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Writing a Literature Review

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A literature review is a document or section of a document that collects key sources on a topic and discusses those sources in conversation with each other (also called synthesis ). The lit review is an important genre in many disciplines, not just literature (i.e., the study of works of literature such as novels and plays). When we say “literature review” or refer to “the literature,” we are talking about the research ( scholarship ) in a given field. You will often see the terms “the research,” “the scholarship,” and “the literature” used mostly interchangeably.

Where, when, and why would I write a lit review?

There are a number of different situations where you might write a literature review, each with slightly different expectations; different disciplines, too, have field-specific expectations for what a literature review is and does. For instance, in the humanities, authors might include more overt argumentation and interpretation of source material in their literature reviews, whereas in the sciences, authors are more likely to report study designs and results in their literature reviews; these differences reflect these disciplines’ purposes and conventions in scholarship. You should always look at examples from your own discipline and talk to professors or mentors in your field to be sure you understand your discipline’s conventions, for literature reviews as well as for any other genre.

A literature review can be a part of a research paper or scholarly article, usually falling after the introduction and before the research methods sections. In these cases, the lit review just needs to cover scholarship that is important to the issue you are writing about; sometimes it will also cover key sources that informed your research methodology.

Lit reviews can also be standalone pieces, either as assignments in a class or as publications. In a class, a lit review may be assigned to help students familiarize themselves with a topic and with scholarship in their field, get an idea of the other researchers working on the topic they’re interested in, find gaps in existing research in order to propose new projects, and/or develop a theoretical framework and methodology for later research. As a publication, a lit review usually is meant to help make other scholars’ lives easier by collecting and summarizing, synthesizing, and analyzing existing research on a topic. This can be especially helpful for students or scholars getting into a new research area, or for directing an entire community of scholars toward questions that have not yet been answered.

What are the parts of a lit review?

Most lit reviews use a basic introduction-body-conclusion structure; if your lit review is part of a larger paper, the introduction and conclusion pieces may be just a few sentences while you focus most of your attention on the body. If your lit review is a standalone piece, the introduction and conclusion take up more space and give you a place to discuss your goals, research methods, and conclusions separately from where you discuss the literature itself.

Introduction:

• An introductory paragraph that explains what your working topic and thesis is
• A forecast of key topics or texts that will appear in the review
• Potentially, a description of how you found sources and how you analyzed them for inclusion and discussion in the review (more often found in published, standalone literature reviews than in lit review sections in an article or research paper)
• 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 sentence to draw connections, comparisons, and contrasts.

Conclusion:

• Summarize the key findings you have taken from the literature and emphasize their significance
• Connect it back to your primary research question

How should I organize my lit review?

Lit reviews can take many different organizational patterns depending on what you are trying to accomplish with the review. Here are some examples:

• Chronological : The simplest approach is to trace the development of the topic over time, which helps familiarize the audience with the topic (for instance if you are introducing something that is not commonly known in your field). If you choose this strategy, be careful to avoid simply listing and summarizing sources in order. Try to analyze the patterns, turning points, and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred (as mentioned previously, this may not be appropriate in your discipline — check with a teacher or mentor if you’re unsure).
• Thematic : If you have found some recurring central themes that you will continue working with throughout your piece, you can organize your literature review into subsections that address different aspects of the topic. For example, if you are reviewing literature about women and religion, key themes can include the role of women in churches and the religious attitude towards women.
• Qualitative versus quantitative research
• Empirical versus theoretical scholarship
• Divide the research by sociological, historical, or cultural sources
• Theoretical : In many humanities articles, the literature review is the foundation for the theoretical framework. You can use it to discuss various theories, models, and definitions of key concepts. You can argue for the relevance of a specific theoretical approach or combine various theorical concepts to create a framework for your research.

What are some strategies or tips I can use while writing my lit review?

Any lit review is only as good as the research it discusses; make sure your sources are well-chosen and your research is thorough. Don’t be afraid to do more research if you discover a new thread as you’re writing. More info on the research process is available in our "Conducting Research" resources .

As you’re doing your research, create an annotated bibliography ( see our page on the this type of document ). Much of the information used in an annotated bibliography can be used also in a literature review, so you’ll be not only partially drafting your lit review as you research, but also developing your sense of the larger conversation going on among scholars, professionals, and any other stakeholders in your topic.

Usually you will need to synthesize research rather than just summarizing it. This means drawing connections between sources to create a picture of the scholarly conversation on a topic over time. Many student writers struggle to synthesize because they feel they don’t have anything to add to the scholars they are citing; here are some strategies to help you:

• It often helps to remember that the point of these kinds of syntheses is to show your readers how you understand your research, to help them read the rest of your paper.
• Writing teachers often say synthesis is like hosting a dinner party: imagine all your sources are together in a room, discussing your topic. What are they saying to each other?
• Look at the in-text citations in each paragraph. Are you citing just one source for each paragraph? This usually indicates summary only. When you have multiple sources cited in a paragraph, you are more likely to be synthesizing them (not always, but often
• Read more about synthesis here.

The most interesting literature reviews are often written as arguments (again, as mentioned at the beginning of the page, this is discipline-specific and doesn’t work for all situations). Often, the literature review is where you can establish your research as filling a particular gap or as relevant in a particular way. You have some chance to do this in your introduction in an article, but the literature review section gives a more extended opportunity to establish the conversation in the way you would like your readers to see it. You can choose the intellectual lineage you would like to be part of and whose definitions matter most to your thinking (mostly humanities-specific, but this goes for sciences as well). In addressing these points, you argue for your place in the conversation, which tends to make the lit review more compelling than a simple reporting of other sources.

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• What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

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.

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 summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

Why write 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, frequently asked questions about literature reviews, introduction.

• Quick Run-through
• Step 1 & 2

When you write a dissertation or thesis, you will 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 scholarly context
• Develop a theoretical framework and methodology for your research
• Position yourself in relation to other researchers and theorists
• Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. 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 objectives and questions .

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

Start by creating a list of keywords related to your research topic. 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 if 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 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 use boolean operators to help narrow down your search:

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.

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

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?
• How does the publication contribute to your understanding of the topic? What are its key insights and arguments?
• 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 find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

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’s important to keep track of your sources with references to avoid plagiarism . It can be helpful to make an annotated bibliography, where you compile full reference 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.

You can use our free APA Reference Generator for quick, correct, consistent citations.

Prevent plagiarism, run a free check.

To begin organising your literature review’s argument and structure, you need to 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 organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

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 summarising sources in order.

Try to analyse 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 organise 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.

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

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, make sure to follow these tips:

• Summarise and synthesise: give an overview of the main points of each source and combine them into a coherent whole.
• Analyse and interpret: don’t just paraphrase other researchers – add your own interpretations, 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 transitions and topic sentences to draw connections, comparisons and contrasts.

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

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

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 dissertation , thesis, research paper , or proposal .

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

• To familiarise 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  dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

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Libraries | Research Guides

Literature reviews, what is a literature review, learning more about how to do a literature review.

• Planning the Review
• The Research Question
• Choosing Where to Search
• Organizing the Review
• Writing the Review

A literature review is a review and synthesis of existing research on a topic or research question. A literature review is meant to analyze the scholarly literature, make connections across writings and identify strengths, weaknesses, trends, and missing conversations. A literature review should address different aspects of a topic as it relates to your research question. A literature review goes beyond a description or summary of the literature you have read. 

• Sage Research Methods Core Collection This link opens in a new window SAGE Research Methods supports research at all levels by providing material to guide users through every step of the research process. SAGE Research Methods is the ultimate methods library with more than 1000 books, reference works, journal articles, and instructional videos by world-leading academics from across the social sciences, including the largest collection of qualitative methods books available online from any scholarly publisher. – Publisher

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SWRK 330 - Social Work Research Methods

• Literature Reviews and Empirical Research
• Databases and Search Tips
• Article Citations
• Scholarly Journal Evaulation
• Statistical Sources
• Books and eBooks

What is a Literature Review?

Empirical research.

• Annotated Bibliographies

A literature review  summarizes and discusses previous publications  on a topic.

It should also:

explore past research and its strengths and weaknesses.

be used to validate the target and methods you have chosen for your proposed research.

consist of books and scholarly journals that provide research examples of populations or settings similar to your own, as well as community resources to document the need for your proposed research.

The literature review does not present new  primary  scholarship. 

be completed in the correct citation format requested by your professor  (see the  C itations Tab)

Access Purdue  OWL's Social Work Literature Review Guidelines here .  

Empirical Research  is  research  that is based on experimentation or observation, i.e. Evidence. Such  research  is often conducted to answer a specific question or to test a hypothesis (educated guess).

How do you know if a study is empirical? Read the subheadings within the article, book, or report and look for a description of the research "methodology."  Ask yourself: Could I recreate this study and test these results?

These are some key features to look for when identifying empirical research.

NOTE:  Not all of these features will be in every empirical research article, some may be excluded, use this only as a guide.

• Statement of methodology
• Research questions are clear and measurable
• Individuals, group, subjects which are being studied are identified/defined
• Data is presented regarding the findings
• Controls or instruments such as surveys or tests were conducted
• There is a literature review
• There is discussion of the results included
• Citations/references are included

See also Empirical Research Guide

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Methodological Approaches to Literature Review

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• First Online: 09 May 2023
• Cite this living reference work entry

• Dennis Thomas 2 ,
• Elida Zairina 3 &
• Johnson George 4  

473 Accesses

The literature review can serve various functions in the contexts of education and research. It aids in identifying knowledge gaps, informing research methodology, and developing a theoretical framework during the planning stages of a research study or project, as well as reporting of review findings in the context of the existing literature. This chapter discusses the methodological approaches to conducting a literature review and offers an overview of different types of reviews. There are various types of reviews, including narrative reviews, scoping reviews, and systematic reviews with reporting strategies such as meta-analysis and meta-synthesis. Review authors should consider the scope of the literature review when selecting a type and method. Being focused is essential for a successful review; however, this must be balanced against the relevance of the review to a broad audience.

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The Critical Appraisal Program. Critical appraisal skills program. Available at https://casp-uk.net/ . 2022. Accessed 29 Aug 2022.

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The Writing Center University of Winconsin-Madison. Learn how to write a literature review in The Writer’s Handbook – Academic Professional Writing. 2022. Available at https://writing.wisc.edu/handbook/assignments/reviewofliterature/ . Accessed 29 Aug 2022.

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Thomas, D., Zairina, E., George, J. (2023). Methodological Approaches to Literature Review. In: Encyclopedia of Evidence in Pharmaceutical Public Health and Health Services Research in Pharmacy. Springer, Cham. https://doi.org/10.1007/978-3-030-50247-8_57-1

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Writing a literature review

Find out how to write a lit review.

What is a literature review ?

A literature review explores and evaluates the literature on a specific topic or question. It synthesises the contributions of the different authors, often to identify areas that need further exploration.

You may be required to write a literature review as a standalone document or part of a larger body of research, such as a thesis.

• The point of a standalone literature review is to demonstrate that you have read widely in your field and you understand the main arguments.
• As part of a thesis or research paper, the literature review defines your project by establishing how your work will extend or differ from previous work and what contribution it will make.

What are markers looking for?

In the best literature reviews, the writer:

• Has a clear understanding of key concepts within the topic.
• Clarifies important definitions and terminology.
• Covers the breadth of the specific topic.
• Critically discusses the ideas in the literature and evaluates how authors present them.
• Clearly indicates a research gap for future enquiry.

How do I write a literature review?

This video outlines a step by step approach to help you evaluate readings, organise ideas and write critically. It provides examples of how to connect, interpret and critique ideas to make sure your voice comes through strongly.

Tips for research, reading and writing

You may be given a specific question to research or broad topics which must be refined to a question that can be reasonably addressed in the time and word limit available.

Use your early reading to help you determine and refine your topic.

• Too much literature? You probably need to narrow your scope. Try to identify a more specific issue of interest.
• Not enough literature? Your topic may be too specific and needs to be broader.

Start with readings suggested by your lecturers or supervisors. Then, do your own research - the best place to go is the Library Website .

You can also use the Library Guides or speak to a librarian to identify the most useful databases for you and to learn how to search for sources effectively and efficiently.

Cover the field

Make sure your literature search covers a broad range of views and information relevant to your topic. Focussing on a narrow selection of sources may result in a lack of depth. You are not expected to cover all research and scholarly opinions on your topic, but you need to identify and include important viewpoints. A quality literature review examines and evaluates different viewpoints based on the evidence presented, rather than providing only material that reinforces a bias.

Use reading strategies

Survey, skim and scan to find the most relevant articles, and the most relevant parts of those articles. These can be re-read more closely later when you have acquired an overview of your topic.

Take notes as you read

This helps to organise and develop your thoughts. Record your own reactions to the text in your notes, perhaps in a separate column. These notes can form the basis of your critical evaluation of the text. Record any facts, opinions or direct quotes that are likely to be useful to your review, noting the page numbers, author and year.

Stop reading when you have enough

This depends on the word count required of this literature review. A review of one thousand words can only cover the major ideas and probably less than ten references. Longer reviews that form part of a large research paper will include more than fifty. Your tutor or supervisor should be able to suggest a suitable number.

As you read, ask yourself these questions:

• Have I answered my question without any obvious gaps?
• Have I read this before? Are there any new related issues coming up as I search the literature?
• Have I found multiple references which cover the same material or just enough to prove agreement?

There are many possible ways to organise the material. For example:

• chronologically
• by theoretical perspective
• from most to least important
• by issue or theme

It is important to remember that you are not merely cataloguing or describing the literature you read. Therefore, you need to choose an organisation that will enable you to compare the various authors' treatment of ideas. This is often best achieved by organising thematically, or grouping ideas into sets of common issues tackled in the various texts. These themes will form the basis of the different threads that are the focus of your study.

A standalone literature review

A standalone literature review is structured much like an academic essay.

• Introduction - establish the context for your topic and outline your main contentions about the literature
• Main body - explain and support these inferences in the main body
• Conclusion - summarise your main points and restate the contention.

The main difference between an essay and this kind of literature review is that an essay focuses on a topic and uses the literature as a support for the arguments. In a standalone literature review, the literature itself is the topic of discussion and evaluation. This means you evaluate and discuss not only the informational content but the quality of the author’s handling of the content.

A literature review as part of a larger research paper?

As part of a larger research paper, the literature review may take many forms, depending on your discipline, your topic and the logic of your research. Traditionally, in empirical research, the literature review is included in the introduction, or a standalone chapter immediately following the introduction. For other forms of research, you may need to engage more extensively with the literature and thus, the literature review may spread over more than one chapter, or even be distributed throughout the thesis.

Start writing early. Writing will clarify your thinking on the topic and reveal any gaps in information and logic. If your ideas change, sections and paragraphs can be reworked to change your contentions or include extra information.

Similarly, draft an overall plan for your review as soon as you are ready, but be prepared to rework sections of it to reflect your developing argument.

The most important thing to remember is that you are writing a review . That means you must move past describing what other authors have written by connecting, interpreting and critiquing their ideas and presenting your own analysis and interpretation.

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Research Methods

• Getting Started
• Literature Review Research
• Research Design
• Research Design By Discipline
• SAGE Research Methods
• Teaching with SAGE Research Methods

Literature Review

• What is a Literature Review?
• What is NOT a Literature Review?
• Purposes of a Literature Review
• Types of Literature Reviews
• Literature Reviews vs. Systematic Reviews
• Systematic vs. Meta-Analysis

Literature Review  is a comprehensive survey of the works published in a particular field of study or line of research, usually over a specific period of time, in the form of an in-depth, critical bibliographic essay or annotated list in which attention is drawn to the most significant works.

Also, we can define a literature review as the collected body of scholarly works related to a topic:

• Summarizes and analyzes previous research relevant to a topic
• Includes scholarly books and articles published in academic journals
• Can be an specific scholarly paper or a section in a research paper

The objective of a Literature Review is to find previous published scholarly works relevant to an specific topic

• Help gather ideas or information
• Keep up to date in current trends and findings
• Help develop new questions

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Helps focus your own research questions or problems
• Discovers relationships between research studies/ideas.
• Suggests unexplored ideas or populations
• Identifies major themes, concepts, and researchers on a topic.
• Tests assumptions; may help counter preconceived ideas and remove unconscious bias.
• Identifies critical gaps, points of disagreement, or potentially flawed methodology or theoretical approaches.
• Indicates potential directions for future research.

All content in this section is from Literature Review Research from Old Dominion University 

Keep in mind the following, a literature review is NOT:

Not an essay 

Not an annotated bibliography  in which you summarize each article that you have reviewed.  A literature review goes beyond basic summarizing to focus on the critical analysis of the reviewed works and their relationship to your research question.

Not a research paper   where you select resources to support one side of an issue versus another.  A lit review should explain and consider all sides of an argument in order to avoid bias, and areas of agreement and disagreement should be highlighted.

A literature review serves several purposes. For example, it

• provides thorough knowledge of previous studies; introduces seminal works.
• helps focus one’s own research topic.
• identifies a conceptual framework for one’s own research questions or problems; indicates potential directions for future research.
• suggests previously unused or underused methodologies, designs, quantitative and qualitative strategies.
• identifies gaps in previous studies; identifies flawed methodologies and/or theoretical approaches; avoids replication of mistakes.
• helps the researcher avoid repetition of earlier research.
• suggests unexplored populations.
• determines whether past studies agree or disagree; identifies controversy in the literature.
• tests assumptions; may help counter preconceived ideas and remove unconscious bias.

As Kennedy (2007) notes*, it is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the original studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally that become part of the lore of field. In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews.

Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are several approaches to how they can be done, depending upon the type of analysis underpinning your study. Listed below are definitions of types of literature reviews:

Argumentative Review      This form examines literature selectively in order to support or refute an argument, deeply imbedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to to make summary claims of the sort found in systematic reviews.

Integrative Review      Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication.

Historical Review      Few things rest in isolation from historical precedent. Historical reviews are focused on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review      A review does not always focus on what someone said [content], but how they said it [method of analysis]. This approach provides a framework of understanding at different levels (i.e. those of theory, substantive fields, research approaches and data collection and analysis techniques), enables researchers to draw on a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection and data analysis, and helps highlight many ethical issues which we should be aware of and consider as we go through our study.

Systematic Review      This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyse data from the studies that are included in the review. Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?"

Theoretical Review      The purpose of this form is to concretely examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review help establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

* Kennedy, Mary M. "Defining a Literature."  Educational Researcher  36 (April 2007): 139-147.

All content in this section is from The Literature Review created by Dr. Robert Larabee USC

Robinson, P. and Lowe, J. (2015),  Literature reviews vs systematic reviews.  Australian and New Zealand Journal of Public Health, 39: 103-103. doi: 10.1111/1753-6405.12393

What's in the name? The difference between a Systematic Review and a Literature Review, and why it matters . By Lynn Kysh from University of Southern California

Systematic review or meta-analysis?

A  systematic review  answers a defined research question by collecting and summarizing all empirical evidence that fits pre-specified eligibility criteria.

A  meta-analysis  is the use of statistical methods to summarize the results of these studies.

Systematic reviews, just like other research articles, can be of varying quality. They are a significant piece of work (the Centre for Reviews and Dissemination at York estimates that a team will take 9-24 months), and to be useful to other researchers and practitioners they should have:

• clearly stated objectives with pre-defined eligibility criteria for studies
• explicit, reproducible methodology
• a systematic search that attempts to identify all studies
• assessment of the validity of the findings of the included studies (e.g. risk of bias)
• systematic presentation, and synthesis, of the characteristics and findings of the included studies

Not all systematic reviews contain meta-analysis. 

Meta-analysis is the use of statistical methods to summarize the results of independent studies. By combining information from all relevant studies, meta-analysis can provide more precise estimates of the effects of health care than those derived from the individual studies included within a review.  More information on meta-analyses can be found in  Cochrane Handbook, Chapter 9 .

A meta-analysis goes beyond critique and integration and conducts secondary statistical analysis on the outcomes of similar studies.  It is a systematic review that uses quantitative methods to synthesize and summarize the results.

An advantage of a meta-analysis is the ability to be completely objective in evaluating research findings.  Not all topics, however, have sufficient research evidence to allow a meta-analysis to be conducted.  In that case, an integrative review is an appropriate strategy. 

Some of the content in this section is from Systematic reviews and meta-analyses: step by step guide created by Kate McAllister.

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• Next: Research Design >>
• Last Updated: Aug 21, 2023 4:07 PM
• URL: https://guides.lib.udel.edu/researchmethods

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Module 2 Chapter 3: What is Empirical Literature & Where can it be Found?

In Module 1, you read about the problem of pseudoscience. Here, we revisit the issue in addressing how to locate and assess scientific or empirical literature . In this chapter you will read about:

• distinguishing between what IS and IS NOT empirical literature
• how and where to locate empirical literature for understanding diverse populations, social work problems, and social phenomena.

Probably the most important take-home lesson from this chapter is that one source is not sufficient to being well-informed on a topic. It is important to locate multiple sources of information and to critically appraise the points of convergence and divergence in the information acquired from different sources. This is especially true in emerging and poorly understood topics, as well as in answering complex questions.

What Is Empirical Literature

Social workers often need to locate valid, reliable information concerning the dimensions of a population group or subgroup, a social work problem, or social phenomenon. They might also seek information about the way specific problems or resources are distributed among the populations encountered in professional practice. Or, social workers might be interested in finding out about the way that certain people experience an event or phenomenon. Empirical literature resources may provide answers to many of these types of social work questions. In addition, resources containing data regarding social indicators may also prove helpful. Social indicators are the “facts and figures” statistics that describe the social, economic, and psychological factors that have an impact on the well-being of a community or other population group.The United Nations (UN) and the World Health Organization (WHO) are examples of organizations that monitor social indicators at a global level: dimensions of population trends (size, composition, growth/loss), health status (physical, mental, behavioral, life expectancy, maternal and infant mortality, fertility/child-bearing, and diseases like HIV/AIDS), housing and quality of sanitation (water supply, waste disposal), education and literacy, and work/income/unemployment/economics, for example.

Three characteristics stand out in empirical literature compared to other types of information available on a topic of interest: systematic observation and methodology, objectivity, and transparency/replicability/reproducibility. Let’s look a little more closely at these three features.

Systematic Observation and Methodology. The hallmark of empiricism is “repeated or reinforced observation of the facts or phenomena” (Holosko, 2006, p. 6). In empirical literature, established research methodologies and procedures are systematically applied to answer the questions of interest.

Objectivity. Gathering “facts,” whatever they may be, drives the search for empirical evidence (Holosko, 2006). Authors of empirical literature are expected to report the facts as observed, whether or not these facts support the investigators’ original hypotheses. Research integrity demands that the information be provided in an objective manner, reducing sources of investigator bias to the greatest possible extent.

Transparency and Replicability/Reproducibility.   Empirical literature is reported in such a manner that other investigators understand precisely what was done and what was found in a particular research study—to the extent that they could replicate the study to determine whether the findings are reproduced when repeated. The outcomes of an original and replication study may differ, but a reader could easily interpret the methods and procedures leading to each study’s findings.

What is NOT Empirical Literature

By now, it is probably obvious to you that literature based on “evidence” that is not developed in a systematic, objective, transparent manner is not empirical literature. On one hand, non-empirical types of professional literature may have great significance to social workers. For example, social work scholars may produce articles that are clearly identified as describing a new intervention or program without evaluative evidence, critiquing a policy or practice, or offering a tentative, untested theory about a phenomenon. These resources are useful in educating ourselves about possible issues or concerns. But, even if they are informed by evidence, they are not empirical literature. Here is a list of several sources of information that do not meet the standard of being called empirical literature:

• your course instructor’s lectures
• political statements
• advertisements
• newspapers & magazines (journalism)
• television news reports & analyses (journalism)
• many websites, Facebook postings, Twitter tweets, and blog postings
• the introductory literature review in an empirical article

You may be surprised to see the last two included in this list. Like the other sources of information listed, these sources also might lead you to look for evidence. But, they are not themselves sources of evidence. They may summarize existing evidence, but in the process of summarizing (like your instructor’s lectures), information is transformed, modified, reduced, condensed, and otherwise manipulated in such a manner that you may not see the entire, objective story. These are called secondary sources, as opposed to the original, primary source of evidence. In relying solely on secondary sources, you sacrifice your own critical appraisal and thinking about the original work—you are “buying” someone else’s interpretation and opinion about the original work, rather than developing your own interpretation and opinion. What if they got it wrong? How would you know if you did not examine the primary source for yourself? Consider the following as an example of “getting it wrong” being perpetuated.

Example: Bullying and School Shootings . One result of the heavily publicized April 1999 school shooting incident at Columbine High School (Colorado), was a heavy emphasis placed on bullying as a causal factor in these incidents (Mears, Moon, & Thielo, 2017), “creating a powerful master narrative about school shootings” (Raitanen, Sandberg, & Oksanen, 2017, p. 3). Naturally, with an identified cause, a great deal of effort was devoted to anti-bullying campaigns and interventions for enhancing resilience among youth who experience bullying.  However important these strategies might be for promoting positive mental health, preventing poor mental health, and possibly preventing suicide among school-aged children and youth, it is a mistaken belief that this can prevent school shootings (Mears, Moon, & Thielo, 2017). Many times the accounts of the perpetrators having been bullied come from potentially inaccurate third-party accounts, rather than the perpetrators themselves; bullying was not involved in all instances of school shooting; a perpetrator’s perception of being bullied/persecuted are not necessarily accurate; many who experience severe bullying do not perpetrate these incidents; bullies are the least targeted shooting victims; perpetrators of the shooting incidents were often bullying others; and, bullying is only one of many important factors associated with perpetrating such an incident (Ioannou, Hammond, & Simpson, 2015; Mears, Moon, & Thielo, 2017; Newman &Fox, 2009; Raitanen, Sandberg, & Oksanen, 2017). While mass media reports deliver bullying as a means of explaining the inexplicable, the reality is not so simple: “The connection between bullying and school shootings is elusive” (Langman, 2014), and “the relationship between bullying and school shooting is, at best, tenuous” (Mears, Moon, & Thielo, 2017, p. 940). The point is, when a narrative becomes this publicly accepted, it is difficult to sort out truth and reality without going back to original sources of information and evidence.

What May or May Not Be Empirical Literature: Literature Reviews

Investigators typically engage in a review of existing literature as they develop their own research studies. The review informs them about where knowledge gaps exist, methods previously employed by other scholars, limitations of prior work, and previous scholars’ recommendations for directing future research. These reviews may appear as a published article, without new study data being reported (see Fields, Anderson, & Dabelko-Schoeny, 2014 for example). Or, the literature review may appear in the introduction to their own empirical study report. These literature reviews are not considered to be empirical evidence sources themselves, although they may be based on empirical evidence sources. One reason is that the authors of a literature review may or may not have engaged in a systematic search process, identifying a full, rich, multi-sided pool of evidence reports.

There is, however, a type of review that applies systematic methods and is, therefore, considered to be more strongly rooted in evidence: the systematic review .

Systematic review of literature. A systematic reviewis a type of literature report where established methods have been systematically applied, objectively, in locating and synthesizing a body of literature. The systematic review report is characterized by a great deal of transparency about the methods used and the decisions made in the review process, and are replicable. Thus, it meets the criteria for empirical literature: systematic observation and methodology, objectivity, and transparency/reproducibility. We will work a great deal more with systematic reviews in the second course, SWK 3402, since they are important tools for understanding interventions. They are somewhat less common, but not unheard of, in helping us understand diverse populations, social work problems, and social phenomena.

Locating Empirical Evidence

Social workers have available a wide array of tools and resources for locating empirical evidence in the literature. These can be organized into four general categories.

Journal Articles. A number of professional journals publish articles where investigators report on the results of their empirical studies. However, it is important to know how to distinguish between empirical and non-empirical manuscripts in these journals. A key indicator, though not the only one, involves a peer review process . Many professional journals require that manuscripts undergo a process of peer review before they are accepted for publication. This means that the authors’ work is shared with scholars who provide feedback to the journal editor as to the quality of the submitted manuscript. The editor then makes a decision based on the reviewers’ feedback:

• Accept as is
• Accept with minor revisions
• Request that a revision be resubmitted (no assurance of acceptance)

When a “revise and resubmit” decision is made, the piece will go back through the review process to determine if it is now acceptable for publication and that all of the reviewers’ concerns have been adequately addressed. Editors may also reject a manuscript because it is a poor fit for the journal, based on its mission and audience, rather than sending it for review consideration.

Indicators of journal relevance. Various journals are not equally relevant to every type of question being asked of the literature. Journals may overlap to a great extent in terms of the topics they might cover; in other words, a topic might appear in multiple different journals, depending on how the topic was being addressed. For example, articles that might help answer a question about the relationship between community poverty and violence exposure might appear in several different journals, some with a focus on poverty, others with a focus on violence, and still others on community development or public health. Journal titles are sometimes a good starting point but may not give a broad enough picture of what they cover in their contents.

In focusing a literature search, it also helps to review a journal’s mission and target audience. For example, at least four different journals focus specifically on poverty:

• Journal of Children & Poverty
• Journal of Poverty
• Journal of Poverty and Social Justice
• Poverty & Public Policy

Let’s look at an example using the Journal of Poverty and Social Justice . Information about this journal is located on the journal’s webpage: http://policy.bristoluniversitypress.co.uk/journals/journal-of-poverty-and-social-justice . In the section headed “About the Journal” you can see that it is an internationally focused research journal, and that it addresses social justice issues in addition to poverty alone. The research articles are peer-reviewed (there appear to be non-empirical discussions published, as well). These descriptions about a journal are almost always available, sometimes listed as “scope” or “mission.” These descriptions also indicate the sponsorship of the journal—sponsorship may be institutional (a particular university or agency, such as Smith College Studies in Social Work ), a professional organization, such as the Council on Social Work Education (CSWE) or the National Association of Social Work (NASW), or a publishing company (e.g., Taylor & Frances, Wiley, or Sage).

Indicators of journal caliber.  Despite engaging in a peer review process, not all journals are equally rigorous. Some journals have very high rejection rates, meaning that many submitted manuscripts are rejected; others have fairly high acceptance rates, meaning that relatively few manuscripts are rejected. This is not necessarily the best indicator of quality, however, since newer journals may not be sufficiently familiar to authors with high quality manuscripts and some journals are very specific in terms of what they publish. Another index that is sometimes used is the journal’s impact factor . Impact factor is a quantitative number indicative of how often articles published in the journal are cited in the reference list of other journal articles—the statistic is calculated as the number of times on average each article published in a particular year were cited divided by the number of articles published (the number that could be cited). For example, the impact factor for the Journal of Poverty and Social Justice in our list above was 0.70 in 2017, and for the Journal of Poverty was 0.30. These are relatively low figures compared to a journal like the New England Journal of Medicine with an impact factor of 59.56! This means that articles published in that journal were, on average, cited more than 59 times in the next year or two.

Impact factors are not necessarily the best indicator of caliber, however, since many strong journals are geared toward practitioners rather than scholars, so they are less likely to be cited by other scholars but may have a large impact on a large readership. This may be the case for a journal like the one titled Social Work, the official journal of the National Association of Social Workers. It is distributed free to all members: over 120,000 practitioners, educators, and students of social work world-wide. The journal has a recent impact factor of.790. The journals with social work relevant content have impact factors in the range of 1.0 to 3.0 according to Scimago Journal & Country Rank (SJR), particularly when they are interdisciplinary journals (for example, Child Development , Journal of Marriage and Family , Child Abuse and Neglect , Child Maltreatmen t, Social Service Review , and British Journal of Social Work ). Once upon a time, a reader could locate different indexes comparing the “quality” of social work-related journals. However, the concept of “quality” is difficult to systematically define. These indexes have mostly been replaced by impact ratings, which are not necessarily the best, most robust indicators on which to rely in assessing journal quality. For example, new journals addressing cutting edge topics have not been around long enough to have been evaluated using this particular tool, and it takes a few years for articles to begin to be cited in other, later publications.

Beware of pseudo-, illegitimate, misleading, deceptive, and suspicious journals . Another side effect of living in the Age of Information is that almost anyone can circulate almost anything and call it whatever they wish. This goes for “journal” publications, as well. With the advent of open-access publishing in recent years (electronic resources available without subscription), we have seen an explosion of what are called predatory or junk journals . These are publications calling themselves journals, often with titles very similar to legitimate publications and often with fake editorial boards. These “publications” lack the integrity of legitimate journals. This caution is reminiscent of the discussions earlier in the course about pseudoscience and “snake oil” sales. The predatory nature of many apparent information dissemination outlets has to do with how scientists and scholars may be fooled into submitting their work, often paying to have their work peer-reviewed and published. There exists a “thriving black-market economy of publishing scams,” and at least two “journal blacklists” exist to help identify and avoid these scam journals (Anderson, 2017).

This issue is important to information consumers, because it creates a challenge in terms of identifying legitimate sources and publications. The challenge is particularly important to address when information from on-line, open-access journals is being considered. Open-access is not necessarily a poor choice—legitimate scientists may pay sizeable fees to legitimate publishers to make their work freely available and accessible as open-access resources. On-line access is also not necessarily a poor choice—legitimate publishers often make articles available on-line to provide timely access to the content, especially when publishing the article in hard copy will be delayed by months or even a year or more. On the other hand, stating that a journal engages in a peer-review process is no guarantee of quality—this claim may or may not be truthful. Pseudo- and junk journals may engage in some quality control practices, but may lack attention to important quality control processes, such as managing conflict of interest, reviewing content for objectivity or quality of the research conducted, or otherwise failing to adhere to industry standards (Laine & Winker, 2017).

One resource designed to assist with the process of deciphering legitimacy is the Directory of Open Access Journals (DOAJ). The DOAJ is not a comprehensive listing of all possible legitimate open-access journals, and does not guarantee quality, but it does help identify legitimate sources of information that are openly accessible and meet basic legitimacy criteria. It also is about open-access journals, not the many journals published in hard copy.

An additional caution: Search for article corrections. Despite all of the careful manuscript review and editing, sometimes an error appears in a published article. Most journals have a practice of publishing corrections in future issues. When you locate an article, it is helpful to also search for updates. Here is an example where data presented in an article’s original tables were erroneous, and a correction appeared in a later issue.

• Marchant, A., Hawton, K., Stewart A., Montgomery, P., Singaravelu, V., Lloyd, K., Purdy, N., Daine, K., & John, A. (2017). A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown. PLoS One, 12(8): e0181722. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558917/
• Marchant, A., Hawton, K., Stewart A., Montgomery, P., Singaravelu, V., Lloyd, K., Purdy, N., Daine, K., & John, A. (2018).Correction—A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown. PLoS One, 13(3): e0193937.  http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193937

Search Tools. In this age of information, it is all too easy to find items—the problem lies in sifting, sorting, and managing the vast numbers of items that can be found. For example, a simple Google® search for the topic “community poverty and violence” resulted in about 15,600,000 results! As a means of simplifying the process of searching for journal articles on a specific topic, a variety of helpful tools have emerged. One type of search tool has previously applied a filtering process for you: abstracting and indexing databases . These resources provide the user with the results of a search to which records have already passed through one or more filters. For example, PsycINFO is managed by the American Psychological Association and is devoted to peer-reviewed literature in behavioral science. It contains almost 4.5 million records and is growing every month. However, it may not be available to users who are not affiliated with a university library. Conducting a basic search for our topic of “community poverty and violence” in PsychINFO returned 1,119 articles. Still a large number, but far more manageable. Additional filters can be applied, such as limiting the range in publication dates, selecting only peer reviewed items, limiting the language of the published piece (English only, for example), and specified types of documents (either chapters, dissertations, or journal articles only, for example). Adding the filters for English, peer-reviewed journal articles published between 2010 and 2017 resulted in 346 documents being identified.

Just as was the case with journals, not all abstracting and indexing databases are equivalent. There may be overlap between them, but none is guaranteed to identify all relevant pieces of literature. Here are some examples to consider, depending on the nature of the questions asked of the literature:

• Academic Search Complete—multidisciplinary index of 9,300 peer-reviewed journals
• AgeLine—multidisciplinary index of aging-related content for over 600 journals
• Campbell Collaboration—systematic reviews in education, crime and justice, social welfare, international development
• Google Scholar—broad search tool for scholarly literature across many disciplines
• MEDLINE/ PubMed—National Library of medicine, access to over 15 million citations
• Oxford Bibliographies—annotated bibliographies, each is discipline specific (e.g., psychology, childhood studies, criminology, social work, sociology)
• PsycINFO/PsycLIT—international literature on material relevant to psychology and related disciplines
• SocINDEX—publications in sociology
• Social Sciences Abstracts—multiple disciplines
• Social Work Abstracts—many areas of social work are covered
• Web of Science—a “meta” search tool that searches other search tools, multiple disciplines

Placing our search for information about “community violence and poverty” into the Social Work Abstracts tool with no additional filters resulted in a manageable 54-item list. Finally, abstracting and indexing databases are another way to determine journal legitimacy: if a journal is indexed in a one of these systems, it is likely a legitimate journal. However, the converse is not necessarily true: if a journal is not indexed does not mean it is an illegitimate or pseudo-journal.

Government Sources. A great deal of information is gathered, analyzed, and disseminated by various governmental branches at the international, national, state, regional, county, and city level. Searching websites that end in.gov is one way to identify this type of information, often presented in articles, news briefs, and statistical reports. These government sources gather information in two ways: they fund external investigations through grants and contracts and they conduct research internally, through their own investigators. Here are some examples to consider, depending on the nature of the topic for which information is sought:

• Agency for Healthcare Research and Quality (AHRQ) at https://www.ahrq.gov/
• Bureau of Justice Statistics (BJS) at https://www.bjs.gov/
• Census Bureau at https://www.census.gov
• Morbidity and Mortality Weekly Report of the CDC (MMWR-CDC) at https://www.cdc.gov/mmwr/index.html
• Child Welfare Information Gateway at https://www.childwelfare.gov
• Children’s Bureau/Administration for Children & Families at https://www.acf.hhs.gov
• Forum on Child and Family Statistics at https://www.childstats.gov
• National Institutes of Health (NIH) at https://www.nih.gov , including (not limited to):
• National Institute on Aging (NIA at https://www.nia.nih.gov
• National Institute on Alcohol Abuse and Alcoholism (NIAAA) at https://www.niaaa.nih.gov
• National Institute of Child Health and Human Development (NICHD) at https://www.nichd.nih.gov
• National Institute on Drug Abuse (NIDA) at https://www.nida.nih.gov
• National Institute of Environmental Health Sciences at https://www.niehs.nih.gov
• National Institute of Mental Health (NIMH) at https://www.nimh.nih.gov
• National Institute on Minority Health and Health Disparities at https://www.nimhd.nih.gov
• National Institute of Justice (NIJ) at https://www.nij.gov
• Substance Abuse and Mental Health Services Administration (SAMHSA) at https://www.samhsa.gov/
• United States Agency for International Development at https://usaid.gov

Each state and many counties or cities have similar data sources and analysis reports available, such as Ohio Department of Health at https://www.odh.ohio.gov/healthstats/dataandstats.aspx and Franklin County at https://statisticalatlas.com/county/Ohio/Franklin-County/Overview . Data are available from international/global resources (e.g., United Nations and World Health Organization), as well.

Other Sources. The Health and Medicine Division (HMD) of the National Academies—previously the Institute of Medicine (IOM)—is a nonprofit institution that aims to provide government and private sector policy and other decision makers with objective analysis and advice for making informed health decisions. For example, in 2018 they produced reports on topics in substance use and mental health concerning the intersection of opioid use disorder and infectious disease,  the legal implications of emerging neurotechnologies, and a global agenda concerning the identification and prevention of violence (see http://www.nationalacademies.org/hmd/Global/Topics/Substance-Abuse-Mental-Health.aspx ). The exciting aspect of this resource is that it addresses many topics that are current concerns because they are hoping to help inform emerging policy. The caution to consider with this resource is the evidence is often still emerging, as well.

Numerous “think tank” organizations exist, each with a specific mission. For example, the Rand Corporation is a nonprofit organization offering research and analysis to address global issues since 1948. The institution’s mission is to help improve policy and decision making “to help individuals, families, and communities throughout the world be safer and more secure, healthier and more prosperous,” addressing issues of energy, education, health care, justice, the environment, international affairs, and national security (https://www.rand.org/about/history.html). And, for example, the Robert Woods Johnson Foundation is a philanthropic organization supporting research and research dissemination concerning health issues facing the United States. The foundation works to build a culture of health across systems of care (not only medical care) and communities (https://www.rwjf.org).

While many of these have a great deal of helpful evidence to share, they also may have a strong political bias. Objectivity is often lacking in what information these organizations provide: they provide evidence to support certain points of view. That is their purpose—to provide ideas on specific problems, many of which have a political component. Think tanks “are constantly researching solutions to a variety of the world’s problems, and arguing, advocating, and lobbying for policy changes at local, state, and federal levels” (quoted from https://thebestschools.org/features/most-influential-think-tanks/ ). Helpful information about what this one source identified as the 50 most influential U.S. think tanks includes identifying each think tank’s political orientation. For example, The Heritage Foundation is identified as conservative, whereas Human Rights Watch is identified as liberal.

While not the same as think tanks, many mission-driven organizations also sponsor or report on research, as well. For example, the National Association for Children of Alcoholics (NACOA) in the United States is a registered nonprofit organization. Its mission, along with other partnering organizations, private-sector groups, and federal agencies, is to promote policy and program development in research, prevention and treatment to provide information to, for, and about children of alcoholics (of all ages). Based on this mission, the organization supports knowledge development and information gathering on the topic and disseminates information that serves the needs of this population. While this is a worthwhile mission, there is no guarantee that the information meets the criteria for evidence with which we have been working. Evidence reported by think tank and mission-driven sources must be utilized with a great deal of caution and critical analysis!

In many instances an empirical report has not appeared in the published literature, but in the form of a technical or final report to the agency or program providing the funding for the research that was conducted. One such example is presented by a team of investigators funded by the National Institute of Justice to evaluate a program for training professionals to collect strong forensic evidence in instances of sexual assault (Patterson, Resko, Pierce-Weeks, & Campbell, 2014): https://www.ncjrs.gov/pdffiles1/nij/grants/247081.pdf . Investigators may serve in the capacity of consultant to agencies, programs, or institutions, and provide empirical evidence to inform activities and planning. One such example is presented by Maguire-Jack (2014) as a report to a state’s child maltreatment prevention board: https://preventionboard.wi.gov/Documents/InvestmentInPreventionPrograming_Final.pdf .

When Direct Answers to Questions Cannot Be Found. Sometimes social workers are interested in finding answers to complex questions or questions related to an emerging, not-yet-understood topic. This does not mean giving up on empirical literature. Instead, it requires a bit of creativity in approaching the literature. A Venn diagram might help explain this process. Consider a scenario where a social worker wishes to locate literature to answer a question concerning issues of intersectionality. Intersectionality is a social justice term applied to situations where multiple categorizations or classifications come together to create overlapping, interconnected, or multiplied disadvantage. For example, women with a substance use disorder and who have been incarcerated face a triple threat in terms of successful treatment for a substance use disorder: intersectionality exists between being a woman, having a substance use disorder, and having been in jail or prison. After searching the literature, little or no empirical evidence might have been located on this specific triple-threat topic. Instead, the social worker will need to seek literature on each of the threats individually, and possibly will find literature on pairs of topics (see Figure 3-1). There exists some literature about women’s outcomes for treatment of a substance use disorder (a), some literature about women during and following incarceration (b), and some literature about substance use disorders and incarceration (c). Despite not having a direct line on the center of the intersecting spheres of literature (d), the social worker can develop at least a partial picture based on the overlapping literatures.

Figure 3-1. Venn diagram of intersecting literature sets.

Take a moment to complete the following activity. For each statement about empirical literature, decide if it is true or false.

Social Work 3401 Coursebook Copyright © by Dr. Audrey Begun is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License , except where otherwise noted.

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Research: Overview & Approaches

• Getting Started with Undergraduate Research
• Planning & Getting Started
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• Reading Scholarly Articles
• Creating a Literature Review
• Productivity & Organizing Research
• Scholarly and Professional Relationships

Introduction to Empirical Research

Databases for finding empirical research, guided search, google scholar, examples of empirical research, sources and further reading.

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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: 
• How to write a good literature review 
• 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: 
• 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.

What is the purpose of literature review?

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

• 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. 
• 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. 
• 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. 
• 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. 
• 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. 
• 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: 

a. Habitat Loss and Species Extinction:

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. 

b. Range Shifts and Phenological Changes:

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. 

c. Ocean Acidification and Coral Reefs:

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. 

d. Adaptive Strategies and Conservation Efforts:

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. 

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. 

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. 

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 literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. 

Frequently asked questions

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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Introduction to systematic review and meta-analysis

1 Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Korea

2 Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea

Systematic reviews and meta-analyses present results by combining and analyzing data from different studies conducted on similar research topics. In recent years, systematic reviews and meta-analyses have been actively performed in various fields including anesthesiology. These research methods are powerful tools that can overcome the difficulties in performing large-scale randomized controlled trials. However, the inclusion of studies with any biases or improperly assessed quality of evidence in systematic reviews and meta-analyses could yield misleading results. Therefore, various guidelines have been suggested for conducting systematic reviews and meta-analyses to help standardize them and improve their quality. Nonetheless, accepting the conclusions of many studies without understanding the meta-analysis can be dangerous. Therefore, this article provides an easy introduction to clinicians on performing and understanding meta-analyses.

Introduction

A systematic review collects all possible studies related to a given topic and design, and reviews and analyzes their results [ 1 ]. During the systematic review process, the quality of studies is evaluated, and a statistical meta-analysis of the study results is conducted on the basis of their quality. A meta-analysis is a valid, objective, and scientific method of analyzing and combining different results. Usually, in order to obtain more reliable results, a meta-analysis is mainly conducted on randomized controlled trials (RCTs), which have a high level of evidence [ 2 ] ( Fig. 1 ). Since 1999, various papers have presented guidelines for reporting meta-analyses of RCTs. Following the Quality of Reporting of Meta-analyses (QUORUM) statement [ 3 ], and the appearance of registers such as Cochrane Library’s Methodology Register, a large number of systematic literature reviews have been registered. In 2009, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [ 4 ] was published, and it greatly helped standardize and improve the quality of systematic reviews and meta-analyses [ 5 ].

Levels of evidence.

In anesthesiology, the importance of systematic reviews and meta-analyses has been highlighted, and they provide diagnostic and therapeutic value to various areas, including not only perioperative management but also intensive care and outpatient anesthesia [6–13]. Systematic reviews and meta-analyses include various topics, such as comparing various treatments of postoperative nausea and vomiting [ 14 , 15 ], comparing general anesthesia and regional anesthesia [ 16 – 18 ], comparing airway maintenance devices [ 8 , 19 ], comparing various methods of postoperative pain control (e.g., patient-controlled analgesia pumps, nerve block, or analgesics) [ 20 – 23 ], comparing the precision of various monitoring instruments [ 7 ], and meta-analysis of dose-response in various drugs [ 12 ].

Thus, literature reviews and meta-analyses are being conducted in diverse medical fields, and the aim of highlighting their importance is to help better extract accurate, good quality data from the flood of data being produced. However, a lack of understanding about systematic reviews and meta-analyses can lead to incorrect outcomes being derived from the review and analysis processes. If readers indiscriminately accept the results of the many meta-analyses that are published, incorrect data may be obtained. Therefore, in this review, we aim to describe the contents and methods used in systematic reviews and meta-analyses in a way that is easy to understand for future authors and readers of systematic review and meta-analysis.

Study Planning

It is easy to confuse systematic reviews and meta-analyses. A systematic review is an objective, reproducible method to find answers to a certain research question, by collecting all available studies related to that question and reviewing and analyzing their results. A meta-analysis differs from a systematic review in that it uses statistical methods on estimates from two or more different studies to form a pooled estimate [ 1 ]. Following a systematic review, if it is not possible to form a pooled estimate, it can be published as is without progressing to a meta-analysis; however, if it is possible to form a pooled estimate from the extracted data, a meta-analysis can be attempted. Systematic reviews and meta-analyses usually proceed according to the flowchart presented in Fig. 2 . We explain each of the stages below.

Flowchart illustrating a systematic review.

Formulating research questions

A systematic review attempts to gather all available empirical research by using clearly defined, systematic methods to obtain answers to a specific question. A meta-analysis is the statistical process of analyzing and combining results from several similar studies. Here, the definition of the word “similar” is not made clear, but when selecting a topic for the meta-analysis, it is essential to ensure that the different studies present data that can be combined. If the studies contain data on the same topic that can be combined, a meta-analysis can even be performed using data from only two studies. However, study selection via a systematic review is a precondition for performing a meta-analysis, and it is important to clearly define the Population, Intervention, Comparison, Outcomes (PICO) parameters that are central to evidence-based research. In addition, selection of the research topic is based on logical evidence, and it is important to select a topic that is familiar to readers without clearly confirmed the evidence [ 24 ].

Protocols and registration

In systematic reviews, prior registration of a detailed research plan is very important. In order to make the research process transparent, primary/secondary outcomes and methods are set in advance, and in the event of changes to the method, other researchers and readers are informed when, how, and why. Many studies are registered with an organization like PROSPERO ( http://www.crd.york.ac.uk/PROSPERO/ ), and the registration number is recorded when reporting the study, in order to share the protocol at the time of planning.

Defining inclusion and exclusion criteria

Information is included on the study design, patient characteristics, publication status (published or unpublished), language used, and research period. If there is a discrepancy between the number of patients included in the study and the number of patients included in the analysis, this needs to be clearly explained while describing the patient characteristics, to avoid confusing the reader.

Literature search and study selection

In order to secure proper basis for evidence-based research, it is essential to perform a broad search that includes as many studies as possible that meet the inclusion and exclusion criteria. Typically, the three bibliographic databases Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) are used. In domestic studies, the Korean databases KoreaMed, KMBASE, and RISS4U may be included. Effort is required to identify not only published studies but also abstracts, ongoing studies, and studies awaiting publication. Among the studies retrieved in the search, the researchers remove duplicate studies, select studies that meet the inclusion/exclusion criteria based on the abstracts, and then make the final selection of studies based on their full text. In order to maintain transparency and objectivity throughout this process, study selection is conducted independently by at least two investigators. When there is a inconsistency in opinions, intervention is required via debate or by a third reviewer. The methods for this process also need to be planned in advance. It is essential to ensure the reproducibility of the literature selection process [ 25 ].

Quality of evidence

However, well planned the systematic review or meta-analysis is, if the quality of evidence in the studies is low, the quality of the meta-analysis decreases and incorrect results can be obtained [ 26 ]. Even when using randomized studies with a high quality of evidence, evaluating the quality of evidence precisely helps determine the strength of recommendations in the meta-analysis. One method of evaluating the quality of evidence in non-randomized studies is the Newcastle-Ottawa Scale, provided by the Ottawa Hospital Research Institute 1) . However, we are mostly focusing on meta-analyses that use randomized studies.

If the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system ( http://www.gradeworkinggroup.org/ ) is used, the quality of evidence is evaluated on the basis of the study limitations, inaccuracies, incompleteness of outcome data, indirectness of evidence, and risk of publication bias, and this is used to determine the strength of recommendations [ 27 ]. As shown in Table 1 , the study limitations are evaluated using the “risk of bias” method proposed by Cochrane 2) . This method classifies bias in randomized studies as “low,” “high,” or “unclear” on the basis of the presence or absence of six processes (random sequence generation, allocation concealment, blinding participants or investigators, incomplete outcome data, selective reporting, and other biases) [ 28 ].

The Cochrane Collaboration’s Tool for Assessing the Risk of Bias [ 28 ]

Data extraction

Two different investigators extract data based on the objectives and form of the study; thereafter, the extracted data are reviewed. Since the size and format of each variable are different, the size and format of the outcomes are also different, and slight changes may be required when combining the data [ 29 ]. If there are differences in the size and format of the outcome variables that cause difficulties combining the data, such as the use of different evaluation instruments or different evaluation timepoints, the analysis may be limited to a systematic review. The investigators resolve differences of opinion by debate, and if they fail to reach a consensus, a third-reviewer is consulted.

Data Analysis

The aim of a meta-analysis is to derive a conclusion with increased power and accuracy than what could not be able to achieve in individual studies. Therefore, before analysis, it is crucial to evaluate the direction of effect, size of effect, homogeneity of effects among studies, and strength of evidence [ 30 ]. Thereafter, the data are reviewed qualitatively and quantitatively. If it is determined that the different research outcomes cannot be combined, all the results and characteristics of the individual studies are displayed in a table or in a descriptive form; this is referred to as a qualitative review. A meta-analysis is a quantitative review, in which the clinical effectiveness is evaluated by calculating the weighted pooled estimate for the interventions in at least two separate studies.

The pooled estimate is the outcome of the meta-analysis, and is typically explained using a forest plot ( Figs. 3 and ​ and4). 4 ). The black squares in the forest plot are the odds ratios (ORs) and 95% confidence intervals in each study. The area of the squares represents the weight reflected in the meta-analysis. The black diamond represents the OR and 95% confidence interval calculated across all the included studies. The bold vertical line represents a lack of therapeutic effect (OR = 1); if the confidence interval includes OR = 1, it means no significant difference was found between the treatment and control groups.

Forest plot analyzed by two different models using the same data. (A) Fixed-effect model. (B) Random-effect model. The figure depicts individual trials as filled squares with the relative sample size and the solid line as the 95% confidence interval of the difference. The diamond shape indicates the pooled estimate and uncertainty for the combined effect. The vertical line indicates the treatment group shows no effect (OR = 1). Moreover, if the confidence interval includes 1, then the result shows no evidence of difference between the treatment and control groups.

Forest plot representing homogeneous data.

Dichotomous variables and continuous variables

In data analysis, outcome variables can be considered broadly in terms of dichotomous variables and continuous variables. When combining data from continuous variables, the mean difference (MD) and standardized mean difference (SMD) are used ( Table 2 ).

Summary of Meta-analysis Methods Available in RevMan [ 28 ]

The MD is the absolute difference in mean values between the groups, and the SMD is the mean difference between groups divided by the standard deviation. When results are presented in the same units, the MD can be used, but when results are presented in different units, the SMD should be used. When the MD is used, the combined units must be shown. A value of “0” for the MD or SMD indicates that the effects of the new treatment method and the existing treatment method are the same. A value lower than “0” means the new treatment method is less effective than the existing method, and a value greater than “0” means the new treatment is more effective than the existing method.

When combining data for dichotomous variables, the OR, risk ratio (RR), or risk difference (RD) can be used. The RR and RD can be used for RCTs, quasi-experimental studies, or cohort studies, and the OR can be used for other case-control studies or cross-sectional studies. However, because the OR is difficult to interpret, using the RR and RD, if possible, is recommended. If the outcome variable is a dichotomous variable, it can be presented as the number needed to treat (NNT), which is the minimum number of patients who need to be treated in the intervention group, compared to the control group, for a given event to occur in at least one patient. Based on Table 3 , in an RCT, if x is the probability of the event occurring in the control group and y is the probability of the event occurring in the intervention group, then x = c/(c + d), y = a/(a + b), and the absolute risk reduction (ARR) = x − y. NNT can be obtained as the reciprocal, 1/ARR.

Calculation of the Number Needed to Treat in the Dichotomous table

Fixed-effect models and random-effect models

In order to analyze effect size, two types of models can be used: a fixed-effect model or a random-effect model. A fixed-effect model assumes that the effect of treatment is the same, and that variation between results in different studies is due to random error. Thus, a fixed-effect model can be used when the studies are considered to have the same design and methodology, or when the variability in results within a study is small, and the variance is thought to be due to random error. Three common methods are used for weighted estimation in a fixed-effect model: 1) inverse variance-weighted estimation 3) , 2) Mantel-Haenszel estimation 4) , and 3) Peto estimation 5) .

A random-effect model assumes heterogeneity between the studies being combined, and these models are used when the studies are assumed different, even if a heterogeneity test does not show a significant result. Unlike a fixed-effect model, a random-effect model assumes that the size of the effect of treatment differs among studies. Thus, differences in variation among studies are thought to be due to not only random error but also between-study variability in results. Therefore, weight does not decrease greatly for studies with a small number of patients. Among methods for weighted estimation in a random-effect model, the DerSimonian and Laird method 6) is mostly used for dichotomous variables, as the simplest method, while inverse variance-weighted estimation is used for continuous variables, as with fixed-effect models. These four methods are all used in Review Manager software (The Cochrane Collaboration, UK), and are described in a study by Deeks et al. [ 31 ] ( Table 2 ). However, when the number of studies included in the analysis is less than 10, the Hartung-Knapp-Sidik-Jonkman method 7) can better reduce the risk of type 1 error than does the DerSimonian and Laird method [ 32 ].

Fig. 3 shows the results of analyzing outcome data using a fixed-effect model (A) and a random-effect model (B). As shown in Fig. 3 , while the results from large studies are weighted more heavily in the fixed-effect model, studies are given relatively similar weights irrespective of study size in the random-effect model. Although identical data were being analyzed, as shown in Fig. 3 , the significant result in the fixed-effect model was no longer significant in the random-effect model. One representative example of the small study effect in a random-effect model is the meta-analysis by Li et al. [ 33 ]. In a large-scale study, intravenous injection of magnesium was unrelated to acute myocardial infarction, but in the random-effect model, which included numerous small studies, the small study effect resulted in an association being found between intravenous injection of magnesium and myocardial infarction. This small study effect can be controlled for by using a sensitivity analysis, which is performed to examine the contribution of each of the included studies to the final meta-analysis result. In particular, when heterogeneity is suspected in the study methods or results, by changing certain data or analytical methods, this method makes it possible to verify whether the changes affect the robustness of the results, and to examine the causes of such effects [ 34 ].

Heterogeneity

Homogeneity test is a method whether the degree of heterogeneity is greater than would be expected to occur naturally when the effect size calculated from several studies is higher than the sampling error. This makes it possible to test whether the effect size calculated from several studies is the same. Three types of homogeneity tests can be used: 1) forest plot, 2) Cochrane’s Q test (chi-squared), and 3) Higgins I 2 statistics. In the forest plot, as shown in Fig. 4 , greater overlap between the confidence intervals indicates greater homogeneity. For the Q statistic, when the P value of the chi-squared test, calculated from the forest plot in Fig. 4 , is less than 0.1, it is considered to show statistical heterogeneity and a random-effect can be used. Finally, I 2 can be used [ 35 ].

I 2 , calculated as shown above, returns a value between 0 and 100%. A value less than 25% is considered to show strong homogeneity, a value of 50% is average, and a value greater than 75% indicates strong heterogeneity.

Even when the data cannot be shown to be homogeneous, a fixed-effect model can be used, ignoring the heterogeneity, and all the study results can be presented individually, without combining them. However, in many cases, a random-effect model is applied, as described above, and a subgroup analysis or meta-regression analysis is performed to explain the heterogeneity. In a subgroup analysis, the data are divided into subgroups that are expected to be homogeneous, and these subgroups are analyzed. This needs to be planned in the predetermined protocol before starting the meta-analysis. A meta-regression analysis is similar to a normal regression analysis, except that the heterogeneity between studies is modeled. This process involves performing a regression analysis of the pooled estimate for covariance at the study level, and so it is usually not considered when the number of studies is less than 10. Here, univariate and multivariate regression analyses can both be considered.

Publication bias

Publication bias is the most common type of reporting bias in meta-analyses. This refers to the distortion of meta-analysis outcomes due to the higher likelihood of publication of statistically significant studies rather than non-significant studies. In order to test the presence or absence of publication bias, first, a funnel plot can be used ( Fig. 5 ). Studies are plotted on a scatter plot with effect size on the x-axis and precision or total sample size on the y-axis. If the points form an upside-down funnel shape, with a broad base that narrows towards the top of the plot, this indicates the absence of a publication bias ( Fig. 5A ) [ 29 , 36 ]. On the other hand, if the plot shows an asymmetric shape, with no points on one side of the graph, then publication bias can be suspected ( Fig. 5B ). Second, to test publication bias statistically, Begg and Mazumdar’s rank correlation test 8) [ 37 ] or Egger’s test 9) [ 29 ] can be used. If publication bias is detected, the trim-and-fill method 10) can be used to correct the bias [ 38 ]. Fig. 6 displays results that show publication bias in Egger’s test, which has then been corrected using the trim-and-fill method using Comprehensive Meta-Analysis software (Biostat, USA).

Funnel plot showing the effect size on the x-axis and sample size on the y-axis as a scatter plot. (A) Funnel plot without publication bias. The individual plots are broader at the bottom and narrower at the top. (B) Funnel plot with publication bias. The individual plots are located asymmetrically.

Funnel plot adjusted using the trim-and-fill method. White circles: comparisons included. Black circles: inputted comparisons using the trim-and-fill method. White diamond: pooled observed log risk ratio. Black diamond: pooled inputted log risk ratio.

Result Presentation

When reporting the results of a systematic review or meta-analysis, the analytical content and methods should be described in detail. First, a flowchart is displayed with the literature search and selection process according to the inclusion/exclusion criteria. Second, a table is shown with the characteristics of the included studies. A table should also be included with information related to the quality of evidence, such as GRADE ( Table 4 ). Third, the results of data analysis are shown in a forest plot and funnel plot. Fourth, if the results use dichotomous data, the NNT values can be reported, as described above.

The GRADE Evidence Quality for Each Outcome

N: number of studies, ROB: risk of bias, PON: postoperative nausea, POV: postoperative vomiting, PONV: postoperative nausea and vomiting, CI: confidence interval, RR: risk ratio, AR: absolute risk.

When Review Manager software (The Cochrane Collaboration, UK) is used for the analysis, two types of P values are given. The first is the P value from the z-test, which tests the null hypothesis that the intervention has no effect. The second P value is from the chi-squared test, which tests the null hypothesis for a lack of heterogeneity. The statistical result for the intervention effect, which is generally considered the most important result in meta-analyses, is the z-test P value.

A common mistake when reporting results is, given a z-test P value greater than 0.05, to say there was “no statistical significance” or “no difference.” When evaluating statistical significance in a meta-analysis, a P value lower than 0.05 can be explained as “a significant difference in the effects of the two treatment methods.” However, the P value may appear non-significant whether or not there is a difference between the two treatment methods. In such a situation, it is better to announce “there was no strong evidence for an effect,” and to present the P value and confidence intervals. Another common mistake is to think that a smaller P value is indicative of a more significant effect. In meta-analyses of large-scale studies, the P value is more greatly affected by the number of studies and patients included, rather than by the significance of the results; therefore, care should be taken when interpreting the results of a meta-analysis.

When performing a systematic literature review or meta-analysis, if the quality of studies is not properly evaluated or if proper methodology is not strictly applied, the results can be biased and the outcomes can be incorrect. However, when systematic reviews and meta-analyses are properly implemented, they can yield powerful results that could usually only be achieved using large-scale RCTs, which are difficult to perform in individual studies. As our understanding of evidence-based medicine increases and its importance is better appreciated, the number of systematic reviews and meta-analyses will keep increasing. However, indiscriminate acceptance of the results of all these meta-analyses can be dangerous, and hence, we recommend that their results be received critically on the basis of a more accurate understanding.

1) http://www.ohri.ca .

2) http://methods.cochrane.org/bias/assessing-risk-bias-included-studies .

3) The inverse variance-weighted estimation method is useful if the number of studies is small with large sample sizes.

4) The Mantel-Haenszel estimation method is useful if the number of studies is large with small sample sizes.

5) The Peto estimation method is useful if the event rate is low or one of the two groups shows zero incidence.

6) The most popular and simplest statistical method used in Review Manager and Comprehensive Meta-analysis software.

7) Alternative random-effect model meta-analysis that has more adequate error rates than does the common DerSimonian and Laird method, especially when the number of studies is small. However, even with the Hartung-Knapp-Sidik-Jonkman method, when there are less than five studies with very unequal sizes, extra caution is needed.

8) The Begg and Mazumdar rank correlation test uses the correlation between the ranks of effect sizes and the ranks of their variances [ 37 ].

9) The degree of funnel plot asymmetry as measured by the intercept from the regression of standard normal deviates against precision [ 29 ].

10) If there are more small studies on one side, we expect the suppression of studies on the other side. Trimming yields the adjusted effect size and reduces the variance of the effects by adding the original studies back into the analysis as a mirror image of each study.

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What is a literature review?

A literature review is an integrated analysis -- not just a summary-- of scholarly writings and other relevant evidence related directly to your research question.  That is, it represents a synthesis of the evidence that provides background information on your topic and shows a association between the evidence and your research question.

A literature review may be a stand alone work or the introduction to a larger research paper, depending on the assignment.  Rely heavily on the guidelines your instructor has given you.

Why is it important?

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Discovers relationships between research studies/ideas.
• Identifies major themes, concepts, and researchers on a topic.
• Identifies critical gaps and points of disagreement.
• Discusses further research questions that logically come out of the previous studies.

APA7 Style resources

APA Style Blog - for those harder to find answers

1. Choose a topic. Define your research question.

Your literature review should be guided by your central research question.  The literature represents background and research developments related to a specific research question, interpreted and analyzed by you in a synthesized way.

• Make sure your research question is not too broad or too narrow.  Is it manageable?
• Begin writing down terms that are related to your question. These will be useful for searches later.
• If you have the opportunity, discuss your topic with your professor and your class mates.

2. Decide on the scope of your review

How many studies do you need to look at? How comprehensive should it be? How many years should it cover? 

• This may depend on your assignment.  How many sources does the assignment require?

3. Select the databases you will use to conduct your searches.

Make a list of the databases you will search. 

Where to find databases:

• use the tabs on this guide
• Find other databases in the Nursing Information Resources web page
• More on the Medical Library web page
• ... and more on the Yale University Library web page

4. Conduct your searches to find the evidence. Keep track of your searches.

• Use the key words in your question, as well as synonyms for those words, as terms in your search. Use the database tutorials for help.
• Save the searches in the databases. This saves time when you want to redo, or modify, the searches. It is also helpful to use as a guide is the searches are not finding any useful results.
• Review the abstracts of research studies carefully. This will save you time.
• Use the bibliographies and references of research studies you find to locate others.
• Check with your professor, or a subject expert in the field, if you are missing any key works in the field.
• Ask your librarian for help at any time.
• Use a citation manager, such as EndNote as the repository for your citations. See the EndNote tutorials for help.

Review the literature

Some questions to help you analyze the research:

• What was the research question of the study you are reviewing? What were the authors trying to discover?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.
• Does the research seem to be complete? Could it have been conducted more soundly? What further questions does it raise?
• If there are conflicting studies, why do you think that is?
• How are the authors viewed in the field? Has this study been cited? If so, how has it been analyzed?

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
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Literature review vs research articles: how are they different.

Unlock the secrets of academic writing with our guide to the key differences between a literature review and a research paper! 📚 Dive into the world of scholarly exploration as we break down how a literature review illuminates existing knowledge, identifies gaps, and sets the stage for further research. 🌐 Then, gear up for the adventure of crafting a research paper, where you become the explorer, presenting your unique insights and discoveries through independent research. 🚀 Join us on this academic journey and discover the art of synthesizing existing wisdom and creating your own scholarly masterpiece! 🎓✨

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Secondary Education: Empirical and Review Articles

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An  empirical article  is a research article that reports the results of a study that uses  data derived from actual observation  or  experimentation .

A scholarly  literature review  article  summarizes and critically evaluates  academic articles and  other scholarly works  on a topic.  It  does not contain original research .

Click on the links below to determine if the sample articles present empirical studies or review the literature. 

Zbiek, R. M., & Larson, M. R. (2015). Teaching strategies to improve algebra learning.  Mathematics Teacher, 108 (9), 696-699.

Is it peer-reviewed?

• Ulrichs Periodicals Directory This link opens in a new window Directory of approximately 250,000 regularly and irregularly published journals, magazines, newspapers, and full-text electronic resources from more than 200 countries. Search or browse by title, keyword, subject, ISSN or publisher; list and sorting options; and highlights of new, changed, and ceased titles.
• Cabell's Journalytics This link opens in a new window Current information on the addresses, phone, e-mail, web sites and acceptance rates for a large number of journals in education & business. Also, publication guidelines and review information that is useful in evaluating journals and publishing options.
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Empirical Study vs. Literature Review

When writing an essay or an article, it is imperative to identify its theme. The flow of the written content, the information that is presented and all other aspects are based on the topic. When writing the research paper, students often accost empirical studies and literature review. To write a legit paper, it is essential to understand the difference between the two concepts. Both papers account for showing the facts, however, they vary in the approach. If there are difficulties with writing essays, a student can always turn to  write my essays services. They will help you write a paper on almost any subject and on any topic. A question what is empirical research often confuses those who learn. Systematic review vs literature review description is shown below:

1. Legit meaning of empirical research

Empirical research derives conclusions based on experience, which can be directly visualized or indirectly observed with the help of experiments. Normally, the analysis is performed by quantifying the results and the inference is drawn. The idea is to present the findings that are quantifiably observable through calibrated scientific applications. Paper review writers investigate every result before writing any conclusion in a paper or an essay. The experiment is carried out under a planned or controlled observation and the inference is strictly monitored. In contrast to the existing literature, emphasis is on the current findings of the experiment under operation. The previous literature is used to make a hypothesis, which can also be a prediction of a previously proposed theory.

2. How to work on the writing

The results are recorded, and the conclusions are drawn from the same. It is a frequent occurrence that science students are not adept for writing scientific papers. There are multiple services available online that help students with their assignments. The learners can easily avail the services online and get the paper written in accordance with their specific requirements. Services like Edusson or EssayServiceScanner are genuine ones. Students need to login and specify their requirements so that an expert assist with developing the paper. However, before paying a writer, it is better to go through the reviews about the platform. Ensure that it is not a scam. It is also recommended to review the article before you make any submissions.

3. Literature review

In contrast to the empirical study, it is essential to review different researches while working on the literature review. Such an article contains facts and information derived from other theoretical sources. New inferences may be drawn from the compilation of all literature pieces. However, the information and hypothesis are already existent. The literature review is a compilation of all the relevant data in order to produce coherent results. No experimental work may be conducted and the results come out of already existing theories in a systematic manner.

4. Deciding the type of article

College students often have to write different papers. A literature review is when a student attempts to prove or disprove a conceived point or an analysis through literature. By means of existing facts, he or she can challenge a hypothesis or attempt to answer a particular question. The article based on an experiment that was conducted solely to write the paper is an empirical review . The experiment is carried out by means of calibrated instruments in a controlled manner.

It is better to begin writing while conducting the experiment. Observations should be written down systematically during the research. This helps bring out coherence, which is easier to comprehend even later. Furthermore, beginning the writing process earlier provides one with enough time for the review and also produces better work. This is particularly necessary for the empirical papers as the experiments may take time to deliver the desired results. Leaving the writing behind and starting to write it when the deadline is approaching may make the process stressful enough and may lead to confusion. This also hampers with the work leading to decreased levels of quality. Hence, working in a timely way helps in developing the paper and your life on the whole.

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• Published: 23 April 2024

Research on flipped classrooms in foreign language teaching in Chinese higher education

• Wen Kong 1 ,
• Di Li 2 &
• Quanjiang Guo   ORCID: orcid.org/0000-0002-7846-1363 3  

Humanities and Social Sciences Communications volume  11 , Article number:  525 ( 2024 ) Cite this article

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• Language and linguistics

This review examines 233 articles published in Chinese academic journals between 2011 and 2021, documenting the state of research concerning flipped classrooms (FCs) in foreign language teaching within the context of higher education in China. Employing the methodological approach of a scoping review, the investigation is underpinned by the five-stage framework articulated by Arksey and O’Malley. The results reveal a notable surge in FC-related studies between 2013 and 2017, with a subsequent decline in scholarly attention. The majority of the reviewed studies on FCs focused on English instruction at the college level, with a conspicuous dearth of inquiry into the application of FCs in the teaching of other foreign languages. All studies were categorized as either empirical or non-empirical, and the most frequently used instruments for data collection were surveys and interviews; case studies were underrepresented in the literature. Early studies focused on the introduction of the new model, while more recent investigations focused on the impact of its implementation. The findings of the in-depth content analysis unearthed a prevailing trend of high learner satisfaction with the FC model, along with favorable direct and indirect educational outcomes. Noteworthy factors influencing the efficacy of FCs included learners’ foreign language proficiency and their self-regulation or self-discipline abilities. The paper concludes with a discussion of the challenges in FC implementation and a call for future research on this promising pedagogy.

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Introduction.

The flipped classroom (FC), also known as the “inverted classroom”, is a pedagogical approach that first emerged in the 1980s and came into more widespread use in the 2000s (Baker, 2000 ; Bergmann and Sams, 2012 ; Khan, 2012 ). It has gained prominence as advances in technology afford increasing opportunities for ubiquitous access to a variety of online resources. The FC model removes in-class lectures, freeing up classroom time for more in-depth exploration of topics through discussion with peers or problem-solving activities facilitated by instructors. The removed content is often delivered to learners through pre-class materials like video recordings. As a result, in the FC, learning activities that are active and social occur inside the classroom while most information transmission occurs outside the classroom. Today, the FC has been implemented in many different disciplines and in schools and universities around the world (Akcayir and Akcayir, 2018 ).

Proponents of the FC assert its pedagogical merits on several fronts. First, it alleviates the constraints associated with requiring all learning to happen at the same time and place, furnishing learners with an individualized education that enables flexible online study at their own pace as long as an internet connection is available (Hung, 2014 ). Second, it allocates class time to the cultivation of learners’ higher-order cognitive skills, emphasizing application, analysis, and evaluation, as opposed to lower-order skills such as knowledge and comprehension (Brinks-Lockwood, 2014 ; Lee and Wallace, 2018 ). Third, in contrast to traditional lecturing, the FC is a student-centered approach emphasizing engagement and active learning (Steen-Utheim and Foldnes, 2018 ), fostering students’ autonomy by endowing them with heightened responsibility for their learning (Brinks-Lockwood, 2014 ; O’Flaherty and Philips, 2015 ).

Vygotsky’s social constructivism ( 1978 ) has frequently been adopted as a theoretical foundation for designing learning experiences in technologically rich environments (Marzouki et al., 2017 ), and this framework highlights the particular benefits of technology-enhanced FC pedagogy (Jarvis et al., 2014 ). As mentioned above, in an FC model, learners can watch pre-recorded videos in their own time before class to remember basic information and understand concepts as they prepare for classroom activities, while the higher-order skills of analyzing, applying, evaluating, and creating can be collaborative and interactive, taking place in class with the guidance of a teacher, and thus facilitating progression within the learners’ proximal developmental zone.

Since its introduction in foreign language teaching (FLT) in China in 2011, the FC has attracted increasing research attention and has been welcomed by foreign language teachers (Yan and Zhou, 2021 ). Over the past decade, the Ministry of Education of the People’s Republic of China has exerted increasing pressure on higher education institutions to transition from traditional teacher-centered lecture-style approaches to innovative methods integrating technology and the internet, with the goals of enhancing learning, sustaining student engagement, and improving student satisfaction (Ministry of Education of People’s Republic China, 2021 ). The FC model, combined with traditional face-to-face teaching and personalized online learning, has emerged as a popular strategy in China to meet ministry requirements while delivering cost-effective and learner-centered curricula in response to the increasing student enrollment in higher education.

Despite the wide adoption of FCs in FLT in China, literature reviews about their implementation and effects have been notably scarce in the last decade. A search of the China National Knowledge Infrastructure (CNKI), the largest national research and information publishing company housing China’s most extensive academic database, revealed only three reviews—by Deng ( 2016 ), Qu ( 2019 ), and Su et al. ( 2019 )—published prior to the end of 2021. These reviews primarily focused on FCs in the context of English as a foreign language (EFL) education, overlooking most of the over 100 foreign languages taught in Chinese higher education. As a result, these reviews fell short of delivering a comprehensive analysis of research pertaining to FCs, and the reliability and generalizability of their findings in non-EFL contexts are questionable. Moreover, Deng ( 2016 ) and Su et al.’s (2019) reviews included all published papers without establishing clear inclusion and exclusion criteria. For example, they did not exclude articles that made a passing or token reference to the FC model, short papers of only one or two pages in length, book reviews, or editorials. Qu’s study ( 2019 ), on the other hand, was constrained in scope to articles within the Chinese Social Sciences Citation Index (CSSCI), a sub-database developed by Nanjing University of China Academy of Social Sciences Research Evaluation Center and the Hong Kong University of Science and Technology, and thus omitted relevant contributions from other academic journals. The CNKI incorporates both the CSSCI and the Core Journals of China (CJC), an equally significant sub-database overseen by the Peking University Library and experts from relevant institutions. Given the exclusion of the latter, a reevaluation of the scope and potential limitations of Qu’s study is warranted.

Thus, there persists an imperative for a comprehensive synthesis of the extant studies on FCs in FLT within Chinese higher education over the past decade. The restricted visibility of studies conducted in China, owing to their publication in Chinese and confinement to Chinese academic journals, makes it difficult for international researchers and practitioners to access and comprehend this body of literature. Such understanding among the global academic community is necessary for exploring both the strengths and limitations of FCs in diverse cultural and linguistic contexts.

Research method

The current study adopts a scoping review approach based on the methodological framework developed by Arksey and O’Malley ( 2005 ) to provide both quantitative and qualitative data for researchers and practitioners.

A scoping review is a relatively new approach to synthesizing research data which has been gaining popularity in many disciplines (Davis et al., 2009 ; Daudt et al., 2013 ). It is often undertaken as an independent project when a research area is complex, and no review of that area has previously been made available. A scoping review serves to highlight the relevant literature to researchers with the aim of rapidly mapping the key concepts characterizing a research area and the main sources and types of evidence available (Arksey and O’Malley, 2005 ; Mays et al., 2005 ; Levac et al., 2010 ). According to Arksey and O’Malley ( 2005 ), this kind of review addresses four goals: to examine the extent, range, and nature of research activity; to determine the value of undertaking a full systematic review; to summarize and disseminate research findings; and to identify research gaps in the existing literature. The scoping review is increasingly being employed in the field of foreign language education to provide a comprehensive view of FLT studies, identify implications for theory and pedagogy, or inform subsequent in-depth reviews and empirical studies (Chan et al., 2022 ; Hillman et al., 2020 ; Tullock and Ortega, 2017 ).

The difference between a scoping review and a narrative or traditional literature review lies in the transparency of the review process. A narrative review usually depends on the author’s own knowledge or experience to describe the studies reviewed and uses an implicit process to provide evidence (Garg et al., 2008 ). The reader cannot determine how much literature has been consulted or whether certain studies have been ignored due to contradictory findings. A scoping review, in contrast, uses an explicit, rigorous, and systematic approach to retrieve relevant articles to ensure the transparency and replicability of the data extraction process. For example, the methodological framework adopted by Arksey and O’Malley ( 2005 ) for conducting a scoping study comprises five stages: identifying the research questions; identifying relevant studies; selecting studies for inclusion; charting the data; and collating, summarizing, and reporting the results. By presenting the process and results in an accessible and summarized format, reviewers are in a position to illustrate the field of interest in terms of the volume, nature, and characteristics of the primary research, enabling researchers, practitioners, and policymakers to make effective use of the findings.

Figure 1 presents the process of the scoping review in the current study based on the five-stage methodological framework developed by Arksey and O’Malley ( 2005 ).

Process of the scoping review.

Process of the scoping review

Identifying research questions.

This scoping review is driven by four research questions:

RQ1. What is the current state of FC research in FLT within the context of higher education in China?

RQ2. What research methods and instruments have been employed in the included FC studies?

RQ3. What research foci and trends are displayed in the included FC studies?

RQ4. What are the major findings of the included FC studies?

RQ1 aims to provide an overview of studies on FCs in FLT in Chinese higher education by providing details about the basic information about existing publications, such as the number of publications per year and the distribution of publications by foreign language context. RQ2 leads to a classification of the research methods and instruments used to collect data in FC research. RQ3 explores the topics and trends in FC research over the past decade with the help of the literature visualization and analysis tool CiteSpace5.8R3. RQ4 reveals the effects of the FC model on direct and indirect educational outcomes, learners’ satisfaction with FCs, and the factors influencing the impact of FCs, as documented in the reviewed sources.

Searching for relevant studies

To be as comprehensive as possible in identifying primary evidence and to ensure the quality of the published articles, we searched both CSSCI and CJC in the CNKI database. The key search terms were developed and categorized based on two dimensions according to the purpose of the review. One dimension related to teaching or learning in FCs, while the other dimension related to the types of foreign languages. The key search terms and search methods are listed in Table 1 .

As the FC approach was introduced into FLT in China in 2011, the search included articles published between 2011 and 2021. Further inclusion and exclusion criteria were developed to focus on the scope of the review; these are outlined in Table 2 .

Study selection

Figure 2 shows a process diagram of the study selection process, which consisted of four phases: searching the databases; identifying the total number of articles in each database; screening titles, abstracts, and full texts; and selecting eligible articles for inclusion.

Flowchart diagram for article selection.

The final database search was conducted on January 16, 2022, and resulted in the identification of a total of 333 articles. Subsequently, all potentially relevant articles went through a three-step screening process. The first step excluded 9 duplicates. The second step excluded irrelevant articles by screening titles and abstracts; 37 articles were removed at this stage as they were book reviews, conference proceedings, reports, editorials, or other non-refereed publications. The third step filtered articles by screening full texts; 54 articles were excluded because they made only passing reference to the FC or were not related to higher education. This meticulous selection yielded a corpus of 233 articles suitable for in-depth analysis, each of which was scrutinized by the authors to confirm its suitability for inclusion. During the selection process, the 233 articles were also systematically categorized into two groups: 131 non-empirical and 102 empirical studies. The non-empirical studies were further divided into two subcategories. The first type was literature reviews; the second type was those drawing on personal observations, reflections on current events, or the authority or experience of the author (Dan, 2021 ). The empirical studies used a variety of systematic methods of collecting materials and analyzing data, including quantitative methods (e.g., survey, correlational research, experimental research) and/or qualitative methods (e.g., interview, case study, record keeping, observation, ethnographic research) (Dan, 2021 ).

Data charting and collation

The fourth stage of Arksey and O’Malley’s scoping review framework is the charting of the selected articles. Summaries of each study were developed. for all studies, these summaries included the author, year of publication, citations per year, foreign language taught, and a brief description of the outcomes. For empirical sources, details related to the research design, study population, and sample size were also provided. Tables 3 and 4 list the top ten most-cited non-empirical and empirical sources. In Table 4 , which references experimental and control groups in results summaries, the experimental group (EG) was the group that took courses in the FC model, while the control group (CG) took courses in a traditional classroom.

Results and analysis

In accordance with the fifth stage of Arksey and O’Malley’s framework for a scoping review, the findings from the 233 included studies are summarized and discussed in the following three sections. Section 4.1 summarizes basic information regarding the included studies; section 4.2 presents a holistic analysis of the research foci and trends over time using keyword clustering analysis and keyword burst analysis; and section 4.3 offers an in-depth content analysis focusing on the categorization of the included studies and discussion of the major findings.

Basic information on the included studies

Distribution by year of publication.

As Fig. 3 shows, the first studies on FCs in the field of FLT in China emerged in 2013. The number of such studies began to steadily increase and reached a peak in 2016 and 2017. Although there was some decrease after that, the FC model has continued to attract research attention, in line with global trends. According to Akçayir and Akçayir’s (2018) review of the literature on FCs published in Social Sciences Citation Index (SSCI) journals as of 31 December 2016, the first article about the FC was published in 2000, but the second was not published until more than a decade later, in 2012; 2013 was also the year that FC studies became popular among scholars. A possible explanation for this increase in interest is the growing availability of internet technologies and the popularity of online learning platforms, such as MOOCs and SPOCs (Small Private Online Courses), along with the view of the FC as a promising model that can open doors to new approaches in higher education in the new century.

Number of articles published by year.

Distribution by foreign language

Figure 4 shows the distribution of foreign languages discussed in the FC literature. The FC model was mainly implemented in EFL teaching (93%), which reflects the dominance of English in FLT in Chinese higher education. Only five articles discussed the use of FC models in Japanese teaching, while one article was related to French teaching. Ten non-empirical studies (4%) reported the feasibility of FC models in FLT without mentioning a specific foreign language.

Distribution by foreign language type.

Research methods of the included studies

Figure 5 shows a breakdown of the methodologies adopted by the studies included in our review. Among the 131 non-empirical studies, three were literature reviews, while the remaining 128 (55%) were descriptive studies based on the introduction of the FC model, including descriptions of its strengths and associated challenges and discussions of its design and implementation in FLT.

Methodological paradigms.

Of the 102 empirical studies, 60 (26%) used quantitative methods for data collection, eight (3%) used qualitative methods, and 34 (15%) used mixed methods. It is interesting to note that although quantitative methods are more common in FC studies, seven of the top ten most-cited empirical studies (as listed above in Table 4 ) used mixed methods. A potential reason may be that research findings collected with triangulation from various data sources or methods are seen as more reliable and valid and, hence, more accepted by scholars.

A breakdown of the data collection approaches used in the 102 reviewed empirical studies is displayed in Table 5 . It is important to note that most studies used more than one instrument, and therefore, it is possible for percentages to add up to more than 100%. The survey, as a convenient, cost-effective, and reliable research method, was the tool most frequently used to gain a comprehensive picture of the attitudes and characteristics of a large group of learners. Surveys were used in 79 of the 102 studies—73 times with learners and six times with teachers—to explore students’ learning experiences, attitudes, and emotions, as well as teachers’ opinions. Some studies used paper-based surveys, while others used online ones. Interviews with learners were used in 33 studies to provide in-depth information; one study used interviews with teachers. Surveys and interviews were combined in 24 studies to obtain both quantitative and qualitative data. Other research approaches included comparing the test scores between experimental and control groups (used in 25 studies) or using the results of course assessments (17 studies) to investigate the effects of the FC on academic performance. Learners’ self-reports (9 studies) were also used to capture the effects of the FC on learners’ experience and cognitive changes that could not be obtained in other ways, while one study used a case study for a similar purpose. Teachers’ class observations and reflections were used in eight studies to evaluate students’ engagement, interaction, activities, and learning performance.

Holistic analysis of the research foci and the changing trends of the included studies

A holistic analysis of the research foci in studies of FCs in China was conducted using CiteSpace5.8.R3, a software developed by Chaomei Chen ( http://cluster.cis.drexel.edu/~cchen/citespace/ , accessed on 20 February 2022), to conduct a visual analysis of the literature. This software can help conduct co-citation analysis, keyword co-occurrence analysis, keyword clustering analysis, keyword burst analysis, and social network analysis (Chen, 2016 ). In this study, keyword clustering analysis and keyword burst analysis were chosen to capture important themes and reveal changing trends in FC research.

Keyword clustering analysis primarily serves to identify core topics in a corpus. Figure 6 presents a graph of the top ten keyword clusters identified in the included studies. In this graph, the lower the ID number of a given cluster, the more keywords are in that cluster. As shown in the top left corner of Fig. 6 , the value of modularity q is 0.8122, which is greater than the critical value of 0.3, indicating that the clustering effect is good; the mean silhouette value is 0.9412, which is >0.5, indicating that the clustering results are significant and can accurately represent hot spots and topics in FC research (Hu and Song, 2021 ). The top ten keyword clusters include #0翻转课堂 (flipped classroom), #1大学英语 (college English), #2 MOOC, #3教学模式 (teaching model), #4元认知 (metacognition), #5微课 (micro lecture), #6微课设计 (micro lecture design), #7英语教学 (English teaching), #8 SPOC, and #9 POA (production-oriented approach).

The graph of the top ten keyword clusters.

Keyword burst analysis is used to showcase the changes in keyword frequencies over a given period of time. By analyzing the rise and decline of keywords, and in particular, the years in which some keywords suddenly become significantly more prevalent (“burst”), we can identify emerging trends in the evolution of FC research. Figure 7 displays the 11 keywords with the strongest citation bursts. We can roughly divide the evolution of FC research documented in Fig. 7 into two periods. The first period (2014 to 2017) focused on the introduction of the new model and the analysis of its feasibility in FLT. The keywords that underwent bursts in this period included “MOOC”, “自主学习” (independent learning), “模式” (model), “学习模式” (learning model), “教师话语” (teacher discourse), “茶文化” (tea culture), and “可行性” (feasibility). The reason for the appearance of the keyword “tea culture” lies in the fact that three articles discussing the use of FCs in teaching tea culture in an EFL environment were published in the same journal, entitled Tea in Fujian , during this period. The second period (2018–2021) focused on the investigation of the effect of FCs and the design of micro lectures. Keywords undergoing bursts during this period included “互联网+” (internet plus), “课堂环境” (classroom environment), “教学效果” (teaching effect), and “微课设计” (micro lecture design). The latter two topics (“teaching effect” and “micro lecture design”) may continue to be prevalent in the coming years.

Top 11 keywords with the strongest citation bursts.

In-depth content analysis of the included studies

Along with the findings from the keyword clustering analysis and keyword burst analysis, an open coding system was created to categorize the research topics and contents of the 233 articles for in-depth analysis. Non-empirical and empirical studies were classified further into detailed sub-categories based on research foci and findings. It is important to note that some studies reported more than one research focus. For such studies, more than one sub-category or more than one code was applied; therefore, it is possible for percentages to add up to more than 100%. The findings for each category are discussed in detail in the following sections.

Non-empirical studies

The 131 non-empirical studies can be roughly divided into two categories, as shown in Table 6 . The first category, literature reviews, has no sub-categories. The second, descriptive studies, includes discussions of how to use FCs in FLT; descriptions of the process of implementing the FC in FLT; and comparisons between FCs and traditional classes or comparisons of FCs in Chinese and American educational contexts.

The sub-categories of “introduction and discussion” and “introduction and description” in Table 6 comprise 91.6% of the non-empirical studies included in our review. The difference between them lies in that the former is based on the introduction of the FC literature, while the latter is based both on the introduction of the FC literature and exploration of researchers’ teaching experience; the latter might have become qualitative studies if researchers had gone further in providing systematic methods of collecting information or an analysis of the impact of FCs.

Empirical studies

The 102 empirical studies were divided into four categories based on the domain of their reported findings: the effect of FCs on learners; learners’ satisfaction with FCs; factors influencing FCs; or other research foci. Each group was further classified into more detailed sub-categories.

Effect of FCs on learners

Studies on the effect of FCs on learners were divided into two types, as presented in Table 7 : those concerned with the direct effect of FCs on learning performance and those exploring the indirect effect on learners’ perceptions. Eight codes were applied to categorize the direct effect of FCs on learning performance, which was usually evaluated through test scores; 14 codes were used to categorize the indirect effect of FCs on learners’ perceptions, which were usually investigated through surveys or questionnaires. We do not provide percentages for each code in Tables 7 – 9 because, given that the total number of empirical studies is 102, the percentages are almost identical to the frequencies.

The results shown in Table 7 reveal that 84 studies of direct educational outcomes reported that FCs had a positive effect on basic language skills, content knowledge, and foreign language proficiency. Of these, 64 were concerned with the positive effect of FCs on foreign language proficiency, speaking skills, or listening skills. This result might be explained by the features of FCs. The main difference between FCs and traditional classrooms is that the teaching of content in FCs has been removed from the classes themselves and is often delivered to the students through video recordings, which can be viewed repeatedly outside of the class. In-class time can thus be used for discussion, presentations, or the extension of the knowledge provided in the videos. It is evident that students have more opportunities to practice listening and speaking in FCs, and foreign language proficiency is naturally expected. Only three studies reported that FCs had no effect or a negative effect on the development of foreign language proficiency, speaking, listening, and writing skills. Yan and Zhou ( 2021 ) found that after the FC model had been in place for one semester, college students’ reading abilities improved significantly, while there was no significant improvement in their listening and writing abilities. Yin ( 2016 ) reported that after FC had been implemented for one semester, there was no significant difference in college students’ speaking scores.

A total of 96 studies reported positive effects on indirect educational outcomes, including: boosting learners’ motivation, interest, or confidence; enhancing engagement, interaction, cooperation, creativity, independent learning ability, or critical thinking ability; fostering information literacy, learning strategies, learning efficiency, or self-efficacy; or relieving stress or anxiety. The most frequently documented indirect effect of FCs is improvement in students’ independent learning ability. Only one study found that the FC did not significantly increase student interest in the course (Wang, 2015 ). Similarly, only one study found that students’ anxiety in the FC was significantly higher than that in a traditional class (Gao and Li, 2016 ).

Learners’ satisfaction with FCs

Table 8 presents the results regarding learners’ satisfaction with FCs. Nine codes were used to categorize the different aspects of learners’ satisfaction investigated in the 102 empirical studies. Some researchers represented learner satisfaction using the percentage of students choosing each answer on a five-point Likert scale from 1 (not at all satisfied) to 5 (very satisfied), while others used average scores based on Likert scale values. For the purposes of our synthesis of findings, if the percentage is above 60% or the average score is above 3, the finding is categorized as satisfied; otherwise, it is categorized as not satisfied.

The results in Table 8 show that among the nine aspects investigated, teaching approach and learning outcomes were most frequently asked about in the research, and learners were generally satisfied with both. Only one study (Li and Cao, 2015 ) reported significant dissatisfaction; in this case, 76.19% of students were not satisfied with the videos used in college English teaching due to their poor quality.

Factors influencing the effect of FCs

Eleven factors were found to influence the effect of FCs; these are categorized in Table 9 .

The results shown in Table 9 indicate that learners’ foreign language proficiency and self-regulation or self-discipline abilities are two important factors influencing the effect of FCs. Learners with high foreign language proficiency benefited more from FCs than those with low foreign language proficiency (Lv and Wang, 2016 ; Li and Cao, 2015 ; Wang and Zhang, 2014 ; Qu and Miu, 2016 ; Wang and Zhang, 2013 ; Cheng, 2016 ; Jia et al., 2016 ; Liu, 2016 ), and learners with good self-regulation and self-discipline abilities benefited more than those with limited abilities (Wang and Zhang, 2014 ; Lu, 2014 ; Lv and Wang, 2016 ; Dai and Chen 2016 ; Jia et al. 2016 ; Ling, 2018 ). It is interesting to note that two studies explored the relationship between gender and FCs (Wang and Zhang, 2014 ; Zhang and He, 2020 ), and both reported that girls benefited more from FCs because they were generally more self-disciplined than boys.

Studies with other research foci

There were six studies with other research foci, three of which investigated teachers’ attitudes toward FCs (Liao and Zou, 2019 ; Zhang and Xu, 2018 ; Zhang et al., 2015 ). The results of the surveys in these three studies showed that teachers generally held positive attitudes towards FCs and felt that the learning outcomes were better than those of traditional classes. However, some problems were also revealed in these studies. First, 56% of teachers expressed the desire to receive training before using FCs due to a lack of theoretical and practical expertise regarding this new model. Second, 87% of teachers thought that the FC increased their workload, as they were spending a significant amount of time learning to use new technology and preparing online videos or materials, yet no policy was implemented in the schools to encourage them to undertake this work. Third, 72% of teachers felt that the FC increased the academic burden students faced in their spare time (Zhang and Xu, 2018 ; Zhang et al., 2015 ). The final three studies include Cheng’s ( 2016 ) investigation of the mediative functions of college EFL teachers in the FC, Wang and Ma’s ( 2017 ) construction of a model for assessing the teaching quality of classes using the FC model, and Luo’s ( 2018 ) evaluation of the learning environment of an FC-model college English MOOC.

Discussion and conclusions

This investigation employed literature visualization to systematically analyze 233 research papers sourced from CSSCI and CJC in the CNKI database, thereby conducting a scoping review delineating the landscape of FC research within the domain of FLT in the context of higher education in China.

Our findings in relation to RQ1 highlight a substantial surge in the number of articles relating to FCs in FLT between 2013 and 2017, followed by a discernible, albeit moderate, decrease. Despite this trend, FC studies continue to be of significant interest to foreign language educators and researchers. This may be attributed to Chinese government policies encouraging higher education reform, increased internet access among educators and learners, and the burgeoning popularity of online courses such as MOOCs and SPOCs. However, the majority of the reviewed FC studies were conducted in college English classes, with only 6 studies on classes teaching foreign languages other than English. It seems that foreign language education in China (and in much of the world) has become synonymous with the teaching and learning of English, with other languages occupying a marginal position, struggling to find space in educational programs. In a multilingual world in which each language offers different possibilities for understanding others, their cultures, their epistemologies, and their experiences, this monolingual approach to FLT is dangerous (Liddicoat, 2022 ). The promotion of linguistic diversity in foreign language education policies and research is thus imperative. Another gap that needs to be addressed is the paucity of studies on the implementation of FCs in adult education. The FC model is expected to be potentially effective for teaching adult learners because it is similar in some respects to online distance learning.

In answer to RQ2, we found that the commonly used research methods and instruments in studies of the FC model include surveys, interviews, comparisons of academic measures between EGs and CGs, and course assessments. The case study is the least used method, likely due to limitations such as time demand, researcher bias, and the fact that it provides little basis for the generalization of results to the wider population. However, more case studies are needed in future research on FCs because they can provide detailed and insightful qualitative information that cannot be gathered in other ways.

Our findings regarding RQ3 show that research foci within the FC domain have evolved over time from initial exploration and feasibility discussions to a subsequent focus on the design of FCs incorporating micro-lectures based on MOOC or SPOC structures, and then to the present focus on the examination of FCs’ impacts on learners. The results of the keyword burst analysis indicate that these thematic areas are likely to persist as prominent subjects of research interest for the foreseeable future.

In response to RQ4, our in-depth content analysis found that FCs, on the whole, yield positive outcomes, although isolated studies identify limited negative impacts. FCs are most frequently associated with enhancements in student learning performance, fostering independent learning, promoting engagement and cooperation, and mitigating stress or anxiety. The results of this study suggest that well-designed FCs present a significant opportunity for foreign language educators to revolutionize instructional approaches. Furthermore, well-structured FCs can facilitate the development of learners’ potential while concurrently enabling the seamless integration of digital technology into FLT.

Most learners are satisfied with FCs, particularly with the innovative pedagogical approach of reversing traditional classes. FCs are perceived as beneficial for improving learning outcomes, creating an environment conducive to peer interaction, and gaining immediate teacher feedback and support. In addition, students’ interest in classes is enhanced by the rich and diverse online learning materials uploaded by teachers, which can be accessed conveniently at any time in any place. Furthermore, the dynamic and formative online assessment approach is also welcomed by students because it provides immediate feedback and the ability to discuss any problems they have with teachers or peers online or offline.

However, it is worth noting that most of the reviewed studies on FCs focused on one course, usually over only one semester. Students’ increase in motivation or improvements in learning outcomes might, therefore, be a result of the Hawthorne effect. Compared with the traditional didactic lecture format, the novelty of FCs, when used for the first time, might generate excitement among students, thus increasing their attention and enhancing learning outcomes, but such benefits will diminish over time. Therefore, there is a need to examine whether this model is suitable for large-scale implementation and whether its effects might be sustained over longer periods of implementation.

Learners’ foreign language proficiency and self-regulation or self-discipline abilities are the two key factors influencing the effect of FCs. These two factors are closely related; self-regulation or self-discipline is a prerequisite for successful foreign language learning in FC contexts and plays a crucial role in students’ success in the pre-class sessions for which they are personally responsible. In addition, factors such as learners’ attitudes, expectations of and adaptability to the FC model, the learning tasks and learning environment, the teaching organization and assessment methods, and the learner’s gender also have some impact on the effect of FCs. However, due to the limited number of studies, there is not sufficient evidence to warrant the generalization of any of these effects.

This scoping review highlights some potential challenges that need to be addressed for the effective implementation of FCs.

First, despite the benefits of the FC model, FCs are not equally advantageous to all students due to the self-regulated nature of the model. Many learners have reported difficulties in completing their individual online tasks outside the classroom (Yoon et al., 2021 ). The non-traditional configuration of FCs poses a formidable challenge, particularly for students less inclined to engage in pre-class online activities characterized by a lack of interactivity and for those who are less self-disciplined. Consequentially, students may attend class without having assimilated the pre-assigned material, thereby diminishing the efficacy of this instructional approach. To address this issue, additional support or prompts for students should be provided to remind them of the need to self-regulate their learning. For example, Park and Jo ( 2015 ) employed a learning analytics dashboard displaying visual representations of students’ learning patterns derived from login traces, such as login frequency and interval regularity, within the course’s learning management system. These visual indicators allowed students to monitor their learning engagement and performance in comparison to those of their peers.

Second, a persistent problem with FCs is the inability of students to interact with their peers or receive prompt feedback from instructors after completing independent online learning activities. While some researchers identified a need for teachers to provide immediate online feedback or opportunities for peer discussion, our review of the literature shows that scant attention has been given to this issue. Researchers note that under-stimulation, low perceived control over tasks, and delayed or insufficient feedback in online learning contribute significantly to learner boredom or absenteeism (Yazdanmehr et al., 2021 ; Tao and Gao, 2022 ). Online pedagogical innovations are needed to solve these new problems. For instance, the establishment of online groups employing chat software like QQ or WeChat could facilitate instantaneous feedback or peer interaction through text-based communication, thereby enhancing learners’ satisfaction with FC courses.

Third, despite recognizing the value of FCs in enhancing the learning experience for students, teachers often lack the requisite training to implement FCs effectively. Insights derived from interviews with teachers, as noted in several of the reviewed studies, reveal a pronounced desire for increased opportunities to learn about the underlying theories of FCs and acquire the skills necessary for the translation of FC concepts into pedagogical practice. Specifically, teachers express a need for guidance in creating engaging instructional videos, determining optimal video length to sustain learner interest, and ascertaining the ideal duration for online quizzes to foster optimal learner performance. Further research is required on strategies and technologies that can help teachers produce high-quality videos despite limited time and technical skills. Support from professional communities, institutions, and technology specialists is thus essential for the provision of effective hybrid offline and online instruction.

Fourth, additional research is required to determine whether workloads for students and teachers are increased by the use of FCs. If this is the case, as found in some of the reviewed studies, then the compelling benefits of FCs would be offset by the extra time needed, making it difficult to draw the conclusion that FCs are more efficient than traditional classes. The majority of language teachers, due to limited skills in technology, online environment management, and online interaction, feel too physically and emotionally overworked to expend more time and energy on enhancing teaching effectiveness. With few teachers having excess spare time, the thought of designing and creating new content might discourage even the most enthusiastic teachers.

Finally, robust empirical evidence is needed to evaluate whether FCs can facilitate students’ higher-order thinking through the use of creative technologies and assessment approaches. Constructs such as creativity and critical thinking are not always easily reduced to measurable items on survey instruments or scores on examinations (Haladyna et al., 2002 ).

In conclusion, the insights garnered from this study have the potential to enrich the global discourse on the benefits and limitations of FCs in diverse cultural and linguistic contexts. Our review included literature accessible through CSSCI and CJC in the CNKI database, and while this provides a thorough selection of the Chinese literature on the subject, our search approach may have excluded valuable FC-related papers published in other languages and countries. Consequently, different search criteria might yield different selection and data results. Future researchers are encouraged to undertake more comprehensive literature reviews encompassing broader databases to fill the gaps in our work and to augment the depth and breadth of knowledge in this domain.

Data availability

The raw data for this paper were collected from articles in Chinese Social Sciences Citation Index (CSSCI) journals and A Guide to the Core Journals of China of Peking University (PKU journals) in the database of China National Knowledge Infrastructure (CNKI) ( https://www.cnki.net/ ). The raw data used to support the findings of this study are available from the corresponding author upon request.

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This research was funded by The 14th Five-year Plan for Education Science of Jiangsu Province (Grant number: D/2021/01/79), Changzhou University (Grant number: GJY2021013), and Department of Education of Zhejiang Province, China (Project of Ideological and Political Construction of Courses 2021-337).

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A scoping review of academic and grey literature on migrant health research conducted in Scotland

• G. Petrie 1 ,
• K. Angus 2 &
• R. O’Donnell 2  

BMC Public Health volume  24 , Article number:  1156 ( 2024 ) Cite this article

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Migration to Scotland has increased since 2002 with an increase in European residents and participation in the Asylum dispersal scheme. Scotland has become more ethnically diverse, and 10% of the current population were born abroad. Migration and ethnicity are determinants of health, and information on the health status of migrants to Scotland and their access to and barriers to care facilitates the planning and delivery of equitable health services. This study aimed to scope existing peer-reviewed research and grey literature to identify gaps in evidence regarding the health of migrants in Scotland.

A scoping review on the health of migrants in Scotland was carried out for dates January 2002 to March 2023, inclusive of peer-reviewed journals and grey literature. CINAHL/ Web of Science/SocIndex and Medline databases were systematically searched along with government and third-sector websites. The searches identified 2166 journal articles and 170 grey literature documents for screening. Included articles were categorised according to the World Health Organisation’s 2016 Strategy and Action Plan for Refugee and Migrant Health in the European region. This approach builds on a previously published literature review on Migrant Health in the Republic of Ireland.

Seventy-one peer reviewed journal articles and 29 grey literature documents were included in the review. 66% were carried out from 2013 onwards and the majority focused on asylum seekers or unspecified migrant groups. Most research identified was on the World Health Organisation’s strategic areas of right to health of refugees, social determinants of health and public health planning and strengthening health systems. There were fewer studies on the strategic areas of frameworks for collaborative action, preventing communicable disease, preventing non-communicable disease, health screening and assessment and improving health information and communication.

While research on migrant health in Scotland has increased in recent years significant gaps remain. Future priorities should include studies of undocumented migrants, migrant workers, and additional research is required on the issue of improving health information and communication.

Peer Review reports

The term migrant is defined by the International Organisation for Migration as “ a person who moves away from his or her place of usual residence, whether within a country or across an international border, temporarily or permanently, and for a variety of reasons. The term includes several well-defined legal categories of people, including migrant workers; persons whose particular types of movements are legally-defined, such as smuggled migrants; as well as those whose status are not specifically defined under international law, such as international students.” [ 1 ] Internationally there are an estimated 281 million migrants – 3.6% of the world population, including 26.4 million refugees and 4.1 million asylum seekers – the highest number ever recorded [ 2 ]. The UN Refugee Society defines the term refugee as “ someone who has been forced to flee his or her country because of persecution, war or violence…most likely, they cannot return home or are afraid to do so .” The term asylum-seeker is defined as “someone whose request for sanctuary has yet to be processed.” [ 3 ].

Net-migration to Europe was negative in the 19th century due to higher levels of emigration, however in the mid-20th century immigration began to rise, because of an increase in migrant workers and following conflicts in the Middle East and North Africa [ 4 ]. Current migration drivers include conflicts alongside world-wide economic instability, exacerbated by the Covid-19 pandemic [ 5 ]. Environmental damage due to climate change is expected to inflate the number of asylum seekers entering Europe in future [ 6 ]. The increase in migration to Europe is not a short-term influx but a long-term phenomenon, and European nations must adapt and find solutions to resulting financial, safeguarding and health challenges [ 7 ].

Data on healthcare use by migrants in Europe is variable, which means cross-country comparisons are inadequate [ 8 ]. Many countries do not record migration information within health records and all use disparate criteria to classify migrant status. The lack of comparative data hinders public health surveillance and effective interventions [ 9 ]. Even where information is available, results can be contradictory due to the multifarious migrant population. Migrants have a wide range of origin countries, socio-economic position, age and journeys undertaken which can affect health status [ 10 ].

Migrants initially may have better health than the general population, known as the ‘Healthy Migrant effect’ [ 11 ]. However, health declines with increasing length of residence [ 12 ] and over time to levels comparable with the general population [ 13 ]. Second generation immigrants may have higher mortality than average [ 14 ]. The process of acculturation to the host country, with adoption of unhealthy lifestyle and behaviours, increases the risk for chronic disease [ 15 ]. In addition, inequalities in health of migrants compared to host populations has been confirmed by wide-ranging research [ 16 ].

Host countries may limit healthcare access, with undocumented migrants sometimes only entitled to emergency care [ 17 ]. Even when access is granted, inequitable services can affect quality of care due to language barriers and cultural factors [ 18 ]. Poor working/living conditions and discrimination can exacerbate health inequalities [ 12 ]. Processing facilities for asylum seekers are frequently overpopulated, stressful environments [ 19 ] and threat of deportation, lack of citizenship rights and integration can negatively affect health and access to care [ 20 ]. Undocumented workers are unprotected by health and safety legislation leading to dangerous working conditions and injuries [ 15 ].

A systematic review of migrant health in the European Union (EU) found migrants have worse self-perceived health than the general population [ 21 ]. Research evidence indicates increased prevalence of cardiovascular disease, diabetes, mental health disorders and adverse pregnancy outcomes. Exposure to conflict, harsh travel conditions and suboptimal vaccine programmes can mean higher risk of communicable disease [ 22 ]. Scoping reviews have also been conducted to describe trends within migration health research in the United Kingdom (UK) [ 23 ] and identify gaps for future research agendas in the UK [ 23 ] and in the Republic of Ireland [ 24 ].

Almost three-quarters (73%) of published migration health research in the UK has been conducted in England, focusing primarily on infectious diseases and mental health. There is limited evidence on the social determinants of health, access to and use of healthcare and structural and behavioural factors behaviours that influence migrant health in the UK [ 23 ]. By contrast, a large amount of the migration research conducted in the Republic of Ireland has focused on the social determinants of health, and on health system adaptations, with a paucity of research focusing on improving health information systems [ 24 ].

Migration and Health in Scotland

Immigration to Scotland began to rise in 2003 with the expansion of the EU [ 25 ]. The population in Scotland increased from 5.11 million to 5.47 million between 2005 and 2020 and is predicted to continue rising until 2028 [ 26 ] despite low birth rates, with the increased population resulting from inward migration [ 27 ]. Scotland’s population is becoming more ethnically diverse [ 28 ] and susceptibility to different health conditions varies by ethnic group, which has implications for the planning and provision of health services [ 29 ]. 7% of the current Scottish population are non-UK nationals and 10% were born outside Britain. The commonest countries of origin were Poland, Ireland, Italy, Nigeria and India [ 30 ].

Within Scotland, linking health data to ethnicity is standard in order to monitor and improve health of minority groups [ 31 ]. Ethnic background can differ from country of birth which means migration status cannot be assumed [ 32 ], although health inequalities experienced by migrants often extend to affect all ethnic minority groups [ 33 ]. The Scottish Health and Ethnicity Linkage Study (SHELS) linked census data to health records of 91% of the population which has provided information on mortality and morbidity by ethnic group and country of birth [ 34 ]. SHELS research indicates that the white-Scottish population have a higher mortality rate than other ethnic groups. This may be consequent to the comparatively poor health of the Scottish population relative to other European nations: high mortality rates in the general population may cause a perception that the health of minorities is more advantageous than in reality [ 35 ].

Cezard et al’s [ 13 ] analysis of self-perceived health among people in Scotland found that being born abroad had a positive impact on health status. Health declined with increased length of residence, which may be explained by cultural convergence with the majority population. Allik et al. [ 36 ] compared health inequalities by ethnic background and found that with increasing age, health differences reduced thus people aged over 75 of all ethnicities had similar or worse health status than White-Scottish people. While working-age migrants appear to be healthier than the White Scottish population, it cannot be assumed that in future this would extend to older age groups.

Research has shown deprivation as a cause of heath inequalities among ethnic minority and migrant groups [ 37 ]. The socio-economic status of minority ethnic groups in Scotland is unusual, as most are of similar or higher status than the white-Scottish population [ 38 ]. Therefore, public health interventions targeting deprivation may not address risk-factors for ethnic minorities and migrants [ 36 ]. Further research on determinants of health in migrants can help with planning and design of inclusive policies.

The 2011 census indicated that 50% of immigrants lived in the cities of Edinburgh, Glasgow, and Aberdeen. Glasgow had a greater percentage of non-European immigrants due to participation in the Asylum dispersal programme [ 39 ]. 10% of UK asylum seekers are placed in Glasgow, but records are not kept following approval of asylum claims, therefore the size of the refugee population is unknown [ 40 ]. While immigration is controlled by the British government, in policy areas devolved to the Scottish government, refugees and asylum seekers have more rights than elsewhere in UK, including access to primary healthcare for undocumented migrants [ 40 ]. Despite the mitigating effect of Scottish policies, asylum seekers’ health is worsened by the asylum process and associated poverty, marginalisation, and discrimination [ 40 ]. Health deteriorates with increasing length of time in the asylum system [ 40 ] and asylum seekers and refugees have additional health needs and require enhanced support [ 41 ]. Research on the health needs of asylum seekers in Scotland is required to ensure adequate healthcare.

Aim and objectives

While scoping reviews on migrant health have been carried out in Europe [ 12 ], Ireland [ 24 ] and the UK [ 23 ] none are currently specific to the Scottish context. Given the devolved government of Scotland and demographics described above, a targeted review would help to clarify research priorities, with the aim of improving health and health care within the migrant community in Scotland. This work therefore builds on the published scoping review of migrant health in the Republic of Ireland [ 24 ]. The authors recommend replication of the study in other countries to facilitate cross-country comparison. Our aim was to scope peer-reviewed research and grey literature on migrant health conducted in Scotland and identify any gaps in the evidence. Our objectives were to: [1] understand the extent of the available research by topic area [2] summarise the types of research already conducted, populations studied, topics covered and approaches taken [3], map the existing research conducted in Scotland and [4] identify areas for future research based on any gaps in the evidence identified.

A scoping review was conducted as they can aid detection of evidence gaps [ 42 ] and allow incorporation of grey literature in topics with insufficient published research [ 43 ]. Arksey and O’Malley’s [ 44 ] five stage scoping review framework was used.

Stage 1: identifying the research question

Arskey and O’Malley [ 44 ] suggest maintaining a broad approach to identifying the research question, in order to generate breadth of coverage. On this basis, and in line with the research question identified in the Villarroel et al. [ 24 ] scoping review, our research question was framed as follows: What is the scope, main topics and gaps in evidence in the existing literature on health of international migrants living in Scotland? Arksey and O’Malley [ 44 ] highlight the importance of defining terminology at the outset of scoping reviews. For consistency, we used the broad definition of ‘migrant’ as per Villaroel et al. [ 24 ], from the International Organisation for Migration (IOM) [ 1 ]. References to refugees or asylum seekers followed the United Nations Refugee Agency definitions [ 3 ].

Stage 2: identifying relevant studies

Electronic database searches identified reports alongside a grey literature search, in line with Arskey and O’Malley’s [ 44 ] guidance to search for evidence via different sources. CINAHL, Web of Science, SocIndex and Medline academic databases were selected with input from co-authors. Search terms for the review were based upon those used by Villaroel et al. [ 24 ] with additional relevant terms from Hannigan et al. [ 9 ] The strategy combined three sets of terms for: Migrants (e.g., refugee, migrant, immigrant or newcomer), Scotland and Health. Both free text terms and index terms were used and adapted to the 4 academic databases and searches were run on 10th March 2023 (see Additional File 1 for database search strategies). Thirteen Government, University, and third-sector websites in Scotland were scoped for selection then hand-searched for grey literature (listed in Additional File 1 ).

Stage 3: study selection

Net-migration to Scotland increased in the 2000s [ 27 ] hence a date range of January 2002-March 2023 was used to identify evidence. The search was limited to English only. Inclusion/exclusion criteria for the studies were based on those used by Villaroel et al. [ 24 ] and expanded upon following discussion with co-authors (see Table  1 ). Reports were included if based on primary or secondary research on the health of international migrants in Scotland and used qualitative, quantitative or mixed methods research design. International or UK based reports were only included if Scottish results were documented separately. Reports on the health of ethnic minority groups in Scotland was included if place of birth was recorded. Research on internal (non-international) migrants within Scotland, either moving from one Scottish area to another or from another part of the United Kingdom to Scotland, were excluded.

Stage 4: data charting

All records were saved to RefWorks for screening. Records were first screened at title/abstract stage with 10% independently checked by the co-authors. The remaining reports were single screened using full text by the first author. Data from the included records was extracted and organised in tabular form under the following headings, which were agreed by team members: article type (peer-reviewed article or grey literature), publication date, geographical setting, study/intervention’s target population, funding, primary research focus on migrant health (y/n), study objective, data collection method, study design (qualitative/quantitative/mixed) and main finding. Reports were not critically appraised in this scoping review.

Stage 5: collating, summarising and reporting results

A report (either a peer-reviewed journal article or grey literature report) is used as our unit of analysis. In order to present the range of research identified, reports were grouped by the different headings in our data charting table and the outcomes considered for relevance to our scoping review’s aim. Our Results summarise the recency, focus, study designs and funding sources of the identified research, followed by the geographical settings and whether Scotland was included in international research reports. Reports were grouped by their study population and further sub-divided by publication type and geographical area for summarising. Finally, the WHO’s European strategy and action plan (SAAP) for refugee and migrant health [ 7 ] is a policy framework designed to help governments and other stakeholders monitor and improve migrant health in Europe. There are nine strategic areas in the WHO’s SAAP, which prioritise the most salient issues. In line with Villaroel et al’s [ 24 ] approach and in order to compare scoping review outcomes, these areas were used to categorise the findings of this review. Each report was matched to the most appropriate SAAP:

Establishing a Framework for Collaborative Action.

Advocating for the right to health of refugees.

Addressing the social determinants of health.

Achieving public health preparedness and ensuring an effective response.

Strengthening health systems and their resilience.

Preventing communicable disease.

Preventing and reducing the risks caused by non-communicable disease.

Ensuring ethical and effective health screening and assessment.

Improving health information and communication.

The primary focus (aims and objectives) of each report was used to identify the relevant SAAP area/areas. To improve reliability, results were compared using coding criteria used in Villaroel et al’s study (MacFarlane 2023, personal communication, 31st May). 10% of the reports were checked by one co-author to ensure consistent coding to SAAP categories. Any instances of uncertainty in mapping reports to the relevant SAAP area/areas were discussed and resolved by team members.

This scoping review of the literature on migrant health in Scotland identified 2166 records from academic literature databases, following duplicate removal, and 170 records from website searches (see Fig.  1 ). Following screening, a total of 71 peer-reviewed journal articles and 29 grey literature studies (totalling 100 reports) were included for analysis (Results table and reference list are presented in Additional File 2 ).

Flow chart illustrating the identification of sources of evidence included in the scoping review

Overall findings

The majority of reports were published between 2013 and 2022. Fifty-eight reports (58%) focused exclusively on migrant health [ 18 , 39 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 ]. 23 centred on health but included other populations in addition to migrants – for example research on ethnic minorities or other vulnerable groups [ 13 , 31 , 35 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 ]. Seventeen reports were included where the sample population were migrants, but the primary topic was not health – for example destitution, integration, and service needs [ 27 , 73 , 74 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 ]. Health data was reported as part of the wider subject matter. One report [ 136 ] looked at the social determinants of breastfeeding including migrant status and one [ 137 ] compared attitudes to aging and family support between countries.

Funding sources were not declared for 35 (35%) of reports. The Scottish Government funded 20 reports (20%) [ 13 , 27 , 32 , 39 , 45 , 46 , 47 , 66 , 77 , 88 , 99 , 100 , 101 , 102 , 113 , 116 , 119 , 121 , 129 , 134 ]. Other common sources of funding included Government funded public bodies ( n  = 13) [ 45 , 48 , 49 , 50 , 51 , 52 , 53 , 104 , 107 , 113 , 116 , 131 , 136 ], the Scottish Health Service ( n  = 18) (either the National Health Service (NHS) [ 13 , 54 , 56 , 57 , 58 , 59 , 102 , 113 , 116 ], local NHS trusts [ 45 , 60 , 61 , 77 , 102 , 103 , 112 ] or by Public Health Scotland [ 13 , 113 ]) Eleven reports (11%) were funded by Universities. The charity sector financed 15 (15%) reports [ 53 , 63 , 66 , 69 , 70 , 71 , 72 , 73 , 74 , 103 , 111 , 123 , 125 , 132 , 138 ] and the EU and Scottish local authorities funded four reports each [ 45 , 62 , 75 , 76 , 77 , 102 , 125 , 135 ]. Professional bodies financed one report [ 126 ] as did the Japanese government [ 64 ]. No reports received funding from the business sector. The biggest sources of funding for grey literature were Refugee charities (40%) and the Scottish government (30%) (see Fig. 2 ).

Sources of funding for migrant health research in Scotland

Research methods and data collection

52% of reports used qualitative research methods. Forty-five reports (86%) collected data using 1–1 interviews and 24 (46%) used focus groups. Other methods of data collection included questionnaires (six studies (11%)), workshops (two studies (3.85%)) and observation (two studies (3.85%)). Oral/written evidence, guided play sessions, family case studies and participatory activity sessions were used in one report each.

28% of reports used quantitative research methods, most commonly cross section design (ten studies (36%)) and cohort design (18 studies (64%)). Information was obtained from databases including medical records, Census data and national records in 21 reports (75%). Questionnaires were used in six reports (21%). Other methods including body measurements, food diaries, blood samples, interviews and case reviews were used in 1 report each.

20% of reports used mixed methods. The most common method of data collection was questionnaires in 14 reports (70%), interviews in ten reports (50%), focus groups in seven reports (35%), workshops in three reports (13.6%), and databases in three reports (13.6%). Other methods included literature review in two reports (10%), case note reviews in two reports (10%) and one reports each used mapping and school records.

Geographical areas of study

Ninety-one reports were situated in Scotland, of which 35 (38.5%) covered the whole country and 56 (61.5%) specified a city or area where research was undertaken. Some UK and international reports also specified the area of Scotland. The largest share of research within Scotland overall was in Glasgow with 36 reports, followed by Edinburgh with 16 reports, Lothian with six reports, Aberdeen with five reports and Grampian with three reports. The Northeast, Stirling, Highlands, Inverness, Lanarkshire, Motherwell and Selkirk had one report in each area.

There were seven international reports, three on mortality by country of birth [ 75 , 76 , 78 ], one on cross cultural communication [ 79 ], one on maternity care in Poland and Scotland [ 99 ], one comparing attitudes to aging in China and Scotland [ 137 ] and one on the link between birthweights and integration of migrants [ 64 ]. The remaining two reports were UK based, one on immunisation of Roma and traveller communities [ 117 ] and one on the link between ethnic diversity and mortality [ 104 ]. All the included international and UK reports documented the Scottish data separately within results.

Migrant population

Thirty-one reports included all migrants in the study population. The remaining reports included 30 studies on asylum seekers/refugees, 11 on Polish migrants, ten on Africans, six each on South Asians/Chinese/European, three on Arabs, and two on Roma populations (see Fig.  3 ). Most reports did not specify the country of origin for Asylum seekers and refugees - where country of birth was specified, reports were also included in the appropriate category.

Migrant populations studied in health research in Scotland

Grey literature and peer-reviewed reports differed in population focus. The most common populations of interest in grey literature were asylum seekers/refugees consisting of 18 reports (62%) [ 27 , 47 , 54 , 55 , 59 , 63 , 70 , 71 , 72 , 73 , 74 , 123 , 125 , 127 , 128 , 132 , 134 , 138 ] while for peer-reviewed journals 24 reports (34%) focused on all migrants [ 13 , 35 , 45 , 48 , 64 , 76 , 78 , 79 , 80 , 81 , 104 , 105 , 108 , 109 , 113 , 114 , 115 , 116 , 118 , 120 , 121 , 122 , 136 ].

Migrant study population also differed by local area; Glasgow city, where the majority of research occurred, had 18 reports of 36 (50%) on Asylum seekers/refugees [ 47 , 48 , 52 , 53 , 54 , 55 , 58 , 63 , 70 , 71 , 72 , 82 , 83 , 127 , 128 , 130 , 138 , 139 ] eight reports (22%) on Africans [ 52 , 53 , 84 , 85 , 86 , 87 , 106 , 107 ], seven reports (19%) on all migrants [ 45 , 48 , 80 , 102 , 104 , 105 , 121 ] and two reports (5.5%) on Roma migrants [ 103 , 117 ]. Other populations had one reports each. In Edinburgh five reports of 16 (31%) were on the Polish population [ 56 , 67 , 68 , 89 , 90 ], and two reports (12.5%) on Asylum seekers/refugees [ 60 , 133 ], Chinese [ 62 , 137 ], South Asian [ 46 , 119 ], all migrants [ 105 , 121 ] and Africans [ 87 , 107 ]. The remaining migrant groups had one report each. Other areas of Scotland show no clear pattern with studies in disparate migrant population groups.

Number of reports per Strategic and Action Plan (SAAP) Area

SAAP Area mapping

1. establishing a framework for collaborative action.

Nine reports had a primary focus on collaborative action and were categorised under SAAP area 1 (see Fig.  4 ) [ 66 , 70 , 72 , 73 , 103 , 125 , 129 , 132 , 134 ]. Four reports (33%) used a mixed methods study design, the remaining five reports (67%) used a qualitative design. One report [ 66 ] focused on the epidemiology of female genital mutilation and a proposed intervention strategy. One report [ 66 ] focused on the epidemiology of female genital mutilation and a proposed intervention strategy. One report [ 103 ] evaluated service provision to the Roma community in Glasgow. The remaining reports focused on refugees and asylum seekers: four [ 73 , 125 , 132 , 134 ] evaluations of refugee integration projects, one [ 70 ] on services available to pregnant women, and one [ 72 ] an assessment of a peer-education service. One report [ 129 ] was a review of service provisions for migrants during the Covid-19 pandemic. All reports in SAAP area 1 were grey literature and three (37.5%) had a primary focus on migrant health while four (50%) focused on integration, one (11%) included data on ethnic minorities and one (11%) on services during the covid-19 pandemic. The majority (seven reports (78%)) were also categorised to another SAAP area most commonly area 2 (five studies (55%)) or area 5 (four studies (44%)).

2. Advocating for the right to health of refugees

Nineteen reports focused on SAAP area 2, advocating for the right to health of refugees (see Fig.  4 ) [ 47 , 52 , 53 , 54 , 55 , 63 , 70 , 71 , 83 , 103 , 123 , 124 , 125 , 127 , 128 , 129 , 134 , 138 , 140 ]. Sixteen reports (84%) had a qualitative study design and the remaining three (16%) reports used mixed methods. Nine reports (47%) focused on the health impact of the asylum system [ 52 , 55 , 71 , 74 , 123 , 127 , 128 , 129 , 138 ], five (26%) on health and access to care [ 47 , 54 , 83 , 103 , 124 ], two (10.5%) on maternity care [ 63 , 70 ], two (10.5%) on integration services [ 125 , 134 ] and one report on mental health in HIV positive migrants [ 53 ]. Nine reports (47%) had a primary focus on migrant health while the remaining 10 (53%) also involved wider social issues. The majority (15 (79%)) of reports were grey literature. All the articles in this group overlapped with another SAAP area. Area 3 is the most common joint category with ten reports (53%) followed by area 5 with seven reports (37%), area 1 shares five reports (26%), while areas 4 and 8 share one report each (5%).

3. Addressing the social determinants of health

Twenty-nine reports were categorised to SAAP area 3 – addressing the social determinants of health (see Fig.  4 ) [ 13 , 27 , 45 , 50 , 52 , 55 , 60 , 62 , 63 , 65 , 68 , 71 , 74 , 80 , 81 , 82 , 91 , 92 , 93 , 102 , 112 , 123 , 124 , 127 , 128 , 136 , 137 , 138 ]. The majority (14 (48%)) used a qualitative study method, eight (28%) used quantitative methodology and the remaining seven reports (24%) used mixed methods. Nineteen reports (65.5%) were peer-reviewed journals [ 13 , 45 , 50 , 52 , 60 , 62 , 63 , 65 , 68 , 80 , 81 , 82 , 91 , 92 , 93 , 104 , 112 , 124 , 136 , 137 ] and ten (34.5%) were grey literature [ 27 , 55 , 63 , 71 , 74 , 102 , 123 , 127 , 128 , 138 ]. Ten reports (34.5%) discussed the effects of the asylum system on health [ 27 , 52 , 63 , 71 , 74 , 123 , 124 , 127 , 128 , 137 ] and one (3.5%) migration and health [ 50 ]. Six reports (21%) focused on culture and ethnicity [ 82 , 92 , 102 , 104 , 112 , 137 ], five reports (17%) discussed economic and environmental determinants of health [ 13 , 45 , 67 , 81 , 93 ] and five reports (17%) the health impact of social activities [ 55 , 60 , 62 , 80 , 91 ]. Of the remaining reports, one [ 65 ] discussed Brexit and mental health of European migrants and one discussed the effect of coping strategies on wellbeing in Polish migrants [ 68 ]. Most reports, 18 (62%) had a primary focus on migrant health [ 45 , 50 , 52 , 55 , 60 , 62 , 63 , 65 , 67 , 68 , 71 , 80 , 81 , 82 , 91 , 92 , 93 , 102 ], six reports (21%) discussed wider social factors in addition to health [ 74 , 123 , 124 , 127 , 128 , 138 ]. Of the remaining reports three (10%) looked at ethnic background and country of birth [ 13 , 112 , 136 ], one [ 27 ] included other vulnerable groups and one [ 137 ] included people living in China and Chinese migrants to Scotland. Thirteen reports were also categorised to one or more additional SAAP area - ten (34%) were also applicable to area 2 [ 52 , 55 , 63 , 71 , 74 , 123 , 124 , 127 , 128 , 138 ], three (10%) to area 5 [ 63 , 82 , 92 ] and one (7%) to area 4 [ 27 ].

4. Achieving public health preparedness and ensuring an effective response

Twenty-one reports were assigned to SAAP area 4 (see Fig.  4 ) [ 27 , 31 , 35 , 39 , 47 , 57 , 64 , 75 , 76 , 77 , 78 , 94 , 104 , 108 , 109 , 111 , 113 , 114 , 116 , 120 , 135 ] of which fourteen (67%) used quantitative research methods, four (19%) mixed methods and three (14%) qualitative methods. Thirteen (62%) reports were peer-reviewed journals [ 35 , 59 , 64 , 75 , 78 , 104 , 108 , 109 , 111 , 113 , 114 , 116 , 120 ] and eight (38%) grey literature [ 27 , 31 , 39 , 47 , 57 , 77 , 94 , 135 ]. Most reports (12 (57%)) focused on morbidity and mortality in migrant populations [ 31 , 35 , 64 , 75 , 76 , 78 , 104 , 108 , 109 , 113 , 114 , 116 ]. Six (29%) investigated health status and healthcare needs in migrant groups in Scotland [ 39 , 47 , 57 , 77 , 94 , 135 ]. Two reports (9.5%) analysed the epidemiology of HIV infections [ 111 , 120 ] and the remaining report focused on the health needs of young people during the covid-19 pandemic [ 27 ]. Nine reports (43%) had a primary focus on migrant health [ 39 , 47 , 55 , 64 , 75 , 76 , 77 , 78 , 94 ] while eight (38%) also analysed data by ethnicity [ 31 , 35 , 104 , 108 , 109 , 113 , 114 , 116 ]. Of the remaining reports, three (14%) included other populations within Scotland [ 27 , 111 , 120 ] and one (5%) included other characteristics in addition to health information [ 135 ]. Ten reports (48%) were also categorised to another SAAP area; one to area 2 [ 47 ], one to area 3 [ 27 ], four to area 5 [ 47 , 57 , 77 , 135 ], two to area 6 [ 111 , 120 ] and two to area 9 [ 31 , 108 ].

5. Strengthening health systems and their resilience

Twenty-nine reports were assigned to SAAP area 5 (see Fig.  4 ) [ 18 , 47 , 48 , 49 , 54 , 57 , 63 , 69 , 70 , 72 , 77 , 79 , 82 , 83 , 92 , 95 , 96 , 97 , 99 , 101 , 103 , 118 , 119 , 126 , 129 , 131 , 133 , 135 , 141 ] of which 23 (79%) used qualitative research methods. Three reports used quantitative methods (10.3%) and the remaining three used mixed methods (10.3%). Twelve reports (41%) examined migrants needs and experiences of health care [ 47 , 49 , 54 , 57 , 58 , 77 , 83 , 95 , 103 , 119 , 129 , 135 ], eight (24%) focused on pregnancy and childcare [ 63 , 70 , 92 , 96 , 97 , 99 , 101 , 118 ] and two (7%) on barriers to healthcare access [ 48 , 131 ]. Two reports (7%) evaluated healthcare programmes [ 72 , 133 ] and two focused on communication in primary care [ 79 ] and maternity services [ 69 ]. The remaining three reports (10%) covered sexual health [ 82 ], health information needs of Syrian refugees [ 126 ] and general practitioner training [ 18 ]. Nineteen (65.5%) were peer reviewed journals [ 18 , 48 , 49 , 58 , 69 , 79 , 82 , 83 , 92 , 95 , 96 , 97 , 99 , 101 , 118 , 119 , 125 , 131 , 133 ] and ten (34.5%) were grey literature [ 47 , 54 , 57 , 63 , 70 , 72 , 77 , 103 , 129 , 135 ]. Twenty-one (72%) had a primary focus on migrant health [ 18 , 47 , 48 , 49 , 54 , 57 , 58 , 63 , 69 , 70 , 72 , 77 , 79 , 82 , 83 , 92 , 95 , 96 , 97 , 99 , 101 ]. Six reports (21%) included research on other characteristics or services [ 103 , 126 , 129 , 131 , 133 , 135 ]. The remaining two reports (7%) included ethnic groups as well as migrants in the data [ 118 , 119 ]. Nineteen reports (65.5%) were also assigned to one or more other category areas: five reports (17%) to area 1 [ 47 , 70 , 72 , 103 , 129 ], five reports (17%) to area 2 [ 54 , 63 , 83 , 103 , 129 ], three reports (10%) to area 3 [ 63 , 82 , 92 ], four reports (14%) to area 4 [ 47 , 57 , 77 , 135 ], one (3.5%) to area 7 [ 119 ] and one (3.5%) to area 9 [ 48 ].

6. Preventing communicable diseases

Fourteen reports were assigned to SAAP area 6 (see Fig.  4 ) [ 56 , 61 , 87 , 88 , 89 , 90 , 105 , 106 , 107 , 111 , 115 , 117 , 120 , 122 ] of which four (31%) used quantitative methods, five (38%) used qualitative methods and five (38%) used mixed methods. Five reports (38.5%) examined immunisation behaviour [ 56 , 61 , 89 , 90 , 117 ], five (38%) on epidemiology and treatment of HIV [ 106 , 107 , 111 , 120 , 122 ]. The remaining four reports (31%) focused on tuberculosis in healthcare workers [ 115 ], malaria [ 105 ] and sexual health services [ 87 , 88 ]. Only one reports was grey literature [ 88 ], the remainder were peer-reviewed journals. Six reports (46%) had a primary focus on migrant health [ 56 , 61 , 87 , 88 , 89 , 90 ] while seven reports (54%) also included other at-risk groups in the analysis. Four reports (31%) were also assigned to another SAAP category, two (15%) to area 4 [ 111 , 120 ] and two (15%) to area 8 [ 88 , 115 ].

7. Preventing and reducing the risks posed by non-communicable diseases

Eight reports were categorised to SAAP area 7 (see Fig.  4 ) [ 46 , 51 , 59 , 84 , 85 , 86 , 98 , 119 ] of which six (75%) used qualitative research methods, one (12.5%) used quantitative methods and one (12.5%) used mixed methods. Only one report (12.5%) was grey literature [ 59 ] the remaining seven reports (87.5%) were peer-reviewed journals [ 48 , 87 , 92 , 126 , 127 , 128 , 140 ]. Three reports (37.5%) focused on health behaviours [ 51 , 85 , 98 ], two (25%) on mental health, two (25%) on diabetes and one (12.5%) on chronic disease. Seven reports(87.5%) had a primary focus on migrant health [ 46 , 51 , 59 , 84 , 85 , 86 , 98 ], with the remaining report (12.5%) including ethnic minority groups [ 119 ]. One report (12.5%) was also assigned to SAAP area number 5 [ 119 ].

8. Ensuring ethical and effective health screening and assessment

There were six reports assigned to category 8 (see Fig.  4 ) [ 53 , 88 , 100 , 110 , 115 , 121 ] of which two (33%) used a quantitative research method, three (50%) used a qualitative method and one used mixed methods. One report (14%) was grey literature [ 88 ] the remaining five reports (83%) were peer reviewed journals [ 53 , 100 , 110 , 115 , 121 ]. Three reports (50%) focused on cancer screening in migrant women [ 21 , 100 , 110 ], one (17%) analysed access to HIV testing among African migrants [ 53 ], one (17%) on T.B in healthcare workers [ 72 ] and one (17%) on sexual health [ 36 ]. Three reports (50%) had a primary focus on migrant health [ 53 , 88 , 100 ] while the remaining three reports (50%) included other at-risk groups in the analysis [ 110 , 115 , 121 ]. There were three reports which overlapped with other SAAP areas: one [ 53 ] (17%) was categorised to area 2 while two [ 88 , 115 ] (33%) were categorised to area 6.

9. Improving health information and communication

Three reports were assigned to SAAP area 9 (see Fig.  4 ) [ 31 , 108 , 130 ]. One of these (33%) used a qualitative approach, one (33%) used a quantitative approach and one (33%) used mixed methods. Two [ 108 , 130 ] (66%) were peer-reviewed journal articles and one [ 31 ] (33%) was grey literature. Two reports (66%) focused on improving migrant demographics and health information using databases [ 31 , 108 ] while one (33%) described an information-needs matrix for refugees and asylum seekers [ 130 ]. Two [ 31 , 108 ] included ethnicities in the data while one [ 130 ] had a primary focus on migrant health. Two reports [ 31 , 108 ] (66%) also applied to SAAP area 4 while one report [ 130 ] (33%) was in SAAP area 9 only.

To our knowledge this is the first scoping review conducted on migrant health in Scotland. A previous rapid literature review [ 94 ] found most research focused on health behaviours, mental health, communicable disease and use of and access to healthcare; however, the review limited migrant definition to those who had immigrated within five years and asylum seekers were not included.

In our review, the majority of reports were published from 2013 onwards, aligning with the expansion in migrant research internationally [ 142 ]. 52% used qualitative research methods, 28% used quantitative methods and 20% used mixed methods. 58% focused on migrant health: the remaining papers included other populations or health as part of a wider remit. Research funding was mostly provided by the Scottish Government, NHS, refugee charities and Universities. No studies received funding from the private sector, although this sector has the potential resource and capacity to play a key role in funding future research to improve migrant health in Scotland. Geographically, most studies took place in Glasgow (36%), nationwide (38.5%) or Edinburgh (16%) – other areas were under-represented including Aberdeen (5%), despite being the city with the largest migrant population [ 30 ]. There was a lack of studies in rural localities. These findings concur with a UK migrant health review by Burns et al. [ 23 ] where research was concentrated in larger cities and data was sparse in rural areas relative to the migrant population.

Half of the research identified that was conducted in Glasgow focused on asylum seekers/refugees. Glasgow was previously the only Scottish city to host asylum seekers [ 143 ] and currently supports the most asylum seekers of any local authority in the UK [ 29 ]. In April 2022, the UK government widened the Asylum dispersal scheme to all local authorities [ 144 ]. Around 70% of Scotland’s refugee support services are based in Glasgow and the South-west [ 145 ]. As reduced access to services may impact the health of asylum seekers, research in Glasgow may not be generalizable to other regions of Scotland.

Almost one-third (30%) of all reports focused on asylum seekers and refugees – an overrepresentation given that only 18% of migrants to the UK are asylum seekers [ 146 ] and as low as 2% of all migrants in Scotland [ 147 ]. Asylum seekers and refugees are at risk of poor health due to trauma, difficult journeys, overcrowded camps, poor nutrition and lack of access to healthcare [ 148 ]. They have worse maternity outcomes and increased rates of mental illness [ 149 ]. Increased research on health of asylum seekers and refugees is necessary due to their additional vulnerabilities [ 142 ]. However, asylum seeker’s country of origin was generally not specified. Asylum seekers have heterogenic backgrounds [ 150 ] and nationality and trauma experience affect health status [ 151 ]. Further research focused on specific nationalities of asylum seekers would enhance understanding of the health needs in this population.

Almost one-third (31%) of studies did not specify a migrant group. This concurs with a Norwegian migrant health study by Laue et al. [ 152 ] where 36% of research did not identify country of birth. Where nationality was identified, Polish, African and South Asian were most prevalent. Poles are the largest migrant group in Scotland, however for the other most common immigrant groups of Irish, Italian and Nigerian [ 30 ] there was an absence of research. No studies took place on Nigerian migrants – nine studies indicated African populations, but country of birth was not specified. Since March 2022, 23,000 Ukrainians have migrated to Scotland [ 153 ], however no studies on Ukrainians were identified currently. Research may be underway which is yet to be published.

Only one study explored the impact of Brexit on European migrants’ health despite 56% of migrants to Scotland being EU nationals [ 30 ]. Again, research may be taking place currently, which is yet to be published. No studies involved undocumented migrants despite this populations’ high rates of poor physical/mental health exacerbated by poor housing and working conditions [ 154 ]. An estimated 7.2–9.5% of the workforce in the UK are migrant workers who have higher risks of poor working conditions and injury [ 155 ]. Scotland depends on a migrant workforce for some industries such as agriculture [ 156 ] but only two research papers specified migrant workers.

Most research papers related to the right to health of refugees (SAAP 2), social determinants of health (SAAP 3), public health planning (SAAP 4) and strengthening health systems (SAAP 5). Areas with less research were frameworks for collaborative action (SAAP 1), preventing communicable disease (SAAP 6), preventing non-communicable disease (SAAP 7) and health screening and assessment (SAAP 8). Only three studies related to improving health information and communication (SAAP 9). Lebano et al. [ 12 ] conducted a literature review of migrant health in Europe and found data collection unreliable and disorganised. There is a lack of data on the numbers and types of migrants entering Scotland and research tends not to differentiate between ethnic minorities and migrants [ 94 ]. As poor-quality information hinders surveillance and planning of services SAAP area 9 is an important consideration for increased research.

Villarroel et al. [ 24 ] also found more research in SAAP areas 3 to 5 and less in areas 6 to 9. However, their study returned no results in category 1, collaborative action, or 2, the right to health of refugees, while this study assigned 9% of articles to category 1 and 19% to category 2. Most articles in our study relating to categories 1 and 2 were grey literature, which was excluded from the original Irish scoping review. This highlights a potential difference in the focus of peer-reviewed articles compared to government/refugee charity commissioned reports. Collaborative action and the right to health of refugees and asylum seekers are entwined in Scotland due to the complex policy environment; the social determinants of health such as housing, education, welfare rights and social integration are influenced by a variety of UK and Scottish statutory bodies as well as third sector organisations [ 157 ]. Despite this complexity, organisations work well together [ 158 ]. Further academic research in this area would enhance joint working practices and networks.

A scoping review in the UK [ 23 ] found similar quantities of research corresponding to SAAP areas 3, 2 and 9. However in Scotland areas 1, 5 and 8 were a combined 44% of included papers compared with 27.8% of results on health systems and structures in Burns et al’s [ 23 ] study. Almost half of the articles in SAAP areas 1,5 and 8 were grey literature, which was not included in Burns et al’s [ 23 ] review. Conversely, Burns et al. [ 23 ] found 81.9% of research in the UK related to epidemiology, equivalent to SAAP categories 4,6 and 7. In a Norwegian scoping review of migrant health [ 152 ] 65% of research was related to epidemiological data on health and disease. Only 42% of the research in this current study related to epidemiological data; the quantity of evidence was reduced by excluding combined research from the UK. As Scotland has higher mortality and morbidity than elsewhere in the UK [ 29 ] it is important to undertake further epidemiological research limited to Scotland.

Strengths and weaknesses

Strengths of this review include the use of the WHO’s SAAP categories [ 7 ] to classify data, in accordance with the Villarroel et al’s [ 24 ] study: this means results are linked to policy on migrant health and facilitates comparability to the Irish study results. Additionally results include data on migrant groups, locality, and funding of included papers; these highlight potential omissions for future research consideration. Results include diverse research methods and published and grey literature giving a wide overview of available evidence, reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) checklist (see Additional File 3 ) [ 159 ].

Limitations included the lack of an open-access protocol and search limitations of English language and selected databases. This means some relevant reports may be omitted. Due to time and resource limitations no quality appraisal was planned for included reports. Whilst we did not synthesise the findings for each topic area and migrant group, future systematic reviews could be undertaken to address this limitation and build on this work.

Conclusions

Immigration and ethnic diversity in Scotland have increased since 2002 which is reflected in the expansion of migrant health research. This review highlights evidence gaps including a lack of research in rural areas, undocumented migrants and migrant workers. There is a tendency to cluster asylum seekers together rather than differentiate between national groups. Within the SAAP areas there is less evidence relating to collaborative action, preventing communicable disease, preventing non-communicable disease and health screening and assessment. Further research is required on improving health information and communication for migrant populations in Scotland – a significant omission given the importance of accurate information for health service planning.

Availability of data and materials

All data analysed during this review comes from the papers listed in Additional file 2 .

Abbreviations

European Union

Human Immunodeficiency Virus

National Health Service

Strategy and Action Plan

The Scottish Health and Ethnicity Linkage Study

United Kingdom

World Health Organisation

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Acknowledgements

Thank-you to Professor Anne MacFarlane and PHD student Anne Cronin, of the University of Limerick, Ireland for sharing the coding guidelines currently used in an update to Villarroel et. al’s 2019 study on Migrant Health in the Republic of Ireland.

No funding was received for this work, which was undertaken as G. Petrie’s Master of Public Health dissertation module at the University of Stirling.

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KA, RO and GP finalised the study design collectively. GP conducted the searches, analysis and write up, with support from KA and RO. All three authors read and approved the manuscript prior to submission.

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Petrie, G., Angus, K. & O’Donnell, R. A scoping review of academic and grey literature on migrant health research conducted in Scotland. BMC Public Health 24 , 1156 (2024). https://doi.org/10.1186/s12889-024-18628-1

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DOI : https://doi.org/10.1186/s12889-024-18628-1

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