn how to research and analyze topics. In this case, they do not need to conduct serious experiments with the analysis and calculation of data. Moreover, students must use the Internet or libraries in searching for credible secondary sources to find potential answers to specific questions. As a result, students gather information on topics and learn how to take defined sides, present unique positions, or explain new directions. Hence, typical research papers require an analysis of primary and secondary sources without serious experiments or data.

Serious Research Studies

Although long papers require a lot of time for finding and analyzing credible sources, real experiments are an integral part of research work. Firstly, scholars at universities need to analyze the information from past studies to expand or disapprove of researched topics. Then, if scholars want to prove specific positions or ideas, they must get real evidence. In this case, experiments can be surveys, calculations, or other types of data that scholars do personally. Moreover, a dissertation is a typical serious research paper that young scientists write based on the research analysis of topics, data from conducted experiments, and conclusions at the end of work. Thus, serious research papers are studies that take a lot of time, analysis of sources with gained data, and interpretation of results.

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• Academic Writing

What is a Research Paper?

• Steps in Writing a Research Paper
• Critical Reading and Writing
• Punctuation
• Writing Exercises
• ELL/ESL Resources

"Research paper." What image comes into mind as you hear those words: working with stacks of articles and books, hunting the "treasure" of others' thoughts? Whatever image you create, it's a sure bet that you're envisioning sources of information--articles, books, people, artworks. Yet a research paper is more than the sum of your sources, more than a collection of different pieces of information about a topic, and more than a review of the literature in a field. A research paper analyzes a perspective argues a point . Regardless of the type of research paper you are writing, your finished research paper should present your own thinking backed up by others' ideas and information.

To draw a parallel, a lawyer researches and reads about many cases and uses them to support his or her own case. A scientist reads many case studies to support an idea about a scientific principle. In the same way, a history student writing about the Vietnam War might read newspaper articles and books and interview veterans to develop and/or confirm a viewpoint and support it with evidence.

A research paper is an expanded essay that presents your own interpretation or evaluation or argument. When you write an essay, you use everything that you personally know and have thought about a subject. When you write a research paper you build upon what you know about the subject and make a deliberate attempt to find out what experts know. A research paper involves surveying a field of knowledge in order to find the best possible information in that field. And that survey can be orderly and focused, if you know how to approach it. Don't worry--you won't get lost in a sea of sources.

In fact, this guide is designed to help you navigate the research voyage, through developing a research question and thesis, doing the research, writing the paper, and correctly documenting your sources.

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13.1 Formatting a Research Paper

Learning objectives.

• Identify the major components of a research paper written using American Psychological Association (APA) style.
• Apply general APA style and formatting conventions in a research paper.

In this chapter, you will learn how to use APA style , the documentation and formatting style followed by the American Psychological Association, as well as MLA style , from the Modern Language Association. There are a few major formatting styles used in academic texts, including AMA, Chicago, and Turabian:

• AMA (American Medical Association) for medicine, health, and biological sciences
• APA (American Psychological Association) for education, psychology, and the social sciences
• Chicago—a common style used in everyday publications like magazines, newspapers, and books
• MLA (Modern Language Association) for English, literature, arts, and humanities
• Turabian—another common style designed for its universal application across all subjects and disciplines

While all the formatting and citation styles have their own use and applications, in this chapter we focus our attention on the two styles you are most likely to use in your academic studies: APA and MLA.

If you find that the rules of proper source documentation are difficult to keep straight, you are not alone. Writing a good research paper is, in and of itself, a major intellectual challenge. Having to follow detailed citation and formatting guidelines as well may seem like just one more task to add to an already-too-long list of requirements.

Following these guidelines, however, serves several important purposes. First, it signals to your readers that your paper should be taken seriously as a student’s contribution to a given academic or professional field; it is the literary equivalent of wearing a tailored suit to a job interview. Second, it shows that you respect other people’s work enough to give them proper credit for it. Finally, it helps your reader find additional materials if he or she wishes to learn more about your topic.

Furthermore, producing a letter-perfect APA-style paper need not be burdensome. Yes, it requires careful attention to detail. However, you can simplify the process if you keep these broad guidelines in mind:

• Work ahead whenever you can. Chapter 11 “Writing from Research: What Will I Learn?” includes tips for keeping track of your sources early in the research process, which will save time later on.
• Get it right the first time. Apply APA guidelines as you write, so you will not have much to correct during the editing stage. Again, putting in a little extra time early on can save time later.
• Use the resources available to you. In addition to the guidelines provided in this chapter, you may wish to consult the APA website at http://www.apa.org or the Purdue University Online Writing lab at http://owl.english.purdue.edu , which regularly updates its online style guidelines.

General Formatting Guidelines

This chapter provides detailed guidelines for using the citation and formatting conventions developed by the American Psychological Association, or APA. Writers in disciplines as diverse as astrophysics, biology, psychology, and education follow APA style. The major components of a paper written in APA style are listed in the following box.

These are the major components of an APA-style paper:

Body, which includes the following:

• Headings and, if necessary, subheadings to organize the content
• In-text citations of research sources
• References page

All these components must be saved in one document, not as separate documents.

The title page of your paper includes the following information:

• Title of the paper
• Author’s name
• Name of the institution with which the author is affiliated
• Header at the top of the page with the paper title (in capital letters) and the page number (If the title is lengthy, you may use a shortened form of it in the header.)

List the first three elements in the order given in the previous list, centered about one third of the way down from the top of the page. Use the headers and footers tool of your word-processing program to add the header, with the title text at the left and the page number in the upper-right corner. Your title page should look like the following example.

The next page of your paper provides an abstract , or brief summary of your findings. An abstract does not need to be provided in every paper, but an abstract should be used in papers that include a hypothesis. A good abstract is concise—about one hundred fifty to two hundred fifty words—and is written in an objective, impersonal style. Your writing voice will not be as apparent here as in the body of your paper. When writing the abstract, take a just-the-facts approach, and summarize your research question and your findings in a few sentences.

In Chapter 12 “Writing a Research Paper” , you read a paper written by a student named Jorge, who researched the effectiveness of low-carbohydrate diets. Read Jorge’s abstract. Note how it sums up the major ideas in his paper without going into excessive detail.

Write an abstract summarizing your paper. Briefly introduce the topic, state your findings, and sum up what conclusions you can draw from your research. Use the word count feature of your word-processing program to make sure your abstract does not exceed one hundred fifty words.

Depending on your field of study, you may sometimes write research papers that present extensive primary research, such as your own experiment or survey. In your abstract, summarize your research question and your findings, and briefly indicate how your study relates to prior research in the field.

Margins, Pagination, and Headings

APA style requirements also address specific formatting concerns, such as margins, pagination, and heading styles, within the body of the paper. Review the following APA guidelines.

Use these general guidelines to format the paper:

• Set the top, bottom, and side margins of your paper at 1 inch.
• Use double-spaced text throughout your paper.
• Use a standard font, such as Times New Roman or Arial, in a legible size (10- to 12-point).
• Use continuous pagination throughout the paper, including the title page and the references section. Page numbers appear flush right within your header.
• Section headings and subsection headings within the body of your paper use different types of formatting depending on the level of information you are presenting. Additional details from Jorge’s paper are provided.

Begin formatting the final draft of your paper according to APA guidelines. You may work with an existing document or set up a new document if you choose. Include the following:

• Your title page
• The abstract you created in Note 13.8 “Exercise 1”
• Correct headers and page numbers for your title page and abstract

APA style uses section headings to organize information, making it easy for the reader to follow the writer’s train of thought and to know immediately what major topics are covered. Depending on the length and complexity of the paper, its major sections may also be divided into subsections, sub-subsections, and so on. These smaller sections, in turn, use different heading styles to indicate different levels of information. In essence, you are using headings to create a hierarchy of information.

The following heading styles used in APA formatting are listed in order of greatest to least importance:

• Section headings use centered, boldface type. Headings use title case, with important words in the heading capitalized.
• Subsection headings use left-aligned, boldface type. Headings use title case.
• The third level uses left-aligned, indented, boldface type. Headings use a capital letter only for the first word, and they end in a period.
• The fourth level follows the same style used for the previous level, but the headings are boldfaced and italicized.
• The fifth level follows the same style used for the previous level, but the headings are italicized and not boldfaced.

Visually, the hierarchy of information is organized as indicated in Table 13.1 “Section Headings” .

Table 13.1 Section Headings

A college research paper may not use all the heading levels shown in Table 13.1 “Section Headings” , but you are likely to encounter them in academic journal articles that use APA style. For a brief paper, you may find that level 1 headings suffice. Longer or more complex papers may need level 2 headings or other lower-level headings to organize information clearly. Use your outline to craft your major section headings and determine whether any subtopics are substantial enough to require additional levels of headings.

Working with the document you developed in Note 13.11 “Exercise 2” , begin setting up the heading structure of the final draft of your research paper according to APA guidelines. Include your title and at least two to three major section headings, and follow the formatting guidelines provided above. If your major sections should be broken into subsections, add those headings as well. Use your outline to help you.

Because Jorge used only level 1 headings, his Exercise 3 would look like the following:

Citation Guidelines

In-text citations.

Throughout the body of your paper, include a citation whenever you quote or paraphrase material from your research sources. As you learned in Chapter 11 “Writing from Research: What Will I Learn?” , the purpose of citations is twofold: to give credit to others for their ideas and to allow your reader to follow up and learn more about the topic if desired. Your in-text citations provide basic information about your source; each source you cite will have a longer entry in the references section that provides more detailed information.

In-text citations must provide the name of the author or authors and the year the source was published. (When a given source does not list an individual author, you may provide the source title or the name of the organization that published the material instead.) When directly quoting a source, it is also required that you include the page number where the quote appears in your citation.

This information may be included within the sentence or in a parenthetical reference at the end of the sentence, as in these examples.

Epstein (2010) points out that “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive” (p. 137).

Here, the writer names the source author when introducing the quote and provides the publication date in parentheses after the author’s name. The page number appears in parentheses after the closing quotation marks and before the period that ends the sentence.

Addiction researchers caution that “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive” (Epstein, 2010, p. 137).

Here, the writer provides a parenthetical citation at the end of the sentence that includes the author’s name, the year of publication, and the page number separated by commas. Again, the parenthetical citation is placed after the closing quotation marks and before the period at the end of the sentence.

As noted in the book Junk Food, Junk Science (Epstein, 2010, p. 137), “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive.”

Here, the writer chose to mention the source title in the sentence (an optional piece of information to include) and followed the title with a parenthetical citation. Note that the parenthetical citation is placed before the comma that signals the end of the introductory phrase.

David Epstein’s book Junk Food, Junk Science (2010) pointed out that “junk food cannot be considered addictive in the same way that we think of psychoactive drugs as addictive” (p. 137).

Another variation is to introduce the author and the source title in your sentence and include the publication date and page number in parentheses within the sentence or at the end of the sentence. As long as you have included the essential information, you can choose the option that works best for that particular sentence and source.

Citing a book with a single author is usually a straightforward task. Of course, your research may require that you cite many other types of sources, such as books or articles with more than one author or sources with no individual author listed. You may also need to cite sources available in both print and online and nonprint sources, such as websites and personal interviews. Chapter 13 “APA and MLA Documentation and Formatting” , Section 13.2 “Citing and Referencing Techniques” and Section 13.3 “Creating a References Section” provide extensive guidelines for citing a variety of source types.

Writing at Work

APA is just one of several different styles with its own guidelines for documentation, formatting, and language usage. Depending on your field of interest, you may be exposed to additional styles, such as the following:

• MLA style. Determined by the Modern Languages Association and used for papers in literature, languages, and other disciplines in the humanities.
• Chicago style. Outlined in the Chicago Manual of Style and sometimes used for papers in the humanities and the sciences; many professional organizations use this style for publications as well.
• Associated Press (AP) style. Used by professional journalists.

References List

The brief citations included in the body of your paper correspond to the more detailed citations provided at the end of the paper in the references section. In-text citations provide basic information—the author’s name, the publication date, and the page number if necessary—while the references section provides more extensive bibliographical information. Again, this information allows your reader to follow up on the sources you cited and do additional reading about the topic if desired.

The specific format of entries in the list of references varies slightly for different source types, but the entries generally include the following information:

• The name(s) of the author(s) or institution that wrote the source
• The year of publication and, where applicable, the exact date of publication
• The full title of the source
• For books, the city of publication
• For articles or essays, the name of the periodical or book in which the article or essay appears
• For magazine and journal articles, the volume number, issue number, and pages where the article appears
• For sources on the web, the URL where the source is located

The references page is double spaced and lists entries in alphabetical order by the author’s last name. If an entry continues for more than one line, the second line and each subsequent line are indented five spaces. Review the following example. ( Chapter 13 “APA and MLA Documentation and Formatting” , Section 13.3 “Creating a References Section” provides extensive guidelines for formatting reference entries for different types of sources.)

In APA style, book and article titles are formatted in sentence case, not title case. Sentence case means that only the first word is capitalized, along with any proper nouns.

Key Takeaways

• Following proper citation and formatting guidelines helps writers ensure that their work will be taken seriously, give proper credit to other authors for their work, and provide valuable information to readers.
• Working ahead and taking care to cite sources correctly the first time are ways writers can save time during the editing stage of writing a research paper.
• APA papers usually include an abstract that concisely summarizes the paper.
• APA papers use a specific headings structure to provide a clear hierarchy of information.
• In APA papers, in-text citations usually include the name(s) of the author(s) and the year of publication.
• In-text citations correspond to entries in the references section, which provide detailed bibliographical information about a source.

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Genre and the Research Paper

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This handout provides detailed information about how to write research papers including discussing research papers as a genre, choosing topics, and finding sources.

Research: What it is.

A research paper is the culmination and final product of an involved process of research, critical thinking, source evaluation, organization, and composition. It is, perhaps, helpful to think of the research paper as a living thing, which grows and changes as the student explores, interprets, and evaluates sources related to a specific topic. Primary and secondary sources are the heart of a research paper, and provide its nourishment; without the support of and interaction with these sources, the research paper would morph into a different genre of writing (e.g., an encyclopedic article). The research paper serves not only to further the field in which it is written, but also to provide the student with an exceptional opportunity to increase her knowledge in that field. It is also possible to identify a research paper by what it is not.

Research: What it is not.

A research paper is not simply an informed summary of a topic by means of primary and secondary sources. It is neither a book report nor an opinion piece nor an expository essay consisting solely of one's interpretation of a text nor an overview of a particular topic. Instead, it is a genre that requires one to spend time investigating and evaluating sources with the intent to offer interpretations of the texts, and not unconscious regurgitations of those sources. The goal of a research paper is not to inform the reader what others have to say about a topic, but to draw on what others have to say about a topic and engage the sources in order to thoughtfully offer a unique perspective on the issue at hand. This is accomplished through two major types of research papers.

Two major types of research papers.

Argumentative research paper:

The argumentative research paper consists of an introduction in which the writer clearly introduces the topic and informs his audience exactly which stance he intends to take; this stance is often identified as the thesis statement . An important goal of the argumentative research paper is persuasion, which means the topic chosen should be debatable or controversial. For example, it would be difficult for a student to successfully argue in favor of the following stance.

Perhaps 25 years ago this topic would have been debatable; however, today, it is assumed that smoking cigarettes is, indeed, harmful to one's health. A better thesis would be the following.

In this sentence, the writer is not challenging the current accepted stance that both firsthand and secondhand cigarette smoke is dangerous; rather, she is positing that the social acceptance of the latter over the former is indicative of a cultural double-standard of sorts. The student would support this thesis throughout her paper by means of both primary and secondary sources, with the intent to persuade her audience that her particular interpretation of the situation is viable.

Analytical research paper:

The analytical research paper often begins with the student asking a question (a.k.a. a research question) on which he has taken no stance. Such a paper is often an exercise in exploration and evaluation. For example, perhaps one is interested in the Old English poem Beowulf . He has read the poem intently and desires to offer a fresh reading of the poem to the academic community. His question may be as follows.

His research may lead him to the following conclusion.

Though his topic may be debatable and controversial, it is not the student's intent to persuade the audience that his ideas are right while those of others are wrong. Instead, his goal is to offer a critical interpretation of primary and secondary sources throughout the paper--sources that should, ultimately, buttress his particular analysis of the topic. The following is an example of what his thesis statement may look like once he has completed his research.

This statement does not negate the traditional readings of Beowulf ; instead, it offers a fresh and detailed reading of the poem that will be supported by the student's research.

It is typically not until the student has begun the writing process that his thesis statement begins to take solid form. In fact, the thesis statement in an analytical paper is often more fluid than the thesis in an argumentative paper. Such is one of the benefits of approaching the topic without a predetermined stance.

Mean, Mode and Median

Mean, mode and median are popular quantitative research methods used in business, as well as, engineering and computer sciences. In business studies these methods can be used in data comparisons such as comparing performances of two different businesses within the same period of time or comparing performance of the same business during different time periods.

Mean implies average and it is the sum of a set of data divided by the number of data. Mean can prove to be an effective tool when comparing different sets of data; however this method might be disadvantaged by the impact of extreme values.

Mode is the value that appears the most. A given set of data can contain more than one mode, or it can contain no mode at all. Extreme values have no impact on mode in data comparisons, however, the effectiveness of mode in data comparisons are compromised in the presence of more than one mode.

Median is the middle value when the data is arranged in numerical order. It is another effective tool to compare different sets of data, however, the negative impact of extreme values is lesser on median compared to mean.

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Ten simple rules for reading a scientific paper

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Kevin L. Steiner

William a. petri, jr, introduction.

“There is no problem that a library card can't solve” according to author Eleanor Brown [ 1 ]. This advice is sound, probably for both life and science, but even the best tool (like the library) is most effective when accompanied by instructions and a basic understanding of how and when to use it.

For many budding scientists, the first day in a new lab setting often involves a stack of papers, an email full of links to pertinent articles, or some promise of a richer understanding so long as one reads enough of the scientific literature. However, the purpose and approach to reading a scientific article is unlike that of reading a news story, novel, or even a textbook and can initially seem unapproachable. Having good habits for reading scientific literature is key to setting oneself up for success, identifying new research questions, and filling in the gaps in one’s current understanding; developing these good habits is the first crucial step.

Advice typically centers around two main tips: read actively and read often. However, active reading, or reading with an intent to understand, is both a learned skill and a level of effort. Although there is no one best way to do this, we present 10 simple rules, relevant to novices and seasoned scientists alike, to teach our strategy for active reading based on our experience as readers and as mentors of undergraduate and graduate researchers, medical students, fellows, and early career faculty. Rules 1–5 are big picture recommendations. Rules 6–8 relate to philosophy of reading. Rules 9–10 guide the “now what?” questions one should ask after reading and how to integrate what was learned into one’s own science.

Rule 1: Pick your reading goal

What you want to get out of an article should influence your approach to reading it. Table 1 includes a handful of example intentions and how you might prioritize different parts of the same article differently based on your goals as a reader.

1 Yay! Welcome!

2 A journal club is when a group of scientists get together to discuss a paper. Usually one person leads the discussion and presents all of the data. The group discusses their own interpretations and the authors’ interpretation.

Rule 2: Understand the author’s goal

In written communication, the reader and the writer are equally important. Both influence the final outcome: in this case, your scientific understanding! After identifying your goal, think about the author’s goal for sharing this project. This will help you interpret the data and understand the author’s interpretation of the data. However, this requires some understanding of who the author(s) are (e.g., what are their scientific interests?), the scientific field in which they work (e.g., what techniques are available in this field?), and how this paper fits into the author’s research (e.g., is this work building on an author’s longstanding project or controversial idea?). This information may be hard to glean without experience and a history of reading. But don’t let this be a discouragement to starting the process; it is by the act of reading that this experience is gained!

A good step toward understanding the goal of the author(s) is to ask yourself: What kind of article is this? Journals publish different types of articles, including methods, review, commentary, resources, and research articles as well as other types that are specific to a particular journal or groups of journals. These article types have different formatting requirements and expectations for content. Knowing the article type will help guide your evaluation of the information presented. Is the article a methods paper, presenting a new technique? Is the article a review article, intended to summarize a field or problem? Is it a commentary, intended to take a stand on a controversy or give a big picture perspective on a problem? Is it a resource article, presenting a new tool or data set for others to use? Is it a research article, written to present new data and the authors’ interpretation of those data? The type of paper, and its intended purpose, will get you on your way to understanding the author’s goal.

Rule 3: Ask six questions

When reading, ask yourself: (1) What do the author(s) want to know (motivation)? (2) What did they do (approach/methods)? (3) Why was it done that way (context within the field)? (4) What do the results show (figures and data tables)? (5) How did the author(s) interpret the results (interpretation/discussion)? (6) What should be done next? (Regarding this last question, the author(s) may provide some suggestions in the discussion, but the key is to ask yourself what you think should come next.)

Each of these questions can and should be asked about the complete work as well as each table, figure, or experiment within the paper. Early on, it can take a long time to read one article front to back, and this can be intimidating. Break down your understanding of each section of the work with these questions to make the effort more manageable.

Rule 4: Unpack each figure and table

Scientists write original research papers primarily to present new data that may change or reinforce the collective knowledge of a field. Therefore, the most important parts of this type of scientific paper are the data. Some people like to scrutinize the figures and tables (including legends) before reading any of the “main text”: because all of the important information should be obtained through the data. Others prefer to read through the results section while sequentially examining the figures and tables as they are addressed in the text. There is no correct or incorrect approach: Try both to see what works best for you. The key is making sure that one understands the presented data and how it was obtained.

For each figure, work to understand each x- and y-axes, color scheme, statistical approach (if one was used), and why the particular plotting approach was used. For each table, identify what experimental groups and variables are presented. Identify what is shown and how the data were collected. This is typically summarized in the legend or caption but often requires digging deeper into the methods: Do not be afraid to refer back to the methods section frequently to ensure a full understanding of how the presented data were obtained. Again, ask the questions in Rule 3 for each figure or panel and conclude with articulating the “take home” message.

Rule 5: Understand the formatting intentions

Just like the overall intent of the article (discussed in Rule 2), the intent of each section within a research article can guide your interpretation. Some sections are intended to be written as objective descriptions of the data (i.e., the Results section), whereas other sections are intended to present the author’s interpretation of the data. Remember though that even “objective” sections are written by and, therefore, influenced by the authors interpretations. Check out Table 2 to understand the intent of each section of a research article. When reading a specific paper, you can also refer to the journal’s website to understand the formatting intentions. The “For Authors” section of a website will have some nitty gritty information that is less relevant for the reader (like word counts) but will also summarize what the journal editors expect in each section. This will help to familiarize you with the goal of each article section.

Research articles typically contain each of these sections, although sometimes the “results” and “discussion” sections (or “discussion” and “conclusion” sections) are merged into one section. Additional sections may be included, based on request of the journal or the author(s). Keep in mind: If it was included, someone thought it was important for you to read.

Rule 6: Be critical

Published papers are not truths etched in stone. Published papers in high impact journals are not truths etched in stone. Published papers by bigwigs in the field are not truths etched in stone. Published papers that seem to agree with your own hypothesis or data are not etched in stone. Published papers that seem to refute your hypothesis or data are not etched in stone.

Science is a never-ending work in progress, and it is essential that the reader pushes back against the author’s interpretation to test the strength of their conclusions. Everyone has their own perspective and may interpret the same data in different ways. Mistakes are sometimes published, but more often these apparent errors are due to other factors such as limitations of a methodology and other limits to generalizability (selection bias, unaddressed, or unappreciated confounders). When reading a paper, it is important to consider if these factors are pertinent.

Critical thinking is a tough skill to learn but ultimately boils down to evaluating data while minimizing biases. Ask yourself: Are there other, equally likely, explanations for what is observed? In addition to paying close attention to potential biases of the study or author(s), a reader should also be alert to one’s own preceding perspective (and biases). Take time to ask oneself: Do I find this paper compelling because it affirms something I already think (or wish) is true? Or am I discounting their findings because it differs from what I expect or from my own work?

The phenomenon of a self-fulfilling prophecy, or expectancy, is well studied in the psychology literature [ 2 ] and is why many studies are conducted in a “blinded” manner [ 3 ]. It refers to the idea that a person may assume something to be true and their resultant behavior aligns to make it true. In other words, as humans and scientists, we often find exactly what we are looking for. A scientist may only test their hypotheses and fail to evaluate alternative hypotheses; perhaps, a scientist may not be aware of alternative, less biased ways to test her or his hypothesis that are typically used in different fields. Individuals with different life, academic, and work experiences may think of several alternative hypotheses, all equally supported by the data.

Rule 7: Be kind

The author(s) are human too. So, whenever possible, give them the benefit of the doubt. An author may write a phrase differently than you would, forcing you to reread the sentence to understand it. Someone in your field may neglect to cite your paper because of a reference count limit. A figure panel may be misreferenced as Supplemental Fig 3E when it is obviously Supplemental Fig 4E. While these things may be frustrating, none are an indication that the quality of work is poor. Try to avoid letting these minor things influence your evaluation and interpretation of the work.

Similarly, if you intend to share your critique with others, be extra kind. An author (especially the lead author) may invest years of their time into a single paper. Hearing a kindly phrased critique can be difficult but constructive. Hearing a rude, brusque, or mean-spirited critique can be heartbreaking, especially for young scientists or those seeking to establish their place within a field and who may worry that they do not belong.

Rule 8: Be ready to go the extra mile

To truly understand a scientific work, you often will need to look up a term, dig into the supplemental materials, or read one or more of the cited references. This process takes time. Some advisors recommend reading an article three times: The first time, simply read without the pressure of understanding or critiquing the work. For the second time, aim to understand the paper. For the third read through, take notes.

Some people engage with a paper by printing it out and writing all over it. The reader might write question marks in the margins to mark parts (s)he wants to return to, circle unfamiliar terms (and then actually look them up!), highlight or underline important statements, and draw arrows linking figures and the corresponding interpretation in the discussion. Not everyone needs a paper copy to engage in the reading process but, whatever your version of “printing it out” is, do it.

Rule 9: Talk about it

Talking about an article in a journal club or more informal environment forces active reading and participation with the material. Studies show that teaching is one of the best ways to learn and that teachers learn the material even better as the teaching task becomes more complex [ 4 – 5 ]; anecdotally, such observations inspired the phrase “to teach is to learn twice.”

Beyond formal settings such as journal clubs, lab meetings, and academic classes, discuss papers with your peers, mentors, and colleagues in person or electronically. Twitter and other social media platforms have become excellent resources for discussing papers with other scientists, the public or your nonscientist friends, or even the paper’s author(s). Describing a paper can be done at multiple levels and your description can contain all of the scientific details, only the big picture summary, or perhaps the implications for the average person in your community. All of these descriptions will solidify your understanding, while highlighting gaps in your knowledge and informing those around you.

Rule 10: Build on it

One approach we like to use for communicating how we build on the scientific literature is by starting research presentations with an image depicting a wall of Lego bricks. Each brick is labeled with the reference for a paper, and the wall highlights the body of literature on which the work is built. We describe the work and conclusions of each paper represented by a labeled brick and discuss each brick and the wall as a whole. The top brick on the wall is left blank: We aspire to build on this work and label this brick with our own work. We then delve into our own research, discoveries, and the conclusions it inspires. We finish our presentations with the image of the Legos and summarize our presentation on that empty brick.

Whether you are reading an article to understand a new topic area or to move a research project forward, effective learning requires that you integrate knowledge from multiple sources (“click” those Lego bricks together) and build upwards. Leveraging published work will enable you to build a stronger and taller structure. The first row of bricks is more stable once a second row is assembled on top of it and so on and so forth. Moreover, the Lego construction will become taller and larger if you build upon the work of others, rather than using only your own bricks.

Build on the article you read by thinking about how it connects to ideas described in other papers and within own work, implementing a technique in your own research, or attempting to challenge or support the hypothesis of the author(s) with a more extensive literature review. Integrate the techniques and scientific conclusions learned from an article into your own research or perspective in the classroom or research lab. You may find that this process strengthens your understanding, leads you toward new and unexpected interests or research questions, or returns you back to the original article with new questions and critiques of the work. All of these experiences are part of the “active reading”: process and are signs of a successful reading experience.

In summary, practice these rules to learn how to read a scientific article, keeping in mind that this process will get easier (and faster) with experience. We are firm believers that an hour in the library will save a week at the bench; this diligent practice will ultimately make you both a more knowledgeable and productive scientist. As you develop the skills to read an article, try to also foster good reading and learning habits for yourself (recommendations here: [ 6 ] and [ 7 ], respectively) and in others. Good luck and happy reading!

Acknowledgments

Thank you to the mentors, teachers, and students who have shaped our thoughts on reading, learning, and what science is all about.

Funding Statement

MAC was supported by the PhRMA Foundation's Postdoctoral Fellowship in Translational Medicine and Therapeutics and the University of Virginia's Engineering-in-Medicine seed grant, and KLS was supported by the NIH T32 Global Biothreats Training Program at the University of Virginia (AI055432). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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How to Write the Rationale of the Study in Research (Examples)

What is the Rationale of the Study?

The rationale of the study is the justification for taking on a given study. It explains the reason the study was conducted or should be conducted. This means the study rationale should explain to the reader or examiner why the study is/was necessary. It is also sometimes called the “purpose” or “justification” of a study. While this is not difficult to grasp in itself, you might wonder how the rationale of the study is different from your research question or from the statement of the problem of your study, and how it fits into the rest of your thesis or research paper. 

The rationale of the study links the background of the study to your specific research question and justifies the need for the latter on the basis of the former. In brief, you first provide and discuss existing data on the topic, and then you tell the reader, based on the background evidence you just presented, where you identified gaps or issues and why you think it is important to address those. The problem statement, lastly, is the formulation of the specific research question you choose to investigate, following logically from your rationale, and the approach you are planning to use to do that.

Table of Contents:

How to write a rationale for a research paper , how do you justify the need for a research study.

• Study Rationale Example: Where Does It Go In Your Paper?

The basis for writing a research rationale is preliminary data or a clear description of an observation. If you are doing basic/theoretical research, then a literature review will help you identify gaps in current knowledge. In applied/practical research, you base your rationale on an existing issue with a certain process (e.g., vaccine proof registration) or practice (e.g., patient treatment) that is well documented and needs to be addressed. By presenting the reader with earlier evidence or observations, you can (and have to) convince them that you are not just repeating what other people have already done or said and that your ideas are not coming out of thin air. 

Once you have explained where you are coming from, you should justify the need for doing additional research–this is essentially the rationale of your study. Finally, when you have convinced the reader of the purpose of your work, you can end your introduction section with the statement of the problem of your research that contains clear aims and objectives and also briefly describes (and justifies) your methodological approach. 

When is the Rationale for Research Written?

The author can present the study rationale both before and after the research is conducted. 

• Before conducting research : The study rationale is a central component of the research proposal . It represents the plan of your work, constructed before the study is actually executed.
• Once research has been conducted : After the study is completed, the rationale is presented in a research article or  PhD dissertation  to explain why you focused on this specific research question. When writing the study rationale for this purpose, the author should link the rationale of the research to the aims and outcomes of the study.

What to Include in the Study Rationale

Although every study rationale is different and discusses different specific elements of a study’s method or approach, there are some elements that should be included to write a good rationale. Make sure to touch on the following:

• A summary of conclusions from your review of the relevant literature
• What is currently unknown (gaps in knowledge)
• Inconclusive or contested results  from previous studies on the same or similar topic
• The necessity to improve or build on previous research, such as to improve methodology or utilize newer techniques and/or technologies

There are different types of limitations that you can use to justify the need for your study. In applied/practical research, the justification for investigating something is always that an existing process/practice has a problem or is not satisfactory. Let’s say, for example, that people in a certain country/city/community commonly complain about hospital care on weekends (not enough staff, not enough attention, no decisions being made), but you looked into it and realized that nobody ever investigated whether these perceived problems are actually based on objective shortages/non-availabilities of care or whether the lower numbers of patients who are treated during weekends are commensurate with the provided services.

In this case, “lack of data” is your justification for digging deeper into the problem. Or, if it is obvious that there is a shortage of staff and provided services on weekends, you could decide to investigate which of the usual procedures are skipped during weekends as a result and what the negative consequences are. 

In basic/theoretical research, lack of knowledge is of course a common and accepted justification for additional research—but make sure that it is not your only motivation. “Nobody has ever done this” is only a convincing reason for a study if you explain to the reader why you think we should know more about this specific phenomenon. If there is earlier research but you think it has limitations, then those can usually be classified into “methodological”, “contextual”, and “conceptual” limitations. To identify such limitations, you can ask specific questions and let those questions guide you when you explain to the reader why your study was necessary:

Methodological limitations

• Did earlier studies try but failed to measure/identify a specific phenomenon?
• Was earlier research based on incorrect conceptualizations of variables?
• Were earlier studies based on questionable operationalizations of key concepts?
• Did earlier studies use questionable or inappropriate research designs?

Contextual limitations

• Have recent changes in the studied problem made previous studies irrelevant?
• Are you studying a new/particular context that previous findings do not apply to?

Conceptual limitations

• Do previous findings only make sense within a specific framework or ideology?

Study Rationale Examples

Let’s look at an example from one of our earlier articles on the statement of the problem to clarify how your rationale fits into your introduction section. This is a very short introduction for a practical research study on the challenges of online learning. Your introduction might be much longer (especially the context/background section), and this example does not contain any sources (which you will have to provide for all claims you make and all earlier studies you cite)—but please pay attention to how the background presentation , rationale, and problem statement blend into each other in a logical way so that the reader can follow and has no reason to question your motivation or the foundation of your research.

Background presentation

Since the beginning of the Covid pandemic, most educational institutions around the world have transitioned to a fully online study model, at least during peak times of infections and social distancing measures. This transition has not been easy and even two years into the pandemic, problems with online teaching and studying persist (reference needed) . 

While the increasing gap between those with access to technology and equipment and those without access has been determined to be one of the main challenges (reference needed) , others claim that online learning offers more opportunities for many students by breaking down barriers of location and distance (reference needed) .  

Rationale of the study

Since teachers and students cannot wait for circumstances to go back to normal, the measures that schools and universities have implemented during the last two years, their advantages and disadvantages, and the impact of those measures on students’ progress, satisfaction, and well-being need to be understood so that improvements can be made and demographics that have been left behind can receive the support they need as soon as possible.

Statement of the problem

To identify what changes in the learning environment were considered the most challenging and how those changes relate to a variety of student outcome measures, we conducted surveys and interviews among teachers and students at ten institutions of higher education in four different major cities, two in the US (New York and Chicago), one in South Korea (Seoul), and one in the UK (London). Responses were analyzed with a focus on different student demographics and how they might have been affected differently by the current situation.

How long is a study rationale?

In a research article bound for journal publication, your rationale should not be longer than a few sentences (no longer than one brief paragraph). A  dissertation or thesis  usually allows for a longer description; depending on the length and nature of your document, this could be up to a couple of paragraphs in length. A completely novel or unconventional approach might warrant a longer and more detailed justification than an approach that slightly deviates from well-established methods and approaches.

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You can also find many more articles, for example on writing the other parts of your research paper , on choosing a title , or on making sure you understand and adhere to the author instructions before you submit to a journal, on the Wordvice academic resources pages.

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What the U.K.’s explosive Cass Review means for gender medicine in the U.S.

The report is a gauntlet thrown down to the biden administration and organizations supporting controversial treatments for children.

By Valerie Hudson

A 388-page bomb just dropped in the U.K., and reverberations will be felt around the world. The long-awaited final Cass Review — commissioned by the National Health Service on gender-related medical treatment — has just been published. Dr. Hilary Cass, the author of this independent review, is one of Britain’s preeminent pediatricians and formerly the president of the Royal College of Paediatrics and Child Health.

The Cass Review is painstaking in its detail and comprehensive in its scope. Its findings have already caused the U.K.’s Council for Psychotherapy to cease its advocacy for an uncritically affirming stance for those with gender dysphoria. In anticipation of the final report, last month the U.K. banned the NHS from providing puberty blockers, cross-sex hormones or surgery to minors. A law prohibiting private clinics from offering these practices is also in the works.

What does the Cass Review say?

Overall, it finds the evidence for the use of puberty blockers and cross-sex hormones as treatment for gender dysphoria to be quite weak.

With regard to puberty blockers, the review “found no evidence that puberty blockers improve body image or dysphoria, and very limited evidence for positive mental health outcomes, which without a control group could be due to placebo effect or concomitant psychological support.”

Additionally, the use of puberty blockers was not only associated with significant loss in bone density, but the review found evidence that “brain maturation may be temporarily or permanently disrupted by the use of puberty blockers, which could have a significant impact on the young person’s ability to make complex risk-laden decisions, as well as having possible longer-term neuropsychological consequences.”

The effects of puberty blockers may not, then, be reversible. In fact, the review notes, “given that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinising/ feminising hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.”

With regard to the use of cross-sex hormones, similar conclusions are reached: “There is a lack of high-quality research assessing the outcomes of hormone interventions in adolescents with gender dysphoria/incongruence, and few studies that undertake long-term follow up. No conclusions can be drawn about the effect on gender dysphoria, body satisfaction, psychosocial health, cognitive development, or fertility. Uncertainty remains about the outcomes for height/growth, cardiometabolic and bone health.”

Noting the lack of evidence as to benefits and harms, the author concludes that it is unethical to prescribe these medications to anyone under the age of 18, and possibly unethical to prescribe them to anyone younger than their mid-20s, when full executive reasoning has been achieved.

Proponents of gender-altering medical treatment have argued that treatment lowers the risk of suicide among gender dysphoric young people but Cass does not find this to be the case. The report says: “[I]t is well established that children and young people with gender dysphoria are at increased risk of suicide, but suicide risk appears to be comparable to other young people with a similar range of mental health and psychosocial challenges. Some clinicians feel under pressure to support a medical pathway based on widespread reporting that gender-affirming treatment reduces suicide risk. This conclusion was not supported by the systematic review. In summary, the evidence does not adequately support the claim that gender-affirming treatment reduces suicide risk.”

Given no real evidence of any improvement with use of puberty blockers and cross-sex hormones in gender dysphoric children, and given the clear gaps in the research literature, the review concludes that there can be no informed consent on the part of either parents or patients to this treatment. Without the possibility of informed consent, it is patently unethical for doctors to prescribe such treatments.

The Cass Review also weighs in on the issue of social transition, which has been a source of conflict between schools and parents in the U.K.

While U.K. schools are prepared to socially transition a child — and to do so without informing parents — the Cass Review asserts that social transition is consequential, especially for younger children. The review notes, “sex of rearing seems to have some influence on eventual gender outcome, and it is possible that social transition in childhood may change the trajectory of gender identity development for children with early gender incongruence. For this reason, a more cautious approach needs to be taken for children than for adolescents.” For this reason, the U.K. government has recently issued guidance to stop schools from socially transitioning children.

The concept of “conversion therapy” also needs to be rethought, according to the Cass Review. Given the significantly higher rate of mental health comorbidities of gender dysphoric children compared to controls, it is important that mental health professionals be allowed to investigate whether a child’s gender dysphoria may be relieved through psychological interventions. Proposed bans on “conversion therapy” might stifle such needed therapy.

Furthermore, the review insists that detransitioning support also be provided by the NHS since, according to Cass, the number of detransitioners appears to be increasing.

All in all, the Cass Review is an important achievement. It will be the foundation for an almost 180-degree turn in how the National Health Service treats gender dysphoric children. It is also a massive repudiation of the care guidelines put forward by WPATH, the World Professional Association of Transgender Healthcare. The guidelines have been unjustifiably influential given their “lack [of] developmental rigour,” as the review politely puts it.

But the report represents more, at least to Americans. It is a gauntlet thrown down to U.S. professional organizations, such as the American Medical Association, the American Academy of Pediatrics and the American Psychological Association, all of which have uncritically adopted the clearly unethical WPATH approach. It is also a gauntlet thrown down to the Biden administration, which has followed suit.

With the publication of the Cass Review, American institutions must rethink their approach to the treatment of gender dysphoric children. That approach is now clearly seen to be wrong, and can no longer be ethically justified.

I’m planning on mailing a copy of the review to the U.S. Department of Health and Human Services, care of Dr. Rachel Levine.

Valerie M. Hudson is a university distinguished professor at the Bush School of Government and Public Service at Texas A&M University and a Deseret News contributor. Her views are her own.

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Methodology

Research Methods | Definitions, Types, Examples

Research methods are specific procedures for collecting and analyzing data. Developing your research methods is an integral part of your research design . When planning your methods, there are two key decisions you will make.

First, decide how you will collect data . Your methods depend on what type of data you need to answer your research question :

• Qualitative vs. quantitative : Will your data take the form of words or numbers?
• Primary vs. secondary : Will you collect original data yourself, or will you use data that has already been collected by someone else?
• Descriptive vs. experimental : Will you take measurements of something as it is, or will you perform an experiment?

Second, decide how you will analyze the data .

• For quantitative data, you can use statistical analysis methods to test relationships between variables.
• For qualitative data, you can use methods such as thematic analysis to interpret patterns and meanings in the data.

Table of contents

Methods for collecting data, examples of data collection methods, methods for analyzing data, examples of data analysis methods, other interesting articles, frequently asked questions about research methods.

Data is the information that you collect for the purposes of answering your research question . The type of data you need depends on the aims of your research.

Qualitative vs. quantitative data

Your choice of qualitative or quantitative data collection depends on the type of knowledge you want to develop.

For questions about ideas, experiences and meanings, or to study something that can’t be described numerically, collect qualitative data .

If you want to develop a more mechanistic understanding of a topic, or your research involves hypothesis testing , collect quantitative data .

You can also take a mixed methods approach , where you use both qualitative and quantitative research methods.

Primary vs. secondary research

Primary research is any original data that you collect yourself for the purposes of answering your research question (e.g. through surveys , observations and experiments ). Secondary research is data that has already been collected by other researchers (e.g. in a government census or previous scientific studies).

If you are exploring a novel research question, you’ll probably need to collect primary data . But if you want to synthesize existing knowledge, analyze historical trends, or identify patterns on a large scale, secondary data might be a better choice.

Descriptive vs. experimental data

In descriptive research , you collect data about your study subject without intervening. The validity of your research will depend on your sampling method .

In experimental research , you systematically intervene in a process and measure the outcome. The validity of your research will depend on your experimental design .

To conduct an experiment, you need to be able to vary your independent variable , precisely measure your dependent variable, and control for confounding variables . If it’s practically and ethically possible, this method is the best choice for answering questions about cause and effect.

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Your data analysis methods will depend on the type of data you collect and how you prepare it for analysis.

Data can often be analyzed both quantitatively and qualitatively. For example, survey responses could be analyzed qualitatively by studying the meanings of responses or quantitatively by studying the frequencies of responses.

Qualitative analysis methods

Qualitative analysis is used to understand words, ideas, and experiences. You can use it to interpret data that was collected:

• From open-ended surveys and interviews , literature reviews , case studies , ethnographies , and other sources that use text rather than numbers.
• Using non-probability sampling methods .

Qualitative analysis tends to be quite flexible and relies on the researcher’s judgement, so you have to reflect carefully on your choices and assumptions and be careful to avoid research bias .

Quantitative analysis methods

Quantitative analysis uses numbers and statistics to understand frequencies, averages and correlations (in descriptive studies) or cause-and-effect relationships (in experiments).

You can use quantitative analysis to interpret data that was collected either:

• During an experiment .
• Using probability sampling methods .

Because the data is collected and analyzed in a statistically valid way, the results of quantitative analysis can be easily standardized and shared among researchers.

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

• Chi square test of independence
• Statistical power
• Descriptive statistics
• Degrees of freedom
• Pearson correlation
• Null hypothesis
• Double-blind study
• Case-control study
• Research ethics
• Data collection
• Hypothesis testing
• Structured interviews

Research bias

• Hawthorne effect
• Unconscious bias
• Recall bias
• Halo effect
• Self-serving bias
• Information bias

Quantitative research deals with numbers and statistics, while qualitative research deals with words and meanings.

Quantitative methods allow you to systematically measure variables and test hypotheses . Qualitative methods allow you to explore concepts and experiences in more detail.

In mixed methods research , you use both qualitative and quantitative data collection and analysis methods to answer your research question .

A sample is a subset of individuals from a larger population . Sampling means selecting the group that you will actually collect data from in your research. For example, if you are researching the opinions of students in your university, you could survey a sample of 100 students.

In statistics, sampling allows you to test a hypothesis about the characteristics of a population.

The research methods you use depend on the type of data you need to answer your research question .

• If you want to measure something or test a hypothesis , use quantitative methods . If you want to explore ideas, thoughts and meanings, use qualitative methods .
• If you want to analyze a large amount of readily-available data, use secondary data. If you want data specific to your purposes with control over how it is generated, collect primary data.
• If you want to establish cause-and-effect relationships between variables , use experimental methods. If you want to understand the characteristics of a research subject, use descriptive methods.

Methodology refers to the overarching strategy and rationale of your research project . It involves studying the methods used in your field and the theories or principles behind them, in order to develop an approach that matches your objectives.

Methods are the specific tools and procedures you use to collect and analyze data (for example, experiments, surveys , and statistical tests ).

In shorter scientific papers, where the aim is to report the findings of a specific study, you might simply describe what you did in a methods section .

In a longer or more complex research project, such as a thesis or dissertation , you will probably include a methodology section , where you explain your approach to answering the research questions and cite relevant sources to support your choice of methods.

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Political typology quiz.

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Where do you fit in the political typology?

Are you a faith and flag conservative progressive left or somewhere in between.

Take our quiz to find out which one of our nine political typology groups is your best match, compared with a nationally representative survey of more than 10,000 U.S. adults by Pew Research Center. You may find some of these questions are difficult to answer. That’s OK. In those cases, pick the answer that comes closest to your view, even if it isn’t exactly right.

About Pew Research Center Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of The Pew Charitable Trusts .

This paper is in the following e-collection/theme issue:

Published on 16.4.2024 in Vol 26 (2024)

User-Centered Development of a Patient Decision Aid for Choice of Early Abortion Method: Multi-Cycle Mixed Methods Study

Authors of this article:

Original Paper

• Kate J Wahl 1 , MSc   ; 
• Melissa Brooks 2 , MD   ; 
• Logan Trenaman 3 , PhD   ; 
• Kirsten Desjardins-Lorimer 4 , MD   ; 
• Carolyn M Bell 4 , MD   ; 
• Nazgul Chokmorova 4 , MD   ; 
• Romy Segall 2 , BSc, MD   ; 
• Janelle Syring 4 , MD   ; 
• Aleyah Williams 1 , MPH   ; 
• Linda C Li 5 , PhD   ; 
• Wendy V Norman 4, 6 * , MD, MHSc   ; 
• Sarah Munro 1, 3 * , PhD  

1 Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada

2 Department of Obstetrics and Gynecology, Dalhousie University, Halifax, NS, Canada

3 Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, United States

4 Department of Family Practice, University of British Columbia, Vancouver, BC, Canada

5 Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada

6 Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom

*these authors contributed equally

Corresponding Author:

Kate J Wahl, MSc

Department of Obstetrics and Gynecology

University of British Columbia

4500 Oak Street

Vancouver, BC, V6H 3N1

Phone: 1 4165231923

Email: [email protected]

Background: People seeking abortion in early pregnancy have the choice between medication and procedural options for care. The choice is preference-sensitive—there is no clinically superior option and the choice depends on what matters most to the individual patient. Patient decision aids (PtDAs) are shared decision-making tools that support people in making informed, values-aligned health care choices.

Objective: We aimed to develop and evaluate the usability of a web-based PtDA for the Canadian context, where abortion care is publicly funded and available without legal restriction.

Methods: We used a systematic, user-centered design approach guided by principles of integrated knowledge translation. We first developed a prototype using available evidence for abortion seekers’ decisional needs and the risks, benefits, and consequences of each option. We then refined the prototype through think-aloud interviews with participants at risk of unintended pregnancy (“patient” participants). Interviews were audio-recorded and documented through field notes. Finally, we conducted a web-based survey of patients and health care professionals involved with abortion care, which included the System Usability Scale. We used content analysis to identify usability issues described in the field notes and open-ended survey questions, and descriptive statistics to summarize participant characteristics and close-ended survey responses.

Results: A total of 61 individuals participated in this study. Further, 11 patients participated in think-aloud interviews. Overall, the response to the PtDA was positive; however, the content analysis identified issues related to the design, language, and information about the process and experience of obtaining abortion care. In response, we adapted the PtDA into an interactive website and revised it to include consistent and plain language, additional information (eg, pain experience narratives), and links to additional resources on how to find an abortion health care professional. In total, 25 patients and 25 health care professionals completed the survey. The mean System Usability Scale score met the threshold for good usability among both patient and health care professional participants. Most participants felt that the PtDA was user-friendly (patients: n=25, 100%; health care professionals: n=22, 88%), was not missing information (patients: n=21, 84%; health care professionals: n=18, 72%), and that it was appropriate for patients to complete the PtDA before a consultation (patients: n=23, 92%; health care professionals: n=23, 92%). Open-ended responses focused on improving usability by reducing the length of the PtDA and making the website more mobile-friendly.

Conclusions: We systematically designed the PtDA to address an unmet need to support informed, values-aligned decision-making about the method of abortion. The design process responded to a need identified by potential users and addressed unique sensitivities related to reproductive health decision-making.

Introduction

In total, 1 in 3 pregnancy-capable people in Canada will have an abortion in their lifetimes, and most will seek care early in pregnancy [ 1 ]. Medication abortion (using the gold-standard mifepristone/misoprostol regimen) and procedural abortion are common, safe, and effective options for abortion care in the first trimester [ 2 , 3 ]. The choice between using medications and presenting to a facility for a procedure is a preference-sensitive decision; there is no clinically superior option and the choice depends on what matters most to the individual patient regarding the respective treatments and the features of those options [ 4 - 6 ].

The choice of method of abortion can involve a process of shared decision-making, in which the patient and health care professional share the best available evidence about options, and the patient is supported to consider those options and clarify an informed preference [ 7 ]. There are many types of interventions available to support shared decision-making, including interventions targeting health care professionals (eg, educational materials, meetings, outreach visits, audit and feedback, and reminders) and patients (eg, patient decision aids [PtDA], appointment preparation packages, empowerment sessions, printed materials, and shared decision-making education) [ 8 ]. Of these interventions, PtDAs are well-suited to address challenges to shared decision-making about the method of abortion, including limited patient knowledge, public misinformation about options, poor access to health care professionals with sufficient expertise, and apprehension about abortion counseling [ 9 ].

PtDAs are widely used interventions that support people in making informed, deliberate health care choices by explicitly describing the health problem and decision, providing information about each option, and clarifying patient values [ 10 ]. The results of the 2023 Cochrane systematic review of 209 randomized controlled trials indicate that, compared to usual care (eg, information pamphlets or webpages), the use of PtDAs results in increases in patient knowledge, expectations of benefits and harms, clarity about what matters most to them, and participation in making a decision [ 11 ]. Of the studies included in the systematic review, 1 tested the effect of a PtDA leaflet for method of abortion and found that patients eligible for both medication and procedural abortion who received the PtDA were more knowledgeable, and had lower risk perceptions and decisional conflict than those who were in the control group [ 12 ]. However, that PtDA was developed 20 years ago in the UK health system and was not publicly available. A recent environmental scan of PtDAs for a method of abortion found that other available options meet few of the criteria set by the International Patient Decision Aid Standards (IPDAS) collaboration and do not include language and content optimized for end users [ 9 , 13 ].

Consequently, no PtDAs for method of abortion were available in Canada at the time of this study. This was a critical gap for both patients and health care professionals as, in 2017, mifepristone/misoprostol medication abortion came to the market, offering a new method of choice for people seeking abortion in the first trimester [ 14 ]. Unlike most jurisdictions, in Canada medication abortion is typically prescribed in primary care and dispensed in community pharmacies. Offering a PtDA in preparation for a brief primary care consultation allows the person seeking abortion more time to digest new information, consider their preferences, be ready to discuss their options, and make a quality decision.

In this context, we identified a need for a high-quality and publicly available PtDA to support people in making an informed choice about the method of abortion that reflects what is most important to them. Concurrently, our team was working in collaboration with knowledge users (health care professionals, patients, and health system decision makers) who were part of a larger project to investigate the implementation of mifepristone in Canada [ 15 , 16 ]. We, therefore, aimed to develop and evaluate the usability of a web-based PtDA for the Canadian context, where abortion care is publicly funded and available without legal restriction.

Study Design

We performed a mixed methods user-centered development and evaluation study informed by principles of integrated knowledge translation. Integrated knowledge translation is an approach to collaborative research in which researchers and knowledge users work together to identify a problem, conduct research as equal partners to address that problem, and coproduce research products that aim to impact health service delivery [ 17 ]. We selected this approach to increase the likelihood that our end PtDAs would be relevant, useable, and used for patients and health care professionals in Canada [ 17 ]. The need for a PtDA was identified through engagement with health care professionals. In 2017, they highlighted the need for patients to be supported in choosing between procedural care—which historically represented more than 90% of abortions in Canada [ 18 ]—and the newly available medication option [ 19 , 20 ]. This need was reaffirmed in 2022 by the Canadian federal health agency, Health Canada, which circulated a request for proposals to generate “evidence-based, culturally-relevant information aimed at supporting people in their reproductive decision-making and in accessing abortion services as needed” [ 21 ].

We operationalized integrated knowledge translation principles in a user-centered design process. User-centered design “grounds the characteristics of an innovation in information about the individuals who use that innovation, with a goal of maximizing ‘usability in context’” [ 22 ]. In PtDA development, user-centered design involves iteratively understanding users, developing and refining a prototype, and observing user interaction with the prototype [ 23 , 24 ]. Like integrated knowledge translation, this approach is predicated on the assumption that involving users throughout the process increases the relevance of the PtDA and the likelihood of successful implementation [ 24 ].

Our design process included the following steps ( Figure 1 ): identification of evidence about abortion patients’ decisional needs and the attributes of medication and procedural abortion that matter most from a patient perspective; development of a paper-based prototype; usability testing via think-aloud interviews with potential end users; refinement of the PtDA prototype into an interactive website; usability testing via a survey with potential end users and abortion health care professionals; and final revisions before launching the PtDA for real-world testing. Our systematic process was informed by user-centered methods for PtDA development [ 23 , 24 ], guidance from the IPDAS collaboration [ 25 - 27 ], and the Standards for Universal Reporting of Patient Decision Aid Evaluation checklist [ 10 ].

Our multidisciplinary team included experts in shared decision-making (SM and LT), a PhD student in patient-oriented knowledge translation (KJW), experts in integrated knowledge translation with health care professionals and policy makers (WVN and SM), clinical experts in abortion counseling and care (WVN and MB), a medical undergraduate student (RS), a research project coordinator (AW), and family medicine residents (KD-L, CMB, NC, and JS) who had an interest in abortion care. Additionally, a panel of experts external to the development process reviewed the PtDA for clinical accuracy following each revision of the prototype. These experts included coauthors of the national Society for Obstetricians and Gynaecologists of Canada (SOGC) clinical practice guidelines for abortion care in Canada. They were invited to this project because of their knowledge of first-trimester abortion care as well as their ability to support the implementation of the PtDA in guidelines and routine clinical practice.

Ethical Considerations

The research was approved by the University of British Columbia Children’s and Women’s Research Ethics Board (H16-01006) and the Nova Scotia Health Research Ethics Board (1027637). In each round of testing, participants received a CAD $20 (US $14.75) Amazon gift card by email for their participation.

Preliminary Work: Identification of Evidence

We identified the decisional needs of people seeking early abortion care using a 2018 systematic review of reasons for choosing an abortion method [ 28 ], an additional search that identified 1 study conducted in Canada following the 2017 availability of mifepristone/misoprostol medication abortion [ 29 ], and the SOGC clinical practice guidelines [ 2 , 3 ]. The review identified several key factors that matter most for patient choice of early abortion method: perceived simplicity and “naturalness,” fear of complication or bleeding , fear of anesthesia or surgery , timing of the procedure , and chance of sedation . The additional Canadian study found that the time required to complete the abortion and side effects were important factors. According to the SOGC clinical practice guidelines, the key information that should be communicated to the patient are gestational age limits and the risk of complications with increasing gestational age [ 2 , 3 ]. The guidelines also indicate that wait times , travel times , and cost considerations may be important in a person’s choice of abortion method and should be addressed [ 2 , 3 ].

We compiled a long list of attributes for our expert panel and then consolidated and refined the attribute list through each stage of the prototype evaluation. For evidence of how these factors differed for medication and procedural abortion, we drew primarily from the SOGC clinical practice guidelines for abortion [ 2 , 3 ]. For cost considerations, we described the range of federal, provincial, and population-specific programs that provide free coverage of abortion care for people in Canada.

Step 1: Developing the Prototype

Our goal was to produce an interactive, web-based PtDA that would be widely accessible to people seeking an abortion in Canada by leveraging the widespread use of digital health information, especially among reproductive-aged people [ 30 ]. Our first prototype was based on a previously identified paper-based question-and-answer comparison grid that presented evidence-based information about the medication and procedural options [ 9 , 31 ]. We calculated readability by inputting the plain text of the paper-based prototype into a Simple Measure of Gobbledygook (SMOG) Index calculator [ 32 ].

We made 2 intentional deviations from common practices in PtDA development [ 33 ]. First, we did not include an “opt-out” or “do nothing” option, which would describe the natural course of pregnancy. We chose to exclude this option to ensure clarity for users regarding the decision point; specifically, our decision point of interest was the method of abortion, not the choice to terminate or continue a pregnancy. Second, we characterized attributes of the options as key points rather than positive and negative features to avoid imposing value judgments onto subjective features (eg, having the abortion take place at home may be beneficial for some people but may be a deterrent for others).

Step 2: Usability Testing of the Prototype

We first conducted usability testing involving think-aloud interviews with patient participants to assess the paper-based prototype. Inclusion criteria included people aged 18-49 years assigned-female-at-birth who resided in Canada and could speak and read English. In January 2020, we recruited participants for the first round of think-aloud interviews [ 34 ] via email and poster advertising circulated to (1) a network of parent research advisors who were convened to guide a broader program of research about pregnancy and childbirth in British Columbia, Canada, and (2) a clinic providing surgical abortion care in Nova Scotia, Canada, as well as snowball sampling with participants. We purposively sought to advertise this study with these populations to ensure variation in age, ethnicity, level of education, parity, and abortion experience. Interested individuals reviewed this study information form and provided consent to participate, before scheduling an interview. The interviewer asked participants to think aloud as they navigated the prototype, for example describing what they liked or disliked, missing information, or lack of clarity. The interviewer noted the participant’s feedback on a copy of the prototype during the interview. Finally, the participant responded to questions adapted from the System Usability Scale [ 35 ], a measure designed to collect subjective ratings of a product’s usability, and completed a brief demographic questionnaire. The interviews were conducted via videoconferencing and were audio recorded. We deidentified the qualitative data and assigned each participant a unique identifier. Then, the interviewer listened to the recording and revised their field notes with additional information including relevant quotes.

For the analysis of think-aloud interviews, we used inductive content analysis to describe the usability and acceptability of different elements of the PtDA [ 36 ]. Further, 3 family medicine residents (KD-L, CMB, and NC) under guidance from a senior coauthor (SM) completed open coding to develop a list of initial categories, which we grouped under higher-order headings. We then organized these results in a table to illustrate usability issues (categories), illustrative participant quotes, and modifications to make. We then used the results of interviews to adapt the prototype into a web-based format, which we tested via further think-aloud interviews and a survey with people capable of becoming pregnant and health care professionals involved with abortion care.

Step 3: Usability Testing of the Website

For the web-based format, we used DecideApp PtDA open-source software, which provides a sustainable solution to the problems of low quality and high maintenance costs faced by web-based PtDAs by allowing developers to host, maintain, and update their tools at no cost. This software has been user-tested and can be accessed by phone, tablet, or computer [ 37 , 38 ]. It organizes a PtDA into 6 sections: Introduction, About Me, My Values, My Choice, Review, and Next Steps. In the My Values section, an interactive values clarification exercise allows users to rank and make trade-offs between attributes of the options. The final pages provide an opportunity for users to make a choice, complete a knowledge self-assessment, and consider the next steps to access their chosen method.

From July to August 2020, we recruited patient and health care professional participants using Twitter and the email list of the Canadian Abortion Providers Support platform, respectively. Participants received an email with a link to the PtDA and were redirected to the survey once they had navigated through the PtDA. As above, inclusion criteria included people aged 18-49 years assigned as female-at-birth who resided in Canada. Among health care professionals, we included eligible prescribers who may not have previously engaged in abortion care (family physicians, residents, nurse practitioners, and midwives), and allied health professionals and stakeholders who provide or support abortion care, who practiced in Canada. All participants had to speak and read English.

The survey included 3 sections: usability, implementation, and participant characteristics. The usability section consisted of the System Usability Scale [ 35 ], and purpose-built questions about what participants liked and disliked about the PtDA. The implementation section included open- and close-ended questions about how the PtDA compares to other resources and when it could be implemented in the care pathway. Patient participants also completed the Control Preference Scale, a validated measure used to determine their preferred role in decision-making (active, collaborative, or passive) [ 39 ]. Data on participant characteristics included gender, abortion experience (patient participants), and abortion practice (health care professional participants). We deidentified the qualitative data and assigned each participant a unique identifier. For the analysis of survey data, we characterized close-ended responses using descriptive statistics, and, following the analysis procedures described in Step 2 in the Methods section, used inductive content analysis of open-ended responses to generate categories associated with usability and implementation [ 36 ]. In 2021, we made minor revisions to the website based on the results of usability testing and published the PtDA for use in routine clinical care.

In the following sections, we outline the results of the development process including the results of the think-aloud interviews and survey, as well as the final decision aid prototype.

Our initial prototype, a paper-based question-and-answer comparison grid, presented evidence-based information comparing medication and procedural abortion. The first version of the prototype also included a second medication abortion regimen involving off-label use of methotrexate, however, we removed this option following a review by the clinical expert panel who advised us that there is very infrequent use of this regimen in Canada in comparison to the gold standard medication abortion option, mifepristone. Other changes at this stage involved clarifying the scope of practice (health care professionals other than gynecologists can perform a procedural abortion), abortion practice (gestational age limit and how the medication is taken), the abortion experience (what to expect in terms of bleeding), and risk (removing information about second- and third-trimester abortion). The updated prototype was finalized by a scientist (SM) and trainee (KJW) with expertise in PtDA development. The prototype (see Multimedia Appendix 1 ) was ultimately 4 pages long and described 18 attributes of each option framed as Frequently Asked Questions, including abortion eligibility (How far along in pregnancy can I be?), duration (How long does it take?), and side effects (How much will I bleed?). The SMOG grade level was 8.4.

Participant Characteristics

We included 11 participants in think-aloud interviews between January and July 2020, including 7 recruited through a parent research advisory network and 4 individuals who had recently attended an abortion clinic. The mean interview duration was 36 minutes (SD 6 minutes). The participants ranged in age from 31 to 37 years. All had been pregnant and 8 out of 11 (73%) participants had a personal experience of abortion (4 participants who had recently attended an abortion clinic and 4 participants from the parent research advisory who disclosed their experience during the interview). The characteristics of the sample are reported in Table 1 .

Overall, participants had a positive view of the paper-based, comparison grid PtDA. In total, 1 participant who had recently sought an abortion said, “I think this is great and super helpful. It would’ve been awesome to have had access to this right away … I don’t think there’s really anything missing from here that I was Googling about” (DA010). The only participant who expressed antichoice views indicated that the PtDA would be helpful to someone seeking to terminate a pregnancy (DA001). Another participant said, “[The PtDA] is not biased, it’s not like you’re going to die. It’s a fact, you know the facts and then you decide whether you want it or not. A lot of people feel it’s so shameful and judgmental, but this is very straightforward. I like it.” (DA002). Several participants stated they felt more informed and knowledgeable about the options.

In response to questions adapted from the System Usability Scale, all 11 participants agreed that the PtDA was easy to use, that most people could learn to use it quickly, and that they felt very confident using the prototype, and disagreed that it was awkward to use. In total, 8 (73%) participants agreed with the statement that the components of the PtDA were well-integrated. A majority of participants disagreed with the statements that the website was unnecessarily complex (n=8, 73%), that they would need the support of an expert to use it (n=8, 73%), that it was too inconsistent (n=9, 82%), and that they would need to learn a lot before using it (n=8, 73%). Further, 2 (18%) participants agreed with the statements that the PtDA was unnecessarily complex and that they would need to learn a lot before using it. Furthermore, 1 (9%) participant agreed with the statement that the PtDA was too inconsistent.

Through inductive analysis of think-aloud interviews, we identified 4 key usability categories: design, language, process, and experience.

Participants liked the side-by-side comparison layout, appreciated the summary of key points to remember, and said that overall, the presented information was clear. For example, 1 participant reflected, “I think it’s very clear ... it’s very simplistic, people will understand the left-hand column is for medical abortion and the right-hand column is for surgical.” (DA005) Some participants raised concerns about the aesthetics of the PtDA, difficulties recalling the headers across multiple pages, and the overall length of the PtDA.

Participants sought to clarify language at several points in the PtDA. Common feedback was that the gestational age limit for the medication and the procedure should be clarified. Participants also pointed out inconsistent use of language (eg, doctor and health care professional) and medical jargon.

Several participants were surprised to learn that family doctors could provide abortion care. Others noted that information about the duration—including travel time—and number of appointments for both medication and procedural abortion could be improved. In addition to clarifying the abortion process, several participants suggested including additional information and resources to help identify an abortion health care professional, understand when to seek help for abortion-related complications, and access emotional support. It was also important to participants that financial impacts (eg, hospital parking and menstrual pads) were included for each option.

Participants provided insight into the description of the physical, psychological, and other consequences associated with the abortion medication and procedure. Participants who had both types of abortion care felt that the description of pain that “may be worse than a period” was inaccurate. Other participants indicated that information about perceived and real risks was distressing or felt out of place, such as correcting myths about future fertility or breast cancer. Some participants indicated that patient stories would be valuable saying, for example, “I think what might be nice to help with the decision-making process is reading stories of people’s experiences” (DA006).

Modifications Made

Changes made based on these findings are described in Table 2 . Key user-centered modifications included transitioning to a web-based format with a consistent color scheme, clarifying who the PtDA is for (for typical pregnancies up to 10 weeks), adding information about telemedicine to reflect guidelines for the provision of abortion during pandemics, and developing brief first-person qualitative descriptions of the pain intensity for each option.

Through analysis of the interviews and consultation with our panel of clinical experts, we also identified that, among the 18 initial attributes in our prototype, 7 had the most relative importance to patients in choosing between medication and procedural abortion. These attributes also represented important differences between each option which forced participants to consider the trade-offs they were willing to make. Thus we moved all other potential attributes into an information section (My Options) that supported the user to gain knowledge before clarifying what mattered most to them by considering the differences between options (My Values).

a PtDA: patient decision aid.

b SOGC: Society of Obstetricians and Gynaecologists of Canada.

Description of the PtDA

As shown in Figure 2 , the revised version of the PtDA resulting from our systematic process is an interactive website. Initially, the title was My Body, My Choice ; however, this was changed to avoid association with antivaccine campaigns that co-opted this reproductive rights slogan. The new title, It’s My Choice or C’est Mon Choix , was selected for its easy use in English and French. The PtDA leads the user through 6 sections:

• The Introduction section provides the user with information about the decision and the PtDA, as well as grids comparing positive and negative features of the abortion pill and procedure, including their chance of benefits (eg, effectiveness), harms (eg, complications), and other relevant factors (eg, number of appointments and cost).
• The About Me section asks the user to identify any contraindications to the methods. It then prompts users to consider their privacy needs and gives examples of how this relates to each option (eg, the abortion pill can be explained to others as a miscarriage; procedural care can be completed quickly).
• The My Values section includes a values clarification exercise, in which the user selects and weights (on a 0-100 scale) the relative importance of at least three of 7 decisional attributes: avoiding pain, avoiding bleeding, having the abortion at home, having an experience that feels like a miscarriage, having fewer appointments, less time off for recovery, and having a companion during the abortion.
• The My Choice section highlights 1 option, based on the attribute weights the user assigned in the My Values section. For instance, if a user strongly preferred to avoid bleeding and have fewer appointments, the software would suggest that a procedural abortion would be a better match. For a user who preferred having the abortion at home and having a companion present, the software would suggest that a medication abortion would be a better match. The user selects the option they prefer.
• The Review section asks the user to complete the 4-item SURE (Sure of Myself, Understand Information, Risk-Benefit Ratio, Encouragement) screening test [ 41 ], and advises them to talk with an expert if they answer “no” to any of the questions. This section also includes information phone lines to ensure that users can seek confidential, accurate, and nonjudgmental support.
• Lastly, in the Next Steps section, users see a summary of their choice and the features that matter most to them, instructions for how to save the results, keep the results private, and find an abortion health care professional. Each section of the PtDA includes a “Leave” button in case users need to navigate away from the website quickly.

We calculated readability by inputting the plain text of the web-based PtDA into a SMOG Index calculator [ 32 ], which assessed the reading level of the web-based PtDA as grade 9.2.

To ensure users’ trust in the information as accurate and unbiased we provided a data declaration on the landing page: “the clinical information presented in this decision aid comes from Society of Obstetricians and Gynaecologists best practice guidelines.” On the landing page, we also specify “This website was developed by researchers at the University of British Columbia and Dalhousie University. This tool is not supported or connected to any pharmaceutical company.”

A total of 50 participants, including 25 patients and 25 health care professionals, reviewed the PtDA website and completed the survey between January and March 2021. The majority of patient (n=23, 92%) and health care professional (n=23, 92%) participants identified as cisgender women. Among patient participants, 16% (n=4) reported one or more previous abortions in various clinical settings. More than half (n=16, 64%) of health care professionals offered care in private medical offices, with other locations including sexual health clinics, community health centers, and youth clinics. Many health care professionals were family physicians (n=11, 44%), and other common types were nurse practitioners (n=7, 28%) and midwives (n=3, 12%). The mean proportion of the clinical practice of each health care professional devoted to abortion care was 18% (SD 13%). Most health care professional respondents (n=18, 72%) were involved with the provision of medication, but not procedural, abortion care. The characteristics of patient and health care professional participants are reported in Table 3 .

a In total, 4 participants reported a history of abortion care, representing 6 abortion procedures.

b Not available.

The mean System Usability Score met the threshold for good usability among both patient (mean 85.7, SD 8.6) and health care professional (mean 80, SD 12) participants, although some health care professionals agreed with the statement, “I found the website to be unnecessarily complex,” (see Multimedia Appendix 3 for the full distribution of responses from patient and health care professionals). All 25 patients and 22 out of 25 (88%) health care professional respondents indicated that the user-friendliness of the PtDA was good or the best imaginable. When asked what they liked most about the PtDA, both participant groups described the ease of use, comparison of options, and the explicit values clarification exercise. When asked what they liked least about the PtDA, several health care professionals and some patients pointed out that it was difficult to use on a cell phone. A summary of usability results is presented in Table 4 .

In total, 21 (84%) patients and 18 (72%) health care professionals felt that the PtDA was not missing any information needed to decide about the method of abortion in early pregnancy. While acknowledging that it is “hard to balance being easy to read/understand while including enough accurate clinical information,” several health care professionals and some patients indicated that the PtDA was too long and repetitive. Among the 4 (16%) patient participants who felt information was missing, the most common suggestion was a tool for locating an abortion health care professional. The 7 (28%) health care professionals who felt information was missing primarily made suggestions about the medical information included in the PtDA (eg, listing midwives as health care professionals with abortion care in scope of practice and the appropriateness of gender-inclusive terminology) and the accessibility of information for various language and cultural groups.

a Not available.

Implementation

Participants viewed the PtDA as a positive addition to current resources. Patients with a history of abortion care described looking for the information on the internet and speaking with friends, family members, and health care professionals. Compared with these sources of information, many patients liked the credibility and anonymity of the PtDA, whereas some disliked that it was less personal than a conversation. Further, 18 (72%) health care professional participants said that the PtDA would add to or replace the resources they currently use in practice. Compared with these other resources, health care professionals liked that the PtDA could be explored by patients independently and that it would support them in thinking about the option that was best for them. The disadvantages of the PtDA compared with existing resources were the length—which health care professionals felt would make it difficult to use in a clinical interaction—and the lack of localized information. In total, 23 each (92%) of patient and health care professional participants felt that they would use the PtDA before a consultation.

Principal Results

We designed a web-based, interactive PtDA for the choice of method of abortion in early pregnancy [ 42 ], taking a user-centered approach that involved usability testing with 36 patients and 25 health care professionals. Both patient and health care professional participants indicated that the PtDA had good usability and would be a valuable resource for decision-making. This PtDA fills a critical need to support the autonomy of patients and shared decision-making with their health care professional related to the preference-sensitive choice of method of abortion.

Comparison With Prior Work

A 2017 systematic review and environmental scan found that existing PtDAs for the method of abortion are of suboptimal quality [ 9 ]. Of the 50 PtDAs identified, all but one were created without expertise in decision aid design (eg, abortion services, reproductive health organizations, and consumer health information organizations); however, the development process for this UK-based pamphlet-style PtDA was not reported. The remaining PtDAs were noninteractive websites, smartphone apps, and PDFs that were not tested with users. The authors found that the information about methods of abortion was presented in a disorganized, inconsistent, and unequal way. Subsequent work has found that existing PtDAs emphasize medical (versus social, emotional, and practical) attributes, do not include values clarification, and can be biased to persuade users of a certain method [ 13 ].

To address some of the challenges identified in the literature, we systematically structured and designed elements of the PtDA following newly proposed IPDAS criteria (eg, showing positive and negative features with equal detail) [ 33 ]. We included an explicit values-clarification exercise, which a recent meta-analysis found to decrease decisional conflict and values-incongruent choices [ 43 ].

We based the decision aid on comprehensive and up-to-date scientific evidence related to the effectiveness and safety of medication abortion and procedural abortion; however, less evidence was available for nonmedical attributes. For example, many existing PtDAs incorrectly frame privacy as a “factual advantage” of medication abortion [ 13 ]. To address this, we included privacy in the About Me section as something that means “different things to different people.” Similarly, evidence suggests that patients who do not feel appropriately informed about the pain associated with their method of abortion are less satisfied with their choice [ 44 , 45 ]; and the degree of pain experienced varies across options and among individuals. Following the suggestion of patient participants to include stories and recognizing that evidence for the inclusion of narratives in PtDAs is emerging [ 46 ], we elected to develop brief first-person qualitative descriptions of the pain experience. The inclusion of narratives in PtDAs may be effective in supporting patients to avoid surprise and regret, to minimize affective forecasting errors, and to “visualize” their health condition or treatment experience [ 46 ]. Guided by the narrative immersion model, our goal was to provide a “real-world preview” of the pain experience [ 47 ].

In addition to integrating user perspectives on the optimal tone, content, and format of the PtDA, user testing provided evidence to inform the future implementation of the PtDA. A clear barrier to the completion of the PtDA during the clinical encounter from the health care professional perspective was its length, supporting the finding of a recent rapid realist review, which theorized that health care professionals are less likely to use long or otherwise complex PtDAs that are difficult to integrate into routine practice [ 48 ]. However, 46 out of 50 (92%) participants endorsed the use of the PtDA by the patient alone before the initial consultation, which was aligned with the patient participant’s preference to take an active role in making the final decision about their method of abortion as well as the best practice of early, pre-encounter distribution of PtDAs [ 48 ].

A unique feature of this PtDA was that it resulted from a broader program of integrated knowledge translation designed to support access to medication abortion once mifepristone became available in Canada in 2017. Guided by the principle that including knowledge users in research yields results that are more relevant and useful [ 49 ], we developed the PtDA in response to a knowledge user need, involved health care professional users as partners in our research process, including as coauthors, and integrated feedback from the expert panel. This parallels a theory of PtDA implementation that proposes that early involvement of health care professionals in PtDA development “creates a sense of ownership, increases buy-in, helps to legitimize content, and ensures the PtDA (content and delivery) is consistent with current practice” thereby increasing the likelihood of PtDA integration into routine clinical settings [ 48 ].

Viewed through an integrated knowledge translation lens, our findings point toward future areas of work to support access to abortion in Canada. Several patient participants indicated a need for tools to identify health care professionals who offer abortion care. Some shared that their primary health care professionals did not offer medication abortion despite it being within their scope of practice, and instead referred them to an abortion clinic for methods of counseling and care. We addressed this challenge in the PtDA by including links to available resources, such as confidential phone lines that link patients to health care professionals in their region. On the website we also indicated that patient users could ask their primary care providers whether they provide abortion care; however, we acknowledge that this may place the patient in a vulnerable position if their health care professional is uncomfortable with, or unable to, provide this service for any reason. Future work should investigate opportunities to shorten the pathway to this time-sensitive care, including how to support patients who use the decision aid to act on their informed preference for the method of abortion. This work may involve developing a tool for patients to talk to their primary care provider about prescribing medication abortion.

Strengths and Limitations

Several factors affect the interpretation of our work. Although potential patient users participated in the iterative development process, the patient perspective was not represented in a formal advisory panel in the same way that the health care professional experts were. Participant characteristics collected for the think-aloud interviews demonstrated that our patient sample did not include people with lower education attainment, for whom the grade level and length of the PtDA could present a barrier [ 50 ]. Any transfer of the PtDA to jurisdictions outside Canada must consider how legal, regulatory, and other contextual factors affect the choice of the method of abortion. Since this study was completed, we have explored additional strategies to address these concerns, including additional user testing with people from equity-deserving groups, drop-down menus to adjust the level of detail, further plain language editing, and videos illustrating core content. Since the focus of this study was usability, we did not assess PtDA effectiveness, including impact on knowledge, decisional conflict, choice predisposition and decision, or concordance; however, a randomized controlled trial currently underway will measure the impact of the PtDA on these outcomes in a clinical setting. Finally, our integrated knowledge translation approach added to the robustness of our study by ensuring that health care professionals and patients were equal partners in the research process. One impact of this partnered approach is that our team has received funding support from Health Canada to implement the website on a national scale for people across Canada considering their abortion options [ 51 ].

Conclusions

The PtDA provides people choosing a method of early abortion and their health care professionals with a resource to understand methods of abortion available in the Canadian context and support to make a values-aligned choice. We designed the PtDA using a systematic approach that included both patient and health care professional participants to help ensure its relevance and usability. Our future work will seek to evaluate the implementation of the PtDA in clinical settings, create alternate formats to enhance accessibility, and develop a sustainable update policy. We will also continue to advance access to abortion care in Canada with our broader integrated knowledge translation program of research.

Acknowledgments

The authors thank the participants for contributing their time and expertise to the design of this tool. Family medicine residents CMB, NC, KD-L, and JS were supported by Sue Harris grants, Department of Family Practice, University of British Columbia. KJW was supported by the Vanier Scholar Award (2020-23). SM was supported by a Michael Smith Health Research BC Scholar Award (18270). WVN was supported by a Canadian Institutes of Health Research and Public Health Agency of Canada Chair in Applied Public Health Research (2014-2024, CPP-329455-107837). All grants underwent external peer review for scientific quality. The funders played no role in the design of this study, data collection, analysis, interpretation, or preparation of this paper.

Data Availability

Our ethics approval has specified the primary data is not available.

Authors' Contributions

KJW, SM, and MB conceived of and designed this study. CMB, NC, and KD-L led interview data collection, analysis, and interpretation with input from SM. RS and JS led survey data collection, analysis, and interpretation with input from SM and MB. AW, LCL, and WVN contributed to the synthesis and interpretation of results. KJW, SM, and LT wrote the first draft of this paper, and all authors contributed to this paper’s revisions and approved the final version.

Conflicts of Interest

None declared.

Patient decision aid prototype.

Raw data for pain narratives.

Full distribution of System Usability Scale scores for patients and providers.

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Abbreviations

Edited by T Leung; submitted 07.05.23; peer-reviewed by G Sebastian, R French, B Zikmund-Fisher; comments to author 11.01.24; revised version received 23.02.24; accepted 25.02.24; published 16.04.24.

©Kate J Wahl, Melissa Brooks, Logan Trenaman, Kirsten Desjardins-Lorimer, Carolyn M Bell, Nazgul Chokmorova, Romy Segall, Janelle Syring, Aleyah Williams, Linda C Li, Wendy V Norman, Sarah Munro. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.04.2024.

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