literature review structure nursing

Nursing: How to Write a Literature Review

• Traditional or Narrative Literature Review

Getting started

1. start with your research question, 2. search the literature, 3. read & evaluate, 4. finalize results, 5. write & revise, brainfuse online tutoring and writing review.

• RESEARCH HELP

The best way to approach your literature review is to break it down into steps.  Remember, research is an iterative process, not a linear one.  You will revisit steps and revise along the way.  Get started with the handout, information, and tips from various university Writing Centers below that provides an excellent overview.  Then move on to the specific steps recommended on this page.

• UNC- Chapel Hill Writing Center Literature Review Handout, from the University of North Carolina at Chapel Hill.
• University of Wisconsin-Madison Writing Center Learn how to write a review of literature, from the University of Wisconsin-Madison.
• University of Toronto-- Writing Advice The Literature Review: A few tips on conducting it, from the University of Toronto.
• Begin with a topic.
• Understand the topic. 
• Familiarize yourself with the terminology.  Note what words are being used and keep track of these for use as database search keywords. 
• See what research has been done on this topic before you commit to the topic.  Review articles can be helpful to understand what research has been done .
• Develop your research question.  (see handout below)
• How comprehensive should it be? 
• Is it for a course assignment or a dissertation? 
• How many years should it cover?
• Developing a good nursing research question Handout. Reviews PICO method and provides search tips.

Your next step is to construct a search strategy and then locate & retrieve articles.

•  There are often 2-4 key concepts in a research question.
• Search for primary sources (original research articles.)
• These are based on the key concepts in your research question.
• Remember to consider synonyms and related terms.
• Which databases to search?
• What limiters should be applied (peer-reviewed, publication date, geographic location, etc.)?

Review articles (secondary sources)

Use to identify literature on your topic, the way you would use a bibliography.  Then locate and retrieve the original studies discussed in the review article. Review articles are considered secondary sources.

• Once you have some relevant articles, review reference lists to see if there are any useful articles.
• Which articles were written later and have cited some of your useful articles?  Are these, in turn, articles that will be useful to you? 
• Keep track of what terms you used and what databases you searched. 
• Use database tools such as save search history in EBSCO to help.
• Keep track of the citations for the articles you will be using in your literature review. 
• Use RefWorks or another method of tracking this information. 
• Database Search Strategy Worksheet Handout. How to construct a search.
• TUTORIAL: How to do a search based on your research question This is a self-paced, interactive tutorial that reviews how to construct and perform a database search in CINAHL.

The next step is to read, review, and understand the articles.

• Start by reviewing abstracts. 
• Make sure you are selecting primary sources (original research articles).
• Note any keywords authors report using when searching for prior studies.
• You will need to evaluate and critique them and write a synthesis related to your research question.
• Consider using a matrix to organize and compare and contrast the articles . 
• Which authors are conducting research in this area?  Search by author.  
• Are there certain authors’ whose work is cited in many of your articles?  Did they write an early, seminal article that is often cited?
• Searching is a cyclical process where you will run searches, review results, modify searches, run again, review again, etc. 
• Critique articles.  Keep or exclude based on whether they are relevant to your research question.
• When you have done a thorough search using several databases plus Google Scholar, using appropriate keywords or subject terms, plus author’s names, and you begin to find the same articles over and over.
• Remember to consider the scope of your project and the length of your paper.  A dissertation will have a more exhaustive literature review than an 8 page paper, for example.
• What are common findings among each group or where do they disagree? 
• Identify common themes. Identify controversial or problematic areas in the research. 
• Use your matrix to organize this.
• Once you have read and re-read your articles and organized your findings, you are ready to begin the process of writing the literature review.

2. Synthesize.  (see handout below)

• Include a synthesis of the articles you have chosen for your literature review.
• A literature review is NOT a list or a summary of what has been written on a particular topic. 
• It analyzes the articles in terms of how they relate to your research question. 
• While reading, look for similarities and differences (compare and contrast) among the articles.  You will create your synthesis from this.
• Synthesis Examples Handout. Sample excerpts that illustrate synthesis.

Regis Online students have access to Brainfuse. Brainfuse is an online tutoring service available through a link in Moodle. Meet with a tutor in a live session or submit your paper for review.

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Nursing: Literature Review

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Good Place to Start: Citation Databases

Interdisciplinary Citation Databases:

A good place to start your research  is to search a research citation database to view the scope of literature available on your topic.

TIP #1: SEED ARTICLE Begin your research with a "seed article" - an article that strongly supports your research topic.  Then use a citation database to follow the studies published by finding articles which have cited that article, either because they support it or because they disagree with it.

TIP #2: SNOWBALLING Snowballing is the process where researchers will begin with a select number of articles they have identified relevant/strongly supports their topic and then search each articles' references reviewing the studies cited to determine if they are relevant to your research.

BONUS POINTS: This process also helps identify key highly cited authors within a topic to help establish the "experts" in the field.

Begin by constructing a focused research question to help you then convert it into an effective search strategy.

• Identify keywords or synonyms
• Type of study/resources
• Which database(s) to search
• Asking a Good Question (PICO)
• PICO - AHRQ
• PICO - Worksheet
• What Is a PICOT Question?

Seminal Works: Search Key Indexing/Citation Databases

• Google Scholar
• Web of Science

TIP – How to Locate Seminal Works

• DO NOT: Limit by date range or you might overlook the seminal works
• DO: Look at highly cited references (Seminal articles are frequently referred to “cited” in the research)
• DO: Search citation databases like Scopus, Web of Science and Google Scholar

Web Resources

What is a literature review?

A literature review is a comprehensive and up-to-date overview of published information on a subject area. Conducting a literature review demands a careful examination of a body of literature that has been published that helps answer your research question (See PICO). Literature reviewed includes scholarly journals, scholarly books, authoritative databases, primary sources and grey literature.

A literature review attempts to answer the following:

• What is known about the subject?
• What is the chronology of knowledge about my subject?
• Are there any gaps in the literature?
• Is there a consensus/debate on issues?
• Create a clear research question/statement
• Define the scope of the review include limitations (i.e. gender, age, location, nationality...)
• Search existing literature including classic works on your topic and grey literature
• Evaluate results and the evidence (Avoid discounting information that contradicts your research)
• Track and organize references
• How to conduct an effective literature search.
• Social Work Literature Review Guidelines (OWL Purdue Online Writing Lab)

What is PICO?

The PICO model can help you formulate a good clinical question. Sometimes it's referred to as PICO-T, containing an optional 5th factor. 

Search Example

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Literature Review Overview

What is a Literature Review? Why Are They Important?

A literature review is important because it presents the "state of the science" or accumulated knowledge on a specific topic. It summarizes, analyzes, and compares the available research, reporting study strengths and weaknesses, results, gaps in the research, conclusions, and authors’ interpretations.

Tips and techniques for conducting a literature review are described more fully in the subsequent boxes:

• Literature review steps
• Strategies for organizing the information for your review
• Literature reviews sections
• In-depth resources to assist in writing a literature review
• Templates to start your review
• Literature review examples

Literature Review Steps

Graphic used with permission: Torres, E. Librarian, Hawai'i Pacific University

1. Choose a topic and define your research question

• Try to choose a topic of interest. You will be working with this subject for several weeks to months.
• Ideas for topics can be found by scanning medical news sources (e.g MedPage Today), journals / magazines, work experiences, interesting patient cases, or family or personal health issues.
• Do a bit of background reading on topic ideas to familiarize yourself with terminology and issues. Note the words and terms that are used.
• Develop a focused research question using PICO(T) or other framework (FINER, SPICE, etc - there are many options) to help guide you.
• Run a few sample database searches to make sure your research question is not too broad or too narrow.
• If possible, discuss your topic with your professor. 

2. Determine the scope of your review

The scope of your review will be determined by your professor during your program. Check your assignment requirements for parameters for the Literature Review.

• How many studies will you need to include?
• How many years should it cover? (usually 5-7 depending on the professor)
• For the nurses, are you required to limit to nursing literature?

3. Develop a search plan

• Determine which databases to search. This will depend on your topic. If you are not sure, check your program specific library website (Physician Asst / Nursing / Health Services Admin) for recommendations.
• Create an initial search string using the main concepts from your research (PICO, etc) question. Include synonyms and related words connected by Boolean operators
• Contact your librarian for assistance, if needed.

4. Conduct searches and find relevant literature

• Keep notes as you search - tracking keywords and search strings used in each database in order to avoid wasting time duplicating a search that has already been tried
• Read abstracts and write down new terms to search as you find them
• Check MeSH or other subject headings listed in relevant articles for additional search terms
• Scan author provided keywords if available
• Check the references of relevant articles looking for other useful articles (ancestry searching)
• Check articles that have cited your relevant article for more useful articles (descendancy searching). Both PubMed and CINAHL offer Cited By links
• Revise the search to broaden or narrow your topic focus as you peruse the available literature
• Conducting a literature search is a repetitive process. Searches can be revised and re-run multiple times during the process.
• Track the citations for your relevant articles in a software citation manager such as RefWorks, Zotero, or Mendeley

5. Review the literature

• Read the full articles. Do not rely solely on the abstracts. Authors frequently cannot include all results within the confines of an abstract. Exclude articles that do not address your research question.
• While reading, note research findings relevant to your project and summarize. Are the findings conflicting? There are matrices available than can help with organization. See the Organizing Information box below.
• Critique / evaluate the quality of the articles, and record your findings in your matrix or summary table. Tools are available to prompt you what to look for. (See Resources for Appraising a Research Study box on the HSA, Nursing , and PA guides )
• You may need to revise your search and re-run it based on your findings.

6. Organize and synthesize

• Compile the findings and analysis from each resource into a single narrative.
• Using an outline can be helpful. Start broad, addressing the overall findings and then narrow, discussing each resource and how it relates to your question and to the other resources.
• Cite as you write to keep sources organized.
• Write in structured paragraphs using topic sentences and transition words to draw connections, comparisons, and contrasts.
• Don't present one study after another, but rather relate one study's findings to another. Speak to how the studies are connected and how they relate to your work.

Organizing Information

Options to assist in organizing sources and information :

1. Synthesis Matrix

• helps provide overview of the literature
• information from individual sources is entered into a grid to enable writers to discern patterns and themes
• article summary, analysis, or results
• thoughts, reflections, or issues
• each reference gets its own row
• mind maps, concept maps, flowcharts
• at top of page record PICO or research question
• record major concepts / themes from literature
• list concepts that branch out from major concepts underneath - keep going downward hierarchically, until most specific ideas are recorded
• enclose concepts in circles and connect the concept with lines - add brief explanation as needed

3. Summary Table

• information is recorded in a grid to help with recall and sorting information when writing
• allows comparing and contrasting individual studies easily
• purpose of study
• methodology (study population, data collection tool)

Efron, S. E., & Ravid, R. (2019). Writing the literature review : A practical guide . Guilford Press.

Literature Review Sections

• Lit reviews can be part of a larger paper / research study or they can be the focus of the paper
• Lit reviews focus on research studies to provide evidence
• New topics may not have much that has been published

* The sections included may depend on the purpose of the literature review (standalone paper or section within a research paper)

Standalone Literature Review (aka Narrative Review):

• presents your topic or PICO question
• includes the why of the literature review and your goals for the review.
• provides background for your the topic and previews the key points
• Narrative Reviews: tmay not have an explanation of methods.
• include where the search was conducted (which databases) what subject terms or keywords were used, and any limits or filters that were applied and why - this will help others re-create the search
• describe how studies were analyzed for inclusion or exclusion
• review the purpose and answer the research question
• thematically - using recurring themes in the literature
• chronologically - present the development of the topic over time
• methodological - compare and contrast findings based on various methodologies used to research the topic (e.g. qualitative vs quantitative, etc.)
• theoretical - organized content based on various theories
• provide an overview of the main points of each source then synthesize the findings into a coherent summary of the whole
• present common themes among the studies
• compare and contrast the various study results
• interpret the results and address the implications of the findings
• do the results support the original hypothesis or conflict with it
• provide your own analysis and interpretation (eg. discuss the significance of findings; evaluate the strengths and weaknesses of the studies, noting any problems)
• discuss common and unusual patterns and offer explanations
•  stay away from opinions, personal biases and unsupported recommendations
• summarize the key findings and relate them back to your PICO/research question
• note gaps in the research and suggest areas for further research
• this section should not contain "new" information that had not been previously discussed in one of the sections above
• provide a list of all the studies and other sources used in proper APA 7

Literature Review as Part of a Research Study Manuscript:

• Compares the study with other research and includes how a study fills a gap in the research.
• Focus on the body of the review which includes the synthesized Findings and Discussion

Literature Reviews vs Systematic Reviews

Systematic Reviews are NOT the same as a Literature Review:

Literature Reviews:

• Literature reviews may or may not follow strict systematic methods to find, select, and analyze articles, but rather they selectively and broadly review the literature on a topic
• Research included in a Literature Review can be "cherry-picked" and therefore, can be very subjective

Systematic Reviews:

• Systemic reviews are designed to provide a comprehensive summary of the evidence for a focused research question
• rigorous and strictly structured, using standardized reporting guidelines (e.g. PRISMA, see link below)
• uses exhaustive, systematic searches of all relevant databases
• best practice dictates search strategies are peer reviewed
• uses predetermined study inclusion and exclusion criteria in order to minimize bias
• aims to capture and synthesize all literature (including unpublished research - grey literature) that meet the predefined criteria on a focused topic resulting in high quality evidence

Literature Review Examples

• Breastfeeding initiation and support: A literature review of what women value and the impact of early discharge (2017). Women and Birth : Journal of the Australian College of Midwives
• Community-based participatory research to promote healthy diet and nutrition and prevent and control obesity among African-Americans: A literature review (2017). Journal of Racial and Ethnic Health Disparities

• Vitamin D deficiency in individuals with a spinal cord injury: A literature review (2017). Spinal Cord

Resources for Writing a Literature Review

These sources have been used in developing this guide.

Resources Used on This Page

Aveyard, H. (2010). Doing a literature review in health and social care : A practical guide . McGraw-Hill Education.

Purdue Online Writing Lab. (n.d.). Writing a literature review . Purdue University. https://owl.purdue.edu/owl/research_and_citation/conducting_research/writing_a_literature_review.html

Torres, E. (2021, October 21). Nursing - graduate studies research guide: Literature review. Hawai'i Pacific University Libraries. Retrieved January 27, 2022, from https://hpu.libguides.com/c.php?g=543891&p=3727230

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• PICO Question
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• What is a literature review?

General Structure

Keep in mind.

• Citation Management

Lit Review Resources

• Literature Review and Synthesis: A Guide for Nurses and Other Healthcare Professionals Focusing on the significance of synthesis as a critical component of the literature review process, this book walks readers through each step of completing an exemplary literature review and synthesis.
• Writing the Literature Review: A Practical Guide This accessible text provides a roadmap for producing a high-quality literature review.
• Conducting Your Literature Review by Susanne Hempel This book is a step-by-step guide to writing a literature review, and includes tips for modifying the process as needed depending on your audience, purpose, and goals.
• Demystifying Literature Reviews by Brian Conner A short article describing different types of literature reviews.

What is a Literature Review?

A literature review is a survey of published literature directly relevant to your research question. It synthesizes authoritative sources to provide background information and demonstrate the significance of the research question. Literature reviews should have an organizational structure and come to an implicit conclusion based on critical evaluation of the sources.

What is synthesis?

Synthesis in a literature review means that you take key points from your source material and make inferences about how the material connects to your research question. Synthesis is not summary . Body paragraphs in a literature review should analyze, quote, or paraphrase a variety of sources that speak to a common theme , rather than summarize each article one-by-one.

How do I organize a lit review?

Like any academic publication, a literature review should contain an introduction, body, and conclusion. Your specific assignment may designate certain sections (such as introduction, methodology, historical background, etc.). Below are some general guidelines:

Introduction

• Why is your topic important?
• How far back does your review extend?
• What demographic populations are included?
• What issues within your topic does the review cover?
• What criteria were used to select the articles reviewed?
• How is your review organized?
• Chronological - tracks the progression of a concept over time and provides historical background for your research question.
• Thematic - focuses on topics or issues shared by the source material; chronology may or may not be considered depending on its use to the argument.
• Methodological - the focusing factor is the methodology of the researcher or writer rather than the content of the source material.
• Synthesize several of your reviewed articles in each paragraph making explicit connections between your sources.
• Critically analyze your sources to reveal how they contribute to the research question you are studying.
• Summarize how the literature agrees, disagrees, or supports the unifying topic of your review (your research question).
• Identify gaps or areas for further research.
• Give your critical analysis of the reviewed articles and how they inform your overall perspective on the topic or the practice you're recommending.

A literature review should center your voice , even though you are presenting the work of others. Strive to begin and end a paragraph with your own interpretation of the evidence. Use quotes sparingly .

Clearly document how you found your sources and why you decided to include or exclude sources.

When paraphrasing , make sure to represent the original author's words or findings accurately and use a signal phrase or in-text citation to give proper credit. See the APA Style page for more information on citation.

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Uw-madison libraries research guides.

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• Conducting a Literature Review

Nursing Resources : Conducting a Literature Review

• Definitions of
• Professional Organizations
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• PICO-Clinical Question
• Types of PICO Question (D, T, P, E)
• Secondary & Guidelines
• Bedside--Point of Care
• Pre-processed Evidence
• Measurement Tools, Surveys, Scales
• Types of Studies
• Table of Evidence
• Qualitative vs Quantitative
• Types of Research within Qualitative and Quantitative
• Cohort vs Case studies
• Independent Variable VS Dependent Variable
• Sampling Methods and Statistics
• Systematic Reviews
• Review vs Systematic Review vs ETC...
• Standard, Guideline, Protocol, Policy
• Additional Guidelines Sources
• Peer Reviewed Articles
• Systematic Reviews and Meta-Analysis
• Writing a Research Paper or Poster
• Annotated Bibliographies
• Levels of Evidence (I-VII)
• Reliability
• Validity Threats
• Threats to Validity of Research Designs
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• Nursing Models
• PRISMA, RevMan, & GRADEPro
• ORCiD & NIH Submission System
• Understanding Predatory Journals
• Nursing Scope & Standards of Practice, 4th Ed
• Distance Ed & Scholarships
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• Assess A Qualitative Study?
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• Other questions you may have
• Search the Databases?
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What is a Literature Review?

A literature review is an essay that surveys, summarizes, links together, and assesses research in a given field. It surveys the literature by reviewing a large body of work on a subject; it summarizes by noting the main conclusions and findings of the research; it links together works in the literature by showing how the information fits into the overall academic discussion and how the information relates to one another; it assesses the literature by noting areas of weakness, expansion, and contention. This is the essentials of literature review construction by discussing the major sectional elements, their purpose, how they are constructed, and how they all fit together.

All literature reviews have major sections:

• Introduction: that indicates the general state of the literature on a given topic;
• Methodology: an overview of how, where, and what subject terms used to conducted your search so it may be reproducable
• Findings: a summary of the major findings in that field;
• Discussion: a general progression from wider studies to smaller, more specifically-focused studies;
• Conclusion: for each major section that again notes the overall state of the research, albeit with a focus on the major synthesized conclusions, problems in the research, and even possible avenues of further research.

In Literature Reviews, it is Not Appropriate to:

• State your own opinions on the subject (unless you have evidence to support such claims).  
• State what you think nurses should do (unless you have evidence to support such claims).
• Provide long descriptive accounts of your subject with no reference to research studies.
• Provide numerous definitions, signs/symptoms, treatment and complications of a particular illness without focusing on research studies to provide evidence and the primary purpose of the literature review.
• Discuss research studies in isolation from each other.

Remember, a literature review is not a book report. A literature review is focus, succinct, organized, and is free of personal beliefs or unsubstantiated tidbits.

• Types of Literature Reviews A detailed explanation of the different types of reviews and required citation retrieval numbers

Outline of a Literture Review

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Literature Reviews for Education and Nursing Graduate Students

(15 reviews)

Linda Frederiksen, Washington State University Vancouver

Sue F. Phelps, Washington State University Vancouver

Copyright Year: 2017

Publisher: Rebus Community

Language: English

Formats Available

Conditions of use.

Learn more about reviews.

Reviewed by Rebecca Appleton, Professor of Nursing, Marshall University on 5/7/24

It is very through in covering the steps of a well written literature review read more

Comprehensiveness rating: 5 see less

It is very through in covering the steps of a well written literature review

Content Accuracy rating: 5

I have not read the entire book, but what I did read was very good.

Relevance/Longevity rating: 5

It is up to date, but doing a Literature Review is covered in a step-wise manner, includes writing the LR>

Clarity rating: 5

Very clear step-by-step approach

Consistency rating: 5

It is very consistent!

Modularity rating: 5

Chapters are orderly and succinct

Organization/Structure/Flow rating: 5

Strait forward order.

Interface rating: 5

I did not notice Interface issues.

Grammatical Errors rating: 5

No grammatical errors were noticed.

Cultural Relevance rating: 5

I did not notice any problems with cultural Insensitivity

I plan to use this in a Nursing Research class for Graduate Students, and I am trying a new approach to finding the best Research Evidence on a Nursing Topic. Can't wait to see if this help my graduate students understand research literature better.

Reviewed by Barbara Schneider, Professor, University of Texas at Arlington on 4/29/24

This textbook covers the range of topics important for a literature review, including formulating a research question, finding scholarly articles, evaluating sources, and synthesizing source content. The videos are great supplements to the text. read more

This textbook covers the range of topics important for a literature review, including formulating a research question, finding scholarly articles, evaluating sources, and synthesizing source content. The videos are great supplements to the text.

Overall, the content is accurate. Consider labeling Nursing as a health profession/discipline.

Relevance/Longevity rating: 4

Much of the content remains relevant. Updated examples would be helpful to today's graduate students.

The textbook is clearly written.

Consistency rating: 4

In general, the text is consistent. There could be more consistency in the formatting of the references.

The modularity is an asset.

There is a logical flow to the topics.

The links to outside materials are helpful.

No grammatical errors were evident.

The examples seemed inclusive.

Those who are new to writing a literature review would find this book useful.

Reviewed by Yolanda Griffiths, Professor of Occupational Therapy, Drake University on 12/15/21

The authors were thorough and very organized in stepping readers through the process of conducting and writing a literature review. Each area is appropriately indexed and examples are provided in a variety of ways. The synthesis section is... read more

The authors were thorough and very organized in stepping readers through the process of conducting and writing a literature review. Each area is appropriately indexed and examples are provided in a variety of ways. The synthesis section is especially useful as students often do not understand what this means. Perhaps some content on plagiarism would benefit this section as well. The flow of the material easily guides users logically through each topic.

The content is accurate and unbiased. The content is presented in an easy to understand way with videos, and examples.

The relevance of the content is classic and the text should be pertinent for many years. The links included in the text are very useful and should be easy for authors to check periodically. Using a digital media is more relevant to today's students than print textbooks. Each section addresses a reasonable chunk of information.

The book is user friendly, written in an easy to understand manner, and graphics or links add to the understanding of the content. Definitions are clearly written. Such as clarifying the types of literature reviews will be useful for students. Providing a test yourself section at the end of sections allows the reader to check if any content was confusing or not clear.

The text is consistently laid out in a logical manner which helps to unpack content which may be new or unfamiliar to the reader/student.

The amount of content allocated to each chapter is appropriate and will be easy to assign readings. The chapter headings are clear and the embedded videos, charts and test questions enlighten each subunit. The hyperlinking in the table of contents helps to navigate the chapters well.

The organization of the content is logical and easy to understand the process of completing a literature review. The book is laid out much like a road map where students can see the big picture as well as the supporting parts to the process. The references by chapter are very useful.

The graphics were clear, and the non-serif font aids in eye fatigue. One recommendation is to lower the brightness of the bold blue text in the table of contents to reduce eye fatigue. There was no problem to play the videos and the audio was clear. All links worked well.

There were no grammatical errors. There were a few typos such as 1.3.1.8 needs a space between "A specific", 2.3 in the phrase "Articles by the type of periodical in which an article it is published" perhaps remove the word "it", in the table on page 41. under Nursing , the word clinical is spelled "Cclinical", remove the capital C.

No evidence of cultural bias or insensitivity.

I am very excited to use this textbook in my doctoral level occupational therapy class. The inclusion of concise explanations of PICO and SPICE will be very useful. This will be a wonderful resource for graduate students and being mindful of costs for textbooks is compassionate.

Reviewed by Susan Bassett, Instructor, Nursing Graduate Program, Eastern New Mexico University on 11/9/21

Each chapter presented a different aspect of doing a literature review. This was organized and orderly. The index/table of contents was very detailed which allowed the reader to easily use this book as a reference while conducting a literature... read more

Each chapter presented a different aspect of doing a literature review. This was organized and orderly. The index/table of contents was very detailed which allowed the reader to easily use this book as a reference while conducting a literature review.

The content appeared to be entirely accurate. It did a good job of combining information for both education and nursing students. The authors addressed pertinent points of research study development as well as the specific methodology of approaching a research-focused literature review.

The text was up-to-date in methodology, which should not change frequently. The many links to websites were very helpful and yet were basic enough that they should be relevant for years. If they do need updating, the are clearly presented and should be easily updated. The breakdown to very small "chunks" of information per section will help in easily updating specific parts of information.

The book presented a rather complex topic in an extremely straight-forward, easy to read, clear manner. Each small "chunk" of information was identified per section numbering which correlated with movement through the content. The writing was professional and yet not overwhelmed with discipline-specific terminology. Where potentially new terminology was presented, it was immediately followed with definitions and examples.

The book was well-organized and moved along the structure set out early in the book. Content was gradually unfolded, as divided per chapter. There was a bit of repetition (probably about three examples) where the authors attempted to tie information together. Although this stood out to a reader, it seemed more useful in organizing than detrimental in repetition.

The book was subdivided into chapters and then into many small modules of discrete information. It could easily be assigned in part. It could also readily be used as a reference for students to go back and easily find processes or pieces of information they might need later.

I found the continual clear and succinct organization of information to be a defining highlight of this book. When presenting early steps of the research process and then linking these steps with how to conduct a literature review and subsequenty organize and write a literature review, this book is presenting numerous procews steps that must work in tandem. This book did that in a clear and easily readable fashion.

The one feature that did distract me was within the bullet points of 1.3.1. "Types of Reviews". There was a mix of complete and incomplete sentences that worked to convey information succinctly, but distracted me as a reader.

Grammatical Errors rating: 4

I did find several spelling and grammaticl errors (1.3.1.8, , 1.3.1.9, 2.1.1, 2.3, 2.3.1.1, , 2.3.1.4, 2.3 Table A., p. 41, p. 53, p. 54). Although small errors (a few letters or spacing) they should be corrected.

I did not find any mistakes in cultural appropriateness The content did repeatedly talk about bias reduction in the process of writing a literature review

I thought this book was very well-written and contained great information for my students. The links provided were very appropriate and helpful. The Table "Guide to searching for literature at various stages of the scholarly communication process” was particularly helpful. I will immediately begin using portions of the content in this book to support my research class. Additionally, I will recommend the entire book as a reference for the dedicated student (or one intending to go forward to a doctoral level of education in nursing). Thank you for collating all this information and helpful links into one clear, easily readable and understandable document.

Reviewed by Leah Nillas, Associate Professor, Illinois Wesleyan University on 9/6/21

This book addresses the basic steps in the process of writing a literature review research. Chapter 2 (What is a Literature Review?) needs to be retitled. I think Chapter 1 (Introduction) clearly defines and characterizes literature review as a... read more

Comprehensiveness rating: 4 see less

This book addresses the basic steps in the process of writing a literature review research. Chapter 2 (What is a Literature Review?) needs to be retitled. I think Chapter 1 (Introduction) clearly defines and characterizes literature review as a research category. Chapter 2 focuses more on the creation of information, information cycle, and selecting appropriate sources. Chapter 7 (Synthesizing Sources) and Chapter 8 (Writing the Lit Review) can still be improved to incorporate specific strategies in synthesizing research literature and examples of writing styles through analysis of a variety of published examples. Writing a synthesis is a challenging skill for most novice researchers.

Information shared is accurate. I did not notice any content error.

Main content is up-to-date. A few citations maybe dated but they are necessary in illustrating different examples of literature reviews. It will be easy to include additional relevant examples of research work that are published recently.

I like how this text is written. Tone is reader friendly and narrative is accessible to novice researchers.

Clearly consistent throughout the chapters.

Clear and purposeful "chunking" of information per chapter.

Readers can easily follow the organization of topics and content.

No obvious interface issues. Appropriate use of multimedia tools.

No grammatical errors.

Text is culturally sensitive. Additional readings, references, or examples can easily be added to incorporate research conducted by diverse authors or literature reviews which focus on diversity and inclusion issues in education and nursing.

This is a good introductory literature review text even for undergraduate education students. Clear discussion of the nature of the research and the writing process. The use of videos and images is helpful in providing multimodal approach in explaining topics or processes. Writing style and tone make the text accessible to novice researchers.

Reviewed by Rebecca Scheckler, Assistant Professor, Radford University on 7/6/20

Two missing topics were inter-library loan and how to avoid plagiarism in writing up the literature review. This second is such an important topic that it deserves its own chapter. read more

Two missing topics were inter-library loan and how to avoid plagiarism in writing up the literature review. This second is such an important topic that it deserves its own chapter.

It is accurate. I found no inaccuracies.

This book is very relevant. Every advanced undergraduate or graduate students requires such a book

I found the book clear. The videos interspersed within the book added much to the clarity. There are lots of good diagrams that add to the clarity. They are not all original but their sources are all cited. The section on boolean searches, usage of asterisks and quotes in searches is very helpful and appropriate although often left out of discussion of searches.

The book is consistent in terminology and framework.

The chapters were cohesive.

Organization/Structure/Flow rating: 4

I like the links to within the text to the references and other matter. What is needed are back links to the text from the references. I also would have liked links from the exercises to the answers of the exercises.

Interface rating: 4

See navigation links mentioned above. The grey literature link is broken.

I saw no grammatical problems. There are many bulleted lists rather than text which is appropriate to this topic.

There could be more attention to cultural context in the frequent examples.

I wondered why nursing and education were combined. They are similar in nature but not identical. separation them out into two books might be appropriate.

Reviewed by Lisa Shooman, Associate Professor, Worcester State University on 6/29/20

Overall, this book provides a very comprehensive and thorough roadmap for creating a literature review. The videos assist the reader in crystallizing the information presented in the text. There is an effective index and glossary that provide... read more

Overall, this book provides a very comprehensive and thorough roadmap for creating a literature review. The videos assist the reader in crystallizing the information presented in the text. There is an effective index and glossary that provide helpful navigation to the reader.

The content is detailed, clearly explained, error-free, and unbiased. My students would greatly benefit from the lucid information presented in this text to guide them with developing a literature review. I would be eager to adopt this book for my students.

The content is timely and will not be quickly out-of-date. The quiz questions at the end of each chapter are relevant and will aid students with the consolidation of the material. The online format allows for updating, and the version history at the end of the text clearly indicated that the book was updated recently.

The text is clear and not ridden with any excess jargon /technical terminology. Pictures, graphics, and videos further elucidate the text. There are helpful questions that stimulate thought and lists that help to organize information.

The internal consistency in the text is excellent. However, Chapter 1.1 and Chapter 2 have the same title and it would benefit the reader to have different titles that would highlight the differences between these two sections. Chapter 1.1 is an overview and Chapter 2 dives into more depth.

The text is efficiently divided into smaller reading sections that are demarcated by numbers. The subsections in each chapter can be assigned at different points in the course. The text is organized logically and systematically that assists the reader with comprehension and provides a roadmap for creating an effective literature review.

The entire text is presented coherently and concisely. The organization of the text takes the reader through the process of creating an effective literature review. It can be used by multiple health professions, although the length of the text is relatively short it includes a considerable depth of the material. Other disciplines that would benefit from using this test in their courses may include occupational therapy, physical therapy, and speech and language pathology students.

The interface of the text is simple and easy to follow. The cover of the text would benefit from photos, color, and graphic design to appeal to the modern digital reader.

No grammatical or spelling errors are noted.

No cultural biases existed in the text in any way. There are no individuals highlighted in the book, and due to the technical nature of the subject matter, the text is inclusive to a variety of races, ethnicities, and backgrounds. No offensive statements are included in this book.

The authors should consider including other health professionals in the title and provide examples that can relate to other health professionals throughout the text. Other health professionals that can benefit from reading this text include occupational therapy, physical therapy, and speech and language pathology students. Literature reviews are relevant for many health professionals in their master's and doctorate programs and the text could serve a wider audience.

Reviewed by Ellen Rearick, Assistant Professor, Framingham State University on 6/1/20

This text covers all areas and the process of the integrative review appropriately. It is an engaging text for graduate students new to these assignments. read more

This text covers all areas and the process of the integrative review appropriately. It is an engaging text for graduate students new to these assignments.

This text is well done, very accurate

This text is relevant. The updates needed regarding APA format should be relatively easy to implement.

This text is clear and provides users with definitions and examples of the variety of reviews.

Very well written using consistent terminology throughout.

The text's reading sections are easily accessible and users will find them organized. Each chapter and its sections are presented in the sequence of the process of an integrative review.

Very clear and logical order.

The navigation of this text was problem-free.

No grammatical errors noted.

No issues with cultural insensitivity noted.

This was a well-organized text using videos to reinforce content that would benefit any education or nursing graduate student new to the integrative review process.

Reviewed by Ruth Stoltzfus, Professor of Nursing; Dir., Grad Programs in Nursing, Goshen College on 6/1/19

This text provides everything a graduate student needs to write a literature review in a concise manner. If you look at the digital pdf, there are many strategies to help the reader learn the process - videos, diagrams, and also text. read more

This text provides everything a graduate student needs to write a literature review in a concise manner. If you look at the digital pdf, there are many strategies to help the reader learn the process - videos, diagrams, and also text.

I found no evidence of bias and no errors.

This book has long-term relevance. The content will not quickly out-date.

I really liked the way the textbook is structured. The author is concise which makes the textbook easy to read.

I found no inconsistencies in terminology or other aspects related to the content.

I will adopt this text for a research course I use and will likely assign only specific chapters. I plan to recommend the textbook to another faculty who teaches a comprehensive research course with the idea of assigning only specific sections to read..

The textbook begins with an introduction to the subject matter. Subsequent chapters develop specific aspects related to lit reviews. The textbook provides a nice "how to" for each element of a lit review. Chapters are also organized in a smooth, easy to follow format.

I only looked at the digital pdf and print pdf versions. The print pdf indicates that there are videos to watch, but of course since it is a print pdf, there is no linkage. I think this would be obvious to a savvy reader - that a print pdf will be limited in what the reader can access.

I found no grammatical errors in my quick read.

I found no evidence of cultural bias or insensitivity.

This is the first open textbook that I have encountered. I was expecting it to be flat and boring! However, it was neither of those. There were color diagrams, color photos, and even videos embedded in the textbook.

I have adopted this book for the Research Lit Review course that I am teaching soon. I am impressed!

Reviewed by Melissa Wells, Assistant Professor, University of Mary Washington on 5/1/19

This book helps students in education and nursing complete a literature review, which may be the first time these students are tackling such a task. The chapters break down the process into defining the special genre of a literature review;... read more

This book helps students in education and nursing complete a literature review, which may be the first time these students are tackling such a task. The chapters break down the process into defining the special genre of a literature review; providing tips to get started; suggesting where students can find literature to review; explaining how to evaluate sources; detailing the process of documenting sources; giving advice for synthesizing sources; and finally, putting all of these pieces together into a final literature review. Most significantly, the text provides specific examples of ideas presented in the context of both nursing and education, which makes the content directly relatable to the student's course of study. The conclusion recaps the main points of each chapter in bullet form. The text is lacking both an index and a glossary, which would be additions that could strengthen the text.

Content Accuracy rating: 4

The text explains 11 different types of literature reviews that students may encounter or be asked to create. Also, the text is framed to work with multiple methodologies; for example, steps for writing a research question or a hypothesis to frame the literature review are provided. One inconsistency I noted was in diagram 6.2: the APA citation is incorrectly capitalized for the journal title (which should use sentence, not title, capitalization).

The text also includes external links to sources, such as a videos, which provide students with multiple modalities in which to digest the information. An example of a literature review for both education and nursing is provided at the end of the book; instead of embedding these in the text, the hyperlinks refer the reader to the external site. This will be easy to change to a new example in the future, but checks will need to be done to ensure that all such external sources remain actively accessible.

Each chapter opens with learning objectives to help frame the content with which the reader is about to engage. Throughout the text, the language is approachable and reader-friendly. For example, when the text explains more factual components (i.e., what makes a literature review or what the basics of an effective literature review include), this information is presented in bullet points with hyperlinks to the original sources.

Each chapter follows a similar construction, which makes it accessible to the reader. For example, chapters end with a "Practice" and "Check Yourself" section to apply new learning and self-check responses (an answer key is provided in an appendix). Examples in these exercises are either related to nursing or education, continuing with the stated theme of the text.

When I used this text with my own students, I assigned chapters in isolation, since they had already taken a research methods course and were applying that knowledge to create a research proposal in a specific area of study in my course.

The book is organized in such a way that logically walks the reader through the literature review writing process. Clear headings (which are hyperlinked in the table of contents) also allow the reader to jump to specific parts with which they need additional support.

The interface of this document offered a lot of flexibility. Options allowed users to access the text online, or as a download in multiple file types (EPUB, Digital PDF, MOBI, XHTML, Pressbooks XML, Wordpress XML, and Open Document). These formats provide the reader with an opportunity to pick the interface that works best for them.

I did not see any grammatical errors in the text.

Cultural Relevance rating: 4

No culturally insensitive/offensive content was noted. A variety of examples of research topics were included from both nursing and education. Of the images/video thumbnails embedded in the text that involved people, all depicted White people except for 2 images; therefore, more intentional selection of culturally diverse visuals would be helpful in future versions of this text.

I feel this text was helpful to my students as they wrote their own literature reviews. The only weakness in their papers that I noted was their organization of their literature review based on themes/topic, which was addressed in Chapters 7- 8. I now know to focus more on this part of literature review writing with future students. This text is approachable and field-specific, and I will be using it again!

Reviewed by Bernita (Bernie) Missal, Professor, Bethel University on 12/14/18

This book includes all areas that a graduate student needs to begin a literature review. However metasynthesis could have also been included in types of literature review. read more

This book includes all areas that a graduate student needs to begin a literature review. However metasynthesis could have also been included in types of literature review.

This book is accurate although missing qualitative research.

Although content is up to date, some of the article examples need to be updated. (Example: articles published in 1981 and 1992 need to be updated to more recent articles.)

The book is clear and easy to follow. Bullet points were used throughout the book with short paragraphs which helps the student.

Each chapter follows the same format with narrative followed by practice and test questions.

Clear subheadings are used throughout the book.

This book is presented in a logical way and easy for the student to follow.

Images are clear and appropriate for the content.

No specific grammar issues were seen.

It would be helpful for students to include additional examples of cultural studies throughout the book

This book is an excellent resource for graduate students. It has helpful information for the preparation and process for a literature review. Examples of written literature reviews in chapter 8 or in an appendix would be helpful for students.

Reviewed by Nancyruth Leibold, Associate Professor, Southwest Minnesota State University on 6/19/18

The text is overall comprehensive, yet it breaks the information up into manageable parts. See the table of contents for an overview of the topics. The text is very quantitative driven in that the focus is on reviewing quantitative studies. The... read more

The text is overall comprehensive, yet it breaks the information up into manageable parts. See the table of contents for an overview of the topics. The text is very quantitative driven in that the focus is on reviewing quantitative studies. The book included information about PICO statements, but did not include PICO(T) or the time variable, which is not always used in every case. Population was included in the PICO explanation, but a bit more information on the population or aggregate narrowing could improve the PICO section. These items do not hinder use of the book, but these items would need further inclusion by the faculty member using the text as specific to the discipline.

The content in the book is very accurate.

The content in the book is current and should not be obsolete within a short period of time. Any updates would be easy to add.

The text is clear and easy to understand.

The internal organization and terminology of the book is consistent and logical

The text is set up in small reading sessions. The videos and learning activities are well done and break up some of the content, so there is a variety of presentation. The tutorials, figures, practice and self-test areas are also fantastic in that they are quality and sprinkled throughout the text.

The topics in the book are presented in clear and organized fashion. I particularly like the upbeat and personal writing tone of the book. This tone makes it seem like the authors are speaking to me.

The text is free of any significant interface issues. The book is available in many formats. I used the book online and I did have one navigational problem and that is when clicking on a video, it does not open in a new tab and so the book is lost and have to start over going in the start to the book. One easy solution to this is to right click your mouse and then select open in new tab to watch videos. That way, your place in the book is not lost.

No grammar problems present.

The book is not culturally insensitive or offensive in any way.

Overall, this is a well written textbook and I recommend it!

Reviewed by Marjorie Webb, Professor, Metropolitan State University on 6/19/18

From the Introduction to the Conclusion, the text covers the step-by-step process of conducting a literature review. The text includes topics such as, “Where to find the Literature” and “Synthesizing Sources” that will be useful to graduate... read more

From the Introduction to the Conclusion, the text covers the step-by-step process of conducting a literature review. The text includes topics such as, “Where to find the Literature” and “Synthesizing Sources” that will be useful to graduate nursing students.

The content in the text, including texts, links, and diagrams, is accurate and unbiased. Again, it will aid the graduate nursing student in the long process of conducting a literature review.

The text is current and this type of material does not become dated quickly. The authors did use internet links in the text which will need to be monitored periodically to ensure they are still available. Updates to the text will be relatively easy and straightforward. If media styles change, there may be some challenges to updating.

The text is clear and easy to read. Technical terminology is defined and/or explained.

The text is internally consistent.

The text is organized in sections which facilitates assigning readings based on the subject matter for the class time. It would be pretty easy to divide up this text into easily readable units based on headings and subheadings.

This text is structured well. The topics flow in an organized manner and really help the student see the process of a literature review. The authors discuss the both theory and purpose of the review and the day-to-day logistics of actually performing the review. The day-today organization is not always included in other texts.

The interface is well-done with no distractions.

There was no indication of cultural bias.

I think this text is appropriate for graduate nursing students. Some students struggle with the difference between writing about a topic (generally undergraduate writing) and synthesizing literature on a given topic (generally graduate writing). Chapters seven and eight focus on preparing the graduate student to make the jump to graduate-level writing and should really benefit new graduate students.

Reviewed by Susanna Thornhill, Associate Professor , George Fox University on 3/27/18

This book is fairly comprehensive and offers step-by-step instructions for conceptualizing/researching a literature review. The Table of Contents is well-organized to reflect the book's progression, from establishing the basics of why to write a... read more

This book is fairly comprehensive and offers step-by-step instructions for conceptualizing/researching a literature review. The Table of Contents is well-organized to reflect the book's progression, from establishing the basics of why to write a literature review and the various types of literature reviews, to getting started with formulating a research idea/question, finding and evaluating sources, synthesizing sources, and guidelines on writing the literature review, itself. I found this text to be a straightforward guide for my graduate students in education, and while I worried at first that the merging of education and nursing topics would prove distracting to my education students, I don't believe this was the case.

One thing that was not comprehensive in this book was discussion of qualitative research and methodologies as a valid means of conceptualizing research aims. I hoped for a more balanced discussion between methodological branches as it applied to literature reviews; this book overly favored quantitative methodologies and studies in terms of its direction to readers about how to conceptualize/choose a topic and design a research question in relation to it. Variables that cannot be measured are not inherently un-researchable, which is the conclusion put forth in this textbook. This might serve nursing students better than education students in terms of their discipline's requirements, but it still represents an element that could be improved.

Finally, while the background on what a literature review is, how to conceptualize research, and how to search for and synthesize research was all valuable, the chapter on actually writing the literature review was a bit thin, simply offering tips for introduction, body, and conclusion and some questions for self-evaluation. Some of the most difficult work for students writing a literature review is achieving proper focus, organization, hierarchy of themes, balance in treatment of related topics, etc. None of these issues were discussed in the chapter pertaining to the writing of a literature review.

I did not have any concerns about the book's accuracy. Content was accurate, albeit biased to quantitative and positivist views of research. I would have liked to see it include additional prompts to support students in conceptualizing and valuing qualitative research; this is an area where I had to supplement course readings with additional texts.

The only significant error I could discern in the text was a lack of an Answer Key corresponding to the questions posed at the end of each chapter.

Content is up-to-date and seems like it will hold meaning well over the next few years. The only things I anticipate might go out-of-date is technological information on things like citation managers, search guidelines, and database information. This is easily updatable with future versions of the text. In my view, ERIC is not the best database for educational research and I have confirmed this with educational librarians who support my students, yet it is the only one identified in this text as the best subject-specific source of educational research; this could be revised for additional relevance.

I noticed no issues with the book's clarity. The authors write in a clear and straightforward style, making the text easy to read. Overall, they did well writing for students across two disciplines by avoiding nursing or education-specific terms that would have been problematic to readers in the other discipline.

The book is internally consistent and did not have issues with terminology or framework.

No issues with the book's modularity. Chapter headings and sub-headings were appropriately paced and spaced. I assigned this textbook to my graduate students as a whole text that I wanted them to read at the beginning of a course, but it has been easy to refer them back to particular topics as the course has continued.

In future iterations of the book, I suggest hyperlinking the Answer Key to the exercises at the end of each chapter and/or listing the Answer Key in the Table of Contents for easy referral.

I found the book's organization to be straightforward and sensible. The Table of Contents offers a helpful snapshot of the scope of the book and the authors write in a direct and clear style, which contributes to an appropriate flow for the text.

I did not note any navigation problems with any links. All charts/images loaded well in my iBook app. The authors did a nice job of pulling relevant content and links in to support their ideas; it provided an easy way to seek more information if I wanted it, without feeling like the text was loaded down with unnecessary information.

I only found a few small typos in the text, with no grammar issues. The book is obviously written by two very detail-oriented librarians. I appreciated the clarity of the text and lack of errors.

The text was not culturally insensitive; a variety of topics across nursing and education were discussed as examples, which yielded a fairly balanced text regarding cultural considerations.

Reviewed by Alicia Rossiter, Assistant Professor, University of South Florida on 3/27/18

I believe the book gives a comprehensive overview on how to complete a literature view at the graduate level. It begins with an overview of the purpose of a literature review and moves through the steps to completing the review process. read more

I believe the book gives a comprehensive overview on how to complete a literature view at the graduate level. It begins with an overview of the purpose of a literature review and moves through the steps to completing the review process.

I believe the book was accurate and unbiased. It was easy to read but comprehensive.

Content within the text is relevant and supports the literature view process. It did discuss the various databases for searches which may need updating to include new sites, search engines but otherwise relevant and useful information.

The text is easy to read, provides appropriate examples, includes a section on putting the process into practice as well as a "test yourself" section to ensure the content is understood.

The text is consistent throughout in regards to terminology, framework, and set up.

The text is easy to read and content is leveled for the reader but not over simplified. Content is chunked into sections making it easy for the reader to digest the content. The chapters are well laid out and flow from chapter to chapter. Each chapter contains learning objectives, content sections, practice section, and test yourself section. Well organized and great visuals.

Topics are presented in a logical, clear fashion that flow from chapter to chapter and build as the reader moves through the process.

The text is free of interface issues. I could not get the videos to play but other visuals were appropriate and useful to support content.

The text contains no grammatical errors.

The text is not culturally offensive. There was no evidence of bias or cultural insensitivity.

I think this would be a great resource for graduate student learning to navigate the literature review process. It is easy to read, straightforward, and guides the individual through the process from start to finish. I will recommend this text to my graduate students in evidence-based practice and research courses as a recommended reference.

Table of Contents

• Chapter 1: Introduction
• Chapter 2: What is a Literature Review?
• Chapter 3: How to Get Started
• Chapter 4: Where to Find the Literature
• Chapter 5: Evaluating Sources
• Chapter 6: Documenting Sources
• Chapter 7: Synthesizing Sources
• Chapter 8: Writing the Literature Review

Ancillary Material

About the book.

Literature Reviews for Education and Nursing Graduate Students is an open textbook designed for students in graduate-level nursing and education programs. Its intent is to recognize the significant role the literature review plays in the research process and to prepare students for the work that goes into writing one. Developed for new graduate students and novice researchers just entering into the work of a chosen discipline, each of the eight chapters covers a component of the literature review process. Students will learn how to form a research question, search existing literature, synthesize results and write the review. The book contains examples, checklists, supplementary materials, and additional resources. Literature Reviews for Education and Nursing Graduate Students is written by two librarians with expertise guiding students through research and writing assignments, and is openly licensed.

About the Contributors

Linda Frederiksen is the Head of Access Services at Washington State University Vancouver.  She has a Master of Library Science degree from Emporia State University in Kansas. Linda is active in local, regional and national organizations, projects and initiatives advancing open educational resources and equitable access to information.

Sue F. Phelps is the Health Sciences and Outreach Services Librarian at Washington State University Vancouver. Her research interests include information literacy, accessibility of learning materials for students who use adaptive technology, diversity and equity in higher education, and evidence based practice in the health sciences

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University Library

• Research Guides
• Literature Reviews
• Evidence-Based Practice
• Books & Media

What is a Literature Review?

Key questions for a literature review, examples of literature reviews, useful links, evidence matrix for literature reviews.

• Annotated Bibliographies

The Scholarly Conversation

A literature review provides an overview of previous research on a topic that critically evaluates, classifies, and compares what has already been published on a particular topic. It allows the author to synthesize and place into context the research and scholarly literature relevant to the topic. It helps map the different approaches to a given question and reveals patterns. It forms the foundation for the author’s subsequent research and justifies the significance of the new investigation.

A literature review can be a short introductory section of a research article or a report or policy paper that focuses on recent research. Or, in the case of dissertations, theses, and review articles, it can be an extensive review of all relevant research.

• The format is usually a bibliographic essay; sources are briefly cited within the body of the essay, with full bibliographic citations at the end.
• The introduction should define the topic and set the context for the literature review. It will include the author's perspective or point of view on the topic, how they have defined the scope of the topic (including what's not included), and how the review will be organized. It can point out overall trends, conflicts in methodology or conclusions, and gaps in the research.
• In the body of the review, the author should organize the research into major topics and subtopics. These groupings may be by subject, (e.g., globalization of clothing manufacturing), type of research (e.g., case studies), methodology (e.g., qualitative), genre, chronology, or other common characteristics. Within these groups, the author can then discuss the merits of each article and analyze and compare the importance of each article to similar ones.
• The conclusion will summarize the main findings, make clear how this review of the literature supports (or not) the research to follow, and may point the direction for further research.
• The list of references will include full citations for all of the items mentioned in the literature review.

A literature review should try to answer questions such as

• Who are the key researchers on this topic?
• What has been the focus of the research efforts so far and what is the current status?
• How have certain studies built on prior studies? Where are the connections? Are there new interpretations of the research?
• Have there been any controversies or debate about the research? Is there consensus? Are there any contradictions?
• Which areas have been identified as needing further research? Have any pathways been suggested?
• How will your topic uniquely contribute to this body of knowledge?
• Which methodologies have researchers used and which appear to be the most productive?
• What sources of information or data were identified that might be useful to you?
• How does your particular topic fit into the larger context of what has already been done?
• How has the research that has already been done help frame your current investigation ?

Example of a literature review at the beginning of an article: Forbes, C. C., Blanchard, C. M., Mummery, W. K., & Courneya, K. S. (2015, March). Prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors . Oncology Nursing Forum, 42(2), 118+. Retrieved from http://go.galegroup.com.sonoma.idm.oclc.org/ps/i.do?p=HRCA&sw=w&u=sonomacsu&v=2.1&it=r&id=GALE%7CA422059606&asid=27e45873fddc413ac1bebbc129f7649c Example of a comprehensive review of the literature: Wilson, J. L. (2016). An exploration of bullying behaviours in nursing: a review of the literature.   British Journal Of Nursing ,  25 (6), 303-306. For additional examples, see:

Galvan, J., Galvan, M., & ProQuest. (2017). Writing literature reviews: A guide for students of the social and behavioral sciences (Seventh ed.). [Electronic book]

Pan, M., & Lopez, M. (2008). Preparing literature reviews: Qualitative and quantitative approaches (3rd ed.). Glendale, CA: Pyrczak Pub. [ Q180.55.E9 P36 2008]

• Write a Literature Review (UCSC)
• Literature Reviews (Purdue)
• Literature Reviews: overview (UNC)
• Review of Literature (UW-Madison)

The  Evidence Matrix  can help you  organize your research  before writing your lit review.  Use it to  identify patterns  and commonalities in the articles you have found--similar methodologies ?  common  theoretical frameworks ? It helps you make sure that all your major concepts covered. It also helps you see how your research fits into the context  of the overall topic.

• Evidence Matrix Special thanks to Dr. Cindy Stearns, SSU Sociology Dept, for permission to use this Matrix as an example.
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Nursing and Midwifery

• Accessing NHS resources
• Journals, Databases and Critical Thinking

What is a literature review?

Choosing a topic, developing your search strategy, carrying out your search, saving and documenting your search, formulating a research question, critical appraisal tools.

• Go to LibrarySearch This link opens in a new window

So you have been asked to complete a literature review, but what is a literature review?

A literature review is a piece of research which aims to address a specific research question. It is a comprehensive summary and analysis of existing literature. The literature itself should be the main topic of discussion in your review. You want the results and themes to speak for themselves to avoid any bias.

The first step is to decide on a topic. Here are some elements to consider when deciding upon a topic:

• Choose a topic which you are interested in, you will be looking at a lot of research surrounding that area so you want to ensure it is something that interests you. 
• Draw on your own experiences, think about your placement or your workplace.
• Think about why the topic is worth investigating.  

Once you have decided on a topic, it is a good practice to carry out an initial scoping search.

This requires you to do a quick search using  LibrarySearch  or  Google Scholar  to ensure that there is research on your topic. This is a preliminary step to your search to check what literature is available before deciding on your question. 

The research question framework elements can also be used as keywords.

• Think about who the population/ sample group. Are you looking for a particular age group, ethnicity, cultural background, gender, health issue etc.
• What is the intervention/issue you want to know more about? This could be a particular type of medication, education, therapeutic technique etc. 
• Do you have a particular context in mind? This could relate to a community setting, hospital, ward etc. 

It is important to remember that databases will only ever search for the exact term you put in, so don't panic if you are not getting the results you hoped for. Think about alternative words that could be used for each keyword to build upon your search. 

Build your search by thinking about about synonyms, specialist language, spellings, acronyms, abbreviations for each keyword that you have.

Inclusion & Exclusion Criteria

Your inclusion and exclusion criteria is also an important step in the literature review process. It allows you to be transparent in how you have  ended up with your final articles. 

Your inclusion/exclusion criteria is completely dependent on your chosen topic. Use your inclusion and exclusion criteria to select your articles, it is important not to cherry pick but to have a reason as to why you have selected that particular article. 

• Search Planning Template Use this template to plan your search strategy.

Once you have thought about your keywords and alternative keywords, it is time to think about how to combine them to form your search strategy. Boolean operators instruct the database how your terms should interact with one another. 

Boolean Operators

• OR can be used to combine your keywords and alternative terms. For example "Social Media OR Twitter". When using OR we are informing the database to bring articles continuing either of those terms as they are both relevant so we don't mind which appears in our article. 
• AND can be used to combine two or more concepts. For example "Social Media AND Anxiety". When using AND we are informing the database that we need both of the terms in our article in order for it to be relevant.
• Truncation can be used when there are multiple possible word endings. For example Nurs* will find Nurse, Nurses and Nursing. 
• Double quotation marks can be used to allow for phrase searching. This means that if you have two or more words that belong together as a phrase the database will search for that exact phrase rather than words separately.  For example "Social Media"

Don't forget the more ORs you use the broader your search becomes, the more ANDs you use the narrower your search becomes. 

One of the databases you will be using is EBSCOHost Research Databases. This is a platform which searches through multiple databases so allows for a comprehensive search. The short video below covers how to access and use EBSCO. 

A reference management software will save you a lot of time especially when you are looking at lots of different articles. 

We provide support for EndNote and Mendeley. The video below covers how to install and use Mendeley. 

Consider using a research question framework. A framework will ensure that your question is specific and answerable.

There are different frameworks available depending on what type of research you are interested in.

Population - Who is the question focussed on? This could relate to staff, patients, an age group, an ethnicity etc.

Intervention - What is the question focussed on? This could be a certain type of medication, therapeutic technique etc. 

Comparison/Context - This may be with our without the intervention or it may be concerned with the context for example where is the setting of your question? The hospital, ward, community etc?

Outcome - What do you hope to accomplish or improve etc.

Sample - as this is qualitative research sample is preferred over patient so that it is not generalised. 

Phenomenon of Interest - reasons for behaviour, attitudes, beliefs and decisions.

Design - the form of research used. 

Evaluation - the outcomes.

Research type -qualitative, quantitative or mixed methods.  

All frameworks help you to be specific, but don't worry if your question doesn't fit exactly into a framework. 

There are many critical appraisal tools or books you can use to assess the credibility of a research paper but these are a few we would recommend in the library. Your tutor may be able to advise you of others or some that are more suitable for your topic.

Critical Appraisal Skills Programme (CASP)

CASP is a well-known critical appraisal website that has checklists for a wide variety of study types. You will see it frequently used by practitioners.

Understanding Health Research

This is a brand-new, interactive resource that guides you through appraising a research paper, highlighting key areas you should consider when appraising evidence.

Greenhalgh, T. (2014) How to read a paper: The basics of evidence-based medicine . 5 th edn. Chichester: Wiley

Greenhalgh’s book is a classic in critical appraisal. Whilst you don’t need to read this book cover-to-cover, it can be useful to refer to its specific chapters on how to assess different types of research papers. We have copies available in the library!

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

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

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

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

There are five key steps to writing a literature review:

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

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

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Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

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

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

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

Download Word doc Download Google doc

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

For each publication, ask yourself:

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

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

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

Take notes and cite your sources

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

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

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

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

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

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

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

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

As you write, you can follow these tips:

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

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

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

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

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

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

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

 Statistics

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

Research bias

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

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

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

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

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

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

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

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

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

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Chapter 1: Introduction

Learning objectives.

At the conclusion of this chapter, you will be able to:

• Identify the purpose of the literature review in  the research process
• Distinguish between different types of literature reviews

1.1 What is a Literature Review?

Pick up nearly any book on research methods and you will find a description of a literature review.  At a basic level, the term implies a survey of factual or nonfiction books, articles, and other documents published on a particular subject.  Definitions may be similar across the disciplines, with new types and definitions continuing to emerge.  Generally speaking, a literature review is a:

• “comprehensive background of the literature within the interested topic area…” ( O’Gorman & MacIntosh, 2015, p. 31 ).
• “critical component of the research process that provides an in-depth analysis of recently published research findings in specifically identified areas of interest.” ( House, 2018, p. 109 ).
• “written document that presents a logically argued case founded on a comprehensive understanding of the current state of knowledge about a topic of study” ( Machi & McEvoy,  2012, p. 4 ).

As a foundation for knowledge advancement in every discipline, it is an important element of any research project.  At the graduate or doctoral level, the literature review is an essential feature of thesis and dissertation, as well as grant proposal writing.  That is to say, “A substantive, thorough, sophisticated literature review is a precondition for doing substantive, thorough, sophisticated research…A researcher cannot perform significant research without first understanding the literature in the field.” ( Boote & Beile, 2005, p. 3 ).  It is by this means, that a researcher demonstrates familiarity with a body of knowledge and thereby establishes credibility with a reader.  An advanced-level literature review shows how prior research is linked to a new project, summarizing and synthesizing what is known while identifying gaps in the knowledge base, facilitating theory development, closing areas where enough research already exists, and uncovering areas where more research is needed. ( Webster & Watson, 2002, p. xiii )

A graduate-level literature review is a compilation of the most significant previously published research on your topic. Unlike an annotated bibliography or a research paper you may have written as an undergraduate, your literature review will outline, evaluate and synthesize relevant research and relate those sources to your own thesis or research question. It is much more than a summary of all the related literature.

It is a type of writing that demonstrate the importance of your research by defining the main ideas and the relationship between them. A good literature review lays the foundation for the importance of your stated problem and research question.

Literature reviews:

• define a concept
• map the research terrain or scope
• systemize relationships between concepts
• identify gaps in the literature ( Rocco & Plathotnik, 2009, p. 128 )

The purpose of a literature review is to demonstrate that your research question  is meaningful. Additionally, you may review the literature of different disciplines to find deeper meaning and understanding of your topic. It is especially important to consider other disciplines when you do not find much on your topic in one discipline. You will need to search the cognate literature before claiming there is “little previous research” on your topic.

Well developed literature reviews involve numerous steps and activities. The literature review is an iterative process because you will do at least two of them: a preliminary search to learn what has been published in your area and whether there is sufficient support in the literature for moving ahead with your subject. After this first exploration, you will conduct a deeper dive into the literature to learn everything you can about the topic and its related issues.

Literature Review Tutorial

1.2 Literature Review Basics

An effective literature review must:

• Methodologically analyze and synthesize quality literature on a topic
• Provide a firm foundation to a topic or research area
• Provide a firm foundation for the selection of a research methodology
• Demonstrate that the proposed research contributes something new to the overall body of knowledge of advances the research field’s knowledge base. ( Levy & Ellis, 2006 ).

All literature reviews, whether they are qualitative, quantitative or both, will at some point:

• Introduce the topic and define its key terms
• Establish the importance of the topic
• Provide an overview of the amount of available literature and its types (for example: theoretical, statistical, speculative)
• Identify gaps in the literature
• Point out consistent finding across studies
• Arrive at a synthesis that organizes what is known about a topic
• Discusses possible implications and directions for future research

1.3 Types of Literature Reviews

There are many different types of literature reviews, however there are some shared characteristics or features.  Remember a comprehensive literature review is, at its most fundamental level, an original work based on an extensive critical examination and synthesis of the relevant literature on a topic. As a study of the research on a particular topic, it is arranged by key themes or findings, which may lead up to or link to the  research question.  In some cases, the research question will drive the type of literature review that is undertaken.

The following section includes brief descriptions of the terms used to describe different literature review types with examples of each.   The included citations are open access, Creative Commons licensed or copyright-restricted.

1.3.1 Types of Review

1.3.1.1 conceptual.

Guided by an understanding of basic issues rather than a research methodology. You are looking for key factors, concepts or variables and the presumed relationship between them. The goal of the conceptual literature review is to categorize and describe concepts relevant to your study or topic and outline a relationship between them. You will include relevant theory and empirical research.

Examples of a Conceptual Review:

• Education : The formality of learning science in everyday life: A conceptual literature review. ( Dohn, 2010 ).
• Education : Are we asking the right questions? A conceptual review of the educational development literature in higher education. ( Amundsen & Wilson, 2012 ).

1.3.1.2 Empirical

An empirical literature review collects, creates, arranges, and analyzes numeric data reflecting the frequency of themes, topics, authors and/or methods found in existing literature. Empirical literature reviews present their summaries in quantifiable terms using descriptive and inferential statistics.

Examples of an Empirical Review:

• Nursing : False-positive findings in Cochrane meta-analyses with and without application of trial sequential analysis: An empirical review. ( Imberger, Thorlund, Gluud, & Wettersley, 2016 ).
• Education : Impediments of e-learning adoption in higher learning institutions of Tanzania: An empirical review ( Mwakyusa & Mwalyagile, 2016 ).

1.3.1.3 Exploratory

Unlike a synoptic literature review, the purpose here is to provide a broad approach to the topic area. The aim is breadth rather than depth and to get a general feel for the size of the topic area. A graduate student might do an exploratory review of the literature before beginning a synoptic, or more comprehensive one.

Examples of an Exploratory Review:

• Education : University research management: An exploratory literature review. ( Schuetzenmeister, 2010 ).
• Education : An exploratory review of design principles in constructivist gaming learning environments. ( Rosario & Widmeyer, 2009 ).

1.3.1.4 Focused

A type of literature review limited to a single aspect of previous research, such as methodology. A focused literature review generally will describe the implications of choosing a particular element of past research, such as methodology in terms of data collection, analysis and interpretation.

Examples of a Focused Review:

• Nursing : Clinical inertia in the management of type 2 diabetes mellitus: A focused literature review. ( Khunti, Davies, & Khunti, 2015 ).
• Education : Language awareness: Genre awareness-a focused review of the literature. ( Stainton, 1992 ).

1.3.1.5 Integrative

Critiques past research and draws overall conclusions from the body of literature at a specified point in time. Reviews, critiques, and synthesizes representative literature on a topic in an integrated way. Most integrative reviews are intended to address mature topics or  emerging topics. May require the author to adopt a guiding theory, a set of competing models, or a point of view about a topic.  For more description of integrative reviews, see Whittemore & Knafl (2005).

Examples of an Integrative Review:

• Nursing : Interprofessional teamwork and collaboration between community health workers and healthcare teams: An integrative review. ( Franklin,  Bernhardt, Lopez, Long-Middleton, & Davis, 2015 ).
• Education : Exploring the gap between teacher certification and permanent employment in Ontario: An integrative literature review. ( Brock & Ryan, 2016 ).

1.3.1.6 Meta-analysis

A subset of a  systematic review, that takes findings from several studies on the same subject and analyzes them using standardized statistical procedures to pool together data. Integrates findings from a large body of quantitative findings to enhance understanding, draw conclusions, and detect patterns and relationships. Gather data from many different, independent studies that look at the same research question and assess similar outcome measures. Data is combined and re-analyzed, providing a greater statistical power than any single study alone. It’s important to note that not every systematic review includes a meta-analysis but a meta-analysis can’t exist without a systematic review of the literature.

Examples of a Meta-Analysis:

• Education : Efficacy of the cooperative learning method on mathematics achievement and attitude: A meta-analysis research. ( Capar & Tarim, 2015 ).
• Nursing : A meta-analysis of the effects of non-traditional teaching methods on the critical thinking abilities of nursing students. ( Lee, Lee, Gong, Bae, & Choi, 2016 ).
• Education : Gender differences in student attitudes toward science: A meta-analysis of the literature from 1970 to 1991. ( Weinburgh, 1995 ).

1.3.1.7 Narrative/Traditional

An overview of research on a particular topic that critiques and summarizes a body of literature. Typically broad in focus. Relevant past research is selected and synthesized into a coherent discussion. Methodologies, findings and limits of the existing body of knowledge are discussed in narrative form. Sometimes also referred to as a traditional literature review. Requires a sufficiently focused research question. The process may be subject to bias that supports the researcher’s own work.

Examples of a Narrative/Traditional Review:

• Nursing : Family carers providing support to a person dying in the home setting: A narrative literature review. ( Morris, King, Turner, & Payne, 2015 ).
• Education : Adventure education and Outward Bound: Out-of-class experiences that make a lasting difference. ( Hattie, Marsh, Neill, & Richards, 1997 ).
• Education : Good quality discussion is necessary but not sufficient in asynchronous tuition: A brief narrative review of the literature. ( Fear & Erikson-Brown, 2014 ).
• Nursing : Outcomes of physician job satisfaction: A narrative review, implications, and directions for future research. ( Williams & Skinner, 2003 ).

1.3.1.8 Realist

Aspecific type of literature review that is theory-driven and interpretative and is intended to explain the outcomes of a complex intervention program(s).

Examples of a Realist Review:

• Nursing : Lean thinking in healthcare: A realist review of the literature. ( Mazzacato, Savage, Brommels, 2010 ).
• Education : Unravelling quality culture in higher education: A realist review. ( Bendermacher, Egbrink, Wolfhagen, & Dolmans, 2017 ).

1.3.1.9 Scoping

Tend to be non-systematic and focus on breadth of coverage conducted on a topic rather than depth. Utilize a wide range of materials; may not evaluate the quality of the studies as much as count the number. One means of understanding existing literature. Aims to identify nature and extent of research; preliminary assessment of size and scope of available research on topic. May include research in progress.

Examples of a Scoping Review:

• Nursing : Organizational interventions improving access to community-based primary health care for vulnerable populations: A scoping review. ( Khanassov, Pluye, Descoteaux, Haggerty,  Russell, Gunn, & Levesque, 2016 ).
• Education : Interdisciplinary doctoral research supervision: A scoping review. ( Vanstone, Hibbert, Kinsella, McKenzie, Pitman, & Lingard, 2013 ).
• Nursing : A scoping review of the literature on the abolition of user fees in health care services in Africa. ( Ridde, & Morestin, 2011 ).

1.3.1.10 Synoptic

Unlike an exploratory review, the purpose is to provide a concise but accurate overview of all material that appears to be relevant to a chosen topic. Both content and methodological material is included. The review should aim to be both descriptive and evaluative. Summarizes previous studies while also showing how the body of literature could be extended and improved in terms of content and method by identifying gaps.

Examples of a Synoptic Review:

• Education : Theoretical framework for educational assessment: A synoptic review. ( Ghaicha, 2016 ).
• Education : School effects research: A synoptic review of past efforts and some suggestions for the future. ( Cuttance, 1981 ).

1.3.1.11 Systematic Review

A rigorous review that follows a strict methodology designed with a presupposed selection of literature reviewed.  Undertaken to clarify the state of existing research, the evidence, and possible implications that can be drawn from that.  Using comprehensive and exhaustive searching of the published and unpublished literature, searching various databases, reports, and grey literature.  Transparent and reproducible in reporting details of time frame, search and methods to minimize bias.  Must include a team of at least 2-3 and includes the critical appraisal of the literature.  For more description of systematic reviews, including links to protocols, checklists, workflow processes, and structure see “ A Young Researcher’s Guide to a Systematic Review “.

Examples of a Systematic Review:

• Education : The potentials of using cloud computing in schools: A systematic literature review ( Hartmann, Braae, Pedersen, & Khalid, 2017 )
• Nursing : Is butter back? A systematic review and meta-analysis of butter consumption and risk of cardiovascular disease, diabetes, and total mortality. ( Pimpin, Wu, Haskelberg, Del Gobbo, & Mozaffarian, 2016 ).
• Education : The use of research to improve professional practice: a systematic review of the literature. ( Hemsley-Brown & Sharp, 2003 ).
• Nursing : Using computers to self-manage type 2 diabetes. ( Pal, Eastwood, Michie, Farmer, Barnard, Peacock, Wood, Inniss, & Murray, 2013 ).

1.3.1.12 Umbrella/Overview of Reviews

Compiles evidence from multiple systematic reviews into one document. Focuses on broad condition or problem for which there are competing interventions and highlights reviews that address those interventions and their effects. Often used in recommendations for practice.

Examples of an Umbrella/Overview Review:

• Education : Reflective practice in healthcare education: An umbrella review. ( Fragknos, 2016 ).
• Nursing : Systematic reviews of psychosocial interventions for autism: an umbrella review. ( Seida, Ospina, Karkhaneh, Hartling, Smith, & Clark, 2009 ).

For a brief discussion see “ Not all literature reviews are the same ” (Thomson, 2013).

1.4 Why do a Literature Review?

The purpose of the literature review is the same regardless of the topic or research method. It tests your own research question against what is already known about the subject.

1.4.1 First – It’s part of the whole. Omission of a literature review chapter or section in a graduate-level project represents a serious void or absence of critical element in the research process.

The outcome of your review is expected to demonstrate that you:

• can systematically explore the research in your topic area
• can read and critically analyze the literature in your discipline and then use it appropriately to advance your own work
• have sufficient knowledge in the topic to undertake further investigation

1.4.2 Second – It’s good for you!

• You improve your skills as a researcher
• You become familiar with the discourse of your discipline and learn how to be a scholar in your field
• You learn through writing your ideas and finding your voice in your subject area
• You define, redefine and clarify your research question for yourself in the process

1.4.3 Third – It’s good for your reader. Your reader expects you to have done the hard work of gathering, evaluating and synthesizes the literature.  When you do a literature review you:

• Set the context for the topic and present its significance
• Identify what’s important to know about your topic – including individual material, prior research, publications, organizations and authors.
• Demonstrate relationships among prior research
• Establish limitations of existing knowledge
• Analyze trends in the topic’s treatment and gaps in the literature

1.4.4 Why do a literature review?

• To locate gaps in the literature of your discipline
• To avoid reinventing the wheel
• To carry on where others have already been
• To identify other people working in the same field
• To increase your breadth of knowledge in your subject area
• To find the seminal works in your field
• To provide intellectual context for your own work
• To acknowledge opposing viewpoints
• To put your work in perspective
• To demonstrate you can discover and retrieve previous work in the area

1.5 Common Literature Review Errors

Graduate-level literature reviews are more than a summary of the publications you find on a topic.  As you have seen in this brief introduction, literature reviews are a very specific type of research, analysis, and writing.  We will explore these topics more in the next chapters.  Some things to keep in mind as you begin your own research and writing are ways to avoid the most common errors seen in the first attempt at a literature review.  For a quick review of some of the pitfalls and challenges a new researcher faces when he/she begins work, see “ Get Ready: Academic Writing, General Pitfalls and (oh yes) Getting Started! ”.

As you begin your own graduate-level literature review, try to avoid these common mistakes:

• Accepts another researcher’s finding as valid without evaluating methodology and data
• Contrary findings and alternative interpretations are not considered or mentioned
• Findings are not clearly related to one’s own study, or findings are too general
• Insufficient time allowed to define best search strategies and writing
• Isolated statistical results are simply reported rather than synthesizing the results
• Problems with selecting and using most relevant keywords, subject headings and descriptors
• Relies too heavily on secondary sources
• Search methods are not recorded or reported for transparency
• Summarizes rather than synthesizes articles

In conclusion, the purpose of a literature review is three-fold:

• to survey the current state of knowledge or evidence in the area of inquiry,
• to identify key authors, articles, theories, and findings in that area, and
• to identify gaps in knowledge in that research area.

A literature review is commonly done today using computerized keyword searches in online databases, often working with a trained librarian or information expert. Keywords can be combined using the Boolean operators, “and”, “or” and sometimes “not”  to narrow down or expand the search results. Once a list of articles is generated from the keyword and subject heading search, the researcher must then manually browse through each title and abstract, to determine the suitability of that article before a full-text article is obtained for the research question.

Literature reviews should be reasonably complete, and not restricted to a few journals, a few years, or a specific methodology or research design. Reviewed articles may be summarized in the form of tables, and can be further structured using organizing frameworks such as a concept matrix.

A well-conducted literature review should indicate whether the initial research questions have already been addressed in the literature, whether there are newer or more interesting research questions available, and whether the original research questions should be modified or changed in light of findings of the literature review.

The review can also provide some intuitions or potential answers to the questions of interest and/or help identify theories that have previously been used to address similar questions and may provide evidence to inform policy or decision-making. ( Bhattacherjee, 2012 ).

Read Abstract 1.  Refer to Types of Literature Reviews.  What type of literature review do you think this study is and why?  See the Answer Key for the correct response.

Nursing : To describe evidence of international literature on the safe care of the hospitalised child after the World Alliance for Patient Safety and list contributions of the general theoretical framework of patient safety for paediatric nursing.

An integrative literature review between 2004 and 2015 using the databases PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science and Wiley Online Library, and the descriptors Safety or Patient safety, Hospitalised child, Paediatric nursing, and Nursing care.

Thirty-two articles were analysed, most of which were from North American, with a descriptive approach. The quality of the recorded information in the medical records, the use of checklists, and the training of health workers contribute to safe care in paediatric nursing and improve the medication process and partnerships with parents.

General information available on patient safety should be incorporated in paediatric nursing care. ( Wegner, Silva, Peres, Bandeira, Frantz, Botene, & Predebon, 2017 ).

Read Abstract 2.  Refer to Types of Literature Reviews.  What type of lit review do you think this study is and why?  See the Answer Key for the correct response.

Education : The focus of this paper centers around timing associated with early childhood education programs and interventions using meta-analytic methods. At any given assessment age, a child’s current age equals starting age, plus duration of program, plus years since program ended. Variability in assessment ages across the studies should enable everyone to identify the separate effects of all three time-related components. The project is a meta-analysis of evaluation studies of early childhood education programs conducted in the United States and its territories between 1960 and 2007. The population of interest is children enrolled in early childhood education programs between the ages of 0 and 5 and their control-group counterparts. Since the data come from a meta-analysis, the population for this study is drawn from many different studies with diverse samples. Given the preliminary nature of their analysis, the authors cannot offer conclusions at this point. ( Duncan, Leak, Li, Magnuson, Schindler, & Yoshikawa, 2011 ).

Test Yourself

See Answer Key for the correct responses.

The purpose of a graduate-level literature review is to summarize in as many words as possible everything that is known about my topic.

A literature review is significant because in the process of doing one, the researcher learns to read and critically assess the literature of a discipline and then uses it appropriately to advance his/her own research.

Read the following abstract and choose the correct type of literature review it represents.

Nursing: E-cigarette use has become increasingly popular, especially among the young. Its long-term influence upon health is unknown. Aim of this review has been to present the current state of knowledge about the impact of e-cigarette use on health, with an emphasis on Central and Eastern Europe. During the preparation of this narrative review, the literature on e-cigarettes available within the network PubMed was retrieved and examined. In the final review, 64 research papers were included. We specifically assessed the construction and operation of the e-cigarette as well as the chemical composition of the e-liquid; the impact that vapor arising from the use of e-cigarette explored in experimental models in vitro; and short-term effects of use of e-cigarettes on users’ health. Among the substances inhaled by the e-smoker, there are several harmful products, such as: formaldehyde, acetaldehyde, acroleine, propanal, nicotine, acetone, o-methyl-benzaldehyde, carcinogenic nitrosamines. Results from experimental animal studies indicate the negative impact of e-cigarette exposure on test models, such as ascytotoxicity, oxidative stress, inflammation, airway hyper reactivity, airway remodeling, mucin production, apoptosis, and emphysematous changes. The short-term impact of e-cigarettes on human health has been studied mostly in experimental setting. Available evidence shows that the use of e-cigarettes may result in acute lung function responses (e.g., increase in impedance, peripheral airway flow resistance) and induce oxidative stress. Based on the current available evidence, e-cigarette use is associated with harmful biologic responses, although it may be less harmful than traditional cigarettes. (J ankowski, Brożek, Lawson, Skoczyński, & Zejda, 2017 ).

• Meta-analysis
• Exploratory

Education: In this review, Mary Vorsino writes that she is interested in keeping the potential influences of women pragmatists of Dewey’s day in mind while presenting modern feminist re readings of Dewey. She wishes to construct a narrowly-focused and succinct literature review of thinkers who have donned a feminist lens to analyze Dewey’s approaches to education, learning, and democracy and to employ Dewey’s works in theorizing on gender and education and on gender in society. This article first explores Dewey as both an ally and a problematic figure in feminist literature and then investigates the broader sphere of feminist pragmatism and two central themes within it: (1) valuing diversity, and diverse experiences; and (2) problematizing fixed truths. ( Vorsino, 2015 ).

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Bettany-Saltikov J. How to do a systematic literature review in nursing: a step-by-step guide.Maidenhead: Open University Press; 2012

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Developing a framework for critiquing health research. 2005. https://tinyurl.com/y3nulqms (accessed 22 July 2019)

Cognetti G, Grossi L, Lucon A, Solimini R. Information retrieval for the Cochrane systematic reviews: the case of breast cancer surgery. Ann Ist Super Sanita. 2015; 51:(1)34-39 https://doi.org/10.4415/ANN_15_01_07

Dixon-Woods M, Cavers D, Agarwal S Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Med Res Methodol. 2006; 6:(1) https://doi.org/10.1186/1471-2288-6-35

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Hanley T, Cutts LA. What is a systematic review? Counselling Psychology Review. 2013; 28:(4)3-6

Cochrane handbook for systematic reviews of interventions. Version 5.1.0. 2011. https://handbook-5-1.cochrane.org (accessed 23 July 2019)

Jahan N, Naveed S, Zeshan M, Tahir MA. How to conduct a systematic review: a narrative literature review. Cureus. 2016; 8:(11) https://doi.org/10.7759/cureus.864

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1997; 33:(1)159-174

Methley AM, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014; 14:(1) https://doi.org/10.1186/s12913-014-0579-0

Moher D, Liberati A, Tetzlaff J, Altman DG Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6:(7) https://doi.org/10.1371/journal.pmed.1000097

Mueller J, Jay C, Harper S, Davies A, Vega J, Todd C. Web use for symptom appraisal of physical health conditions: a systematic review. J Med Internet Res. 2017; 19:(6) https://doi.org/10.2196/jmir.6755

Murad MH, Asi N, Alsawas M, Alahdab F. New evidence pyramid. Evid Based Med. 2016; 21:(4)125-127 https://doi.org/10.1136/ebmed-2016-110401

National Institute for Health and Care Excellence. Methods for the development of NICE public health guidance. 2012. http://nice.org.uk/process/pmg4 (accessed 22 July 2019)

Sambunjak D, Franic M. Steps in the undertaking of a systematic review in orthopaedic surgery. Int Orthop. 2012; 36:(3)477-484 https://doi.org/10.1007/s00264-011-1460-y

Siddaway AP, Wood AM, Hedges LV. How to do a systematic review: a best practice guide for conducting and reporting narrative reviews, meta-analyses, and meta-syntheses. Annu Rev Psychol. 2019; 70:747-770 https://doi.org/0.1146/annurev-psych-010418-102803

Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008; 8:(1) https://doi.org/10.1186/1471-2288-8-45

Wallace J, Nwosu B, Clarke M. Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers' perceptions. BMJ Open. 2012; 2:(5) https://doi.org/10.1136/bmjopen-2012-001220

Carrying out systematic literature reviews: an introduction

Alan Davies

Lecturer in Health Data Science, School of Health Sciences, University of Manchester, Manchester

View articles · Email Alan

Systematic reviews provide a synthesis of evidence for a specific topic of interest, summarising the results of multiple studies to aid in clinical decisions and resource allocation. They remain among the best forms of evidence, and reduce the bias inherent in other methods. A solid understanding of the systematic review process can be of benefit to nurses that carry out such reviews, and for those who make decisions based on them. An overview of the main steps involved in carrying out a systematic review is presented, including some of the common tools and frameworks utilised in this area. This should provide a good starting point for those that are considering embarking on such work, and to aid readers of such reviews in their understanding of the main review components, in order to appraise the quality of a review that may be used to inform subsequent clinical decision making.

Since their inception in the late 1970s, systematic reviews have gained influence in the health professions ( Hanley and Cutts, 2013 ). Systematic reviews and meta-analyses are considered to be the most credible and authoritative sources of evidence available ( Cognetti et al, 2015 ) and are regarded as the pinnacle of evidence in the various ‘hierarchies of evidence’. Reviews published in the Cochrane Library ( https://www.cochranelibrary.com) are widely considered to be the ‘gold’ standard. Since Guyatt et al (1995) presented a users' guide to medical literature for the Evidence-Based Medicine Working Group, various hierarchies of evidence have been proposed. Figure 1 illustrates an example.

Systematic reviews can be qualitative or quantitative. One of the criticisms levelled at hierarchies such as these is that qualitative research is often positioned towards or even is at the bottom of the pyramid, thus implying that it is of little evidential value. This may be because of traditional issues concerning the quality of some qualitative work, although it is now widely recognised that both quantitative and qualitative research methodologies have a valuable part to play in answering research questions, which is reflected by the National Institute for Health and Care Excellence (NICE) information concerning methods for developing public health guidance. The NICE (2012) guidance highlights how both qualitative and quantitative study designs can be used to answer different research questions. In a revised version of the hierarchy-of-evidence pyramid, the systematic review is considered as the lens through which the evidence is viewed, rather than being at the top of the pyramid ( Murad et al, 2016 ).

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Researchers, academics and librarians all use various terms to describe different types of literature reviews. Indeed there is often inconsistency between the ways the types are discussed. Here are a couple of simple explanations.

The image below describes common review types in terms of speed, detail, risk of bias and comprehensiveness:

"Schematic of the main differences between the types of literature review" by Brennan, M. L., Arlt, S. P., Belshaw, Z., Buckley, L., Corah, L., Doit, H., Fajt, V. R., Grindlay, D., Moberly, H. K., Morrow, L. D., Stavisky, J., & White, C. (2020). Critically Appraised Topics (CATs) in veterinary medicine: Applying evidence in clinical practice. Frontiers in Veterinary Science, 7 , 314. https://doi.org/10.3389/fvets.2020.00314 is licensed under CC BY 3.0

The table below has been adapted from a widely used typology of fourteen types of reviews, (Grant & Booth, 2009).  Here are four of the most common types:

For a more detailed list of review types, see:

Grant, M.J. & Booth, A. (2009).  A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26 (2), 91-108.  DOI: 10.1111/j.1471-1842.2009.00848.x

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) outlines standards of practice completing a systematic review to ensure consistency and high-quality results.

• PRISMA 2020 Explanations
• PRISMA 2020 Checklist
• PRISMA 2020 Flow Diagram
• PRISMA Flow Diagram Generator
• PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews

Techniques from the PRISMA process can also be used with other types of reviews to have a systematic process for searching and evaluating results.

• Article Evaluation Handout Key questions to evaluate each section of original research studies (RCTs, cohort studies, etc)

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The Literature Review: A Foundation for High-Quality Medical Education Research

a  These are subscription resources. Researchers should check with their librarian to determine their access rights.

Despite a surge in published scholarship in medical education 1 and rapid growth in journals that publish educational research, manuscript acceptance rates continue to fall. 2 Failure to conduct a thorough, accurate, and up-to-date literature review identifying an important problem and placing the study in context is consistently identified as one of the top reasons for rejection. 3 , 4 The purpose of this editorial is to provide a road map and practical recommendations for planning a literature review. By understanding the goals of a literature review and following a few basic processes, authors can enhance both the quality of their educational research and the likelihood of publication in the Journal of Graduate Medical Education ( JGME ) and in other journals.

The Literature Review Defined

In medical education, no organization has articulated a formal definition of a literature review for a research paper; thus, a literature review can take a number of forms. Depending on the type of article, target journal, and specific topic, these forms will vary in methodology, rigor, and depth. Several organizations have published guidelines for conducting an intensive literature search intended for formal systematic reviews, both broadly (eg, PRISMA) 5 and within medical education, 6 and there are excellent commentaries to guide authors of systematic reviews. 7 , 8

• A literature review forms the basis for high-quality medical education research and helps maximize relevance, originality, generalizability, and impact.
• A literature review provides context, informs methodology, maximizes innovation, avoids duplicative research, and ensures that professional standards are met.
• Literature reviews take time, are iterative, and should continue throughout the research process.
• Researchers should maximize the use of human resources (librarians, colleagues), search tools (databases/search engines), and existing literature (related articles).
• Keeping organized is critical.

Such work is outside the scope of this article, which focuses on literature reviews to inform reports of original medical education research. We define such a literature review as a synthetic review and summary of what is known and unknown regarding the topic of a scholarly body of work, including the current work's place within the existing knowledge . While this type of literature review may not require the intensive search processes mandated by systematic reviews, it merits a thoughtful and rigorous approach.

Purpose and Importance of the Literature Review

An understanding of the current literature is critical for all phases of a research study. Lingard 9 recently invoked the “journal-as-conversation” metaphor as a way of understanding how one's research fits into the larger medical education conversation. As she described it: “Imagine yourself joining a conversation at a social event. After you hang about eavesdropping to get the drift of what's being said (the conversational equivalent of the literature review), you join the conversation with a contribution that signals your shared interest in the topic, your knowledge of what's already been said, and your intention.” 9

The literature review helps any researcher “join the conversation” by providing context, informing methodology, identifying innovation, minimizing duplicative research, and ensuring that professional standards are met. Understanding the current literature also promotes scholarship, as proposed by Boyer, 10 by contributing to 5 of the 6 standards by which scholarly work should be evaluated. 11 Specifically, the review helps the researcher (1) articulate clear goals, (2) show evidence of adequate preparation, (3) select appropriate methods, (4) communicate relevant results, and (5) engage in reflective critique.

Failure to conduct a high-quality literature review is associated with several problems identified in the medical education literature, including studies that are repetitive, not grounded in theory, methodologically weak, and fail to expand knowledge beyond a single setting. 12 Indeed, medical education scholars complain that many studies repeat work already published and contribute little new knowledge—a likely cause of which is failure to conduct a proper literature review. 3 , 4

Likewise, studies that lack theoretical grounding or a conceptual framework make study design and interpretation difficult. 13 When theory is used in medical education studies, it is often invoked at a superficial level. As Norman 14 noted, when theory is used appropriately, it helps articulate variables that might be linked together and why, and it allows the researcher to make hypotheses and define a study's context and scope. Ultimately, a proper literature review is a first critical step toward identifying relevant conceptual frameworks.

Another problem is that many medical education studies are methodologically weak. 12 Good research requires trained investigators who can articulate relevant research questions, operationally define variables of interest, and choose the best method for specific research questions. Conducting a proper literature review helps both novice and experienced researchers select rigorous research methodologies.

Finally, many studies in medical education are “one-offs,” that is, single studies undertaken because the opportunity presented itself locally. Such studies frequently are not oriented toward progressive knowledge building and generalization to other settings. A firm grasp of the literature can encourage a programmatic approach to research.

Approaching the Literature Review

Considering these issues, journals have a responsibility to demand from authors a thoughtful synthesis of their study's position within the field, and it is the authors' responsibility to provide such a synthesis, based on a literature review. The aforementioned purposes of the literature review mandate that the review occurs throughout all phases of a study, from conception and design, to implementation and analysis, to manuscript preparation and submission.

Planning the literature review requires understanding of journal requirements, which vary greatly by journal ( table 1 ). Authors are advised to take note of common problems with reporting results of the literature review. Table 2 lists the most common problems that we have encountered as authors, reviewers, and editors.

Sample of Journals' Author Instructions for Literature Reviews Conducted as Part of Original Research Article a

Common Problem Areas for Reporting Literature Reviews in the Context of Scholarly Articles

Locating and Organizing the Literature

Three resources may facilitate identifying relevant literature: human resources, search tools, and related literature. As the process requires time, it is important to begin searching for literature early in the process (ie, the study design phase). Identifying and understanding relevant studies will increase the likelihood of designing a relevant, adaptable, generalizable, and novel study that is based on educational or learning theory and can maximize impact.

Human Resources

A medical librarian can help translate research interests into an effective search strategy, familiarize researchers with available information resources, provide information on organizing information, and introduce strategies for keeping current with emerging research. Often, librarians are also aware of research across their institutions and may be able to connect researchers with similar interests. Reaching out to colleagues for suggestions may help researchers quickly locate resources that would not otherwise be on their radar.

During this process, researchers will likely identify other researchers writing on aspects of their topic. Researchers should consider searching for the publications of these relevant researchers (see table 3 for search strategies). Additionally, institutional websites may include curriculum vitae of such relevant faculty with access to their entire publication record, including difficult to locate publications, such as book chapters, dissertations, and technical reports.

Strategies for Finding Related Researcher Publications in Databases and Search Engines

Search Tools and Related Literature

Researchers will locate the majority of needed information using databases and search engines. Excellent resources are available to guide researchers in the mechanics of literature searches. 15 , 16

Because medical education research draws on a variety of disciplines, researchers should include search tools with coverage beyond medicine (eg, psychology, nursing, education, and anthropology) and that cover several publication types, such as reports, standards, conference abstracts, and book chapters (see the box for several information resources). Many search tools include options for viewing citations of selected articles. Examining cited references provides additional articles for review and a sense of the influence of the selected article on its field.

Box Information Resources

• Web of Science a
• Education Resource Information Center (ERIC)
• Cumulative Index of Nursing & Allied Health (CINAHL) a
• Google Scholar

Once relevant articles are located, it is useful to mine those articles for additional citations. One strategy is to examine references of key articles, especially review articles, for relevant citations.

Getting Organized

As the aforementioned resources will likely provide a tremendous amount of information, organization is crucial. Researchers should determine which details are most important to their study (eg, participants, setting, methods, and outcomes) and generate a strategy for keeping those details organized and accessible. Increasingly, researchers utilize digital tools, such as Evernote, to capture such information, which enables accessibility across digital workspaces and search capabilities. Use of citation managers can also be helpful as they store citations and, in some cases, can generate bibliographies ( table 4 ).

Citation Managers

Knowing When to Say When

Researchers often ask how to know when they have located enough citations. Unfortunately, there is no magic or ideal number of citations to collect. One strategy for checking coverage of the literature is to inspect references of relevant articles. As researchers review references they will start noticing a repetition of the same articles with few new articles appearing. This can indicate that the researcher has covered the literature base on a particular topic.

Putting It All Together

In preparing to write a research paper, it is important to consider which citations to include and how they will inform the introduction and discussion sections. The “Instructions to Authors” for the targeted journal will often provide guidance on structuring the literature review (or introduction) and the number of total citations permitted for each article category. Reviewing articles of similar type published in the targeted journal can also provide guidance regarding structure and average lengths of the introduction and discussion sections.

When selecting references for the introduction consider those that illustrate core background theoretical and methodological concepts, as well as recent relevant studies. The introduction should be brief and present references not as a laundry list or narrative of available literature, but rather as a synthesized summary to provide context for the current study and to identify the gap in the literature that the study intends to fill. For the discussion, citations should be thoughtfully selected to compare and contrast the present study's findings with the current literature and to indicate how the present study moves the field forward.

To facilitate writing a literature review, journals are increasingly providing helpful features to guide authors. For example, the resources available through JGME include several articles on writing. 17 The journal Perspectives on Medical Education recently launched “The Writer's Craft,” which is intended to help medical educators improve their writing. Additionally, many institutions have writing centers that provide web-based materials on writing a literature review, and some even have writing coaches.

The literature review is a vital part of medical education research and should occur throughout the research process to help researchers design a strong study and effectively communicate study results and importance. To achieve these goals, researchers are advised to plan and execute the literature review carefully. The guidance in this editorial provides considerations and recommendations that may improve the quality of literature reviews.

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How to conduct a literature review, john wilkinson lecturer in nursing, institute of advanced nursing education, royal college of nursing, london, christine wilkinson director of nephro-urological and critical care studies, bloomsbury' and islington college of nursing and midwifery, london.

Literature reviews require a range of skills if they are to Ik carried out successfully. This article details some of the skills required and how they can Ik integrated to produce a review relevant to practice.

Nursing Standard . 10, 9, 28-30. doi: 10.7748/ns.10.9.28.s35

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Literature Review: Finding & Identifying Research

Literature review: a survey of information found in scholarly articles, books, and other literature related to an area of study. a presentation of references on a given topic, found through a carefully structured clinical question and in-depth research. , describes, summarizes, evaluates and clarifies prior research., not only summarizes other research, also examines the relationship., determines what has already been investigated, identifies potential relationships, defines key concepts, and relates to research already completed., considers different disciplines topic may cover..

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Learn more about the Types of Literature Reviews you will encounter In your Search Results

Narrative review  , critically appraised topic, rapid review  , scoping review  , systematic review   , meta-analysis  .

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• Published: 13 September 2024

The phenomenon of yoga in the imagination of Turkish nursing students: "The way to place goodness in the heart"

• Özüm Erki̇n 1 ,
• Aynur Çeti̇nkaya 2 &
• Begüm Güler 3  

BMC Nursing volume  23 , Article number:  655 ( 2024 ) Cite this article

Metrics details

The aim of the research is to shed light on the experiences of a group of nursing students enrolled in a yoga elective course who practiced yoga regularly for 14 weeks, regarding yoga and the phenomenon of doing yoga, with a qualitative approach.

This qualitative study was conducted at a public university in Izmir, Turkey. The study sample consisted of 61 students enrolled in the 1st-year yoga course at the Department of Nursing, Faculty of Health Sciences. Except for two students, 59 of them participated in the study. Participants attended a face-to-face yoga course once a week for 1.5 h over a 14-week period. Each session comprised 30 min of theoretical instruction and 60 min of practice. In data collection, an interview form containing five questions was used to understand nursing students' experiences and thoughts about practicing yoga. In addition, A4 sized papers in different colors were presented to the participants. The participants were asked to draw and/or cut a shape by choosing the paper in the color that most evokes yoga. Then they were asked to explain why they chose this color and why they drew this shape. Participants were given one hour. After the data were collected, the pictures drawn by the participants and their descriptions of their drawings were transferred to the computer and included in the analysis. Qualitative data were hand-coded by the researchers. Within in-vivo coding, code names were formed from the participants' expressions. The findings analyzed by content analysis were interpreted with the literature under the themes by presenting quotations.

It was determined that the participants used nature figures (sun, cloud, tree, sky, flower) (f = 75), people doing yoga (f = 12), and sound, light and other figures (bird sound, wave sound, candle, light bulb, traffic light, heart, eye, left key, peace, swing, India, circle, etc.) (f = 29) in the shapes they drew and cut out on A4 sized papers in different colors to describe their experiences and thoughts about practicing yoga. The participants mostly chose blue-green-yellow colors ( n  = 41). With qualitative question analysis, a list of codes was created from the answers given by the students to the questions for the phenomenon of “doing yoga” (number of codes = 98). After the analysis of the data, four categories were reached. The category names and frequency numbers explaining the phenomenon of practicing yoga were distributed as “symbol of health and serenity (f = 345)”, “the way to place goodness in your heart (f = 110)”, “the most effective way to meet the self (f = 93)” and “no guarantee of relaxation (f = 71)”, respectively.

Conclusions

The results indicate that yoga is perceived by nursing students as a multifaceted practice that evokes a range of emotional and physical responses. Most participants associate yoga with symbols of health, serenity, and self-awareness, often using natural elements and blue-green-yellow the colors to represent these feelings. However, there is also recognition that yoga may not guarantee relaxation for everyone, as some students reported difficulties in meditation, physical discomfort, and challenges in focusing. The study highlights the variability in how individuals experience yoga, emphasizing both its positive effects on well-being and the potential challenges in practice. These findings suggest that while yoga is widely valued for its calming and health-promoting benefits, it may not be universally effective in achieving relaxation or mindfulness.

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Introduction

Yoga is a practice that has been subject to many different interpretations and translations over thousands of years. Patanjali's phrase "Yogas Chitta Vrittis Nirodha" translates to "Yoga is the cessation of the fluctuations of the mind" in English [ 1 ]. Hagen & Hagen (2024) have emphasized that yoga is commonly understood in society as a tool for mental calmness and balance[ 2 ]. This provides a comprehensive model for personal development, contributing to the individual's balanced harmony in every aspect—mental, physical, emotional, and spiritual [ 3 , 4 ]. By developing inner awareness as well as meta-awareness, yoga offers a roadmap for individuals to see and understand their own state and surroundings more clearly [ 5 ]. Yoga enhances physical functionality by alleviating pain and discomfort, thereby reducing physical ailments. Moreover, yoga offers physical health benefits, including increased strength and flexibility, as well as improved posture [ 6 , 7 , 8 , 9 , 10 ].

According to Bhavanani (2014), yoga extends beyond mere physical or mental health; it also addresses emotional, social, and spiritual needs [ 11 ]. By increasing personal awareness, it can strengthens both inner attachment and social connections [ 6 , 9 , 12 ]. Research shows that participants' self-confidence increases during yoga practice, and they might gain better skills to manage their mental health. This underscores not only the physical advantages of yoga but also its significant contributions to mental and emotional well-being [ 8 , 9 , 13 , 14 ]. Yoga can fosters heightened bodily awareness, elevates mood, and enhances overall well-being. It also promotes self-acceptance, personal fulfillment, and social harmony. This holistic process provides psychological relief and mental tranquility, aiding in the management of common mental health issues such as anxiety and depression [ 11 ].

Today, young adults increasingly experience stress, pressure, and mental health issues [ 15 ]. Research links young people's stress levels to high demands at school and the pressure to meet these demands [ 16 ]. Additionally, lack of physical activity and sleep problems also can contribute to their difficulties in coping with these issues [ 17 , 18 ]. Academic expectations from parents, especially those from middle-class families, can further increase the pressure on young people, leading them to evaluate their self-worth solely based on their achievements. This adds to the existing academic pressures, causing young people to worry more about future educational and career opportunities [ 19 ].

Yoga can physically contribute to nervous system balance by decreasing stress-related sympathetic activity and stimulating the parasympathetic system. Consequently, it can positively impact stress and mental health issues, particularly in young people. Nursing students, who often undergo a stressful educational period, can also benefit from these effects [ 20 , 21 , 22 , 23 , 24 ]. Therefore, it is recommended to integrate mindfulness programs, including breathing techniques, meditation, and yoga, into the nursing curriculum [ 21 , 22 ]. In the literature, a yoga course was integrated into the nursing curriculum in Turkey for the first time by Erkin and Aykar (2021) [ 20 ]. Most studies with students in the field of yoga in the literature are quantitative, although yoga has been studied in college students using qualitative methods, no studies found in nursing. This is one of the starting points of this research. The aim of the research is to shed light on the experiences of a group of nursing students enrolled in a yoga elective course who practiced yoga regularly for 14 weeks, regarding yoga and the phenomenon of doing yoga, with a qualitative approach. This qualitative study tries to fill this gap in the literature by explaining the imaginary meanings that nursing students attending yoga courses attribute to the yoga experience.

Design and participants

The research, designed in a qualitative type, was conducted during the 2018–2019 academic year. In line with the qualitative research approach, a purposeful sampling method was used. The qualitative method sees the experience of reality as subjective, varying from person to person. Moreover, it is a reliable method for studying a little known or understood area. Therefore, a qualitative descriptive design was adopted to explore students’ knowledge and perspectives [ 25 ].

Participants attended a face-to-face yoga course once a week for 1.5 h over a 14-week period. Each session comprised 30 min of theoretical instruction and 60 min of practice. The content of the yoga course is detailed in Table 1 . The theoretical component included a weekly 30-min PowerPoint presentation covering topics such as the history of yoga, meditation, breathing techniques (pranayama), yoga poses (asanas), chakras, mindfulness, and compassion. The practical sessions were conducted in a tranquil and dimly lit room, following a structured 60-min schedule: 15 min of pranayama (e.g., ocean breath, equal breathing, cooling breath, humming bee breath, alternate nostril breath, kapalbhati pranayama), 30 min of hatha yoga asanas involving gentle stretching and strengthening exercises with each pose held for 5–10 breaths and repeated five times, 5 min of meditation, and 10 min of shavasana. These sessions were led by a yoga instructor (first author) registered with the Yoga Alliance. No home practice was required. According to the course rules, students were allowed up to 20% absenteeism. At the end of the 14-week period, it was determined that students were absent for an average of 1.5 weeks. There was only one change in the planned yoga protocol. Although it was initially planned to use one breathing technique every two weeks, all breathing techniques were combined based on the students’ feedback and used in the sessions after students learned all the techniques (after the 6th week). Class attendance was encouraged through messages in a WhatsApp group. However, attendance was not included in the scoring.

The sample of the research was planned to consist of first-year students enrolled in the elective course "Yoga" in the Nursing Department of the Faculty of Health Sciences at İzmir Democracy University in Izmir ( N  = 61). Two students did not participate in the study because the topic and objectives did not interest them. Data were collected from a total of 59 nursing students on a voluntary basis. After the yoga course, the last week interviews were conducted with 59 participants who voluntarily agreed to participate in the study. Of the participants (n:59), 40 were female and 19 were male, with ages ranging from 18 to 21. Forty-six participants described their health perception as "good," nine as "very good," and four as "poor." (Appendix 1).

Data collection

Data collection was conducted using a structured interview form alongside a creative activity where participants were asked to draw a picture and write a text representing the concept of doing yoga. Data were collected through structured interviews guided by a pre-developed interview Schedule (see Appendix 1). The structured interview form developed for this study included seven open-ended questions and prompts designed to elicit detailed responses from the participants regarding their experiences with the yoga course. Prior to commencing data collection with the main participant group, the interview schedule was pilot tested with five nursing students who met the inclusion criteria but were not part of the final sample. This pilot testing allowed for refinement of the interview questions and ensured clarity and comprehensiveness.

After obtaining the necessary permissions for the research, the students engaged in the yoga course were comprehensively briefed on the study’s objectives, content, methodology, and the individuals responsible for its execution. The last week of "Yoga" course (14th week), students asked to draw a picture and write a text representing the concept of doing yoga. Each student was given colored A4 papers and, for those who wished to use them, colored pencils in the classroom environment. Before starting to draw, students were asked to write their gender on the back of the paper, but not their name or surname. In addition to the picture they drew, they were asked to write their thoughts about yoga and what they drew regarding the concept of doing yoga on a separate piece of paper or in appropriate spaces on their drawing paper. Besides students filled the interview form. They also filled out a structured interview form to capture their experiences and thoughts about practicing yoga. Participants were given one hour to complete the task. After the data were collected, the drawings and their related descriptions made by the participants were digitized and included in the analysis [ 26 ]. For security purposes, the data were stored in Google Drive™ accessible to authors.

To examine subjective experiences, the techniques of "drawing" and "description" were used together, attempting to integrate the strengths of both methods. Participants were provided with A4 papers in different colors and asked to choose the color that most reminded them of yoga. Starting from the theme of "The meaning of doing yoga for them," participants were asked to draw pictures representing their perceptions and to write descriptions related to their drawings. In a similar approach referred to as "projective technique" in the literature, the drawing is accepted as a tool for reflecting emotions. Projection means expression and is based on the assumption that "an individual's behavior is a reflection of their personality" [ 26 , 27 ].

Data analysis and interpretation process

The data were analyzed using an inductive approach. Inductive analysis involves coding the data to categorize it, identifying relationships between these categories, and reaching a holistic picture based on this. The key point in data analysis in this study was to create categorical labels embedded in the data [ 26 , 27 ]. In this study, a code list was developed, data were coded, categories were created, and data were reported within these categories. Data analysis was conducted by the researchers through coding. For some themes, in-vivo coding, which is included in the qualitative research methodology of grounded theory, was used as an inductive coding process. In vivo coding involves creating a theme tag using the code that comes directly from the data, i.e., the participant's own expressions [ 28 ].

All these processes were carried out in collaboration with two field experts (ÖE, AÇ). Similar codes were grouped together to form a certain number of categories and reported to establish the main idea in the data. Comparing codes and categories with the literature aimed to contribute to the validity of the data analysis. At the end of the data collection phase, a conceptual model related to the topic was developed by the researchers [ 26 ]

The research team acknowledges the importance of reflexivity in qualitative research. The first researcher, who has a PhD degree in public health nursing with 16 years of experience in nursing, is an instructor of yoga courses for undergraduate nursing students. The researcher maintained a critical awareness of their own biases and assumptions that could potentially influence the data analysis throughout the research process. We aimed to minimize bias by employing a systematic thematic analysis approach and by regularly discussing the emerging themes with a second author, who is a specialist on qualitative research and has a qualitative PhD thesis in public health nursing. This cooperation contributed to ensuring the findings’ objectivity and reliability. Regretfully, it was not possible to get direct participant input on the findings because of the anonymous nature of the data collection process. The third researcher, who is a master’s degree student in public health nursing with 3 years of clinical experience in nursing, is an instructor of yoga. Nonetheless, we think that the utilization of rich participant quotes in conjunction with the iterative analytic process guarantees that the results truly reflect the participants’ experiences with the yoga course.

Ethics approval and consent to participate

Before starting data collection, information about the research was provided to the school administration, permission was obtained, and contact was made with the participants. Approval was obtained from the Ethics Committee of Manisa Celal Bayar University (02/12/2019, no:20.478.486). Participation was based on voluntariness and willingness, and students were informed about sensitive points related to the teacher-student relationship (such as participation or non-participation in the research not affecting their performance evaluations, etc.). Written informed consent to participate was obtained from all of the participants in this study.

Research validity and reliability

In qualitative research, the researcher investigating the problem is at the center of the research. The main measurement tool in the research is the researcher themselves. Therefore, the issue of objectivity has always been at the center of methodological debates in social sciences. In qualitative research, the concept of "trustworthiness" is considered instead of validity and reliability [ 27 ]. Various criteria of trustworthiness were considered in the processes of this research.

During the data analysis phase, in the creation of the code list, and in the interpretation of the findings, a comprehensive perspective was attempted to be reflected through a thorough literature review on the subject. All records in the data collection and analysis processes were kept systematically. Quotations were made from all data sources. The frequencies of the drawings and descriptions were determined, and those with high frequencies and those that were strikingly related to the topic were included. The data collection and data analysis processes were reported in detail as far as space limitations allowed, and original quotations from the data were included. Furthermore, in the quotations, descriptions written by the participants in their own handwriting were also used.

The number of participants in the study was 56. This number is considered sufficient for an in-depth exploration of the research topic. Students were instructed to create an illustration and compose a text depicting the concept of practicing yoga. Each student received colored A4 paper, and colored pencils were provided for those who wished to use them within the classroom setting. Prior to beginning their drawings, students were asked to indicate their gender on the back of the paper, ensuring that they did not include their name or surname. Alongside their drawings, students were required to write their reflections on yoga and describe what they had drawn related to the practice of yoga, either on a separate sheet of paper or in suitable spaces on their drawing paper. Additionally, students completed an interview form. Participants were allotted one hour to finish the assignment. This approach allowed for a thorough and comprehensive examination of the participants’ perspectives. To enhance transferability, purposive sampling was employed in the study. In purposive sampling, participants are selected to have specific characteristics relevant to the research topic. This approach ensured that the participants’ perspectives would represent the research topic effectively. To ensure dependability, interview questions, data collection, and analysis were consistently applied throughout the entire research process. In this study, to achieve confirmability, all stages of the research were described openly and transparently, aiming to reduce the impact of researcher bias. All transcripts and notes used in the study were stored for reference.

The reporting process of the study adhered to the COREQ (CONsolidated criteria for Reporting Qualitative research) guidelines, as outlined by Tong et al. (2007) [ 29 ]. The study follows CLARIFY 2021 guidelines for reporting yoga research [ 30 ].

Participants expressed their experiences and thoughts about practicing yoga by drawing and cutting shapes on A4-sized papers of different colors. It was determined that they used nature figures (sun, cloud, tree, sky, flower) (f = 75), figures of people practicing yoga (f = 12), and other figures such as sound, light, and others (bird sound, wave sound, candle, light bulb, traffic light, heart, eye, key, peace, swing, India, circle, etc.) (f = 29). Participants mostly chose blue-green-yellow colors ( n  = 41).

A code list was created from the responses of students to questions about the concept of "practicing yoga" through qualitative question analysis (number of codes = 98). After analyzing the data, four categories were reached. The categories describing the concept of practicing yoga were distributed as follows in terms of symbols and frequency numbers: "symbol of health and tranquility (f = 345)", "the way to place goodness in your heart (f = 110)", "the most effective way to meet oneself (f = 93)", and "no guarantee of relaxation (f = 71)" (Fig. 1 ).

Concepts and codes identified in the qualitative analysis of nursing students' perception of the phenomenon of "practicing yoga"

Category 1. Symbol of health and serenity (f = 345)

The subcategories that received the most references from nursing students in explaining the phenomenon of practicing yoga under this category are "Serenity and Peace (f = 169)", "Comfort (f = 120)", "Health, Well-being, Happiness, and Energy (f = 56)". Below is the picture and description of the participant related to the subcategory "Symbol of Health and Serenity" (Fig. 2 ): "The reason for choosing the shape of a cloud and the color blue is that it brings me peace, reminds me to take deep breaths and be grateful. It reminds me that there are beautiful things in life and that I need to enjoy life." Additionally, "when you start doing yoga, your thoughts change, you feel rested, and your heart fills with peace." Participant 7, Female.

Cloud figure (blue) -participant 7

Participant 22 wrote the following in the interpretation of the figure they drew (Fig. 3 ): "The color blue always makes me feel happy and peaceful. I chose this color because yoga makes me feel peaceful and happy. For example, when I feel restless and unhappy, going to the beach, seeing the sea, seeing blue calms me down. Also, when I think of yoga, I imagine an endless deep blue sea. A sea with birds flying over it and a deep blue sky. A painting with sunny weather" Participant 22.

Interpretation by participant 22 (blue)

Participant 35's drawn figure is a butterfly, and their description is as follows (Fig. 4 ): “When I think of yoga, I think of a butterfly. Because when I do yoga, I feel as free and light as a butterfly. I imagine my wings taking me wherever I want inside. The green color relaxes me and makes me happy. The wings of the butterfly in my soul's greenery take me to purity…”.

Butterfly figure (green) -participant 35

Participant 9, in the chosen color and the comment on their drawing, expressed the following regarding the sub-category "Symbol of Health and Serenity" (Fig. 5 ): "I chose this color for its energy. Since energy is important in yoga, I chose orange. I chose this shape because I believe yoga is best done in a natural environment. Yoga reminds me of serenity, the feeling of being in emptiness, and relaxation (Fig. 5 )."

Tree figure and comment (orange) -participant 9

Participant 19, in the chosen figure and the comment on their drawing, stated the following (Fig. 6 ): "Because yoga reminds me of mental and physical health. In my opinion, health is manifested in the combination of blue and green colors. That is, balance in nature is something that exists in the soul and body." Participant 19 depicted a ladder figure in combination with blue and green, defining yoga as "soul and body therapy" (Fig. 6 ).

The place where the moon meets the sun (turquoise)-participant 19

Category 2. The way to place goodness in your heart (f = 110)

The meaning of the phenomenon of doing yoga by participant 11, an 18-year-old female nursing student, was labeled as "being aware of placing goodness in heart" as the category tag. This category, referred to 110 times by the participants, includes the subcategories of "Purification (f = 65)" and "Being a virtuous person (f = 45)". Participants mentioned virtues such as "patience, tolerance, love for all creatures, flexibility, equality, non-prejudice, peace, optimism, freedom" contributing to the concept.

Participant 51, an 18-year-old male who described his health as poor, used the light bulb figure to express "happiness, peace, security" and commented, "It causes positive effects on people" (Fig. 7 ). Participant 51 expressed the following regarding the subcategory " The way to place goodness in your heart" in the figure and comment (Fig. 7 ): "The light bulb illuminating the environment is connected to yoga. Yoga enlightens a person's mind."

Light bulb (yellow) -participant 51

Participant 39, a 19-year-old male, mentioned that practicing yoga leads to "thinking more compassionately." Participant 21, a female, stated, "Yoga is something that requires patience."

Here is the drawn peace figure and comment by participant 46, related to this category (Fig. 8 ). This participant said, "I chose pink because it opens up and gives peace. Of course, there is also light pink, not just dark pinks. I chose this sign because where there is yoga, there is love for all living beings, and where there is love, peace is inevitable."

Peace figure (pink) -participant 46

Category 3. The most effective way to meet yourself (f = 93)

For nursing students, practicing yoga means creating "awareness" and is the most effective way to meet oneself (f = 93). Participant 43, a 19-year-old female with a poor health perception, described feeling "calmer, more aware, and internally peaceful" when practicing yoga, as shown in Fig. 9 . Under the category of "the most effective way to meet oneself," Participant 43's figure and comment about yoga are as follows (Fig. 9 ): "…I chose this color because it gives me peace. The other colors make me restless, but this color makes me feel like I can breathe. Yellow is like an endless void to me. A color that makes me experience everything with all its reality. It's like a sky where you can escape from the chaos of the world and get lost in it…".

The world and heart (yellow) -participant 43

Participant 8 chose a cloud figure, describing yoga as "like rising above the clouds" and wrote the following about yoga practice: "Finding oneself in life, being at peace with oneself… [someone who starts practicing yoga] starts to know themselves, their love for life increases." Participant 8, Female.

Participant 33, a female who chose yellow for its calmness and non-straining quality, described the effect of yoga as "self-discovery" and wrote the following (Fig. 10 ): "You awaken your sleeping mind and body, and find the 'self' within you." Participant 33, Female.

Flower and human (yellow)- participant 33

The statement from participant 48 is as follows (Fig. 11 ): "In this image, what I want to convey is; the individual who practices yoga finds themselves, reaches their essence, and becomes aware of their own existence after a long and perhaps short journey. I chose the color orange because it reminds me that energy exists, is alive, and can be transmitted at any moment. For me, yoga is an indicator of energy. After yoga, the body revives and rejuvenates."

The road (orange)- participant 48

Category 4. No guarantee of relaxation (f = 71)

Among the nursing students ( n  = 59), 16 (27.1%) indicated that they do not recommend yoga. The subcategories of this category include "difficulty in relaxing during meditation/emptying the mind (f = 23)", physical complaints (f = 21)", "difficulty in focusing (f = 18)", and "negative perceptions (f = 9)". Participants used expressions such as "headache, neck pain, back pain, dizziness, exhausting, feeling bad, difficult, fear, nervousness, inability to relax, disbelief" in relation to this category. A 19-year-old male participant, participant 41, stated about yoga, "I cannot meditate, I do not feel comfortable." Participant 44, a 19-year-old female participant who rated her health as poor, stated during yoga, "I cannot fully control my breathing and do meditation, I cannot empty my mind, so I cannot achieve complete peace."

Yoga, often conceptualized in the Western world as a physical practice [ 31 ], is considered a practice that can calm the mind and access a higher state of consciousness where individual and universal consciousness merge, using the body [ 32 ], in yoga traditions, the physical, mental, and spiritual dimensions of the individual are intricately connected [ 1 ]. When we relate the benefits of yoga to traditional yoga theories and systems, it can be interesting to explore its connection with the chakra system and colors. The main focus of yoga can be to regulate the functioning of chakras while awakening the associated energies [ 33 , 34 ]. It was thought that the free association of the students' drawings and descriptions could provide guidance in determining their experiences related to the concept of yoga. In this study, where the experiences of nursing students who took the elective yoga course were evaluated with a qualitative approach, participants mostly chose blue, green, and yellow-colored papers, symbolizing nature. When viewed from the perspective of the chakra-yoga system explained in the yoga course, it was thought that the participants might have resonated with certain energy centers or chakras. Blue, green, and yellow colors are respectively associated with the throat chakra, heart chakra, and solar plexus chakra [ 35 ]. The throat chakra is associated with communication, speech power, intellectual development, creativity, and expression [ 36 ]. Participants 7 and 22, who currently perceive their health as good, and participant 19, who chose blue and turquoise colors, may reflect a desire for in-depth communication and original expression, or a need for improvement in these areas. During yoga practice, especially breathing exercises and poses focusing on the throat region can be worked on this chakra, thus enhancing students' capacity for clearer communication and expressing inner truths [ 37 , 38 ].

The philosophy of yoga emphasizes the importance of harmony and unity with nature, which is why many yoga asanas (poses) are named after elements from nature, such as the tree pose, which symbolizes the stability and balance of a tree through its strong roots and upward-reaching branches [ 39 ]. In this study, visuals related to yoga such as the sun, clouds, trees, sky, and flowers were found. Participant 9 recalling and drawing a tree figure during yoga experiences indicates their awareness of this symbolic relationship. Research has shown that spending time in nature has positive effects on people's mood and mental health [ 40 , 41 ]; similarly, many yoga philosophies emphasize the importance of being in harmony with nature [ 42 ]. Therefore, a student's preference for a natural environment while practicing yoga and associating this practice with a tree in nature is thought to reflect both the healing power of nature and the relationship of yoga poses with elements in nature. This symbiotic relationship reminds us of how interconnected humans are with nature and how yoga practice can strengthen this connection. This aspect of yoga can also encourage individuals to strengthen their relationship with nature and adopt a more respectful attitude towards the environment. This can be seen as a reflection of the principle of 'ahimsa' or non-harming, which is one of the foundational principles of yoga philosophy [ 43 ].

Deep breathing practices are fundamental components of yoga and meditation. Consciously controlling breathing can activate the parasympathetic nervous system and trigger the relaxation response [ 44 , 45 ]. Additionally, breath awareness is part of mindfulness practice and brings the individual into the present moment. Feeling gratitude helps a person recognize the positive aspects of their life and develop a more positive life perspective [ 46 ]. Gratitude practice can improve mental health and allow for greater enjoyment of life [ 47 ]. Participant 7's choice of a cloud shape and blue color is explained by the feeling of tranquility it brings, reminding them to take deep breaths and be thankful, and to remember that there are beautiful things in life that they should enjoy. Participant 7's statement confirms this. The shape of a cloud and the choice of the color blue directing them to take deep breaths, be thankful, remember that there are beautiful things in life, and enjoy life, can contribute to the participant's spirituality [ 48 ]. Such an approach can be balancing both mentally and emotionally, especially for students under academic pressure [ 49 ].

Yoga, meditation, and breathwork (pranayama) practices can be effective in creating a deep sense of peace by bringing individuals to the present moment and calming their inner dialogue [ 50 , 51 ]. Participant 22's statement, " The color blue always makes me feel happy and peaceful. I chose this color because yoga makes me feel peaceful and happy. For example, when I feel restless and unhappy, going to the beach, seeing the sea, and seeing blue calms me down ," also indicates the participant's association of yoga practice with feelings of peace and happiness, demonstrating the potential of yoga experience to provide inner tranquility and balance. Furthermore, the participant's desire to go to the beach and see the sea may refer to the healing and calming effect of nature [ 52 ]. Participant 19 states, " Yoga reminds me of spiritual and physical health. For me, health lives in the colors blue and green, meaning it is something in nature and in the spirit of nature ," and Participant 35 says, " When I think of yoga, I think of a butterfly because when I do yoga, I feel as light as a butterfly. I think my wings take me wherever I want inside me. The color green relaxes me, makes me happy, and the green inside me takes me to purity. " These statements may be associated with the heart chakra represented by the color green. This chakra is considered the center of love, compassion, and connection [ 36 ], and therefore, the association of green with this chakra may symbolize the participant's feelings of relaxation and happiness during yoga practice [ 48 ]. The phrase " the green inside me takes me to purity " in Participant 35's statement indicates that green represents purity and healing in the heart chakra, and the opening of this chakra allows the person to feel more peaceful and purer [ 53 ]. In this context, Participant 35's positive feelings toward green and the sense of relaxation may be a result of balancing and opening the heart chakra, contributing to their emotional experiences such as lightness and tranquility in yoga practices [ 54 ].

Participant 51, despite describing their health as poor, mentioning positive effects such as " Happiness, peace, trust " through the figure of a light bulb during yoga practices, can be explained by the illuminating effect of yoga on the mind. Just as a light bulb illuminates its surroundings, yoga enlightens the individual's mental and spiritual state, capable of transforming negative thoughts and emotions into positive ones. This contributes to achieving a general state of well-being and a positive mood by providing both physical and mental relaxation [ 55 ]. Participant 39 mentioned the effect of " thinking more humanely " while practicing yoga. Participant 21 commented that " yoga requires patience ." Participant 46 chose pink because " It opens up and gives peace within me, where there is yoga, there is love for all living beings, and where there is love, peace is inevitable. " Yoga can facilitates a tranquil mental state, reducing stress and tension, thereby promoting harmonious relationships and fostering peace within individuals and their social interactions. Central to yoga philosophy are humanism and the pursuit of a peaceful life [ 56 ] qualities reflected in participants' experiences, affirming yoga's role in cultivating positive personal and societal outcomes.

In the chakra system, colors and their associated energy centers are believed to promote balance and harmony in our daily lives and physical well-being [ 33 ]. Students' selection of these colors related to chakras may reflect their own energy balances and personal development needs, often unconsciously. Yoga practice can equips individuals with tools to enhance the harmony and integrity of these energy centers [ 57 ]. Participant 43, with a negative perception of health, reported becoming " A calmer person, awareness increases, and inner peace occurs; I chose this color (yellow) because it gives me peace. While other colors make me uneasy, when I look at this color, it feels like it gives me breath, and it continues to an endless void. Yellow, for me, is like escaping from the chaos of the world and getting lost in an endless sky ." Participants finding the color yellow soothing and describing it as providing a sense of freedom and freshness like an endless sky can be associated with the solar plexus chakra, typically represented by the color yellow [ 35 ]. This chakra is linked to self-confidence, willpower, and self-realization. [ 58 ]. Participant 33 described the experince of yoga with a flower and human figure as " Self-discovery ," stating, " you awaken your sleeping mind and body and find the 'self' within ." Participant 8 drawn a cloud figure, describing yoga as " like rising above the clouds," saying, "finding yourself in life, being at peace with yourself… [someone who starts practicing yoga] begins to know themselves, their love for life increases ."These statements and figures reinforce the basic themes of "self-discovery" and "being at peace with oneself" in yoga practice [ 59 ], indicating an important relationship between one's yoga practice, personal growth, and quest for inner peace [ 60 ]. Participant 48 believes that " After a long and perhaps short journey of practicing yoga, individuals find themselves, reach their essence, and become aware of their existence. I chose this color (orange) because it reminds me that energy exists, is alive, and can be transmitted at any moment. For me, yoga is a sign of energy; after yoga, the body revitalizes and refreshes. " The choice of orange suggests a strong relationship between yoga practice and energy, as this color, can be associated with the Sacral chakra, symbolizes vitality, creativity, and emotional balance [ 36 ].

In this study, there seem to be mixed views among some participants regarding yoga practice. While yoga and meditation are generally recommended as tools for reducing stress and enhancing personal well-being [ 24 , 61 , 62 ], some students (participants 41–44) have reported not finding this practice beneficial. For example, some participants have advised against practicing yoga due to physical discomfort (head, neck, and back pain, dizziness), inability to empty the mind during meditation, difficulty in focusing, and negative perceptions. The comments of participants 41 and 44 are thought to indicate their individual experiences regarding their inability to meditate and the discomfort they feel during yoga practice. Yoga and meditation practices can create different experiences in each individual; while they can be relaxing and healing for some, they can be challenging and discomforting for others [ 63 ]. This suggests that yoga and meditation can not universal solutions but practices that should be compatible with an individual's personal preferences, experiences, and health conditions [ 26 ].

Participants' health conditions can influence their experiences during yoga practice. Participants who feel unwell or have a specific health problem may find the practice challenging. This underscores the importance for educators and health professionals to provide stress management and relaxation techniques tailored to individual needs [ 64 ].

Limitations

The qualitative data collected in this study regarding the phenomenon of yoga is in Turkish. However, selecting an international journal for publication and translating the text into English may have limited the full conveyance of the figures and participants' expressions to the readers due to the unique cultural characteristics of the language. The concepts of yoga and chakras, meditation, and similar topics, which were theoretically as well as practically conveyed to the participants during the 14-week course content, may have influenced the participants' views on the phenomenon of yoga. The use of a qualitative design tradition in the research both limited the generalizability of the findings and contributed to the originality of the study.

This study has identified four themes that explain the phenomenon of practicing yoga. These are respectively; "symbol of health and tranquility", "way to place goodness in the heart", "most effective way to meet the self", and "no guarantee of relaxation" themes. The findings will contribute to a more comprehensive understanding of student experiences and ultimately understand their positive and negative experiences. By delving into the student perspective, this research aims to provide valuable insights for educators and healthcare professionals. Most of the research on the phenomenon of practicing yoga is conducted abroad, and it is a less studied area in Turkey. Although yoga, which is becoming increasingly popular in our country, is known to be a practice that makes a person feel good; research on how individuals feel about practicing yoga and how they think about it is specific to the subject. Participants associated practicing yoga with symbols and colors found in nature, emphasizing the importance of its effects on the body, mind, and spirituality. In addition, findings regarding the experiences of individuals practicing yoga, a practice that is also becoming increasingly popular in Turkey, have been obtained. Although it is seen that qualitative approaches such as in-depth interviews and content analysis are used in almost all of the qualitative studies on the subject [ 48 , 65 , 66 ], no study has been found that examines individuals' perceptions by drawing pictures and interpreting them. In this respect, the current research's unique research method can contribute to the literature.

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The authors extend their sincere gratitude to the nursing students who willingly took part in this study. Their participation is greatly valued and appreciated.

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Department of Public Health Nursing, Faculty of Health Sciences, Izmir Democracy University, Izmir, Turkey

Özüm Erki̇n

Department of Public Health Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey

Aynur Çeti̇nkaya

Begüm Güler

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ÖE and AÇ contributed to study design. AÇ contributed to analyze data. ÖE, AÇ and BG write the manuscript. All authors read and approved the final manuscript.

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Ethical approval for the study was obtained from Manisa Celal Bayar University Non-invasive Clinical Research Ethics Committee (Decision no:20.478.486, Date:02/13/2019). We adhered to the principles of the Declaration of Helsinki and relevant guidelines. Written informed consent was obtained from all participants in this study. Participants were ensured to provide their consent voluntarily and without coercion. Written informed consent to participate was obtained from all of the participants in this study. Before the research, the purpose of the study was explained to the students and that they could leave the study at any time. At the beginning of the study, it was informed that participation in the study was voluntary and that no grade would be given. The evaluation of this course consisted of 10 open-ended questions as part of the year-end assessment. Students were asked to name 10 yoga poses they knew, describe the posture, explain the benefits, indicate the indications and contraindications, and identify the associated chakras. The grade distribution of the students was as follows: AA (n:31), BA (n:16), BB (n:6), CB (n:6).  Necessary precautions were taken to protect the confidentiality of the data, the identity information of the participants was not included in the data collection tools and all personal details in the data collection forms were kept confidential. The identifying images or other personal details of participants are presented in a way that does not compromise anonymity.

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Erki̇n, Ö., Çeti̇nkaya, A. & Güler, B. The phenomenon of yoga in the imagination of Turkish nursing students: "The way to place goodness in the heart". BMC Nurs 23 , 655 (2024). https://doi.org/10.1186/s12912-024-02288-y

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Received : 28 June 2024

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DOI : https://doi.org/10.1186/s12912-024-02288-y

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