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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.

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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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• Faculty Portal

Library Guide to Capstone Literature Reviews: Find a Research Gap

Find a research gap: tips to get started.

Finding a research gap is not an easy process and there is no one linear path. These tips and suggestions are just examples of possible ways to begin. 

In Ph.D. dissertations, students identify a gap in research. In other programs, students identify a gap in practice. The literature review for a gap in practice will show the context of the problem and the current state of the research. 

Research gap definition

A research gap exists when:

• a question or problem has not been answered by existing studies/research in the field 
• a concept or new idea has not been studied at all
• all the existing literature on a topic is outdated 
• a specific population/location/age group etc has not been studied 

A research gap should be:

• grounded in the literature
• amenable to scientific study
• Litmus Test for a Doctoral-Level Research Problem (Word) This tool helps students determine if they have identified a doctoral level research problem.

Identify a research gap

To find a gap you must become very familiar with a particular field of study. This will involve a lot of research and reading, because a gap is defined by what does (and does not) surround it.

• Search the research literature and dissertations (search all university dissertations, not just Walden!).
• Understand your topic! Review background information in books and encyclopedias . 
• Look for literature reviews, systematic reviews, and meta-analyses.
• Take notes on concepts, themes, and subject terms . 
• Look closely at each article's limitations, conclusions, and recommendations for future research. 
• Organize, analyze, and repeat! 

• Quick Answer: How do I find dissertations on a topic?

Start with broad searches

Use the Library Search (formerly Thoreau)  to do a broad search with just one concept at a time . Broad searches give you an idea of the academic conversation surrounding your topic.

• Try the terms you know (keywords) first.
• Look at the Subject Terms (controlled language) to brainstorm terms. 
• Subject terms help you understand what terms are most used, and what other terms to try.
• No matter what your topic is, not every researcher will be using the same terms. Keep an eye open for additional ways to describe your topic.
• Guide: Subject Terms & Index Searches: Index Overview

Keep a list of terms

• Create a list of terms
• Example list of terms

This list will be a record of what terms are: 

• related to or represent your topic
• synonyms or antonyms
• more or less commonly used
• keywords (natural language) or subject terms (controlled language)
• Synonyms & antonyms (database search skills)
• Turn keywords into subject terms

Term I started with:

culturally aware 

Subject terms I discovered:

cultural awareness (SU) 

cultural sensitivity (SU) 

cultural competence (SU) 

Search with different combinations of terms

• Combine search terms list
• Combine search terms table
• Video: Search by Themes

Since a research gap is defined by the absence of research on a topic, you will search for articles on everything that relates to your topic. 

• List out all the themes related to your gap.
• Search different combinations of the themes as you discover them 

For example, suppose your research gap is on the work-life balance of tenured and tenure-track women in engineering professions. In that case, you might try searching different combinations of concepts, such as: 

• women and STEM 
• STEM or science or technology or engineering or mathematics
• female engineering professors 
• tenure-track women in STEM
• work-life balance and women in STEM
• work-life balance and women professors
• work-life balance and tenure 

Topic adapted from one of the award winning Walden dissertations. 

• Walden University Award Winning Dissertations
• Gossage, Lily Giang-Tien, "Work-Life Balance of Tenured and Tenure-Track Women Engineering Professors" (2019). Walden Dissertations and Doctoral Studies. 6435.

Break your topic into themes and try combining the terms from different themes in different ways. For example: 

Theme 1 and Theme 4

Theme 2 and Theme 1

Theme 3 and Theme 4

Video: Search by Themes (YouTube)

(2 min 40 sec) Recorded April 2014 Transcript

Track where more research is needed

Most research articles will identify where more research is needed. To identify research trends, use the literature review matrix to track where further research is needed. 

• Download or create your own Literature Review Matrix (examples in links below).
• Do some general database searches on broad topics.
• Find an article that looks interesting.
• When you read the article, pay attention to the conclusions and limitations sections.
• Use the Literature Review Matrix to track where  'more research is needed' or 'further research needed'. NOTE:  you might need to add a column to the template.
• As you fill in the matrix you should see trends where more research is needed.

There is no consistent section in research articles where the authors identify where more research is needed. Pay attention to these sections: 

• limitations
• conclusions
• recommendations for future research 
• Literature Review Matrix Templates: learn how to keep a record of what you have read
• Literature Review Matrix (Excel) with color coding Sample template for organizing and synthesizing your research
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• Next Page: Get & Stay Organized
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Research Process

• Brainstorming
• Explore Google This link opens in a new window
• Explore Web Resources
• Explore Background Information
• Explore Books
• Explore Scholarly Articles
• Narrowing a Topic
• Primary and Secondary Resources
• Academic, Popular & Trade Publications
• Scholarly and Peer-Reviewed Journals
• Grey Literature
• Clinical Trials
• Evidence Based Treatment
• Scholarly Research
• Database Research Log
• Search Limits
• Keyword Searching
• Boolean Operators
• Phrase Searching
• Truncation & Wildcard Symbols
• Proximity Searching
• Field Codes
• Subject Terms and Database Thesauri
• Reading a Scientific Article
• Website Evaluation
• Article Keywords and Subject Terms
• Cited References
• Citing Articles
• Related Results
• Search Within Publication
• Database Alerts & RSS Feeds
• Personal Database Accounts
• Persistent URLs
• Literature Gap and Future Research
• Web of Knowledge
• Annual Reviews
• Systematic Reviews & Meta-Analyses
• Finding Seminal Works
• Exhausting the Literature
• Finding Dissertations
• Researching Theoretical Frameworks
• Research Methodology & Design
• Tests and Measurements
• Organizing Research & Citations This link opens in a new window
• Picking Where to Publish
• Bibliometrics
• Learn the Library This link opens in a new window

Research Articles

These examples below illustrate how researchers from different disciplines identified gaps in existing literature. For additional examples, try a NavigatorSearch using this search string: ("Literature review") AND (gap*)

• Addressing the Recent Developments and Potential Gaps in the Literature of Corporate Sustainability
• Applications of Psychological Science to Teaching and Learning: Gaps in the Literature
• Attitudes, Risk Factors, and Behaviours of Gambling Among Adolescents and Young People: A Literature Review and Gap Analysis
• Do Psychological Diversity Climate, HRM Practices, and Personality Traits (Big Five) Influence Multicultural Workforce Job Satisfaction and Performance? Current Scenario, Literature Gap, and Future Research Directions
• Entrepreneurship Education: A Systematic Literature Review and Identification of an Existing Gap in the Field
• Evidence and Gaps in the Literature on HIV/STI Prevention Interventions Targeting Migrants in Receiving Countries: A Scoping Review
• Homeless Indigenous Veterans and the Current Gaps in Knowledge: The State of the Literature
• A Literature Review and Gap Analysis of Emerging Technologies and New Trends in Gambling
• A Review of Higher Education Image and Reputation Literature: Knowledge Gaps and a Research Agenda
• Trends and Gaps in Empirical Research on Open Educational Resources (OER): A Systematic Mapping of the Literature from 2015 to 2019
• Where Should We Go From Here? Identified Gaps in the Literature in Psychosocial Interventions for Youth With Autism Spectrum Disorder and Comorbid Anxiety

What is a ‘gap in the literature’?

The gap, also considered the missing piece or pieces in the research literature, is the area that has not yet been explored or is under-explored. This could be a population or sample (size, type, location, etc.), research method, data collection and/or analysis, or other research variables or conditions.

It is important to keep in mind, however, that just because you identify a gap in the research, it doesn't necessarily mean that your research question is worthy of exploration. You will want to make sure that your research will have valuable practical and/or theoretical implications. In other words, answering the research question could either improve existing practice and/or inform professional decision-making (Applied Degree), or it could revise, build upon, or create theoretical frameworks informing research design and practice (Ph.D Degree). See the Dissertation Center  for additional information about dissertation criteria at NU.

For a additional information on gap statements, see the following:

• How to Find a Gap in the Literature
• Write Like a Scientist: Gap Statements

How do you identify the gaps?

Conducting an exhaustive literature review is your first step. As you search for journal articles, you will need to read critically across the breadth of the literature to identify these gaps. You goal should be to find a ‘space’ or opening for contributing new research. The first step is gathering a broad range of research articles on your topic. You may want to look for research that approaches the topic from a variety of methods – qualitative, quantitative, or mixed methods. 

See the videos below for further instruction on identifying a gap in the literature.

Identifying a Gap in the Literature - Dr. Laurie Bedford

How Do You Identify Gaps in Literature? - SAGE Research Methods

Literature Gap & Future Research - Library Workshop

This workshop presents effective search techniques for identifying a gap in the literature and recommendations for future research.

Where can you locate research gaps?

As you begin to gather the literature, you will want to critically read for what has, and has not, been learned from the research. Use the Discussion and Future Research sections of the articles to understand what the researchers have found and where they point out future or additional research areas. This is similar to identifying a gap in the literature, however, future research statements come from a single study rather than an exhaustive search. You will want to check the literature to see if those research questions have already been answered.

Roadrunner Search

Identifying the gap in the research relies on an exhaustive review of the literature. Remember, researchers may not explicitly state that a gap in the literature exists; you may need to thoroughly review and assess the research to make that determination yourself.

However, there are techniques that you can use when searching in NavigatorSearch to help identify gaps in the literature. You may use search terms such as "literature gap " or "future research" "along with your subject keywords to pinpoint articles that include these types of statements.

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A Framework for Rigorously Identifying Research Gaps in Qualitative Literature Reviews

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Write Like a Scientist

A Guide to Scientific Communication

Gap Statements

  A gap is something that remains to be done or learned in an area of research; it’s a gap in the knowledge of the scientists in the field of research of your study. Every research project must, in some way, address a gap–that is, attempt to fill in some piece of information missing in the scientific literature. Otherwise, it is not novel research and is therefore not contributing to the overall goals of science.

Identify the gap.

  A gap statement is found in the Introduction section of a journal article or poster or in the Goals and Importance section of a research proposal and succinctly identifies for your audience the gap that you will attempt to address in your project.

A gap might be a lack of understanding about how well a particular instrument works in a certain situation. It could be introducing a new method that needs to be tested. Or it could be that you are studying a whole new organism, system, or part of a process. Your project may also address multiple gaps, in which case you should be sure to identify each of them clearly!

In a class, you might not always be studying something brand “new.” But, in most cases, you should still try to come up with something unique about your project, however small. Talk to your professor about what they expect for your gap statement if nothing seems to work.

Here, the authors signal to us that this is a gap because they use the words “has not yet been clarified.” Other phrases that might help you identify (or form!) a gap statement are:

• …has/have not been… (studied/reported/elucidated)
• …is required/needed…
• …the key question is/remains…
• …it is important to address…

Fill the gap.

  Once you identify the gap in the literature, you must tell your audience how you attempt to at least somewhat address in your project this lack of knowledge or understanding . In a journal article or poster, this is often done in a new paragraph and should be accomplished in one summary statement, such as:

Therefore, the purpose of this study was to determine the effects of lead on the hepatobiliary system, especially on the liver and on the gallbladder (adapted from Sipos et al. 2003 ).

You’ll often find that the first sentence of the last paragraph in a paper’s introduction will start somewhat like this, indicating the gap fill.  

Remember–always keep your voice professional! Colloquial phrases such as “we looked into” or “we checked if” should be avoided when introducing your gap fill.

So let’s look at this idea in context by looking at some examples from a couple of types of papers. The gap statements are underlined; the fills are italicized.  

In the second and third examples, the gap may be a little less obvious–it doesn’t use any phrases to signal to you that there’s something missing, such as “has not been clarified” or “have not been reported.” But because of the way the paragraph is laid out–following the conventions of our move structures–we can see that the underlined section of text is indeed the missing information in the literature that the group sought to address in their project.

Literature Review Example/Sample

Detailed Walkthrough + Free Literature Review Template

If you’re working on a dissertation or thesis and are looking for an example of a strong literature review chapter , you’ve come to the right place.

In this video, we walk you through an A-grade literature review from a dissertation that earned full distinction . We start off by discussing the five core sections of a literature review chapter by unpacking our free literature review template . This includes:

• The literature review opening/ introduction section
• The theoretical framework (or foundation of theory)
• The empirical research
• The research gap
• The closing section

We then progress to the sample literature review (from an A-grade Master’s-level dissertation) to show how these concepts are applied in the literature review chapter. You can access the free resources mentioned in this video below.

PS – If you’re working on a dissertation, be sure to also check out our collection of dissertation and thesis examples here .

FAQ: Literature Review Example

Literature review example: frequently asked questions, is the sample literature review real.

Yes. The literature review example is an extract from a Master’s-level dissertation for an MBA program. It has not been edited in any way.

Can I replicate this literature review for my dissertation?

As we discuss in the video, every literature review will be slightly different, depending on the university’s unique requirements, as well as the nature of the research itself. Therefore, you’ll need to tailor your literature review to suit your specific context.

You can learn more about the basics of writing a literature review here .

Where can I find more examples of literature reviews?

The best place to find more examples of literature review chapters would be within dissertation/thesis databases. These databases include dissertations, theses and research projects that have successfully passed the assessment criteria for the respective university, meaning that you have at least some sort of quality assurance. 

The Open Access Thesis Database (OATD) is a good starting point. 

How do I get the literature review template?

You can access our free literature review chapter template here .

Is the template really free?

Yes. There is no cost for the template and you are free to use it as you wish. 

Psst… there’s more!

This post is an extract from our bestselling short course, Literature Review Bootcamp . If you want to work smart, you don't want to miss this .

What will it take for you to guide me in my Ph.D research work?

Thank you so much for all this information. I am unable to download the literature review template and the excel worksheet. When I click the button it takes me to the top of the page. I would really love to use this template, thank you again!

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• Writing Tips

How to Identify a Research Gap

5-minute read

• 10th January 2024

If you’ve been tasked with producing a thesis or dissertation, one of your first steps will be identifying a research gap. Although finding a research gap may sound daunting, don’t fret! In this post, we will define a research gap, discuss its importance, and offer a step-by-step guide that will provide you with the essential know-how to complete this critical step and move on to the rest of your research project.

What Is a Research Gap?

Simply put, a research gap is an area that hasn’t been explored in the existing literature. This could be an unexplored population, an untested method, or a condition that hasn’t been investigated yet. 

Why Is Identifying a Research Gap Important?

Identifying a research gap is a foundational step in the research process. It ensures that your research is significant and has the ability to advance knowledge within a specific area. It also helps you align your work with the current needs and challenges of your field. Identifying a research gap has many potential benefits.

1. Avoid Redundancy in Your Research

Understanding the existing literature helps researchers avoid duplication. This means you can steer clear of topics that have already been extensively studied. This ensures your work is novel and contributes something new to the field.

2. Guide the Research Design

Identifying a research gap helps shape your research design and questions. You can tailor your studies to specifically address the identified gap. This ensures that your work directly contributes to filling the void in knowledge.

3. Practical Applications

Research that addresses a gap is more likely to have practical applications and contributions. Whether in academia, industry, or policymaking, research that fills a gap in knowledge is often more applicable and can inform decision-making and practices in real-world contexts.

4. Field Advancements

Addressing a research gap can lead to advancements in the field . It may result in the development of new theories, methodologies, or technologies that push the boundaries of current understanding.

5. Strategic Research Planning

Identifying a research gap is crucial for strategic planning . It helps researchers and institutions prioritize areas that need attention so they can allocate resources effectively. This ensures that efforts are directed toward the most critical gaps in knowledge.

6. Academic and Professional Recognition

Researchers who successfully address significant research gaps often receive peer recognition within their academic and professional communities. This recognition can lead to opportunities for collaboration, funding, and career advancement.

How Do I Identify a Research Gap?

1. clearly define your research topic .

Begin by clearly defining your research topic. A well-scoped topic serves as the foundation for your studies. Make sure it’s not too broad or too narrow; striking the right balance will make it easier to identify gaps in existing literature.

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2. Conduct a Thorough Literature Review

A comprehensive literature review is a vital step in any research. Dive deep into the existing research related to your topic. Look for patterns, recurring themes, and consensus among scholars. Pay attention to areas where conflicting opinions or gaps in understanding emerge.

3. Evaluate Existing Studies

Critically evaluate the studies you encounter during your literature review. Assess the paradigms , methodologies, findings, and limitations of each. Note any discrepancies, unanswered questions, or areas where further investigation is warranted. These are potential indicators of research gaps.

4. Identify Unexplored Perspectives

Consider the perspectives presented in the existing literature. Are there alternative viewpoints or marginalized voices that haven’t been adequately explored? Identifying and incorporating diverse perspectives can often lead to uncharted territory and help you pinpoint a unique research gap.

Additional Tips

Stay up to date with emerging trends.

The field of research is dynamic, with new developments and emerging trends constantly shaping the landscape. Stay up to date with the latest publications, conferences, and discussions in your field and make sure to regularly check relevant academic search engines . Often, identifying a research gap involves being at the forefront of current debates and discussions.

Seek Guidance From Experts

Don’t hesitate to reach out to experts in your field for guidance. Attend conferences, workshops, or seminars where you can interact with seasoned researchers. Their insights and experience can provide valuable perspectives on potential research gaps that you may have overlooked. You can also seek advice from your academic advisor .

Use Research Tools and Analytics

Leverage tech tools to analyze patterns and trends in the existing literature. Tools like citation analysis, keyword mapping, and data visualization can help you identify gaps and areas with limited exploration.

Identifying a research gap is a skill that evolves with experience and dedication. By defining your research topic, meticulously navigating the existing literature, critically evaluating studies, and recognizing unexplored perspectives, you’ll be on your way to identifying a research gap that will serve as the foundation for your paper, thesis, or dissertation topic .

If you need any help with proofreading your research paper , we can help with our research paper editing services . You can even try a sample of our services for free . Good luck with all your research!

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Research to Action

The Global Guide to Research Impact

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Framing challenges

Gap analysis for literature reviews and advancing useful knowledge

By Steve Wallis and Bernadette Wright 02/06/2020

The basics of research are seemingly clear. Read a lot of articles, see what’s missing, and conduct research to fill the gap in the literature. Wait a minute. What is that? ‘See what’s missing?’ How can we see something that is not there?

Imagine you are videoconferencing a colleague who is showing you the results of their project. Suddenly, the screen and sound cut out for a minute. After pressing some keys, you manage to restore the link; only to have your colleague ask, ‘What do you think?’. Of course, you know that you missed something from the presentation because of the disconnection. You can see that something is missing, and you know what to ask for to get your desired results, ‘Sorry, could you repeat that last minute of your presentation, please’. It’s not so easy when we’re looking at research results, proposals, or literature reviews.

While all research is, to some extent, useful, we’ve seen a lot of research that does not have the expected impact. That means wasted time, wasted money, under-served clients, and frustration on multiple levels. A big part of that problem is that directions for research are often chosen intuitively; in a sort of ad-hoc process. While we deeply respect the intuition of experts, that kind of process is not very rigorous.

In this post, we will show you how to ‘see the invisible’: How to identify the missing pieces in any study, literature review, or program analysis. With these straight-forward techniques, you will be able to better target your research in a more cost-effective way to fill those knowledge gaps to develop more effective theories, plans, and evaluations.

The first step is to choose your source material. That can be one or more articles, reports, or other study results. Of course, you want to be sure that the material you use is of high quality . Next, you want to create a causal map of your source material.

We’re going to go a bit abstract on you here because people sometimes get lost in the ‘content’ when what we are looking at here is more about the ‘structure’. Think of it like choosing how to buy a house based on how well it is built, rather than what color it is painted. So, instead of using actual concepts, we’ll refer to them as concepts A, B, C… and so on.

So, the text might say something like: ‘Our research shows that A causes B, B causes C, and D causes less C. Oh yes, and E is also important (although we’re not sure how it’s causally connected to A, B, C, or D)’.

When we draw causal maps from the source material we’ve found, we like to have key concepts in circles, with causal connections represented by arrows.

Figure 1. Abstract example of a causal map of a theory

There are really three basic kinds of gaps for you to find: relevance/meaning, logic/structure, and data/evidence. Starting with structure, there is a gap any place where there are two circles NOT connected by a causal arrow. It is important to have at least two arrows pointing at each concept/circle for the same reason we like to have multiple independent variables for each dependent variable (although, with more complex maps, we’re learning to see these as interdependent variables).

For example, there is no arrow between A and D. Also, there is no arrow between E and any of the other concepts. Each of those is a structural gap – an opening for additional research.

You might also notice that there are two arrows pointing directly at C. Like having two independent variables and one dependent variable, it is structurally better to have at least two arrows pointing at each concept.

So, structurally , C is in good shape. This part of the map has the least need for additional research. A larger gap exists around B, because it has only one arrow pointing at it (the arrow from A to B). Larger still is the gap around A, D, and E; because they have no arrows pointing at them.

To get the greatest leverage for your research dollar, it is generally best to search for that second arrow. In short, one research question would be: What (aside from A) has a causal influence on B? Other good research questions would be (a) Is there a causal relationship between A and D? (b) Is there a causal relationship between E and any of the other concepts? (c) What else besides A helps cause B? (d) What are the causes of A, D, and E?

Now, let’s take a look at gaps in the data, evidence, or information upon which each causal arrow is established.

From structure to data

Here, we add to the drawing by making a note showing (very briefly) the kind of data supporting each causal arrow. We like to have that in a box – with a loopy line ‘typing’ the evidence to the connection. You can also use different colors to more easily differentiate between the concepts and the evidence on your map. You can also write the note along the length of the arrow.

Figure 2. Tying the data to the structure

From data to stakeholder relevance

Finally, the gap in meaning (relevance) asks if those studies were done with the ‘right’ people. By this, we mean people related to the situation or topic you are studying. Managers, line workers, clients, suppliers, those providing related services; all of those and more should be included. Similarly, you might look to a variety of academic disciplines, drawing expertise from psychology, sociology, business, economics, policy, and others.

Which participants or stakeholders are actually part of your research depends on the project. However, in general, having a broader selection of stakeholder groups results in a better map. This applies to both choosing what concepts go on the map and also who to contact for interviews and surveys.

Visualizing the gaps

All of these three gaps – gaps in structure, data, and stakeholder perspectives – can (and should) be addressed to help you choose more focused directions for your research – to generate research results that will have more impact. As a final note, remember that many gaps may be filled with secondary research; a new literature review that fills the gaps in the logic/structure, data/information, and meaning/relevance of your map so that your organisation can have a greater impact.

Figure 3. Visualizing the gaps (shown in green)

Some deeper reading on literature reviews may be found here:

• Practical Mapping for Applied Research and Program Evaluation (SAGE) provides a ‘jargon free’ explanation for every phase of research:

https://us.sagepub.com/en-us/nam/practical-mapping-for-applied-research-and-program-evaluation/book261152   (especially Chapter 3)

• This paper uses theories for addressing poverty from a range of academic disciplines and from policy centers from across the political spectrum as an example of interdisciplinary knowledge mapping and synthesis:

https://www.emerald.com/insight/content/doi/10.1108/K-03-2018-0136/full/html

• Restructuring evaluation findings into useful knowledge:

http://journals.sfu.ca/jmde/index.php/jmde_1/article/download/481/436/

This approach helps you to avoid fuzzy understandings and the dangerous ‘pretence of knowledge’ that occasionally crops up in some reports and recommendations. Everyone can see that a piece is missing and so more easily agree where more research is needed to advance our knowledge to better serve our organisational and community constituents.

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Robinson KA, Akinyede O, Dutta T, et al. Framework for Determining Research Gaps During Systematic Review: Evaluation [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Feb.

Framework for Determining Research Gaps During Systematic Review: Evaluation [Internet].

Introduction.

The identification of gaps from systematic reviews is essential to the practice of “evidence-based research.” Health care research should begin and end with a systematic review. 1 - 3 A comprehensive and explicit consideration of the existing evidence is necessary for the identification and development of an unanswered and answerable question, for the design of a study most likely to answer that question, and for the interpretation of the results of the study. 4

In a systematic review, the consideration of existing evidence often highlights important areas where deficiencies in information limit our ability to make decisions. We define a research gap as a topic or area for which missing or inadequate information limits the ability of reviewers to reach a conclusion for a given question. A research gap may be further developed, such as through stakeholder engagement in prioritization, into research needs. Research needs are those areas where the gaps in the evidence limit decision making by patients, clinicians, and policy makers. A research gap may not be a research need if filling the gap would not be of use to stakeholders that make decisions in health care. The clear and explicit identification of research gaps is a necessary step in developing a research agenda. Evidence reports produced by Evidence-based Practice Centers (EPCs) have always included a future research section. However, in contrast to the explicit and transparent steps taken in the completion of a systematic review, there has not been a systematic process for the identification of research gaps.

In a prior methods project, our EPC set out to identify and pilot test a framework for the identification of research gaps. 5 , 6 We searched the literature, conducted an audit of EPC evidence reports, and sought information from other organizations which conduct evidence synthesis. Despite these efforts, we identified little detail or consistency in the frameworks used to determine research gaps within systematic reviews. In general, we found no widespread use or endorsement of a specific formal process or framework for identifying research gaps using systematic reviews.

We developed a framework to systematically identify research gaps from systematic reviews. This framework facilitates the classification of where the current evidence falls short and why the evidence falls short. The framework included two elements: (1) the characterization the gaps and (2) the identification and classification of the reason(s) for the research gap.

The PICOS structure (Population, Intervention, Comparison, Outcome and Setting) was used in this framework to describe questions or parts of questions inadequately addressed by the evidence synthesized in the systematic review. The issue of timing, sometimes included as PICOTS, was considered separately for Intervention, Comparison, and Outcome. The PICOS elements were the only sort of framework we had identified in an audit of existing methods for the identification of gaps used by EPCs and other related organizations (i.e., health technology assessment organizations). We chose to use this structure as it is one familiar to EPCs, and others, in developing questions.

It is not only important to identify research gaps but also to determine how the evidence falls short, in order to maximally inform researchers, policy makers, and funders on the types of questions that need to be addressed and the types of studies needed to address these questions. Thus, the second element of the framework was the classification of the reasons for the existence of a research gap. For each research gap, the reason(s) that most preclude conclusions from being made in the systematic review is chosen by the review team completing the framework. To leverage work already being completed by review teams, we mapped the reasons for research gaps to concepts from commonly used evidence grading systems. Briefly, these categories of reasons, explained in detail in the prior JHU EPC report 5 , are:

• Insufficient or imprecise information
• Biased information
• Inconsistent or unknown consistency results
• Not the right information

The framework facilitates a systematic approach to identifying research gaps and the reasons for those gaps. The identification of where the evidence falls short and how the evidence falls short is essential to the development of important research questions and in providing guidance in how to address these questions.

As part of the previous methods product, we developed a worksheet and instructions to facilitate the use of the framework when completing a systematic review (See Appendix A ). Preliminary evaluation of the framework and worksheet was completed by applying the framework to two completed EPC evidence reports. The framework was further refined through peer review. In this current project, we extend our work on this research gaps framework.

Our objective in this project was to complete two types of further evaluation: (1) application of the framework across a larger sample of existing systematic reviews in different topic areas, and (2) implementation of the framework by EPCs. These two objectives were used to evaluate the framework and instructions for usability and to evaluate the application of the framework by others, outside of our EPC, including as part of the process of completing an EPC report. Our overall goal was to produce a revised framework with guidance that could be used by EPCs to explicitly identify research gaps from systematic reviews.

• Cite this Page Robinson KA, Akinyede O, Dutta T, et al. Framework for Determining Research Gaps During Systematic Review: Evaluation [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Feb. Introduction.
• PDF version of this title (425K)

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Home » Literature Review – Types Writing Guide and Examples

Literature Review – Types Writing Guide and Examples

Table of Contents

Literature Review

Definition:

A literature review is a comprehensive and critical analysis of the existing literature on a particular topic or research question. It involves identifying, evaluating, and synthesizing relevant literature, including scholarly articles, books, and other sources, to provide a summary and critical assessment of what is known about the topic.

Types of Literature Review

Types of Literature Review are as follows:

• Narrative literature review : This type of review involves a comprehensive summary and critical analysis of the available literature on a particular topic or research question. It is often used as an introductory section of a research paper.
• Systematic literature review: This is a rigorous and structured review that follows a pre-defined protocol to identify, evaluate, and synthesize all relevant studies on a specific research question. It is often used in evidence-based practice and systematic reviews.
• Meta-analysis: This is a quantitative review that uses statistical methods to combine data from multiple studies to derive a summary effect size. It provides a more precise estimate of the overall effect than any individual study.
• Scoping review: This is a preliminary review that aims to map the existing literature on a broad topic area to identify research gaps and areas for further investigation.
• Critical literature review : This type of review evaluates the strengths and weaknesses of the existing literature on a particular topic or research question. It aims to provide a critical analysis of the literature and identify areas where further research is needed.
• Conceptual literature review: This review synthesizes and integrates theories and concepts from multiple sources to provide a new perspective on a particular topic. It aims to provide a theoretical framework for understanding a particular research question.
• Rapid literature review: This is a quick review that provides a snapshot of the current state of knowledge on a specific research question or topic. It is often used when time and resources are limited.
• Thematic literature review : This review identifies and analyzes common themes and patterns across a body of literature on a particular topic. It aims to provide a comprehensive overview of the literature and identify key themes and concepts.
• Realist literature review: This review is often used in social science research and aims to identify how and why certain interventions work in certain contexts. It takes into account the context and complexities of real-world situations.
• State-of-the-art literature review : This type of review provides an overview of the current state of knowledge in a particular field, highlighting the most recent and relevant research. It is often used in fields where knowledge is rapidly evolving, such as technology or medicine.
• Integrative literature review: This type of review synthesizes and integrates findings from multiple studies on a particular topic to identify patterns, themes, and gaps in the literature. It aims to provide a comprehensive understanding of the current state of knowledge on a particular topic.
• Umbrella literature review : This review is used to provide a broad overview of a large and diverse body of literature on a particular topic. It aims to identify common themes and patterns across different areas of research.
• Historical literature review: This type of review examines the historical development of research on a particular topic or research question. It aims to provide a historical context for understanding the current state of knowledge on a particular topic.
• Problem-oriented literature review : This review focuses on a specific problem or issue and examines the literature to identify potential solutions or interventions. It aims to provide practical recommendations for addressing a particular problem or issue.
• Mixed-methods literature review : This type of review combines quantitative and qualitative methods to synthesize and analyze the available literature on a particular topic. It aims to provide a more comprehensive understanding of the research question by combining different types of evidence.

Parts of Literature Review

Parts of a literature review are as follows:

Introduction

The introduction of a literature review typically provides background information on the research topic and why it is important. It outlines the objectives of the review, the research question or hypothesis, and the scope of the review.

Literature Search

This section outlines the search strategy and databases used to identify relevant literature. The search terms used, inclusion and exclusion criteria, and any limitations of the search are described.

Literature Analysis

The literature analysis is the main body of the literature review. This section summarizes and synthesizes the literature that is relevant to the research question or hypothesis. The review should be organized thematically, chronologically, or by methodology, depending on the research objectives.

Critical Evaluation

Critical evaluation involves assessing the quality and validity of the literature. This includes evaluating the reliability and validity of the studies reviewed, the methodology used, and the strength of the evidence.

The conclusion of the literature review should summarize the main findings, identify any gaps in the literature, and suggest areas for future research. It should also reiterate the importance of the research question or hypothesis and the contribution of the literature review to the overall research project.

The references list includes all the sources cited in the literature review, and follows a specific referencing style (e.g., APA, MLA, Harvard).

How to write Literature Review

Here are some steps to follow when writing a literature review:

• Define your research question or topic : Before starting your literature review, it is essential to define your research question or topic. This will help you identify relevant literature and determine the scope of your review.
• Conduct a comprehensive search: Use databases and search engines to find relevant literature. Look for peer-reviewed articles, books, and other academic sources that are relevant to your research question or topic.
• Evaluate the sources: Once you have found potential sources, evaluate them critically to determine their relevance, credibility, and quality. Look for recent publications, reputable authors, and reliable sources of data and evidence.
• Organize your sources: Group the sources by theme, method, or research question. This will help you identify similarities and differences among the literature, and provide a structure for your literature review.
• Analyze and synthesize the literature : Analyze each source in depth, identifying the key findings, methodologies, and conclusions. Then, synthesize the information from the sources, identifying patterns and themes in the literature.
• Write the literature review : Start with an introduction that provides an overview of the topic and the purpose of the literature review. Then, organize the literature according to your chosen structure, and analyze and synthesize the sources. Finally, provide a conclusion that summarizes the key findings of the literature review, identifies gaps in knowledge, and suggests areas for future research.
• Edit and proofread: Once you have written your literature review, edit and proofread it carefully to ensure that it is well-organized, clear, and concise.

Examples of Literature Review

Here’s an example of how a literature review can be conducted for a thesis on the topic of “ The Impact of Social Media on Teenagers’ Mental Health”:

• Start by identifying the key terms related to your research topic. In this case, the key terms are “social media,” “teenagers,” and “mental health.”
• Use academic databases like Google Scholar, JSTOR, or PubMed to search for relevant articles, books, and other publications. Use these keywords in your search to narrow down your results.
• Evaluate the sources you find to determine if they are relevant to your research question. You may want to consider the publication date, author’s credentials, and the journal or book publisher.
• Begin reading and taking notes on each source, paying attention to key findings, methodologies used, and any gaps in the research.
• Organize your findings into themes or categories. For example, you might categorize your sources into those that examine the impact of social media on self-esteem, those that explore the effects of cyberbullying, and those that investigate the relationship between social media use and depression.
• Synthesize your findings by summarizing the key themes and highlighting any gaps or inconsistencies in the research. Identify areas where further research is needed.
• Use your literature review to inform your research questions and hypotheses for your thesis.

For example, after conducting a literature review on the impact of social media on teenagers’ mental health, a thesis might look like this:

“Using a mixed-methods approach, this study aims to investigate the relationship between social media use and mental health outcomes in teenagers. Specifically, the study will examine the effects of cyberbullying, social comparison, and excessive social media use on self-esteem, anxiety, and depression. Through an analysis of survey data and qualitative interviews with teenagers, the study will provide insight into the complex relationship between social media use and mental health outcomes, and identify strategies for promoting positive mental health outcomes in young people.”

Reference: Smith, J., Jones, M., & Lee, S. (2019). The effects of social media use on adolescent mental health: A systematic review. Journal of Adolescent Health, 65(2), 154-165. doi:10.1016/j.jadohealth.2019.03.024

Reference Example: Author, A. A., Author, B. B., & Author, C. C. (Year). Title of article. Title of Journal, volume number(issue number), page range. doi:0000000/000000000000 or URL

Applications of Literature Review

some applications of literature review in different fields:

• Social Sciences: In social sciences, literature reviews are used to identify gaps in existing research, to develop research questions, and to provide a theoretical framework for research. Literature reviews are commonly used in fields such as sociology, psychology, anthropology, and political science.
• Natural Sciences: In natural sciences, literature reviews are used to summarize and evaluate the current state of knowledge in a particular field or subfield. Literature reviews can help researchers identify areas where more research is needed and provide insights into the latest developments in a particular field. Fields such as biology, chemistry, and physics commonly use literature reviews.
• Health Sciences: In health sciences, literature reviews are used to evaluate the effectiveness of treatments, identify best practices, and determine areas where more research is needed. Literature reviews are commonly used in fields such as medicine, nursing, and public health.
• Humanities: In humanities, literature reviews are used to identify gaps in existing knowledge, develop new interpretations of texts or cultural artifacts, and provide a theoretical framework for research. Literature reviews are commonly used in fields such as history, literary studies, and philosophy.

Role of Literature Review in Research

Here are some applications of literature review in research:

• Identifying Research Gaps : Literature review helps researchers identify gaps in existing research and literature related to their research question. This allows them to develop new research questions and hypotheses to fill those gaps.
• Developing Theoretical Framework: Literature review helps researchers develop a theoretical framework for their research. By analyzing and synthesizing existing literature, researchers can identify the key concepts, theories, and models that are relevant to their research.
• Selecting Research Methods : Literature review helps researchers select appropriate research methods and techniques based on previous research. It also helps researchers to identify potential biases or limitations of certain methods and techniques.
• Data Collection and Analysis: Literature review helps researchers in data collection and analysis by providing a foundation for the development of data collection instruments and methods. It also helps researchers to identify relevant data sources and identify potential data analysis techniques.
• Communicating Results: Literature review helps researchers to communicate their results effectively by providing a context for their research. It also helps to justify the significance of their findings in relation to existing research and literature.

Purpose of Literature Review

Some of the specific purposes of a literature review are as follows:

• To provide context: A literature review helps to provide context for your research by situating it within the broader body of literature on the topic.
• To identify gaps and inconsistencies: A literature review helps to identify areas where further research is needed or where there are inconsistencies in the existing literature.
• To synthesize information: A literature review helps to synthesize the information from multiple sources and present a coherent and comprehensive picture of the current state of knowledge on the topic.
• To identify key concepts and theories : A literature review helps to identify key concepts and theories that are relevant to your research question and provide a theoretical framework for your study.
• To inform research design: A literature review can inform the design of your research study by identifying appropriate research methods, data sources, and research questions.

Characteristics of Literature Review

Some Characteristics of Literature Review are as follows:

• Identifying gaps in knowledge: A literature review helps to identify gaps in the existing knowledge and research on a specific topic or research question. By analyzing and synthesizing the literature, you can identify areas where further research is needed and where new insights can be gained.
• Establishing the significance of your research: A literature review helps to establish the significance of your own research by placing it in the context of existing research. By demonstrating the relevance of your research to the existing literature, you can establish its importance and value.
• Informing research design and methodology : A literature review helps to inform research design and methodology by identifying the most appropriate research methods, techniques, and instruments. By reviewing the literature, you can identify the strengths and limitations of different research methods and techniques, and select the most appropriate ones for your own research.
• Supporting arguments and claims: A literature review provides evidence to support arguments and claims made in academic writing. By citing and analyzing the literature, you can provide a solid foundation for your own arguments and claims.
• I dentifying potential collaborators and mentors: A literature review can help identify potential collaborators and mentors by identifying researchers and practitioners who are working on related topics or using similar methods. By building relationships with these individuals, you can gain valuable insights and support for your own research and practice.
• Keeping up-to-date with the latest research : A literature review helps to keep you up-to-date with the latest research on a specific topic or research question. By regularly reviewing the literature, you can stay informed about the latest findings and developments in your field.

Advantages of Literature Review

There are several advantages to conducting a literature review as part of a research project, including:

• Establishing the significance of the research : A literature review helps to establish the significance of the research by demonstrating the gap or problem in the existing literature that the study aims to address.
• Identifying key concepts and theories: A literature review can help to identify key concepts and theories that are relevant to the research question, and provide a theoretical framework for the study.
• Supporting the research methodology : A literature review can inform the research methodology by identifying appropriate research methods, data sources, and research questions.
• Providing a comprehensive overview of the literature : A literature review provides a comprehensive overview of the current state of knowledge on a topic, allowing the researcher to identify key themes, debates, and areas of agreement or disagreement.
• Identifying potential research questions: A literature review can help to identify potential research questions and areas for further investigation.
• Avoiding duplication of research: A literature review can help to avoid duplication of research by identifying what has already been done on a topic, and what remains to be done.
• Enhancing the credibility of the research : A literature review helps to enhance the credibility of the research by demonstrating the researcher’s knowledge of the existing literature and their ability to situate their research within a broader context.

Limitations of Literature Review

Limitations of Literature Review are as follows:

• Limited scope : Literature reviews can only cover the existing literature on a particular topic, which may be limited in scope or depth.
• Publication bias : Literature reviews may be influenced by publication bias, which occurs when researchers are more likely to publish positive results than negative ones. This can lead to an incomplete or biased picture of the literature.
• Quality of sources : The quality of the literature reviewed can vary widely, and not all sources may be reliable or valid.
• Time-limited: Literature reviews can become quickly outdated as new research is published, making it difficult to keep up with the latest developments in a field.
• Subjective interpretation : Literature reviews can be subjective, and the interpretation of the findings can vary depending on the researcher’s perspective or bias.
• Lack of original data : Literature reviews do not generate new data, but rather rely on the analysis of existing studies.
• Risk of plagiarism: It is important to ensure that literature reviews do not inadvertently contain plagiarism, which can occur when researchers use the work of others without proper attribution.

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What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

What is the purpose of literature review , a. habitat loss and species extinction: , b. range shifts and phenological changes: , c. ocean acidification and coral reefs: , d. adaptive strategies and conservation efforts: .

• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• How to write a literature review faster with Paperpal? 

Frequently asked questions 

What is a literature review .

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

1. Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 

2. Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field.

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3. Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 

4. Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 

5. Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 

6. Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example 

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:  

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

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How to write a good literature review 

Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

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Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review 

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:  

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:  

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:  

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:  

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:  

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:  

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

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How to write a literature review faster with Paperpal?  

Paperpal, an AI writing assistant, integrates powerful academic search capabilities within its writing platform. With the Research | Cite feature, you get 100% factual insights, with citations backed by 250M+ verified research articles, directly within your writing interface. It also allows you auto-cite references in 10,000+ styles and save relevant references in your Citation Library. By eliminating the need to switch tabs to find answers to all your research questions, Paperpal saves time and helps you stay focused on your writing.   

Here’s how to use the Research feature:  

• Ask a question: Get started with a new document on paperpal.com. Click on the “Research | Cite” feature and type your question in plain English. Paperpal will scour over 250 million research articles, including conference papers and preprints, to provide you with accurate insights and citations. 

• Review and Save: Paperpal summarizes the information, while citing sources and listing relevant reads. You can quickly scan the results to identify relevant references and save these directly to your built-in citations library for later access. 
• Cite with Confidence: Paperpal makes it easy to incorporate relevant citations and references in 10,000+ styles into your writing, ensuring your arguments are well-supported by credible sources. This translates to a polished, well-researched literature review. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a good literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. By combining effortless research with an easy citation process, Paperpal Research streamlines the literature review process and empowers you to write faster and with more confidence. Try Paperpal Research now and see for yourself.  

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

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What Is A Research Gap? (With Tips + Examples)

A research gap is a specific area within a field of study that remains unexplored or under-explored. Identifying a research gap involves recognizing where existing research is lacking or where there are unanswered questions that could provide opportunities for further investigation. Understanding research gaps is crucial for advancing knowledge, as it helps scholars and researchers focus their efforts on areas that can contribute significantly to their field.

What Is A Research Gap?

It is actually a question or any issue that needs to be solved by any pre-existing work or research in your area of study. A research gap can also exist where some new idea still needs to be studied.

Tips on Identifying Research Gap

Research always plays an essential role in acquiring more knowledge and addressing the gaps in different fields. When you are identifying a research gap, you are taking a very important step in the whole research process. This aids the researchers in contributing meaningful insights and triggers the knowledge boundaries.

Understanding the Literature You Are Studying: In order to identify any research gap, it is essential to have an excellent advertising of the preexisting literature in your study field.

Here, you need to conduct a review of many books, scholarly articles, conferences, and other relevant sources. In this way, you can get a good foundation as well as insights into any present state of in-depth knowledge in your own study area.

Defining Your Own Research Question: After getting a good knowledge of the pre-existing literature, you need to define a concise and clear idea of the research question. This research question needs to be very specific, attainable, measurable, time-bound and relevant. An acronym for this entire thing is known as SMART. This also needs to address any significant issue that still needs to be fully solved or adequately answered.

Identifying Your Study Objectives: Here, you need to identify the major objectives of your research paper. All these objectives need to be aligned with the identified research gap. These objectives always guide the researcher and aid you in determining the direction and scope of your research study.

Analyze the Existing Studies: Here, you need to analyze very carefully all the existing studies that are related to your research question. Here, it would help if you looked at the most common recurring findings, themes, and patterns of the discussed literature. Here, you also need to pay a lot of attention to the conflicted areas with the results, unanswered questions, and contradictory theories. These areas show the research gaps that can be explored later.

Consider The Practical Relevance: You always need to evaluate the very practical relevance of the research question as well as its potential impact on society. Here, it would help if you always considered the importance of addressing your own research gap as you identified it.

Here, you also need to assess whether your findings can contribute to the original theoretical framework and offer all the practical solutions for leading to the policy recommendations. These practical ads are relevant to the research paper and trigger its impact.

Consulting With the Experts and Peers: You always need to engage you’re discussing with your mentors, peers, and experts in your own field of study. Here, you always need to seek their opinions and perspectives on the research question to identify potential research gaps.

These can provide valuable insights into assumption challenges, and this helps you refine your research work. Your peers and experts can give you a new idea and help you identify the errors in your thinking.

Conducting Your Pilot Study: You need to conduct it to test the viability and feasibility of the research question. This pilot study provides you with feedback and data on the research design, approach and methodology.

This also helps you identify the potential limitations or challenges that need to be solved before conducting the full research studies.

Reflecting and Refining: You need to vividly reflect on the research progress to refine your research preferences. You need to add the objectives. As you go deeper into your research process, additional research gaps may be uncovered to refine your own research needs.

If you follow this process, you can adapt your own approach to ensure the research gaps.

As per the example of the research gap, identifying your research gap allows your research to contribute to gaining more knowledge to address the pre-existing limitations.

This way, you will understand the existing literature to define a crystal clear research statement. You can identify the research gaps by analyzing the existing studies to consider their relevance. According to the research gap finder, if you consult with your peers, doing all the pilot studies reflects on your research process progress.

If you follow the guide mentioned above, you can always embark on meaningful research studies to trigger your knowledge in your subject area and make a prominent contribution to your field.

Also Read: Struggling with Research Paper Writing?

Different Types of Research Gaps

Identifying research gaps is essential for advancing knowledge in any field. Research gaps are areas where more information is available or existing research needs to be more consistent or conclusive. Here are different types of research gaps:

• Evidence Gap

This gap occurs when no empirical evidence supports certain theories, practices, or interventions. It can also refer to areas where existing studies need to sufficiently cover the topic or lack rigorous methodological approaches.

Example: A need for randomized controlled trials on the effectiveness of a new drug.

• Knowledge Gap

This gap refers to areas where there is a deficiency in understanding or awareness about a particular topic. It can be due to outdated information, incomplete research, or the absence of research on emerging issues.

Example: Limited knowledge about the long-term effects of exposure to new environmental pollutants.

• Theoretical Gap

Theoretical gaps arise when existing theories do not fully explain certain phenomena or when there is a lack of theoretical frameworks to guide research in a particular area.

Example: More theoretical models need to be developed to explain the psychological impacts of social media usage on teenagers.

• Methodological Gap

Methodological gaps exist when current research methods are inadequate for addressing certain research questions or when there is a need for new or improved methodologies.

Example: More robust qualitative methods are needed to study the experiences of marginalized communities.

• Population Gap

This type of gap occurs when certain populations are underrepresented in research. It can involve demographics like age, gender, ethnicity, socioeconomic status, or geographic location.

Example: Lack of research on the mental health of older adults living in rural areas.

Geographical Gap

Geographical gaps refer to areas or regions that are under-researched. These gaps highlight the need for studies in different geographic contexts to understand local issues better.

Example: Limited studies on the effects of climate change in the Arctic regions.

Strategies to Identify Research Gaps:

• Literature Reviews: Comprehensive reviews can help identify where current research is lacking or inconsistent.
• Systematic Reviews and Meta-Analyses: These methods provide a structured approach to synthesize existing research and identify gaps.
• Expert Consultations: Discussions with experts in the field can uncover areas that require further investigation.
• Research Databases: Utilizing databases and citation analysis tools to track research trends and identify under-researched areas.
• Interdisciplinary Approaches: Engaging with multiple disciplines can reveal gaps that are not apparent within a single field.

Understanding and addressing these gaps is crucial for advancing research and knowledge across various domains.

Read More: How To Get A+ Grade In Research Paper?

What is a Research Gap Example?

A Research Paper Example gives you a very clear idea of how to find your research gaps and examples in textual forms. A few examples are given below:

• Context Healthcare: Although there have been enough researchers on the management of diabetes, there has been a research gap in understanding the impact of digital health interventions in the rural areas of Europe.
• Content environmental science: In a wealth of research regarding the huge environmental pollution caused by the use of plastics, there are fewer findings of how the plastic material really accumulates in certain areas like lakes, rivers, etc. and why these materials are never biodegradable.
• Context Education: The empirical research surrounding the online mode has become tremendously popular over the past few years. However, there needs to be more solid studies regarding the impact of the online learning process on the students who need special education. In each of these examples, you can see that the writer begins by acknowledging the preexisting reach results and then explains thoroughly the present area where the research gap really exists.

Also Read: Why Research Is Essential For Students? 20 Common Reasons!

How to Find a Research Gap?

After getting a very clear idea of various types of research gaps, the vet’s next question comes to mind is how to find a research gap. There is a basic 2 step strategy to find the research gap.

In the beginning, you need to find a lot of literature reviews, meta-analyses, and systematic reviews covering your research area of interest. Moreover, it would help if you dug into the very recent journals for wrapping your head in your own knowledge area.

Here, you can also study the current theses and dissertations, especially those in the doctoral degree courses. A number of dissertation databases, such as Open Access, EBSCO, Pro-Quest, etc., are very useful in this regard. Here. You also need to ensure that you are always looking for the most recent sources.

After gathering a good collection of these resources, you need to focus on further research opportunities. In this section, you need to state explicitly where more studies are needed. It would help if you also looked at the present research study’s limitation areas and where the research gaps might exist.

Following this procedure will help you become oriented to the present research area. This can serve as a foundation for finding the potential research gaps. Then, you need to shortlist the main ideas and evaluate them as per the given topic. It would help if you also looked only for the recent articles here.

Also Read:  Expert Literature Review Writing Services

How to Deal with Literature Gap?

In any project, a literature review is always very important. It helps you in identifying your excusing knowledge, methods and theories in your own field. However, conducting a literature review has its own challenges.

• Defiling your research question: The very first step is to define your own research question very clearly and briefly. It will help you narrow your scope and focus on the crucial sources. It would help if you used less information here. Your research must always be very specific, answerable, and original. The research project always needs to have real objectives and a purpose.
• Searching and selecting the sources: Your next step is to search and select the sources. That is very much reliable and relevant to your research field. There are a number of databases, like keywords, search engines, etc., related to your study field. However, there are also a lot of limitations to these tools, like currency, coverage, and quality of the sources. Here, certain criteria have to be applied to filter the sources, such as relevance, authority, timeline, and accuracy of the information.
• Analyzing and synthesizing the literature: This is the third step, where you need to analyze and synthesize the literature you selected. Here, you need to summarize the sources and compare, contrast and critique them. In this section, you also need to look for the similarities and differences, the strengths and weaknesses, and the gaps and inconsistencies of the literature review paper. The writers can also identify the major trends, themes, and debates in the discussed field. These should also be related to your research question.
• Fill in the gaps after identifying them: This is the 4th step to filling the literature review research paper. This gap needs to be addressed or is under the researched area and is to be addressed by you with the help of your knowledge. These gaps can be filled by looking for the limitations, contradictions or controversies in the review. You can also do this by asking new questions or proposing new ideas. The gaps can also be filled by providing the newest evidence, arguments or even insights related to your field of study.
• Organizing and structuring the literature review: This is the 5th step of your review, where you need to organize and structure the whole paper in a compact and logical manner. Here, you always need to follow certain guidelines as given by your institute and use the best style and font. Proper headings, subheading citations, and traditions should also be used here. This will help your readers follow your arguments and understand what you want to say. A very clear introduction should also be written, along with a good conclusion and summary to highlight your writing.
• Refining and Revising: The literature review is the final step of writing your literature review. Here, you need to ensure that your review is quite accurate, concise and clear. You must check your literature review thoroughly to make it free from errors, gaps, or inconsistencies in language, content, or presentation. Here, you can also seek feedback from your peers, experts or supervisors in your own field. Their suggestions will help you in performing well. The whore literature review should be thoroughly proofread and edited before the final submission.

Last but not least, never copy from any source; it will be considered plagiarism, and your paper will be cancelled then and there. Thus, write only from your own creativity and not from the writing and articles of other writers.

Read More: Dissertation Literature Review For Masters & PhD

Final Words

Writing a research paper is a challenging task. It would help if you had a lot of Research Skills to accomplish it. You will be given a Research topic on which you have to write. Your ultimate aim in writing the research paper is to get the top grade. This can be done by availing of the best online Case Study Help Service from a reliable provider. The Casestudyhelp is the best choice for you in this respect.

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Different Types of Research Gaps in Literature Review

Know the Types of Research Gaps in Research

If you are a budding researcher, the foremost challenge that stands before you is the identification of a remarkable and novel research topic in your field of study. Some scholars find a note-worthy research problem while many struggles to identify an interesting research problem. Identification of a novel research problem is the first and most vital step to start a research work. Therefore, to help the scholars’ iLovePhD has published an article on “ How to identify research gap ”, wherein the tips for identification of a gap in research are also explained. In this article, the different types of research gaps in the literature review are presented.

Scholars need to understand the difference between research gap and research problem.

“ A research gap is a key problem or a question that has not been answered by any of the existing studies within your area of research.” ilovephd.com

“A research problem is a constructed statement which is developed from a research gap and it should clearly describe the novelty of your study.” ilovephd.com

Different Types of Research Gaps in the Literature Review

According to Robinson, Saldanhea & McKoy (2011), Muller-Bloch, & Kranz (2015), and Miles (2017), the research gap has been classified into seven categories.

Evidence gap : Little or no evidence to address the research problem.

Knowledge gap : Knowledge may not exist in the actual field. It might be the case that the result of a study differs from what was expected.

Practical-Knowledge gap : When professional behavior or practices deviate from research findings or are not covered by the research.

Methodology gap : A distinction in research methods is needed to have new insights or to avoid ambiguous findings.

Empirical gap : Research findings need to be evaluated or empirically verified.

Theoretical gap : Theory should be applied to certain research issues to generate new insights; lack of theoretical knowledge may lead to a gap in research.

Population gap : Type of research gap that deals with a population which is not adequately represented or under-researched in the prior research (Eg., Gender, age, race).

We hope this article makes you understand the different types of research gaps in the literature review.

• Literature Review
• Research Gaps
• Types of Research Gaps

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Education: Lit Review + Methods

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• Children's Literature
• Lit Review + Methods
• Praxis Prep
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What is a Literature Review?

A literature review is a comprehensive and up-to-date overview of the principal research about the topic being studied. Your literature review should contain the following information:

• The most pertinent studies and important past and current research and practices in the field
• An overview of sources you have explored while researching a particular topic
• An explanation to your readers as to how your research fits within a larger field of study.

The review helps form the intellectual framework for the study.

17 - what is a literature review  from  Joshua Vossler  on  Vimeo .

Why do a Literature Review?

At its core, a literature provides a summary of existing knowledge on a subject or topic and identifies areas where research is lacking: missing information, incomplete studies or studies that draw conflicting conclusions, or perhaps even outdated methods of research.

This can be especially helpful if you intend to conduct research of your own on this topic; by explaining where the previous studies have fallen short or leave openings for further examination, you provide a strong foundation and justification for the research project you intend to embark on.

Literature reviews can stand on their own as an article or assignment for a class, or they can serve as an introduction to a larger work, such as an article describing a study or even a book. They can also vary in granularity: a literature review in the beginning of an article might only summarize the largest or most influential studies, while an academic literature review will not only describe the research so far but look for common themes, analyze the quality of the research, and explain gaps where further research is needed.

Elements of a Successful Literature Review

When preparing your literature review, keep these questions in mind:

• What is your literature review about?
• Why are you studying this topic?
• How will you organize your sources?  (You could group them by themes or subtopics, or perhaps keep them in chronological order. The way you present your sources is important, so make sure you think hard about this!)
• What are the major themes/subtopics that you discovered when reading your sources?
• Where could more research be done to increase our understanding of this topic?

For each individual source, be prepared to analyze:

• Who were the key researchers and what are their qualifications?
• How was the research conducted?
• The similarities and differences between this source and the others in your literature review
• How this source contributes to greater understanding of the topic as a whole
• Any questions you have about the research done, which could identify opportunities for further study

When preparing your literature review, examine these elements and determine which ones would be best for your paper. (Tip: If you're not sure which parts of the literature review to include, ask your professor!)

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SOC 200 - Sims: How to Write a Lit Review

• What are Literature Reviews?
• How to Write a Lit Review
• How to Choose a Topic
• Finding the Literature

How to write a literature review

Below are the steps you should follow when crafting a lit review for your class assignment.

• It's preferable if you can select a topic that you find interesting, because this will make the work seem less like work. 
• It's also important to select a topic that many researchers have already explored. This way, you'll actually have "literature" to "review."
• Sometimes, doing a very general search and reading other literature reviews can reveal a topic or avenue of research to you. 
• It's important to gain an understanding of your topic's research history, in order to properly comprehend how and why the current (emerging) research exists.
• One trick is to look at the References (aka Bibliographies aka Works Cited pages) of any especially relevant articles, in order to expand your search for those same sources. This is because there is often overlap between works, and if you're paying attention, one source can point you to several others.
• One method is to start with the most recently-published research and then use their citations to identify older research, allowing you to piece together a timeline and work backwards. 
• Chronologically : discuss the literature in order of its writing/publication. This will demonstrate a change in trends over time, and/or detail a history of controversy in the field, and/or illustrate developments in the field.
• Thematically : group your sources by subject or theme. This will show the variety of angels from which your topic has been studied. This method works well if you are trying to identify a sub-topic that has so far been overlooked by other researchers.
• Methodologically : group your sources by methodology. For example, divide the literature into categories like qualitative versus quantitative, or by population or geographical region, etc. 
• Theoretically : group your sources by theoretical lens. Your textbook should have a section(s) dedicated to the various theories in your field. If you're unsure, you should ask your professor.
• Are there disagreements on some issues, and consensus on others?
• How does this impact the path of research and discovery?
• Many articles will have a Limitations section, or a Discussion section, wherein suggestions are provided for next steps to further the research.
• These are goldmines for helping you see a possible outlook of the situation. 
• Identifying any gaps in the literature that are of a particular interest to your research goals will help you justify why your own research should be performed. 
• Be selective about which points from the source you use. The information should be the most important and the most relevant. 
• Use direct quotes sparingly, and don't rely too heavily on summaries and paraphrasing. You should be drawing conclusions about how the literature relates to your own analysis or the other literature. 
• Synthesize your sources. The goal is not to make a list of summaries, but to show how the sources relate to one another and to your own analysis. 
• At the end, make suggestions for future research. What subjects, populations, methodologies, or theoretical lenses warrant further exploration? What common flaws or biases did you identify that could be corrected in future studies? 
• Common citation styles for sociology classes include APA and ASA.

Understanding how a literature review is structured will help you as you craft your own. 

Below is information and example articles that you should review, in order to comprehend why they are written a certain way.

Below are some very good examples of Literature Reviews:

Cyberbullying: How Physical Intimidation Influences the Way People are Bullied

Use of Propofol and Emergence Agitation in Children

Eternity and Immortality in Spinoza's 'Ethics'

As you read these, take note of the sections that comprise the main structure of each one:

• Introduction 
• Summarize sources
• Synthesize sources

Below are some articles that provide very good examples of an "Introduction" section, which includes a "Review of the Literature."

• Sometimes, there is both an Introduction section, and a separate Review of the Literature section (oftentimes, it simply depends on the publication)

Krimm, H., & Lund, E. (2021). Efficacy of online learning modules for teaching dialogic reading strategies and phonemic awareness.  Language, Speech & Hearing Services in Schools,  52 (4), 1020-1030.  https://doi.org/10.1044/2021_LSHSS-21-00011

Melfsen, S., Jans, T., Romanos, M., & Walitza, S. (2022). Emotion regulation in selective mutism: A comparison group study in children and adolescents with selective mutism.  Journal of Psychiatric Research,  151 , 710-715.  https://doi.org/10.1016/j.jpsychires.2022.05.040

Citation Resources

• MU Library's Citing Sources page
• Purdue OWL's APA Guide
• APA Citation Style - Quick Guide
• Purdue OWL's ASA Guide
• ASA Citation Style - Quick Tips

Suggested Reading

• How to: Conduct a Lit Review (from Central Michigan University)
• Purdue OWL Writing Lab's Advice for Writing a Lit Review

How to Read a Scholarly Article

 read:.

• Things to consider when reading a scholarly article This helpful guide, from Meriam Library at California State University in Chico, explains what a scholarly article is and provides tips for reading them.

  Watch:

• How to read a scholarly article (YouTube) This tutorial, from Western University, quickly and efficiently describes how to read a scholarly article.
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• Systematic Review
• Open access
• Published: 27 September 2024

Factors influencing the formation of balanced care teams: the organisation, performance, and perception of nursing care teams and the link with patient outcomes: a systematic scoping review

• Senne Vleminckx   ORCID: orcid.org/0000-0001-9647-4785 1 ,
• Peter Van Bogaert 1 ,
• Kim De Meulenaere 2 ,
• Lander Willem 3 , 4 &
• Filip Haegdorens 1  

BMC Health Services Research volume  24 , Article number:  1129 ( 2024 ) Cite this article

Metrics details

The composition of care teams is crucial for delivering patient-centered healthcare, yet assembling a well-balanced team remains a challenge. This difficulty stems from the intricate dynamics of team capacity, culture, context, and the demands of the job. The current literature offers limited guidance for decision-makers on how to effectively navigate these dynamics to compose a balanced care team.

We conducted a systematic scoping review of literature spanning from 2009 to 2022. The aim was to identify factors that significantly influence the work environment, team performance, nursing outcomes, and patient outcomes within healthcare settings. Our review focused on extracting and synthesizing evidence to uncover these influencing factors.

Our analysis identified 35 factors that play a significant role in shaping the work environment and influencing team performance, nursing outcomes, and patient outcomes. These factors were categorized into nine key domains: workload, leadership, team composition, stress and demands, professional relationships, safety, logistics and ergonomics, autonomy and responsibility, and transparency and task clearness.

Conclusions

To improve patient care and nursing job satisfaction, policymakers and decision-makers can consider these influencing factors in the design and management of care teams. The findings advocate for strategic adjustments in these domains to enhance a team’s balance. Furthermore, our review underscores the need for further research to fill the identified gaps in knowledge, offering a directive for future studies into optimal care team composition. This systematic approach to team composition can significantly impact patient outcomes and nurse satisfaction, providing a roadmap for creating more effective and harmonious teams.

Peer Review reports

Nursing staff constitute half of the global healthcare workforce. However, there are growing concerns about chronic nursing shortages and high turnover rates in many healthcare organizations. Several countries have reported an increasing gap between the number of practicing nurses and the rising needs of the population due to aging populations and a growing burden of chronic diseases [ 1 , 2 , 3 , 4 ]. These factors have resulted in a quantitative shortage of nurses, which is further exacerbated by high turnover rates [ 5 ], global competition for skilled workers [ 6 ], and nurses’ growing preferences for alternative jobs [ 7 , 8 , 9 ]. In addition, care complexity is increasing due to highly demanding technological innovations [ 10 ] and patient-tailored healthcare, which increases the need for qualified and well-trained staff in changing environments [ 11 ]. The World Healthcare Organization (WHO) estimated a 7.6 million shortfall in nurses by 2030 [ 12 ]. The COVID-19 pandemic proved to be a catalyst for accelerated levels of absenteeism and nurses who permanently leave the profession [ 13 ].

Understaffing and suboptimal skill-mix within care teams could result in missed care, adverse patient outcomes including mortality, and failure to rescue [ 14 , 15 , 16 , 17 ]. The latter also affects nursing staff outcomes such as job satisfaction, potentially leading to increased staff turnover [ 18 , 19 ].

Attracting and, most importantly, retaining nurses is an important global challenge [ 20 ]. Policymakers attempt to address the need for qualified staff by increasing the number of nurses entering the workplace as a first key strategy. However, simply increasing the supply of nurses will be insufficient to address the current staffing problems in healthcare [ 3 , 21 ]. Previous research has shown that experienced and highly educated nurses are essential to provide high-quality care [ 22 , 23 , 24 ]. Therefore, a second and complementary strategy to cope with limited nursing staff is to focus on the composition of care teams and to optimize care through the appropriate allocation of nursing skills across teams. Research has shown that nurses are sometimes overqualified for some tasks, which indicates options for improvement [ 21 ].

At this moment, many decision-makers lack the tools to address the complex interactions between a team’s capacity and job demands and the role of culture and context. As such, building a balanced team adapted to their specific context and the needs of their patient population is complex, although it improves the quality of care and potentially the retention of experienced staff [ 20 ]. In a balanced care team, there is a strategic alignment among the team’s capacity, its operational processes, and the demands of care, all aimed at optimizing outcomes for both the team and the patients. This approach underscores the importance of maintaining a crucial equilibrium between the capabilities of the team and their assigned tasks. It ensures that the design of work systems enhances patient safety, promotes the well-being of staff, and boosts organizational effectiveness. By maintaining this balance, balanced care teams contribute to the sustainability of high-quality care and the achievement of positive outcomes for both healthcare providers and patients.

Despite the potential benefits of a balanced care team, there is currently discussion on how to optimally compose such a team or which factors should be taken into consideration. Additionally, the interactions between these factors can be complex and not well understood. By better understanding which factors influence the development of a balanced care team and how the factors interrelate, healthcare organizations can develop more data-driven strategies to attract and retain nurses, improve patient outcomes, and promote job satisfaction among healthcare professionals.

The objective of this systematic scoping review is to comprehensively examine the literature on the elements that contribute to the formation of balanced healthcare teams, guided by Donabedian’s model [ 25 ] which organizes healthcare quality into three interconnected domains: structure, process, and outcomes. The structure encompasses the characteristics of the healthcare settings and impacts the work environment; the process includes the interactions between patients and providers, reflecting team performance; and the outcomes represent the health effects on patients and nursing staff, aligning with our focus on their respective outcomes. This review aims to explore the interrelationships among the structural conditions of the work environment, the processes of team performance, and the resulting outcomes, offering insights into what could make or break high-performance and balanced care teams and to identify variables that could be effectively utilized in practice to enhance both care quality and workforce stability.

This systematic scoping review was conducted with the guidance of the Preferred Items in Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) [ 26 ].

Data sources and search strategy

Starting from the definition of balanced working teams outlined in the introduction and guided by Donabedian’s model [ 25 ], we identified four dimensions to be included in the search query: work environment, team performance, nurse outcomes, and patient outcomes. In this review, “dimensions” refer to broad categories that encapsulate various factors influencing the functioning of balanced care teams. This terminology is intended to capture the multifaceted nature of these factors, reflecting the broader scope of their impact beyond singular outcomes. By categorizing these aspects as dimensions, we aim to highlight their interconnected roles in shaping the overall performance and effectiveness of healthcare teams, consistent with the holistic approach of the balanced care team framework. In line with PRISMA-ScR guidelines, eligibility criteria were determined by three researchers (SV, FH and PvB) prior to screening. Based on these eligibility criteria and exploratory searches, we defined the queries presented in Fig.  1 . We searched for papers in PubMed and ISI Web of Knowledge on factors influencing the work environment on November 9th, 2022. We restricted the search to papers published from June 2009 onward to obtain information related to the current situation in the continuously evolving healthcare system. Original research papers (quantitative, qualitative, and mixed methods) and reviews were included when they focused on factors influencing the organization of nursing care teams on the work environment and/or team performance and/or nurse outcomes and/or patient outcomes. Papers were excluded if they did not concern the organization of care teams, did not discuss influencing factors or if no significant effects were found.

The search query for the Pubmed and ISI Web of Knowledge databases used on November 9th, 2022

Identification of articles and data extraction

Two researchers independently screened titles, abstracts, keywords, and full texts if necessary to assess the eligibility of the paper (SV and FH). Discrepancies were resolved through discussion with a third reviewer (PvB). During the full-text screening, SV and FH used an electronic matrix to facilitate a structured and systematic extraction of data from each study. The matrix required them to input detailed information about each study, starting with the methodology employed. This included specifying the type of study design (e.g., RCT, cross-sectional, longitudinal), the population studied, and the setting. Next, this process involved identifying the independent variables examined in each study, ensuring a comprehensive understanding of the factors being investigated. Furthermore, our analysis extended to categorizing the impact of these independent variables on the four dimensions of this review: work environment (e.g., the physical work environment, physician‒nurse relations, organizational support, etc.), team performance (e.g., teamwork, team efficacy, task performance, etc.), nurse outcomes (any outcome related to the work attitude or behavior of nurses or affiliated staff:, e.g., job satisfaction, burnout, etc.) and patient outcomes (all outcomes that affect patients, e.g., nurse-sensitive outcomes, mortality, etc.). Lastly, the electronic matrix facilitated the recording of exclusion reasons or supported the inclusion decision-making process. The list of influencing factors was iteratively refined during data extraction by employing a thematic combination approach. This method involved grouping individual factors into broader domains based on their thematic similarities or their interconnectedness within the context of the research findings. The iterative nature of this refining process meant that the list of influencing factors was dynamic as we delved deeper into the literature. Discrepancies in the categorization or interpretation of factors were resolved by a third reviewer (PvB), whose role was to provide an additional layer of scrutiny and consensus, thereby ensuring the reliability and accuracy of the analysis.

Using the online databases PubMed and ISI Web of Knowledge, we identified 2,394 unique articles published between 2009 and 2022 that matched our search criteria. Based on the screening of the title, abstract and keywords with predefined eligibility criteria, we excluded 1,909 articles. Of the remaining 485 full-text articles, we excluded another 122 for which the topic did not concern the organization of care teams, if no influencing factors were studied, no significant effect was found, or if no full text could be retrieved. Finally, 363 studies were included for data extraction and qualitative synthesis. The PRISMA-ScR diagram is shown in Fig.  2 . Due to the large number of included articles, we did not include a citation for every article but provided one reference as an example in the Results section and provided a summary table in Appendix 1 with a complete set of references including study characteristics.

PRISMA-ScR flow diagram of the scoping review process

Study setting

Among the 363 included studies, we found that most of the research was conducted in the acute hospital care setting and in residential care (Table 2 ). A minority of the included papers were carried out in home care (8 articles), revalidation care (9), geriatric care (13) and psychiatric care (18). A descriptive cross-sectional design was used in nearly 70% of studies. In contrast, an experimental study design (RCT, CT) was used in only two included studies. We included 3 meta-analyses and 36 systematic reviews using qualitative data synthesis. Most of the literature has focused on nursing and patient outcomes. Table 1  outlies the number of included articles per context, per evidence level and per studied dimension.

Influencing factors

We utilized a matrix to compile a comprehensive list of factors that influenced the nursing team, the work environment, team performance, and patient outcomes. In total, we identified 35 such factors. As shown in Table 2 , we classified these factors into nine overarching domains: (1) autonomy and responsibility, (2) leadership, (3) logistics and ergonomics, (4) professional relations, (5) stress and physical demands, (6) team compositions, (7) transparency and task clearness, (8) safety, and (9) workload. Not surprisingly, the domain that has received the most research attention is the workload domain ( n  = 298), mostly with a focus on nurse staffing levels ( n  = 206). The two other frequently studied domains are leadership ( n  = 212) and team composition ( n  = 171), the latter with a clear focus on the impact of the educational level of nurses ( n  = 71). The least studied domain was that of transparency and task clearness, yet 23 studies have been published in the area. For the three largest domains (workload, team composition and leadership), Fig.  3 displays the number and evolution of published papers over the period between 2009 and 2022 and demonstrates a noticeable rise in the number of papers, particularly since 2019. To improve the readability of the graph, we only included the three largest domains, although we discuss all domains in the main text. In what follows, we will discuss the literature and research findings for each of these nine domains.

The number of studies included in select domains over time. Legend: Green: Blue: Leadership; Workload; Grey: Team composition. The gray marked area represents the Covid-19 pandemic

Autonomy and responsibility

We found a link in the literature between professional autonomy and educational level, the involvement of direct managers, transformational leadership, and the nurse‒physician relationship [ 27 ]. Unclear responsibilities were identified as counteractive and researched in combination with team composition and leadership [ 28 ]. The papers in this domain focus predominantly on nurse and patient outcomes. Notably, autonomy and responsibility have demonstrated a positive impact on job satisfaction [ 29 ].

Within this domain, we found papers on transformational leadership. In 68% of the included studies, this was linked with the involvement of direct managers (listening to concerns, acknowledgment of problems, and inspirational leadership) [ 28 ]. A management style focused on engaging and empowering nurses has shown a positive effect on both nurse and patient outcomes and has often been studied simultaneously with the involvement of direct managers and transformational leadership [ 30 ]. Seven studies found an effect of the conflict management style of the direct managers and the organization on the outcome measures. The impact on organizational decision-making, perceived trust in management and unfair treatment by management were described as important for nursing team outcomes [ 31 ] and patient outcomes [ 30 ]. Finally, adequate conflict management by the direct manager and a qualified and trusted chief nursing officer (CNO) mostly described the nurse outcomes and team performance.

Logistics and ergonomics

This domain covers the lack of (up-to-date) medical and nursing equipment and the physical work environment of nurses. These factors mainly influence patient outcomes, the work environment and nursing outcomes. However, there was one study that found an effect on team performance, where (physical) work organization had a positive influence on team performance and reduced care left undone [ 32 ]. Several studies where logistics and ergonomics were found to have an effect were conducted on job (dis)satisfaction [ 33 ] and burnout [ 34 ].

Professional relations

Nursing teams encounter many types of interactions and professional relationships. The physician‒nurse relationship has been proven to influence all four dimensions, although most studies focus on nurse outcomes. A positive relationship with physicians has a positive impact on nurses’ job satisfaction [ 35 ] and their intention to leave [ 35 ] and reduces burn-out [ 36 ], mortality [ 37 ] and other outcomes. The relationship between nurses and patients and their families influences both nurse and patient outcomes [ 38 ]. Two studies also showed a link with team performance.

Stress and physical demands

All four studied dimensions were significantly linked with perceived work-related stress and moral or physiological stress due to patient care in combination with emotional and physical demands. In particular, nurse outcomes have been described in various nursing contexts [ 29 ]. Work-life balance in this domain is considered an influencing factor, for example, the effect of a healthy work-life balance on occupational fatigue [ 39 ]. However, work-life balance is also a nurse outcome measure influenced by shift working [ 39 ], overtime [ 40 ] and lack of control [ 27 ]. Therefore, work-life balance is considered a mediator: shift work, overtime and lack of control influence work-life balance, which in turn influences occupational fatigue. The benefits and rewards nurses receive (e.g., salary) had an impact on job (dis)satisfaction and intention to stay [ 41 ].

Team composition

The educational level of nurses within a team had a clear positive effect on patient outcomes and has been researched extensively in acute hospitals and residential care [ 14 ]. Some papers have also shown the effect on nurse outcomes [ 39 ]. In 31 of the identified papers, the educational level was researched jointly with the nurse staffing level. Team cohesion and climate showed an effect on all four dimensions. It relates to the involvement of direct managers and nurse‒physician relationships [ 42 ]. In addition, some studies have discussed the impact of team ‘coreness’, which denotes whether one is in the right team, place, and time [ 30 ]. The deployment of supplemental or agency nurses showed a negative effect on patient outcomes in nine studies [ 43 ]. Only a small number of studies have investigated the effect of team demographics on patient and nurse outcomes, although they have reported significant effects [ 44 ]. Figure  3 shows that the research domain of the composition of care teams is gaining interest in the research community. Especially since 2019, we can see an increasing number of publications about this topic.

Nurse-perceived staffing levels (nurse-reported unsafe staffing situations) were reported to impact both patient and nurse outcomes negatively and are influenced by leadership (involvement of direct managers, impact on organizational decisions and nurse engagement) [ 45 ], nurse staffing levels [ 46 ] and nurse‒physician relations [ 47 ]. It has been described in two systematic reviews regarding the organizational context of nursing [ 45 , 48 ]. Safety culture within a nursing team clearly affects patient outcomes [ 49 ] as well as other dimensions. There was also a link between safety culture and leadership [ 50 ], but we did not find links with the nurse‒physician relationship.

Transparency and task clearness

The domain with the lowest number of retrieved studies consists of two influencing factors: frequent and clear communication and the availability of guidelines or protocols. Whether communication is clear and timely has been linked to all four dimensions and is affected by the physician‒nurse relationship and the involvement of a direct manager [ 48 ]. There was no specific dimension that stood out, given the limited amount of literature on this topic.

Most retrieved research identified an effect between staffing levels and one or more of the four dimensions. The studies were conducted in all work contexts, and we also included one meta-analysis and 17 systematic reviews. A meta-analysis on nurse staffing and nurse outcomes [ 51 ] showed that higher nurse-to-patient ratios were consistently associated with a higher prevalence of burnout, increased job dissatisfaction, and higher intent to leave among nurses. There were disparities in how various papers measured and reported nurse staffing levels, such as the nurse-to-patient ratio, nursing hours per patient day and bed-to-nurse ratio. In 71% of the papers included, there was evidence of the impact of nurse staffing levels on patient outcomes and 26% on nurse outcomes. Shift working influences both nurse and patient outcomes [ 39 ] and has a negative impact on nurses’ work-life balance. It was often jointly investigated with overtime and nurse staffing levels [ 39 ]. The negative effects of workload, shift work and overtime have been shown on patient and nursing outcomes in acute hospitals. High workload also causes care to be left undone, which represents missed, unfinished, or incomplete care, and the effect on patient outcomes is apparent from the literature. As with work-life balance, care left undone is a mediator between workload (e.g., staffing levels) and patient outcomes [ 52 ]. Furthermore, it also has a negative impact on nurse outcomes [ 41 ] (e.g., job dissatisfaction) and the nursing work environment [ 53 ]. Studies focusing on job (dis)satisfaction and intention to leave found a link with workload and emphasized the benefits and rewards of a balanced workload on nurse outcomes.

This systematic scoping review presents an overview of the existing body of knowledge regarding the factors affecting the organization of balanced care teams published between 2009 and 2022. We identified 35 influencing factors that, according to the extant research, have a significant effect on the four dimensions under study, i.e., work environment, team performance, nurse outcomes and patient outcomes. We categorized these factors into nine overarching domains: (1) autonomy and responsibility, (2) leadership, (3) logistics and ergonomics, (4) professional relations, (5) stress and physical demands, (6) team compositions, (7) transparency and task clearness, (8) safety, and (9) workload.

The relationships between the dimensions of work environment, team performance, nurse outcomes, and patient outcomes are inherently complex, and the direction of causality may vary. For example, a supportive work environment can enhance team performance, which in turn positively affects nurse and patient outcomes, demonstrating the bidirectional and dynamic nature of these relationships. Although all four dimensions are important, we know from research that particularly the work environment and team performance seem key to retaining a skilled workforce. Bae et al. [ 54 ] showed that turnover has a serious economic impact on hospitals caused by reduced productivity, the need to hire and train new nurses, and the costs associated with vacancies and temporary replacement. Therefore, optimizing the nursing work environment and supporting a team’s performance can help retain more experienced nurses in the workforce. One way to achieve this is by designing the work system in such a way that there is a balance between a team’s demands and its resources [ 55 ]. The design of work systems in nursing care is predominantly determined by tasks or specific actions in operational care delivery. They are supported by tools and technology, effective organizational design, collaboration, coordination, and the physical work environment. These work systems, in turn, influence patients, care providers and organizational outcomes [ 56 ].

In a balanced care team, there is a strategic alignment among the team’s capacity (e.g., staffing, educational level, support, etc.), its operational processes, and the demands of care (e.g., the complexity of care, patient turnover, physical demands, etc.), all aimed at optimizing outcomes for both the team and the patients. Intuitively, balanced care teams have the capacity to adapt their work system and processes to improve care based on their feedback and learning strategies as a resilient workforce [ 57 , 58 , 59 ].

Some of the factors identified in this review are used to inform decisions by nursing leaders and policymakers. To date, software tools exist to assess patient demand and care team characteristics (absenteeism, vacancies, staff leave) or to estimate and optimize team compositions [ 60 ], for example, based on mandatory staffing levels. However, these systems need to be adjusted to the context and need governance by management to be used for staff deployment [ 61 ]. In the future, nurse leaders will have to work with large volumes of organizational and patient data. An overview of the influencing factors on the performance of nursing teams could offer guidance and support to make decisions on staffing and competencies [ 62 ]. The integration of metrics measuring these factors in a decision support system could be beneficial for decision-makers if clinicians agree on the importance, availability, and impact of those metrics.

Strengths and limitations

To the best of our knowledge, this is the first study to review evidence about all influencing factors in the organization of nursing care teams, their work environment, team performance and nurse as well as patient outcomes. The review process followed the PRISMA-ScR protocol [ 26 ] to ensure the quality of reporting.

Nevertheless, this study is, like others, not without limitations. Foremost among these is the methodological challenge associated with our comprehensive approach to literature inclusion in this scoping review. Given our objective to encompass all relevant literature, a critical appraisal of the included articles to assess the quality of evidence was beyond our scope. Consequently, we are cautious in making definitive conclusions regarding the evidence quality. Notably, a significant majority of the studies we reviewed (70%) employed descriptive cross-sectional designs. While this design offers numerous advantages, such as the ability to provide a snapshot of phenomena at a specific point in time and contribute to hypothesis generation, it inherently limits the ability to establish causality [ 63 , 64 ]. The prevalence of descriptive and cross-sectional studies in our review mirrors the current research landscape within our field, where such methodologies are often favored for their practicality and accessibility. However, this trend underscores a critical gap in the literature – the need for more longitudinal and experimental designs that can more effectively study causal relationships and assess intervention outcomes. Addressing this gap should be a priority for future research, with a focus on integrating higher-quality evidence through more robust study designs. This would significantly enhance our ability to draw causal inferences and advance the field’s understanding of effective interventions and their impacts.

In addition, there are inconsistencies regarding the measurements used in the literature. For example, in both academic consensus and general practice, a lack of agreement exists on how to measure and report nurse staffing levels. Nurse staffing levels are measured by nursing hours per patient day, nurse-to-patient ratio, bed-to-nurse ratio, etc. Standardized reporting of nurse staffing levels will allow comparisons between study results as well as the opportunity to use more data analytics in healthcare. Moreover, by only including literature that showed a significant effect on one of the dimensions, the risk of publication bias exists. However, this scoping review aimed to provide nursing managers, academics, and policymakers with an overview of the current state of research and which domains proved to have a significant impact. As such, we prefer to focus on the influencing factors that are already found to inform policymakers, researchers, and nurse managers.

Second, we made a deliberate decision not to include papers about interventions, policies, and the consequences of the COVID-19 pandemic, based on the assumption that these crisis circumstances are not representative of future operational norms. Nevertheless, it is undeniable that the pandemic crisis has significantly heightened the relevance of the current research. We also recognize that the complex causes and effects of the pandemic on healthcare teams and patient care merit their own dedicated research endeavors, encompassing both comprehensive reviews and longitudinal studies. Future research should specifically address the unique challenges and adaptations brought about by the COVID-19 pandemic, as a separate focus would enable a more nuanced understanding of its impact. Such research could facilitate the development of targeted interventions and policies to enhance healthcare resilience and effectiveness in future crises, thereby addressing the gap left by our exclusion of pandemic-related literature.

Third, we acknowledge that the prevalence of various domains in the literature is not a measure of their significance or importance, as this can be distorted by the frequent use of the Practice Environment Scale of the Nursing Work Index (PES-NWI) in research. The PES-NWI is an instrument used to measure factors that enhance or attenuate a nurse’s ability to practice nursing skillfully and deliver high-quality care [ 65 ]. For example, nurse‒physician-relationship, staffing levels and leadership are part of the five subscales of PES-NWI: “nurse participation in hospital affairs”, “nursing foundations for quality of care”, “nurse manager ability, leadership, and support of nurses”, “staffing and resource adequacy” and “collegial nurse‒physician relations”. Although the PES-NWI is a widely recognized and reliable tool for assessing the work environment of nurses, our research highlights the need for decision-makers to consider additional factors that are crucial for assessing the nursing work environment. For example, team and organizational demographics have been extensively researched by management scholars [ 66 , 67 , 68 , 69 ].

Lastly, despite conducting an extensive search across two comprehensive databases, the specific nature of our search strings and the practical challenges of including all possible databases might lead to the inadvertent omission of relevant studies.

To promote a resilient workforce, ensure high-quality care, and enhance patient safety, it is essential to examine and integrate other influential factors that we have identified. Griffiths et al. (2020) [ 60 ] suggested that future research should concentrate on how to optimally utilize currently available staffing tools. Moreover, while the formation of balanced care teams is crucial, it is equally important to identify and address situations where capacity and demand are misaligned [ 70 , 71 ]. In addition, we recommend that future research should further investigate the concept of balanced care teams to fully comprehend its potential benefits and limitations. By doing so, decision support systems can incorporate this research and strive for balanced care teams by optimizing a team’s capacity to meet their specific demands while considering the context.

Additionally, to augment the robustness of healthcare research, future investigations should employ more rigorous methodologies, such as randomized controlled trials (RCTs) or longitudinal studies. It is also vital to standardize the measurement tools used across studies to ensure comparability and enhance the generalizability of findings. This approach will not only strengthen the validity of the findings but also facilitate their integration into broader meta-analyses, thereby enhancing their applicability in real-world settings. Furthermore, the development and application of comprehensive theoretical and organizational frameworks are recommended to enrich our understanding of the dynamics within healthcare teams. These frameworks should aim to integrate multifaceted aspects of healthcare delivery, providing deeper insights that can inform policy and practice. Finally, the theoretical framework of balanced care teams introduced in this scoping review should be subjected to empirical validation.

Marceau et al. [ 72 ] noted that the COVID-19 pandemic has intensified the existing healthcare crisis and posed a long-lasting burden on the healthcare system. Nevertheless, this crisis presents an opportunity for policymakers to address the shortage of nurses. We extensively reviewed 35 factors that impact nursing practice and organized them into nine overarching domains. We found that policymakers and decision-makers can modify several of these factors to attract and retain nurses.

Nursing leaders, in particular, can use these factors to create well-balanced teams by matching capacity with demand while considering the team’s context. This can lead to improved patient outcomes and heightened job satisfaction among nurses. To expand the knowledge in this area, future research should explore other elements beyond staffing levels. For instance, researchers could investigate the impact of team composition, which includes demographic characteristics, nurse autonomy, and work-life balance.

Availability of data and materials

The datasets generated and/or analyzed during the current study are available in the supplementary material.

Abbreviations

Chief Nursing Officer

19-coronavirus disease 2019

Clinical Trial

Institute for Scientific Information

NWI-Practice Environment Scale of the Nursing Work Index

ScR-Preferred Items in Systematic Reviews and meta-analysis extension for Scoping Reviews

Randomized Controlled Trial

Registered Nurse

World Health Organization

Blay N, Smith LE. An integrative review of enrolled nurse recruitment and retention. Collegian. 2020;27:89–94.

Article   Google Scholar  

Morioka N, Okubo S, Moriwaki M, Hayashida K. Evidence of the Association between Nurse staffing levels and patient and nurses’ outcomes in Acute Care hospitals across Japan: a scoping review. Healthc (Basel). 2022;10:1052.

Google Scholar  

Shembavnekar N, Buchan J, Bazeer N, Kelly E, Beech J, Charlesworth A, Fisher R. REAL centre projections. NHS workforce projections. London: The Health Foundation; 2022.

Studiedienst VDAB. Beroepen in cijfers. 2021. https://www.vdab.be/trendsdoc/beroepen/index.html . Accessed Mar 2021.

Lasater KB, et al. Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: an observational study. BMJ Open. 2021;11:e052899.

Article   PubMed   PubMed Central   Google Scholar  

Beyea SC. AORN’s response to the nursing shortage in perioperative settings. (headquarters Report). AORN J. 2002;76:236–40.

Article   PubMed   Google Scholar  

Barnett T, Namasivayam P, Narudin DA. A critical review of the nursing shortage in Malaysia. Int Nurs Rev. 2010;57:32–9.

Article   CAS   PubMed   Google Scholar  

Buchan J, Seccombe I, Gershlick B, Charlesworth A. Short supply: pay policy and nurse numbers. London: Health Foundation; 2017.

Shamsi A, Peyravi H. Nursing shortage, a different challenge in Iran: a systematic review. Med J Islam Repub Iran. 2020;34:8.

PubMed   PubMed Central   Google Scholar  

Simoens S, Villeneuve M, Hurst J. Tackling nurse shortages in OECD countries. Paris: OECD; 2005.

Garner CH, Boese SM. The case for bringing the licensed practical nurse back to the hospital. Nurs Adm Q. 2017;41:E1–4.

World Health Organization. Global strategy on human resources for health: workforce 2030. Geneva: World Health Organization; 2016.

Schug C, et al. Sick leave and Intention to quit the job among nursing staff in German hospitals during the COVID-19 pandemic. Int J Environ Res Public Health. 2022;19:1947.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Aiken LH, et al. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet. 2014;383:1824–30.

Ausserhofer D, et al. Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study. BMJ Qual Saf. 2014;23:126–35.

Ball JE, et al. Post-operative mortality, missed care and nurse staffing in nine countries: a cross-sectional study. Int J Nurs Stud. 2018;78:10–5.

Haegdorens F, Van Bogaert P, De Meester K, Monsieurs KG. The impact of nurse staffing levels and nurse’s education on patient mortality in medical and surgical wards: an observational multicentre study. BMC Health Serv Res. 2019;19:864.

Shader K, Broome ME, Broome CD, West ME, Nash M. Factors influencing satisfaction and anticipated turnover for nurses in an Academic Medical Center. JONA: J Nurs Adm. 2001;31(4):210–6.

Article   CAS   Google Scholar  

Van Bogaert P, et al. Predictors of burnout, work engagement and nurse reported job outcomes and quality of care: a mixed method study. BMC Nurs. 2017;16:5.

Van Bogaert P, Clarke S. Concepts: organization of nursing work and the psychosocial experience of nurses. Springer; 2018. pp. 5–47.

Drennan VM, Ross F. Global nurse shortages-the facts, the impact and action for change. Br Med Bull. 2019;130:25–37.

Aiken LH, et al. Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care. BMJ Qual Saf. 2017;26:559–68.

Blegen MA, Goode CJ, Park SH, Vaughn T, Spetz J. Baccalaureate education in nursing and patient outcomes. J Nurs Adm. 2013;43:89–94.

Estabrooks CA, Midodzi WK, Cummings GG, Ricker KL, Giovannetti P. The impact of hospital nursing characteristics on 30-day mortality. Nurs Res. 2005;54:74–84.

Donabedian A. Evaluating the quality of medical care. Milbank Q. 2005;83(4):691.

Tricco AC, et al. PRISMA Extension for scoping reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169:467–73.

Duffield C, Roche M, O’Brien-Pallas L, Catling-Paull C, King M. Staff satisfaction and retention and the role of the nursing unit manager. Collegian. 2009;16:11–7.

Hodroj B, Wayn KA, Scott TL, Wright AL, Manchha A. Does context count? The association between quality of care and job characteristics in residential aged care and hospital settings: a systematic review and meta-analysis. Gerontologist. 2023;63:1012–27.

Aloisio LD, Coughlin M, Squires JE. Individual and organizational factors of nurses’ job satisfaction in long-term care: a systematic review. Int J Nurs Stud. 2021;123:104073.

Williams B, et al. Evaluation of the impact of an augmented model of the productive Ward: releasing Time to Care on staff and patient outcomes: a naturalistic stepped-wedge trial. BMJ Qual Saf. 2021;30:27–37.

Bormann L, Abrahamson K. Do staff nurse perceptions of nurse leadership behaviors influence staff nurse job satisfaction? The case of a hospital applying for Magnet ® designation. J Nurs Adm. 2014;44:219–25.

Peterson H, Uibu E, Kangasniemi M. Care left undone and work organisation: a cross-sectional questionnaire-based study in surgical wards of Estonian hospitals. Scand J Caring Sci. 2022;36:285–94.

Atefi N, Abdullah KL, Wong LP, Mazlom R. Factors influencing registered nurses perception of their overall job satisfaction: a qualitative study. Int Nurs Rev. 2014;61:352–60.

Zhou W, et al. Job dissatisfaction and burnout of nurses in Hunan, China: a cross-sectional survey. Nurs Health Sci. 2015;17:444–50.

Alenazy FS, Dettrick Z, Keogh S. The relationship between practice environment, job satisfaction and intention to leave in critical care nurses. Nurs Crit Care. 2023;28:167–76.

Hanrahan NP, Aiken LH, McClaine L, Hanlon AL. Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals. Issues Ment Health Nurs. 2010;31:198–207.

Kang XL, Brom HM, Lasater KB, McHugh MD. The Association of Nurse-Physician Teamwork and Mortality in Surgical patients. West J Nurs Res. 2020;42:245–53.

Al Sabei SD, et al. Nursing work environment, turnover intention, Job Burnout, and Quality of Care: the moderating role of job satisfaction. J Nurs Scholarsh. 2020;52:95–104.

Butler M, et al. Hospital nurse-staffing models and patient- and staff-related outcomes. Cochrane Database Syst Rev. 2019;4:CD007019.

PubMed   Google Scholar  

Shin S, Oh SJ, Kim J, Lee I, Bae SH. Impact of nurse staffing on intent to leave, job satisfaction, and occupational injuries in Korean hospitals: a cross-sectional study. Nurs Health Sci. 2020;22:658–66.

Atefi N, Abdullah KL, Wong LP. Job satisfaction of Malaysian registered nurses: a qualitative study. Nurs Crit Care. 2016;21:8–17.

Park K, Jang A. Factors affecting the resilience of New nurses in their Working Environment. Int J Environ Res Public Health. 2022;19:5158.

Dall’Ora C, Maruotti A, Griffiths P. Temporary staffing and patient death in Acute Care hospitals: a retrospective longitudinal study. J Nurs Scholarsh. 2020;52:210–6.

Xie W, et al. The levels, prevalence and related factors of compassion fatigue among oncology nurses: a systematic review and meta-analysis. J Clin Nurs. 2021;30:615–32.

Ying L, Fitzpatrick JM, Philippou J, Huang W, Rafferty AM. The organisational context of nursing practice in hospitals in China and its relationship with quality of care, and patient and nurse outcomes: a mixed-methods review. J Clin Nurs. 2021;30:3–27.

Aiken LH, Fagin CM. Evidence-based Nurse staffing: ICN’s new position Statement. Int Nurs Rev. 2018;65:469–71.

van Oostveen CJ, Mathijssen E, Vermeulen H. Nurse staffing issues are just the tip of the iceberg: a qualitative study about nurses’ perceptions of nurse staffing. Int J Nurs Stud. 2015;52:1300–9.

Zhao Y, et al. Associations between work environment and implicit rationing of nursing care: a systematic review. J Nurs Manag. 2020;28:1841–50.

Hong S, Li Q. The reasons for Chinese nursing staff to report adverse events: a questionnaire survey. J Nurs Manag. 2017;25:231–9.

Cristina Gasparino R, Daiana Mendonça Ferreira T, Ceretta Oliveira H, Fernanda Dos Santos Alves D, Pazetto Balsanelli A. Leadership, adequate staffing and material resources, and collegial nurse-physician relationships promote better patients, professionals and institutions outcomes. J Adv Nurs. 2021;77:2739–47.

Shin S, Park JH, Bae SH. Nurse staffing and nurse outcomes: a systematic review and meta-analysis. Nurs Outlook. 2018;66:273–82.

Cho SH, Mark BA, Knafl G, Chang HE, Yoon HJ. Relationships between Nurse staffing and patients’ experiences, and the Mediating effects of missed nursing care. J Nurs Scholarsh. 2017;49:347–55.

Chaboyer W, Harbeck E, Lee BO, Grealish L. Missed nursing care: an overview of reviews. Kaohsiung J Med Sci. 2021;37:82–91.

Bae SH. Noneconomic and economic impacts of nurse turnover in hospitals: a systematic review. Int Nurs Rev. 2022;69:392–404.

Bakker AB, Demerouti E. The job demands-resources model: state of the art. J Managerial Psychol. 2007;22:309–28.

Holden RJ, et al. SEIPS 2.0: a human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics. 2013;56:1669–86.

Rieckert A, et al. How can we build and maintain the resilience of our health care professionals during COVID-19? Recommendations based on a scoping review. BMJ Open. 2021;11:e043718.

Van Bogaert P, Clarke S. Organizational predictors and determinants of nurses’ reported outcomes: evidence from a 10-Year program of Research. In: Van Bogaert P, Clarke S, editors. The organizational context of nursing practice. Cham: Springer International Publishing; 2018. pp. 49–100.

Chapter   Google Scholar  

Bogaert PV, et al. Staff empowerment and engagement in a magnet ® recognized and joint commission international accredited academic centre in Belgium: a cross-sectional survey. BMC Health Serv Res. 2018;18:756.

Griffiths P, et al. Nursing workload, nurse staffing methodologies and tools: a systematic scoping review and discussion. Int J Nurs Stud. 2020;103:103487.

Fagerström L, Kinnunen M, Saarela J. Nursing workload, patient safety incidents and mortality: an observational study from Finland. BMJ Open. 2018;8:e016367.

Enticott J, Johnson A, Teede H. Learning health systems using data to drive healthcare improvement and impact: a systematic review. BMC Health Serv Res. 2021;21:200.

Flynn M, McKeown M. Nurse staffing levels revisited: a consideration of key issues in nurse staffing levels and skill mix research. J Nurs Manag. 2009;17:759–66.

Wang X, Cheng Z. Cross-sectional studies: strengths, weaknesses, and recommendations. Chest. 2020;158:S65–71.

Swiger PA, et al. The Practice Environment Scale of the nursing work index: an updated review and recommendations for use. Int J Nurs Stud. 2017;74:76–84.

Paoletti J, Gilberto JM, Beier ME, Salas E. The role of aging, age diversity, and age heterogeneity within teams. Curr Emerg Trends Aging work. 2020;319–336.

Pfeffer J. Organizational demography. Res Organizational Behav. 1983;5:299–357.

Van Knippenberg D, De Dreu CKW, Homan AC. Work group diversity and group performance: an integrative model and research agenda. J Appl Psychol. 2004;89:1008.

Van Knippenberg D, Mell JN. Past, present, and potential future of team diversity research: from compositional diversity to emergent diversity. Organ Behav Hum Decis Process. 2016;136:135–45.

Anderson JE, Ross AJ, Back J, Duncan M, Snell P, Hopper A, Jaye P. Beyond ‘find and fix’: improving quality and safety through resilient healthcare systems. Int J Qual Health Care. 2020;32(3):204–11.

Sanford N, Lavelle M, Markiewicz O, Reedy G, Rafferty AM, Darzi A, Anderson JE. Understanding complex work using an extension of the resilience CARE model: an ethnographic study. BMC Health Serv Res. 2022;22(1):1126.

Marceau M, et al. Exploration of the occupational and personal dimensions impacted by the COVID-19 pandemic for nurses: a qualitative analysis of survey responses. J Adv Nurs. 2022;78:2150–64.

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Acknowledgements

We express our gratitude to the reviewers for their comprehensive and insightful assessments of our manuscript. Their detailed and constructive feedback has significantly contributed to refining our arguments and improving the clarity of our research.

The authors gratefully acknowledge support of the Research Fund of the University of Antwerp.

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S.V. and F.H. conducted the analysis and interpretation of the results obtained from the literature search. P.v.B. resolved any discrepancies that arose during the process. S.V. was responsible for writing the scoping review, while all other authors contributed input from their respective fields and edited the manuscript. The final version of the manuscript was read and approved by all authors.

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Vleminckx, S., Van Bogaert, P., De Meulenaere, K. et al. Factors influencing the formation of balanced care teams: the organisation, performance, and perception of nursing care teams and the link with patient outcomes: a systematic scoping review. BMC Health Serv Res 24 , 1129 (2024). https://doi.org/10.1186/s12913-024-11625-5

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Using best-worst scaling to inform policy decisions in Africa: a literature review

• Laura K. Beres 1 ,
• Nicola B. Campoamor 2 ,
• Rachael Hawthorn 3 ,
• Melissa L. Mugambi 4 ,
• Musunge Mulabe 5 ,
• Natlie Vhlakis 5 ,
• Michael Kabongo 5 ,
• Anne Schuster 2 &
• John F. P. Bridges 2  

BMC Public Health volume  24 , Article number:  2607 ( 2024 ) Cite this article

Metrics details

Stakeholder engagement in policy decision-making is critical to inform required trade-offs, especially in low-and-middle income settings, such as many African countries. Discrete-choice experiments are now commonly used to engage stakeholders in policy decisions, but other methods such as best-worst scaling (BWS), a theory-driven prioritization technique, could be equally important. We sought to document and explore applications of BWS to assess stakeholder priorities in the African context to bring attention to BWS as a method and to assess how and why it is being used to inform policy.

We conducted a literature review of published applications of BWS for prioritization in Africa.

Our study identified 35 studies, with the majority published in the past four years. BWS has most commonly been used in agriculture (43%) and health (34%), although its broad applicability is demonstrated through use in fields influencing social and economic determinants of health, including business, environment, and transportation. Published studies from eastern, western, southern, and northern Africa include a broad range of sample sizes, design choices, and analytical approaches. Most studies are of high quality and high policy relevance. Several studies cited benefits of using BWS, with many of those citing potential limitations rather than observed limitations in their study.

Conclusions

Growing use of the method across the African continent demonstrates its feasibility and utility, recommending it for consideration among researchers, program implementers, policy makers, and funders when conducting preference research to influence policy and improve health systems.

Registration

The review was registered on PROSPERO (CRD42020209745).

Peer Review reports

Introduction

Health policies govern both health systems hardware (e.g., human resources, finance, medicines and technologies) and software (e.g., values, norms, power dynamics) by constraining or facilitating individual, organizational, and community actions and experiences [ 1 , 2 , 3 ]. Additionally, healthcare workers take numerous discretionary decisions each day to translate policy into practice and to fill gaps between policy guidance and implementation realities [ 4 , 5 , 6 ]. When guided by evidence, health policies and clinical decision-making facilitate optimized health practices and outcomes [ 6 , 7 , 8 ]. However, policy and practice decisions are often made in an evidence void due to a lack of data or poor evidence access and translation, resulting in inefficient, ineffective, or harmful health system outcomes [ 9 , 10 , 11 ].

Evidence about the preferences of those affected by health decision-making is particularly limited, but greatly needed for policy and practice. Internationally recognized processes for developing health guidelines and recommendations include incorporating the values and preferences of affected parties, such as patients and healthcare workers, into decision-making [ 12 , 13 ]. Limited availability of preference-based evidence downgrades the strength of recommendations [ 13 , 14 ]. Additionally, the welcomed and growing call for person-centered healthcare explicitly requires integration of patient preferences and perspectives into health practice [ 15 , 16 ]. Across all settings, policy makers must trade off services implemented with available resources. Required trade-offs are often more common and more challenging in more resource-limited settings, such as low-and-middle-income countries. Expanded use of tools to understand and systematically incorporate evidence on the preferences of patients, healthcare workers, and other stakeholders into policies and practices is needed to improve health systems at every level [ 17 , 18 , 19 , 20 ].

Researchers and practitioners use multiple methods to understand preferences and priorities, including deliberative processes such as testimony or community meetings, qualitative processes such as focus group discussions and interviews, and mixed methods approaches such as human-centered participatory design processes, surveys, Likert scales, and community scorecards. Developing an even broader methodological toolkit allows for more influential data to facilitate policy and practice changes, as teams will be equipped to optimize the methods selected for the target audience and research question. Stated preference methods offer a theory-driven, structured approach to understanding preferences and priorities. They produce interpretable outcomes with clear relevance to the questions of interest. They have been used across various industries, including healthcare, transportation services, and grocery retailing demonstrating their versatility and potential for suitability. However, while a range of preference elicitation methods exist [ 21 , 22 , 23 ], discrete choice experiments (DCEs) predominate in published health literature [ 24 ]. Recent studies internationally have shown the potential utility and appropriateness of other, lesser known but valuable quantitative stated preference methods, such as best-worst scaling (BWS) [ 25 ]. Studies from eastern, western, southern, and northern Africa have demonstrated interesting advances [ 26 , 27 , 28 ], but have received less attention than BWS in other regions.

The goal of this study was to document and explore applications of BWS to assess stakeholder priorities in eastern, western, southern, and northern Africa to inform future preference assessment implementation. Such documentation of current BWS in the African setting is an important step in bringing attention to this increasingly important method and to stress that there are other theory-driven alternatives to DCEs – that are now commonly applied in Africa [ 24 ]. The review presents study design, methods, quality, and policy relevance from extant studies to enable preference researchers to consider the appropriateness of similar BWS applications in their work. While several international reviews have been conducted on BWS in health [ 25 , 29 ] and more generally [ 30 ], it is important to document how this method is being used in the African context, and what specific role it might have in informing policy there. Furthermore, there has been increased use of these methods in Africa since these previous reviews. It is important that contributions of African preference researchers are well-document to ensure their inclusion in international efforts around preference methods and the presented strengths and weaknesses of these methods are well understood [ 31 ].

Best-worst scaling (BWS) is a choice experiment that is aimed to assess how individiuals or groups prioritize concepts. It offers a theory-driven alternative to descriptive rating, ranking or Likert scale preference measurement, leveraging relative participant ease of selecting extremes compared to mid-range rankings. Several types of BWS exist; however, they all share the same underlying concept. BWS relies on the concept of individuals choosing the ‘best’ and ‘worst’ (or ‘most’ and ‘least’ important) items from a given sub-set of three or more items. Sub-sets of the items are shown repeatedly in different combinations requiring choices of ‘best’ and ‘worst’ within each sub-set. This results in a prioritization of the items. Even if all options are preferred, participants are forced to prioritize among the choices. The purpose is to determine the most and least preferred options of items existing on a subjective, latent value continuum. The application of BWS for prioritizing objects has also been referred to as MaxDiff, object scaling, BWS case 1, or BWS object case. Best-worst responses can also be used in other choice formats that are more similar to DCEs, which are not the focus of this paper [ 32 ].

BWS draws on random utility theory to identify perceived importance and priorities among a set of items (known as attributes) of a scenario based on repeat choices. It can estimate the likelihood of preference selection and heterogeneity of preferences between groups. BWS can be used with a relatively small sample size and analyzed with a range of methods including more simple count analyses or more complex probablistic models. The range of analysis approaches makes them particularly useful when working across a broad range of stakeholders, including policy makers, who would want and need to understand how conclusions were drawn. Compared to DCEs, where participants select which of two or more presented profiles (specific item combinations) are preferred, BWS offers more information per choice task (i.e., best and worst choices instead of only best), allowing for a more efficient design with either a smaller sample size or more information per task. BWS may have a lower cognitive burden for participants than DCEs [ 33 , 34 ]. We refer the reader to additional resources for more detail on the theory, methods, and application of BWS [ 35 , 36 ].

Our review of BWS for prioritization in published research from southern, eastern, western, and northern Africa drew from a broader database of BWS studies identified in previous reviews. While an earlier literature review on all types of BWS choice formats had previously been published [ 29 ], our team completed the first systematic review of BWS applications in health published prior to 2022 [ 25 ]. We then extended our review (PROSPERO: CRD42020209745) to include publications from any field (e.g., health, business, agriculture, etc.) published prior to 2023 [ 30 ]. We have continued to improve this database of articles, utilizing additional search strategies and including previously unidentified relevant articles directly sent to our team. Our database currently has 623 published studies from which we systematically extract data application, development, design, administration/analysis, quality, and policy relevance. The study reported in this paper leverages the most expanded database. Review methods were detailed in prior publications [ 25 ].

We included all studies from the database that focused exclusively on, or incorporated into a multi-country study, participants from eastern, western, southern, or northern Africa. We then accessed extracted data in the database for each study to characterize BWS application types, study methods, context, quality, and policy relevance. Specific fields included: study year, country, topic, objective, sample size, perspective (i.e., whose preferences are measured), terminology used to describe BWS type (e.g., object case, MaxDiff), mode of survey administration (e.g., in-person), time frame of prioritization scenario (i.e., past, present, or future), methods of instrument development (e.g., formative research, literature review to determine attributes and survey tool), time frame of prioritization scenario (i.e., past, present, or future), measurement scale, experimental design type, BWS anchor description (i.e., most/least, best/worst), directionality, total number of objects, number of objects per task, number of tasks in the experiment, number of tasks per respondent, analysis approach, and theoretical assumptions [ 25 ]. We re-classified database ‘topic’ for three studies from ‘agriculture’ to ‘business’ after reviewing study journal and conclusions. To understand study quality, we utilized the PREFS checklist quality assessment which measures quality and validity of preference studies on a 0–5 point scale, assigning one point for each of the following: p urpose of the study clearly defined; r espondents similar to non-respondents (sampling); e xplanation of preference assessment methods clear; f indings reported for all respondents; and significance testing done [ 37 ]. We also present the validated subjective quality (range: 1–10) and policy relevance (range: 1–10) scores adjudicated by the prior review.

Identified strengths and weaknesses of BWS were extracted from the studies. This information primarily came from the background, methods, and discussion portions of the studies, specifically when justifying the use of BWS and highlighting any study limitations. Seven domains of strengths and weaknesses were dervied and modified from exisiting best-practice documents for preference research [ 38 , 39 ].

To highlight the application of BWS and improve understanding of the method, we include a narrative case study description of two of the included manuscripts. We chose health-related studies selected for their high quality (≥ 4 PREFS score) and policy relevance (≥ 7) with illustrative diversity across other factors including country, perspective, design, instrument development, and analysis approach. While diversity in other points such as assumptions, directionality, and heterogeneity analysis are interesting, (See Tables  1 , 2 and 3 ) the selected articles offered rich contrast among the articles in this review.

The review identified 35 published studies using best-worst scaling for prioritization focused on (in full or in part) participants from Africa. As seen in Table  1 , studies originated from northern Africa ( N  = 1), eastern Africa ( N  = 7), southern Africa ( N  = 13), and western Africa ( N  = 14). This included 7 studies not identified by previous reviews. The majority of the papers (72%) from Africa were published between 2019 and 2023 [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ] and referred to ‘Best Worst Scaling’ in their write-up (85%) [ 40 , 41 , 43 , 44 , 45 , 46 , 47 , 49 , 51 , 52 , 54 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ]. Of the 14 countries where research was conducted, South Africa produced the most studies (34%) [ 41 , 42 , 46 , 51 , 52 , 55 , 56 , 60 , 61 , 66 , 67 , 70 , 74 ]. Most papers presented results from empirical research (97%) [ 40 , 41 , 42 , 44 , 45 , 46 , 47 , 48 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 70 , 71 , 72 , 73 , 74 ]. Agriculture (43%) [ 41 , 43 , 44 , 45 , 47 , 49 , 50 , 51 , 54 , 59 , 60 , 63 , 64 , 65 , 69 , 70 , 71 ] and health (34%) [ 40 , 46 , 48 , 52 , 55 , 56 , 57 , 62 , 67 , 72 , 73 , 74 ] were the most common research topics. Most studies (51%) measured preferences from the perspective of the patient / consumer [ 41 , 42 , 46 , 49 , 51 , 54 , 55 , 57 , 60 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 72 ], with nearly a third measuring provider / producer preferences (37%) [ 40 , 43 , 44 , 45 , 47 , 48 , 50 , 56 , 58 , 59 , 62 , 71 , 74 ].

Study design

All identified studies articulated their approach to developing their BWS instrument. The vast majority, (74%), utilized a literature review [ 41 , 42 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 52 , 53 , 54 , 55 , 56 , 57 , 60 , 61 , 64 , 65 , 66 , 67 , 68 , 69 , 71 , 72 , 74 ] while less than a quarter conducted piloting (17%) [ 42 , 46 , 50 , 53 , 56 , 73 ] or pretesting (20%) [ 47 , 50 , 52 , 54 , 56 , 66 , 71 ] of the instrument prior to administration. Half of the studies reported utilizing formal qualitative methods during instrument development [ 40 , 42 , 43 , 46 , 48 , 50 , 53 , 56 , 57 , 60 , 62 , 67 , 68 , 69 , 73 , 74 ]. In-person, surveyor-administered was the most common mode of survey administration (66%) [ 40 , 43 , 44 , 45 , 46 , 47 , 48 , 50 , 52 , 53 , 54 , 55 , 58 , 59 , 61 , 62 , 64 , 65 , 66 , 67 , 68 , 69 , 72 ] with online (9%) [ 51 , 56 , 74 ] and self-administered (11%) [ 41 , 57 , 70 , 73 ] less frequently utilized. The time horizon used to contextualize the survey was present tense most frequently (89%) [ 40 , 41 , 42 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 74 ] with only four studies asking about the future (11%) [ 43 , 54 , 55 , 73 ] and no studies asking about the past. BWS most frequently measured importance (69%) [ 41 , 45 , 46 , 49 , 51 , 52 , 53 , 55 , 56 , 57 , 59 , 60 , 61 , 63 , 64 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ], followed by preferences motivating responses (17%) [ 40 , 43 , 44 , 48 , 54 , 65 ]. The most common phrasing to anchor the experiment was asking participants to choose the “most” and “least” [important/preferred/concerning] (86%) [ 40 , 41 , 42 , 44 , 45 , 46 , 47 , 48 , 49 , 51 , 52 , 54 , 55 , 56 , 57 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ], followed by asking participants to choose the “best” and “worst” (11%) [ 43 , 53 , 58 , 67 ]. The most common experimental design used was a Balanced Incomplete Block Design (BIBD) (69%) [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 53 , 54 , 56 , 58 , 59 , 60 , 64 , 65 , 67 , 70 , 71 , 72 , 73 ] with 14% using a design from Sawtooth software [ 47 , 57 , 66 , 68 , 69 ]. The mean total objects per experiment was 15.9 (standard deviation (sd): 9.1, min 6: max: 48). Experiments had a mean of 5.2 objects per task (sd: 3.5, min: 3 max: 24), 22.4 (sd: 38.4, min: 1 max: 210) choice tasks per experiment and a mean of 13.7 (sd: 8.2, min: 1 max: 51) choice tasks per respondent during their participation in the experiment (Table  2 ).

BWS administration and analysis

Median sample size was 282 participants (IQR: 150–451, min: 28, max: 1002) but only 17% of papers gave a formal sample size justification (Table  3 ) [ 40 , 47 , 48 , 57 , 62 , 66 ]. Stata was the most reported data analysis program utilized (14%) [ 46 , 50 , 53 , 67 , 73 ], followed by Excel [ 42 , 61 , 66 ], SAS [ 43 , 48 , 62 ], or SPSS (9% each) [ 47 , 66 , 69 ]. The remaining studies (60%) did not specify which statistical analysis program they used. Probability / ratio rescaling (43%) [ 40 , 42 , 43 , 45 , 48 , 49 , 51 , 54 , 59 , 60 , 64 , 65 , 67 , 68 , 71 ], counts (49%) [ 40 , 41 , 45 , 46 , 50 , 52 , 53 , 54 , 56 , 58 , 61 , 63 , 66 , 67 , 70 , 71 , 73 ], regression coefficients (43%) [ 43 , 44 , 48 , 49 , 52 , 53 , 55 , 63 , 64 , 65 , 68 , 69 , 71 , 72 , 73 ], and best-worst scores (46%) [ 41 , 42 , 45 , 46 , 47 , 52 , 54 , 58 , 59 , 60 , 61 , 64 , 66 , 70 , 71 , 73 ] were common analysis approaches. Approximately half of the studies (40%) effects coded their data [ 40 , 42 , 49 , 50 , 52 , 55 , 64 , 65 , 69 , 71 , 72 ] while fewer (17%) used an omitted variable [ 43 , 44 , 48 , 53 , 54 , 62 ]. Heterogeneity analyses were conducted by most studies (63%) [ 42 , 43 , 44 , 45 , 46 , 49 , 50 , 51 , 52 , 54 , 55 , 57 , 58 , 59 , 64 , 66 , 67 , 68 , 69 , 72 ], with stratification being the most common heterogeneity analysis approach (40%) [ 42 , 44 , 49 , 51 , 52 , 55 , 57 , 63 , 64 , 65 , 66 , 67 , 68 , 72 ] followed next by latent class analysis (20%) [ 45 , 46 , 50 , 54 , 58 , 59 , 69 ].

Study quality and policy relevance

Policy relevance of studies was high with 66% scoring 7 or above on the 10-point scale [ 40 , 41 , 42 , 44 , 46 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 57 , 59 , 64 , 65 , 67 , 68 , 70 , 71 , 72 , 73 ]. Most studies scored in the upper half of the PREFS scale [ 3 , 4 , 5 , 40 , 42 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 57 , 58 , 59 , 60 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 ].

Strengths and weaknesses of BWS

Strengths and weaknesses of using BWS were identified in most of the published studies from Africa. Most of these studies focused solely on strengths of using BWS, though some identified both strengths and weaknesses and a few focused solely on weaknesses. These strengths and weaknesses were categorized into seven domains: context, purpose, method, burden, results, comparisons, and bias (Table  4 ).

Strengths were noted across all seven domains. In the context domain, BWS was noted for eliciting priorities and preferences from populations with lower education levels [ 52 , 72 ] and lower income [ 72 , 73 ]. The purpose domain highlighted strengths such as engaging communities [ 42 ] and informing decision-making [ 55 ]. The method domain emphasized that BWS overcomes limitations of other ranking methods [ 41 , 42 , 59 , 61 , 71 ], including variations in interpretation related to Likert-type scales. The burden domain commonly cited that BWS reduces respondent burden [ 41 , 45 , 49 , 50 , 52 , 55 , 59 , 61 , 66 , 68 , 72 ]. The results domain stressed that BWS captures more information [ 49 , 59 , 64 , 66 , 68 , 72 ] and produces higher quality and more precise results than other methods [ 41 , 45 , 49 , 58 , 71 ]. The comparisons domain focused on the ability to discriminate between objects [ 45 , 49 , 59 , 65 , 68 , 73 ]. The bias domain noted a reduction of general bias [ 41 , 51 , 53 , 59 , 66 , 70 ].

Weaknesses or limitations of using BWS were provided for only five of the seven domains. In the context domain, it was suggested that BWS might be challenging to use in clinical practice as a decision-making tool [ 57 ] and, contrary to studies noting it as a strength, some identified it as, challenging for populations with lower education levels [ 52 ]. The method domain pointed out that BWS involves hypothetical scenarios that may not be realistic [ 64 ]. The burden domain cited possible respondent burden associated with completing a series of BWS tasks [ 52 , 59 , 66 ]. The comparisons domain highlighted potential difficulties in making comparisons between populations within the sample [ 68 , 69 ]. The bias domain noted the possibility of desirability bias, where respondents report socially acceptable factors rather than genuine preferences [ 72 ]. Most of these weaknesses were posed as possibilities, rather than observed limitations.

Case studies

Policy relevance : Ozawa et al. [ 72 ] used BWS scaling to inform message development and effective delivery strategies with the goal of improving childhood vaccination awareness and demand in Nahuche, Zamfara State northern Nigeria, a region with low vaccination uptake. Instrument development : The survey items were developed through a review of published literature from Nigeria and other low-and-middle income countries on factors that affect childhood vaccine demand and uptake. Identified factors were categorized into four groups and each written out as a negative or positive influence based on the literature (e.g., vaccines may harm a child (negative), trust the views of leaders about vaccines (positive)), balancing equal numbers of positive and negative statements. A local study advisory board reviewed the items. Population : The survey was administered in-person to parents with children under 5 years old during a household survey from a representative sample of households. Administration : The survey was translated into Hausa and presented as a pictorial questionnaire with both photographs and words used to represent each factor. Perspective and time scale : Participants were asked to select the most and least important factors to them (consumer/patient) when deciding whether to vaccinate a 1-year-old child (present). Design : The study utilized a BIBD where every participant was presented with 16 choice sets of 6 factors. The survey took approximately 1 h to complete. Analysis : They assumed sequential BWS and used conditional logistic regression with effects coding to determine factor rankings. Heterogeneity : They examined heterogeneity in the results by looking at different strata: male/female parent and by previous diphtheria, tetanus, and pertussis (DTaP) vaccination status (yes/no). Participation : 198 parents participated. Results : The most important motivating factor for vaccinating children was the perception that vaccination makes one a good parent. Trust and norms were found to be more important than benefits and risks in vaccination decisions. They identified differences in rankings between fathers and mothers and in families with and without prior DTaP vaccination.

Policy relevance : Yemeke et al. [ 52 ] compared the Uganda national budget resource allocations across 16 sectors to citizen preferences for such allocations. A particular emphasis was placed on understanding the health care sector as a funding priority. Instrument development : The sixteen survey factors represented each of the sixteen sector allocations within the Uganda national government’s budget. Results from a pre-test of the survey to assess respondent understanding were used to improve the instrument. Population : The survey was administered in-person to the head of household or spouse, of at least 18 years of age, in both rural and urban areas in the Mukono district in central Uganda. Administration : The survey was translated into Luganda and displayed accompanying pictorial representations (such as photographs or graphics) of the sectors. Descriptions of the sectors and their functions were also read aloud. Perspective and time scale : Respondents were asked to select the most and least important sectors for resource allocation for their community (present) in each choice task, offering societal perspective prioritization. Design : A main effects orthogonal design was used to generate 16 choice tasks, each with 4 sectors (factors). Analysis : Count analysis: Relative mean best-worse scores were calculated for each sector. Scores were transformed to a positive scale, anchored at zero, to calculate percentage preference relative to estimated cumulative sums. The preferred percentages were compared to the actual percentages allocated in the national budget. Assuming sequential BWS, the authors used McFadden’s conditional logistic regression with effects coding to regress a single dichotomous choice variable on all sectors to assess ranking of preferred sectors. Heterogeneity : They examined heterogeneity in the results across two strata (urban/rural). Participation : There were 432 respondents across two settings (217 urban respondents, 215 rural respondents). Results : The health sector was the highest ranked sector by a significant margin amongst both rural and urban respondents. This result was consistent in both the relative best-minus-worst score method and the regression analysis. This highlighted a clear disparity between citizen preferences and national budget al.location, where the health sector was ranked sixth.

Policy relevance : Nyarko et al. [ 48 ] used BWS to quantify the antimicrobial dispensing practices of medicine sales outlet staff. Understanding these practices can help to improve patient safety and care quality, as well as to serve as a guide for decision-making in the pharmaceutical sector. Instrument development : The initial list of survey items was identified through informant interviews with medicine sales experts and an extensive literature review. The list of items was condensed into eight objects through focus group discussions with medicine sales outlet staff. Population : The survey was conducted in-person through interviewer-questionnaire administration with medicine sales outlet staff over a two-month period. Staff were eligible for the study if they had dispensed microbials within the past year. Administration : Demographic information was collected at the start of the questionnaire, followed by questions regarding the staff’s prescribing and dispensing practices of antimicrobial medications. Perspective and time scale : Participants were asked to indicate which object regarding antimicrobial dispensing practices concerned them the most and least. Design : A BIBD was used, generating 8 tasks, each with 7 objects. Analysis : Assuming the respondent chose the items they most liked and disliked, a maximum difference model with effects coding was used to determine parameter estimates. The relative importance of each object was determined based on the parameter estimates, allowing the objects to be ranked by level of importance. Heterogeneity : Heterogeneity was examined by comparing antimicrobial dispensing practices with their associated objects. Participation : 200 staff participated. Results : The antimicrobial dispensing practice that concerned respondents most was the need to follow the drug act and avoid dispensing antimicrobials without a prescription. Dispensing antibiotics to poor patients who may not be able to afford medical bills was not a concern for respondents. Overall, the study suggests that staff are careful when dispensing antimicrobials.

Our study identified 35 studies from across Africa, with the majority published in the past four years. BWS has most commonly been used in agriculture and health, although its broad applicability is demonstrated through its use in fields including business, environment, and transportation. Published studies from eastern, western, southern, and northern Africa include a broad range of sample sizes, design choices, and analytical approaches. Consistent with other BWS reviews [ 25 ], the majority of studies are both of high quality and of high policy relevance. It is interesting to highlight that among articles classified as ‘multi-country,’ two articles included participants from at least one African country in their sample. However, we considered them ‘near misses’ and excluded them as neither disaggregated data by country to ensure review data came from Africa. Both had few participants from African countries relative to the overall sample.

The application of BWS for prioritization in the Africa context is an emerging practice as demonstrated by our findings that its use has increased dramatically over time. The quality of studies, as measured by PREFS, has remained consistently high over time [ 24 ]. As the method continues to be applied, guidelines exist that could further ensure researchers conduct high-quality studies and publish high-quality papers about them [ 38 , 39 , 75 ]. This includes the increased use of instrument development methods, especially formal qualitative work, pretesting with cognitive interviewing, and piloting [ 76 ]. Importantly, this also requires attentiveness to ensuring accuracy of conceptual translation which is often missed if focusing exclusively on linguistic translation for studies working across multiple language groups [ 77 ].

The use of BWS also draws attention to the notion of prioritization itself. Our findings highlight the relevance of the method to policy making; over three-quarters of the included studies received a policy relevance score of seven or more. Clearly expressed priorities may allow policy makers to shift away from informal decision-making heuristics to more formal, principled decision making practices. Certainly, the more recently observed integration of BWS into deliberative processes [ 78 ] such as the modified policy Delphi [ 79 ] and deliberative democracy [ 80 ] exemplifies other ways that priority and preference elicitation can help inform group deliberation to achieve consensus [ 81 , 82 ]. That said, there remain questions about aggregating individual priorities in group decision making [ 36 ] and is a topic that others have grappled with, including in health state valuation [ 83 ]. Finally, it is important to note that BWS is only one method to assess priorities, where other methods include deliberation [ 84 ], simple rating or ranking approaches alone or as a part of a Delphi approach [ 85 ], pick n of m tasks [ 86 ], or stated preference methods such as willingness to pay [ 87 ], DCEs, or conjoint analyses [ 88 ].

With only 34% of included studies in health, this shows an opportunity for greater application in the health field. The range of health-specific topics to which BWS was applied in this study demonstrates versatility across health areas. Various types of preference facilitation have proven successful in health-specific areas [ 25 , 89 ]. Additionally, as health systems are conceptualized more broadly to include social determinants of health such as transportation options, food systems, and the environment the other topical applications demonstrate direct relevance to health systems and decision-making. Similarly, its use in business may be applicable to business-based approaches to health such as social marketing strategies for behavior change. While patient-centered care may involve individual-level preference accommodation of individual patients (e.g., choosing a community-adherence group over fast-track appointments among HIV differentiated service delivery options), systematic understanding of trends in patient preferences at a broader level can inform efficient health system decision-making (e.g., the creation of differentiated service delivery options for HIV). The two studies including data from an African country that we nearly included but did not due to lack of geographic specificity both show successful implementation of multi-country BWS.

Our study is subject to publication bias, as the systematic review searched published literature. The review targeted object case BWS (also known as case 1, MaxDiff, and object scaling). Further research into other types of BWS would contribute to a more comprehensive understanding of BWS in Africa. While we introduce BWS, we do not offer guidance on methods or analysis. Multiple other peer reviewed papers, including some included in this review [ 42 ], and texts offer clear instruction on BWS implementation to aid researchers wishing to apply this method [ 36 ]. Further, we do not include assessments of BWS participation from the participant perspective, as literature on this topic is very limited [ 90 ]. The field would benefit from frameworks for participant assessment of BWS participation to better incorporate this into BWS findings, as have been developed for instrument development [ 76 ].

We need effective tools to measure preferences and priorities, including tools that suit those whose input is more traditionally sought in health decision making (e.g., providers) and those whose voice is critical, but often unheard (e.g., patients, consumers, and community members). BWS is one of those tools. BWS offers a versatile alternative to DCEs and other better-known methods of measuring preferences. Researchers can successfully employ BWS across a range of sample sizes, and using various analysis approaches and programs. Growing use of the method across the African continent demonstrates its feasibility and utility, recommending it for consideration among researchers, program implementers, policy makers, and funders when conducting preference research to influence policy and improve health systems. Further research can help to recommend specific applications, including further work to understand context-specific implications of the strengths and limitations of the methods alongside cognitive burden and population-specific recommendations.

Data availability

All study data are available upon request from the authors for the review registered on PROSPERO (CRD42020209745).

Abbreviations

Balanced incomplete block design

• Best-worst scaling

Discrete choice experiments

Diphtheria, tetanus, and pertussis

Purpose, responses, explanations, findings

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Sheikh K, Gilson L, Agyepong IA, Hanson K, Ssengooba F, Bennett S. Building the field of health policy and systems research: framing the questions. PLoS Med. 2011;8(8):e1001073.

Article   PubMed   PubMed Central   Google Scholar  

Waitzberg R, Quentin W, Webb E, Glied S. The structure and financing of Health Care systems affected how providers coped with COVID-19. Milbank Q. 2021;99(2):542.

Maeda M, Muraki Y, Kosaka T, Yamada T, Aoki Y, Kaku M, et al. Impact of health policy on structural requisites for antimicrobial stewardship: a nationwide survey conducted in Japanese hospitals after enforcing the revised reimbursement system for antimicrobial stewardship programs. J Infect Chemother. 2021;27(1):1–6.

Article   PubMed   Google Scholar  

Lipsky M. Street-level bureaucracy: dilemmas of the individual in public service. Russell Sage Foundation; 2010.

Mwamba C, Mukamba N, Sharma A, Lumbo K, Foloko M, Nyirenda H, et al. Provider discretionary power practices to support implementation of patient-centered HIV care in Lusaka, Zambia. Front Health Serv. 2022;2:918874.

Bylund S, Målqvist M, Peter N, van Herzig S. Negotiating social norms, the legacy of vertical health initiatives and contradicting health policies: a qualitative study of health professionals’ perceptions and attitudes of providing adolescent sexual and reproductive health care in Arusha and Kilimanjaro region, Tanzania. Global Health Action. 2020;13(1):1775992.

Akobeng AK. Principles of evidence based medicine. Arch Dis Child. 2005;90(8):837–40.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Petticrew M, Whitehead M, Macintyre SJ, Graham H, Egan M. Evidence for public health policy on inequalities: 1: the reality according to policymakers. J Epidemiol Community Health. 2004;58(10):811–6.

Gagliardi AR, Brouwers MC. Do guidelines offer implementation advice to target users? A systematic review of guideline applicability. BMJ open. 2015;5(2):e007047.

Cairney P, Oliver K. Evidence-based policymaking is not like evidence-based medicine, so how far should you go to bridge the divide between evidence and policy? Health Res Policy Syst. 2017;15:1–11.

Article   Google Scholar  

Orton L, Lloyd-Williams F, Taylor-Robinson D, O’Flaherty M, Capewell S. The use of research evidence in public health decision making processes: systematic review. PLoS ONE. 2011;6(7):e21704.

Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924–6.

Organization WH. WHO handbook for guideline development. 2nd ed. Geneva: World Health Organization; 2014.

Google Scholar  

Neumann I, Brignardello-Petersen R, Wiercioch W, Carrasco-Labra A, Cuello C, Akl E, et al. The GRADE evidence-to-decision framework: a report of its testing and application in 15 international guideline panels. Implement Sci. 2015;11:1–8.

De Man J, Roy WM, Sarkar N, Waweru E, Leys M, Van Olmen J, et al. Patient-centered care and people-centered health systems in sub-saharan Africa: why so little of something so badly needed? Int J Person Centered Med. 2016;6(3):162.

Scholl I, Zill JM, Härter M, Dirmaier J. An integrative model of patient-centeredness–a systematic review and concept analysis. PLoS ONE. 2014;9(9):e107828.

Armstrong MJ, Bloom JA. Patient involvement in guidelines is poor five years after institute of medicine standards: review of guideline methodologies. Res Involv Engagem. 2017;3:1–11.

Erismann S, Pesantes MA, Beran D, Leuenberger A, Farnham A, Berger Gonzalez de White M, et al. How to bring research evidence into policy? Synthesizing strategies of five research projects in low-and middle-income countries. Health Res Policy Syst. 2021;19:1–13.

McHugh N, Baker R, Bambra C. Policy actors’ perceptions of public participation to tackle health inequalities in Scotland: a paradox? Int J Equity Health. 2023;22(1):57.

Kuipers SJ, Cramm JM, Nieboer AP. The importance of patient-centered care and co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. BMC Health Serv Res. 2019;19:1–9.

Soekhai V, Whichello C, Levitan B, Veldwijk J, Pinto CA, Donkers B, et al. Methods for exploring and eliciting patient preferences in the medical product lifecycle: a literature review. Drug Discovery Today. 2019;24(7):1324–31.

Meara A, Crossnohere NL, Bridges JF. Methods for measuring patient preferences: an update and future directions. Curr Opin Rheumatol. 2019;31(2):125–31.

Bridges JFW, Albert W, Segal J, Bandeen-Roche K, Bone LR, Purnell T. Stated-preference methods. Center for Health Services and Outcome Research - The Johns Hopkins Bloomberg School of Public Health; 2014.

Brown L, Lee TH, De Allegri M, Rao K, Bridges JFP. Applying stated-preference methods to improve health systems in sub-saharan Africa: a systematic review. Expert Rev PharmacoEcon Outcomes Res. 2017;17(5):441–58.

Hollin IL, Paskett J, Schuster ALR, Crossnohere NL, Bridges JFP. Best-worst scaling and the prioritization of objects in Health: a systematic review. PharmacoEconomics. 2022;40(9):883–99.

Karuga R, Kok M, Luitjens M, Mbindyo P, Broerse JE, Dieleman M. Participation in primary health care through community-level health committees in Sub-saharan Africa: a qualitative synthesis. BMC Public Health. 2022;22(1):359.

Laterra A, Callahan T, Msiska T, Woelk G, Chowdhary P, Gullo S, et al. Bringing women’s voices to PMTCT CARE: adapting CARE’s community score Card© to engage women living with HIV to build quality health systems in Malawi. BMC Health Serv Res. 2020;20:1–14.

Rosenberg NE, Obiezu-Umeh C, Gbaja-Biamila T, Tahlil KM, Nwaozuru U, Oladele D, et al. Strategies for enhancing uptake of HIV self-testing among Nigerian youths: a descriptive analysis of the 4YouthByYouth crowdsourcing contest. BMJ Innovations. 2021;7(3):590.

Cheung KL, Wijnen BFM, Hollin IL, Janssen EM, Bridges JFP, Evers SMAA, et al. Using Best–Worst Scaling Investigate Preferences Health Care PharmacoEconomics. 2016;34(12):1195–209.

PubMed   Google Scholar  

Schuster ALR, Crossnohere NL, Campoamor NB, Hollin IL, Bridges JFP. The rise of best-worst scaling for prioritization: a transdisciplinary literature review. J Choice Modelling. 2024;50:100466.

DiSantostefano RL, Smith IP, Falahee M, Jiménez-Moreno AC, Oliveri S, Veldwijk J, et al. Research priorities to increase confidence in and Acceptance of Health Preference Research. What Questions Should be Prioritized Now? The Patient - Patient-Centered Outcomes Research; 2023.

Mühlbacher AC, Kaczynski A, Zweifel P, Johnson FR. Experimental measurement of preferences in health and healthcare using best-worst scaling: an overview. Health Econ Rev. 2016;6(1):2.

Potoglou D, Burge P, Flynn T, Netten A, Malley J, Forder J, et al. Best–worst scaling vs. discrete choice experiments: an empirical comparison using social care data. Soc Sci Med. 2011;72(10):1717–27.

Flynn TN, Louviere JJ, Peters TJ, Coast J. Best–worst scaling: what it can do for health care research and how to do it. J Health Econ. 2007;26(1):171–89.

Aizaki H, Fogarty J. R packages and tutorial for case 1 best–worst scaling. J Choice Modelling. 2023;46:100394.

Louviere JJ, Flynn TN, Marley AAJ. Best-worst scaling: theory, methods and applications. Cambridge: Cambridge University Press; 2015.

Book   Google Scholar  

Joy SM, Little E, Maruthur NM, Purnell TS, Bridges JFP. Patient preferences for the treatment of type 2 diabetes: a scoping review. PharmacoEconomics. 2013;31(10):877–92.

Bridges JFP, de Bekker-Grob EW, Hauber B, Heidenreich S, Janssen E, Bast A, et al. A Roadmap for increasing the usefulness and impact of patient-preference studies in decision making in Health: a good practices Report of an ISPOR Task Force. Value Health. 2023;26(2):153–62.

Bridges JFP, Hauber AB, Marshall D, Lloyd A, Prosser LA, Regier DA, et al. Conjoint Analysis Applications in Health—a Checklist: a report of the ISPOR Good Research Practices for Conjoint Analysis Task Force. Value Health. 2011;14(4):403–13.

Honda A, Krucien N, Ryan M, Diouf ISN, Salla M, Nagai M, et al. For more than money: willingness of health professionals to stay in remote Senegal. Hum Resour Health. 2019;17(1):28.

Pentz C, Filter M, editors. From Generation Y to Generation Wine? A Best-Worst scaling study of wine attribute importance. Proceedings of the 52nd International Academic Conferences; 2019; Barcelona: International Institute of Social and Economic Sciences.

Teffo M, Earl A, Zuidgeest M. Understanding public transport needs in Cape Town’s informal settlements: a best-worst-scaling approach. J South Afr Institution Civil Eng. 2019;61(2):39–50.

Amadou Z. Agropastoralists’ Climate Change Adaptation Strategy Modeling: Software and Coding Method Accuracies for Best-Worst Scaling Data. African Handbook of Climate Change Adaptation2020. pp. 1–10.

Amadou Z. Which Sustainable Development Goals and Eco-challenges Matter Most to Niger’s Farmers and Herdsmen? A Best Worst Scaling Approach. Agricultural Research & Technology Open Access Journal; 2020.

Jin S, Mansaray B, Jin X, Li H. Farmers’ preferences for attributes of rice varieties in Sierra Leone. Food Secur. 2020;12(5):1185–97.

Kim H-Y, Hanrahan CF, Dowdy DW, Martinson NA, Golub JE, Bridges JF. Priorities among HIV-positive individuals for tuberculosis preventive therapies. Int J Tuberculosis Lung Disease. 2020;24(4):396–402.

Nyabinwa P, Kashongwe OB, Hirwa CD, Bebe BO. Perception of farmers about endometritis prevention and control measures for zero-grazed dairy cows on smallholder farms in Rwanda. BMC Vet Res. 2020;16(1):175.

Nyarko E, Akoto FM, Doku-Amponsah K. Perceived antimicrobial dispensing practices in medicine outlets in Ghana: a maximum difference experiment design. PLoS ONE. 2023;18(7):e0288519.

Okpiaifo G, Durand-Morat A, West GH, Nalley LL, Nayga RM, Wailes EJ. Consumers’ preferences for sustainable rice practices in Nigeria. Global Food Secur. 2020;24.

Ola O, Menapace L. Revisiting constraints to smallholder participation in high-value markets: a best‐worst scaling approach. Agric Econ. 2020;51(4):595–608.

Pentz C, Forrester A. The importance of wine attributes in an emerging wine-producing country. South Afr J Bus Manage. 2020;51(1).

Yemeke TT, Kiracho EE, Mutebi A, Apolot RR, Ssebagereka A, Evans DR, et al. Health versus other sectors: multisectoral resource allocation preferences in Mukono district, Uganda. PLoS ONE. 2020;15(7):e0235250.

Lewis-Brown E, Beatty H, Davis K, Rabearisoa A, Ramiaramanana J, Mascia MB et al. The importance of future generations and conflict management in conservation. Conserv Sci Pract. 2021;3(9).

Muunda E, Mtimet N, Schneider F, Wanyoike F, Dominguez-Salas P, Alonso S. Could the new dairy policy affect milk allocation to infants in Kenya? A best-worst scaling approach. Food Policy. 2021;101:102043.

Seymour ZA, Cloete E, McCurdy M, Olson M, Hughes J. Understanding values of sanitation users: examining preferences and behaviors for sanitation systems. J Water Sanitation Hygiene Dev. 2021;11(2):195–207.

van Niekerk K, Dada S, Tönsing K. Perspectives of rehabilitation professionals on assistive technology provision to young children in South Africa: a national survey. Disabil Rehabilitation: Assist Technol. 2023;18(5):588–95.

Gertz AM, Soffi ASM, Mompe A, Sickboy O, Gaines AN, Ryan R et al. Developing an Assessment of Contraceptive preferences in Botswana: piloting a Novel Approach using best-worst scaling of attributes. Front Global Women’s Health. 2022;3.

Maruyama Y, Ujiie K, Ahmed C, Diagne M, Irie M. Farmers’ preferences of the agricultural inputs for rice farming in Senegal River Basin, Mauritania: a best-worst scaling approach. J Arid Land Stud. 2022;32(S):61–5.

Ahoudou I, Sogbohossou DE, Hotegni NVF, Adjé CO, Komlan FA, Moumouni-Moussa I, et al. Farmers’ selection criteria for sweet potato varieties in Benin: an application of best-worst scaling. Exp Agric. 2023;59:e25.

Filter M, Pentz CD. Dealcoholised wine: exploring the purchasing considerations of South African generation Y consumers. Br Food J. 2023;125(13):205–19.

Walaza S, Onderwater P, Zuidgeest M, editors. Best-worst scaling approach to measure public transport user quality perceptions and preferences in cape town2023: Southern African Transport Conference.

Nyarko E, Arku D, Duah G. Best-worst scaling in studying the impact of the coronavirus pandemic on health professionals in Ghana. Model Assist Stat Appl. 2023;18(3):227–36.

Amadou Z, Which agricultural innovations matter most to Niger’s farmers?, Count-based and best-worst scaling approaches. Russian J Agricultural Socio-Economic Sci. 2023;140(8):3–12.

Abubakar M, Amadou Z, Daniel K. Best-worst scaling approach in predicting seed attribute preferences among resource poor farmers in Northern Nigeria. Int J Humanit Social Sci. 2014;2(9):304–10.

Amadou Z, Baky AD. Consumers’ preferences for quality and safety attributes of milk products in Niger: a best-worst scaling approach. J Agric Sci Technol. 2015;5(9):635–42.

Irlam JH, Zuidgeest M. Barriers to cycling mobility in a low-income community in Cape Town: a best-worst scaling approach. Case Stud Transp Policy. 2018;6(4):815–23.

Kim HY, Dowdy DW, Martinson NA, Golub E, Bridges J, Hanrahan JF. Maternal priorities for preventive therapy among HIV-positive pregnant women before and after delivery in South Africa: a best–worst scaling survey. J Int AIDS Soc. 2018;21(7):e25143.

Lagerkvist CJ, Kokko S, Karanja N. Health in perspective: framing motivational factors for personal sanitation in urban slums in Nairobi, Kenya, using anchored best–worst scaling. J Water Sanitation Hygiene Dev. 2014;4(1):108–19.

Lagerkvist CJ, Okello J, Karanja N. Anchored vs. relative best–worst scaling and latent class vs. hierarchical bayesian analysis of best–worst choice data: investigating the importance of food quality attributes in a developing country. Food Qual Prefer. 2012;25(1):29–40.

Lategan BW, Pentz CD, du Preez R. Importance of wine attributes: a South African generation Y perspective. Br Food J. 2017;119(7):1536–46.

Mansaray B, Jin S, Yuan R, Li H, editors. Farmers Preferences for Attributes of Seed Rice in Sierra Leone: A Best-Worst Scaling Approach. International Conference of Agricultural Economists; 2018.

Ozawa S, Wonodi C, Babalola O, Ismail T, Bridges J. Using best-worst scaling to rank factors affecting vaccination demand in northern Nigeria. Vaccine. 2017;35(47):6429–37.

Torbica A, De Allegri M, Belemsaga D, Medina-Lara A, Ridde V. What criteria guide national entrepreneurs’ policy decisions on user fee removal for maternal health care services? Use of a best–worst scaling choice experiment in West Africa. J Health Serv Res Policy. 2014;19(4):208–15.

van Niekerk K, Dada S, Tönsing K. Perspectives of rehabilitation professionals on assistive technology provision to young children in South Africa: a national survey. Disability and Rehabilitation: Assistive Technology; 2021.

Hollin IL, Craig BM, Coast J, Beusterien K, Vass C, DiSantostefano R, et al. Reporting formative qualitative research to support the development of quantitative preference study protocols and corresponding Survey instruments: guidelines for authors and reviewers. Patient - Patient-Centered Outcomes Res. 2020;13(1):121–36.

Janssen EM, Segal JB, Bridges JFP. A Framework for Instrument Development of a choice experiment: an application to type 2 diabetes. Patient - Patient-Centered Outcomes Res. 2016;9(5):465–79.

Herdman M, Fox-Rushby J, Badia X. ‘Equivalence’and the translation and adaptation of health-related quality of life questionnaires. Qual Life Res. 1997;6.

Oortwijn W, Husereau D, Abelson J, Barasa E, Bayani DD, Santos VC, et al. Designing and implementing deliberative processes for health technology assessment: a good practices report of a joint HTAi/ISPOR task force. Int J Technol Assess Health Care. 2022;38(1):e37.

Majumder MA, Blank ML, Geary J, Bollinger JM, Guerrini CJ, Robinson JO, et al. Challenges to building a gene variant commons to assess hereditary cancer risk: results of a modified policy Delphi panel deliberation. J Personalized Med. 2021;11(7):646.

Boyd JL, Sugarman J. Toward responsible public engagement in neuroethics. AJOB Neurosci. 2022;13(2):103–6.

Manera KE, Tong A, Craig JC, Shen J, Jesudason S, Cho Y, et al. An international Delphi survey helped develop consensus-based core outcome domains for trials in peritoneal dialysis. Kidney Int. 2019;96(3):699–710.

Van Schoubroeck S, Springael J, Van Dael M, Malina R, Van Passel S. Sustainability indicators for biobased chemicals: a Delphi study using Multi-criteria decision analysis. Resour Conserv Recycl. 2019;144:198–208.

Akunne AF, Bridges JF, Sanon M, Sauerborn R. Comparison of individual and group valuation of health state scenarios across communities in West Africa. Appl Health Econ Health Policy. 2006;5:261–8.

Raj M, Ryan K, Nong P, Calhoun K, Trinidad MG, De Vries R, et al. Public deliberation process on patient perspectives on health information sharing: evaluative descriptive study. JMIR cancer. 2022;8(3):e37793.

Voehler D, Neumann PJ, Ollendorf DA. Patient and caregiver views on measures of the value of health interventions. Patient Prefer Adherence. 2022:3383–92.

Kinter ET, Schmeding A, Rudolph I, dosReis S, Bridges JFP. Identifying patient-relevant endpoints among individuals with schizophrenia: an application of patient-centered health technology assessment. Int J Technol Assess Health Care. 2009;25(1):35–41.

Heinzen RR, Bridges JF. Comparison of four contingent valuation methods to estimate the economic value of a pneumococcal vaccine in Bangladesh. Int J Technol Assess Health Care. 2008;24(4):481–7.

Bridges JFP, Selck FW, Gray GE, McIntyre JA, Martinson NA. Condom avoidance and determinants of demand for male circumcision in Johannesburg, South Africa. Health Policy Plann. 2011;26(4):298–306.

Beckham SW, Crossnohere NL, Gross M, Bridges JFP. Eliciting preferences for HIV Prevention technologies: a systematic review. Patient - Patient-Centered Outcomes Res. 2021;14(2):151–74.

Rogers HJ, Marshman Z, Rodd H, Rowen D. Discrete choice experiments or best-worst scaling? A qualitative study to determine the suitability of preference elicitation tasks in research with children and young people. J patient-reported Outcomes. 2021;5:1–11.

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John F.P. Bridges holds an Innovation in Regulatory Science Award from the Burroughs Wellcome Fund. Laura K Beres’ contributions were supported by National Institute of Mental Health 1K01MH130244-01A1. The contents included here are the responsibility of the authors and do not represent the official views of the National Institute of Mental Health.

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Beres, L.K., Campoamor, N.B., Hawthorn, R. et al. Using best-worst scaling to inform policy decisions in Africa: a literature review. BMC Public Health 24 , 2607 (2024). https://doi.org/10.1186/s12889-024-20068-w

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Received : 10 February 2024

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DOI : https://doi.org/10.1186/s12889-024-20068-w

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