how to make a synthesis of related literature

How to Synthesize Written Information from Multiple Sources

Shona McCombes

Content Manager

B.A., English Literature, University of Glasgow

Shona McCombes is the content manager at Scribbr, Netherlands.

Learn about our Editorial Process

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

On This Page:

When you write a literature review or essay, you have to go beyond just summarizing the articles you’ve read – you need to synthesize the literature to show how it all fits together (and how your own research fits in).

Synthesizing simply means combining. Instead of summarizing the main points of each source in turn, you put together the ideas and findings of multiple sources in order to make an overall point.

At the most basic level, this involves looking for similarities and differences between your sources. Your synthesis should show the reader where the sources overlap and where they diverge.

Unsynthesized Example

Franz (2008) studied undergraduate online students. He looked at 17 females and 18 males and found that none of them liked APA. According to Franz, the evidence suggested that all students are reluctant to learn citations style. Perez (2010) also studies undergraduate students. She looked at 42 females and 50 males and found that males were significantly more inclined to use citation software ( p < .05). Findings suggest that females might graduate sooner. Goldstein (2012) looked at British undergraduates. Among a sample of 50, all females, all confident in their abilities to cite and were eager to write their dissertations.

Synthesized Example

Studies of undergraduate students reveal conflicting conclusions regarding relationships between advanced scholarly study and citation efficacy. Although Franz (2008) found that no participants enjoyed learning citation style, Goldstein (2012) determined in a larger study that all participants watched felt comfortable citing sources, suggesting that variables among participant and control group populations must be examined more closely. Although Perez (2010) expanded on Franz’s original study with a larger, more diverse sample…

Step 1: Organize your sources

After collecting the relevant literature, you’ve got a lot of information to work through, and no clear idea of how it all fits together.

Before you can start writing, you need to organize your notes in a way that allows you to see the relationships between sources.

One way to begin synthesizing the literature is to put your notes into a table. Depending on your topic and the type of literature you’re dealing with, there are a couple of different ways you can organize this.

Summary table

A summary table collates the key points of each source under consistent headings. This is a good approach if your sources tend to have a similar structure – for instance, if they’re all empirical papers.

Each row in the table lists one source, and each column identifies a specific part of the source. You can decide which headings to include based on what’s most relevant to the literature you’re dealing with.

For example, you might include columns for things like aims, methods, variables, population, sample size, and conclusion.

For each study, you briefly summarize each of these aspects. You can also include columns for your own evaluation and analysis.

The summary table gives you a quick overview of the key points of each source. This allows you to group sources by relevant similarities, as well as noticing important differences or contradictions in their findings.

Synthesis matrix

A synthesis matrix is useful when your sources are more varied in their purpose and structure – for example, when you’re dealing with books and essays making various different arguments about a topic.

Each column in the table lists one source. Each row is labeled with a specific concept, topic or theme that recurs across all or most of the sources.

Then, for each source, you summarize the main points or arguments related to the theme.

The purposes of the table is to identify the common points that connect the sources, as well as identifying points where they diverge or disagree.

Step 2: Outline your structure

Now you should have a clear overview of the main connections and differences between the sources you’ve read. Next, you need to decide how you’ll group them together and the order in which you’ll discuss them.

For shorter papers, your outline can just identify the focus of each paragraph; for longer papers, you might want to divide it into sections with headings.

There are a few different approaches you can take to help you structure your synthesis.

If your sources cover a broad time period, and you found patterns in how researchers approached the topic over time, you can organize your discussion chronologically .

That doesn’t mean you just summarize each paper in chronological order; instead, you should group articles into time periods and identify what they have in common, as well as signalling important turning points or developments in the literature.

If the literature covers various different topics, you can organize it thematically .

That means that each paragraph or section focuses on a specific theme and explains how that theme is approached in the literature.

Source Used with Permission: The Chicago School

If you’re drawing on literature from various different fields or they use a wide variety of research methods, you can organize your sources methodologically .

That means grouping together studies based on the type of research they did and discussing the findings that emerged from each method.

If your topic involves a debate between different schools of thought, you can organize it theoretically .

That means comparing the different theories that have been developed and grouping together papers based on the position or perspective they take on the topic, as well as evaluating which arguments are most convincing.

Step 3: Write paragraphs with topic sentences

What sets a synthesis apart from a summary is that it combines various sources. The easiest way to think about this is that each paragraph should discuss a few different sources, and you should be able to condense the overall point of the paragraph into one sentence.

This is called a topic sentence , and it usually appears at the start of the paragraph. The topic sentence signals what the whole paragraph is about; every sentence in the paragraph should be clearly related to it.

A topic sentence can be a simple summary of the paragraph’s content:

“Early research on [x] focused heavily on [y].”

For an effective synthesis, you can use topic sentences to link back to the previous paragraph, highlighting a point of debate or critique:

“Several scholars have pointed out the flaws in this approach.” “While recent research has attempted to address the problem, many of these studies have methodological flaws that limit their validity.”

By using topic sentences, you can ensure that your paragraphs are coherent and clearly show the connections between the articles you are discussing.

As you write your paragraphs, avoid quoting directly from sources: use your own words to explain the commonalities and differences that you found in the literature.

Don’t try to cover every single point from every single source – the key to synthesizing is to extract the most important and relevant information and combine it to give your reader an overall picture of the state of knowledge on your topic.

Step 4: Revise, edit and proofread

Like any other piece of academic writing, synthesizing literature doesn’t happen all in one go – it involves redrafting, revising, editing and proofreading your work.

Checklist for Synthesis

•   Do I introduce the paragraph with a clear, focused topic sentence?
•   Do I discuss more than one source in the paragraph?
•   Do I mention only the most relevant findings, rather than describing every part of the studies?
•   Do I discuss the similarities or differences between the sources, rather than summarizing each source in turn?
•   Do I put the findings or arguments of the sources in my own words?
•   Is the paragraph organized around a single idea?
•   Is the paragraph directly relevant to my research question or topic?
•   Is there a logical transition from this paragraph to the next one?

Further Information

How to Synthesise: a Step-by-Step Approach

Help…I”ve Been Asked to Synthesize!

Learn how to Synthesise (combine information from sources)

How to write a Psychology Essay

The Sheridan Libraries

• Write a Literature Review
• Sheridan Libraries
• Find This link opens in a new window
• Evaluate This link opens in a new window

Get Organized

• Lit Review Prep Use this template to help you evaluate your sources, create article summaries for an annotated bibliography, and a synthesis matrix for your lit review outline.

Synthesize your Information

Synthesize: combine separate elements to form a whole.

Synthesis Matrix

A synthesis matrix helps you record the main points of each source and document how sources relate to each other.

After summarizing and evaluating your sources, arrange them in a matrix or use a citation manager to help you see how they relate to each other and apply to each of your themes or variables.  

By arranging your sources by theme or variable, you can see how your sources relate to each other, and can start thinking about how you weave them together to create a narrative.

• Step-by-Step Approach
• Example Matrix from NSCU
• Matrix Template
• << Previous: Summarize
• Next: Integrate >>
• Last Updated: Sep 26, 2023 10:25 AM
• URL: https://guides.library.jhu.edu/lit-review

• University of Oregon Libraries
• Research Guides

How to Write a Literature Review

• 6. Synthesize
• Literature Reviews: A Recap
• Reading Journal Articles
• Does it Describe a Literature Review?
• 1. Identify the Question
• 2. Review Discipline Styles
• Searching Article Databases
• Finding Full-Text of an Article
• Citation Chaining
• When to Stop Searching
• 4. Manage Your References
• 5. Critically Analyze and Evaluate

Synthesis Visualization

Synthesis matrix example.

• 7. Write a Literature Review

• Synthesis Worksheet

About Synthesis

Approaches to synthesis.

You can sort the literature in various ways, for example:

How to Begin?

Read your sources carefully and find the main idea(s) of each source

Look for similarities in your sources – which sources are talking about the same main ideas? (for example, sources that discuss the historical background on your topic)

Use the worksheet (above) or synthesis matrix (below) to get organized

This work can be messy. Don't worry if you have to go through a few iterations of the worksheet or matrix as you work on your lit review!

Four Examples of Student Writing

In the four examples below, only ONE shows a good example of synthesis: the fourth column, or  Student D . For a web accessible version, click the link below the image.

Long description of "Four Examples of Student Writing" for web accessibility

• Download a copy of the "Four Examples of Student Writing" chart

Click on the example to view the pdf.

From Jennifer Lim

• << Previous: 5. Critically Analyze and Evaluate
• Next: 7. Write a Literature Review >>
• Last Updated: Jan 10, 2024 4:46 PM
• URL: https://researchguides.uoregon.edu/litreview

Contact Us Library Accessibility UO Libraries Privacy Notices and Procedures

1501 Kincaid Street Eugene, OR 97403 P: 541-346-3053 F: 541-346-3485

• Visit us on Facebook
• Visit us on Twitter
• Visit us on Youtube
• Visit us on Instagram
• Report a Concern
• Nondiscrimination and Title IX
• Accessibility
• Privacy Policy
• Find People

Literature Syntheis 101

How To Synthesise The Existing Research (With Examples)

By: Derek Jansen (MBA) | Expert Reviewer: Eunice Rautenbach (DTech) | August 2023

One of the most common mistakes that students make when writing a literature review is that they err on the side of describing the existing literature rather than providing a critical synthesis of it. In this post, we’ll unpack what exactly synthesis means and show you how to craft a strong literature synthesis using practical examples.

This post is based on our popular online course, Literature Review Bootcamp . In the course, we walk you through the full process of developing a literature review, step by step. If it’s your first time writing a literature review, you definitely want to use this link to get 50% off the course (limited-time offer).

Overview: Literature Synthesis

• What exactly does “synthesis” mean?
• Aspect 1: Agreement
• Aspect 2: Disagreement
• Aspect 3: Key theories
• Aspect 4: Contexts
• Aspect 5: Methodologies
• Bringing it all together

What does “synthesis” actually mean?

As a starting point, let’s quickly define what exactly we mean when we use the term “synthesis” within the context of a literature review.

Simply put, literature synthesis means going beyond just describing what everyone has said and found. Instead, synthesis is about bringing together all the information from various sources to present a cohesive assessment of the current state of knowledge in relation to your study’s research aims and questions .

Put another way, a good synthesis tells the reader exactly where the current research is “at” in terms of the topic you’re interested in – specifically, what’s known , what’s not , and where there’s a need for more research .

So, how do you go about doing this?

Well, there’s no “one right way” when it comes to literature synthesis, but we’ve found that it’s particularly useful to ask yourself five key questions when you’re working on your literature review. Having done so,  you can then address them more articulately within your actual write up. So, let’s take a look at each of these questions.

1. Points Of Agreement

The first question that you need to ask yourself is: “Overall, what things seem to be agreed upon by the vast majority of the literature?”

For example, if your research aim is to identify which factors contribute toward job satisfaction, you’ll need to identify which factors are broadly agreed upon and “settled” within the literature. Naturally, there may at times be some lone contrarian that has a radical viewpoint , but, provided that the vast majority of researchers are in agreement, you can put these random outliers to the side. That is, of course, unless your research aims to explore a contrarian viewpoint and there’s a clear justification for doing so. 

Identifying what’s broadly agreed upon is an essential starting point for synthesising the literature, because you generally don’t want (or need) to reinvent the wheel or run down a road investigating something that is already well established . So, addressing this question first lays a foundation of “settled” knowledge.

Need a helping hand?

2. Points Of Disagreement

Related to the previous point, but on the other end of the spectrum, is the equally important question: “Where do the disagreements lie?” .

In other words, which things are not well agreed upon by current researchers? It’s important to clarify here that by disagreement, we don’t mean that researchers are (necessarily) fighting over it – just that there are relatively mixed findings within the empirical research , with no firm consensus amongst researchers.

This is a really important question to address as these “disagreements” will often set the stage for the research gap(s). In other words, they provide clues regarding potential opportunities for further research, which your study can then (hopefully) contribute toward filling. If you’re not familiar with the concept of a research gap, be sure to check out our explainer video covering exactly that .

3. Key Theories

The next question you need to ask yourself is: “Which key theories seem to be coming up repeatedly?” .

Within most research spaces, you’ll find that you keep running into a handful of key theories that are referred to over and over again. Apart from identifying these theories, you’ll also need to think about how they’re connected to each other. Specifically, you need to ask yourself:

• Are they all covering the same ground or do they have different focal points  or underlying assumptions ?
• Do some of them feed into each other and if so, is there an opportunity to integrate them into a more cohesive theory?
• Do some of them pull in different directions ? If so, why might this be?
• Do all of the theories define the key concepts and variables in the same way, or is there some disconnect? If so, what’s the impact of this ?

Simply put, you’ll need to pay careful attention to the key theories in your research area, as they will need to feature within your theoretical framework , which will form a critical component within your final literature review. This will set the foundation for your entire study, so it’s essential that you be critical in this area of your literature synthesis.

If this sounds a bit fluffy, don’t worry. We deep dive into the theoretical framework (as well as the conceptual framework) and look at practical examples in Literature Review Bootcamp . If you’d like to learn more, take advantage of our limited-time offer to get 60% off the standard price.

4. Contexts

The next question that you need to address in your literature synthesis is an important one, and that is: “Which contexts have (and have not) been covered by the existing research?” .

For example, sticking with our earlier hypothetical topic (factors that impact job satisfaction), you may find that most of the research has focused on white-collar , management-level staff within a primarily Western context, but little has been done on blue-collar workers in an Eastern context. Given the significant socio-cultural differences between these two groups, this is an important observation, as it could present a contextual research gap .

In practical terms, this means that you’ll need to carefully assess the context of each piece of literature that you’re engaging with, especially the empirical research (i.e., studies that have collected and analysed real-world data). Ideally, you should keep notes regarding the context of each study in some sort of catalogue or sheet, so that you can easily make sense of this before you start the writing phase. If you’d like, our free literature catalogue worksheet is a great tool for this task.

5. Methodological Approaches

Last but certainly not least, you need to ask yourself the question: “What types of research methodologies have (and haven’t) been used?”

For example, you might find that most studies have approached the topic using qualitative methods such as interviews and thematic analysis. Alternatively, you might find that most studies have used quantitative methods such as online surveys and statistical analysis.

But why does this matter?

Well, it can run in one of two potential directions . If you find that the vast majority of studies use a specific methodological approach, this could provide you with a firm foundation on which to base your own study’s methodology . In other words, you can use the methodologies of similar studies to inform (and justify) your own study’s research design .

On the other hand, you might argue that the lack of diverse methodological approaches presents a research gap , and therefore your study could contribute toward filling that gap by taking a different approach. For example, taking a qualitative approach to a research area that is typically approached quantitatively. Of course, if you’re going to go against the methodological grain, you’ll need to provide a strong justification for why your proposed approach makes sense. Nevertheless, it is something worth at least considering.

Regardless of which route you opt for, you need to pay careful attention to the methodologies used in the relevant studies and provide at least some discussion about this in your write-up. Again, it’s useful to keep track of this on some sort of spreadsheet or catalogue as you digest each article, so consider grabbing a copy of our free literature catalogue if you don’t have anything in place.

Bringing It All Together

Alright, so we’ve looked at five important questions that you need to ask (and answer) to help you develop a strong synthesis within your literature review.  To recap, these are:

• Which things are broadly agreed upon within the current research?
• Which things are the subject of disagreement (or at least, present mixed findings)?
• Which theories seem to be central to your research topic and how do they relate or compare to each other?
• Which contexts have (and haven’t) been covered?
• Which methodological approaches are most common?

Importantly, you’re not just asking yourself these questions for the sake of asking them – they’re not just a reflection exercise. You need to weave your answers to them into your actual literature review when you write it up. How exactly you do this will vary from project to project depending on the structure you opt for, but you’ll still need to address them within your literature review, whichever route you go.

The best approach is to spend some time actually writing out your answers to these questions, as opposed to just thinking about them in your head. Putting your thoughts onto paper really helps you flesh out your thinking . As you do this, don’t just write down the answers – instead, think about what they mean in terms of the research gap you’ll present , as well as the methodological approach you’ll take . Your literature synthesis needs to lay the groundwork for these two things, so it’s essential that you link all of it together in your mind, and of course, on paper.

Psst… there’s more!

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

You Might Also Like:

excellent , thank you

Submit a Comment Cancel reply

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

• Print Friendly

Literature Review How To

• Things To Consider
• Synthesizing Sources
• Video Tutorials
• Books On Literature Reviews

What is Synthesis

What is Synthesis? Synthesis writing is a form of analysis related to comparison and contrast, classification and division. On a basic level, synthesis requires the writer to pull together two or more summaries, looking for themes in each text. In synthesis, you search for the links between various materials in order to make your point. Most advanced academic writing, including literature reviews, relies heavily on synthesis. (Temple University Writing Center)  

How To Synthesize Sources in a Literature Review

Literature reviews synthesize large amounts of information and present it in a coherent, organized fashion. In a literature review you will be combining material from several texts to create a new text – your literature review.

You will use common points among the sources you have gathered to help you synthesize the material. This will help ensure that your literature review is organized by subtopic, not by source. This means various authors' names can appear and reappear throughout the literature review, and each paragraph will mention several different authors. 

When you shift from writing summaries of the content of a source to synthesizing content from sources, there is a number things you must keep in mind: 

• Look for specific connections and or links between your sources and how those relate to your thesis or question.
• When writing and organizing your literature review be aware that your readers need to understand how and why the information from the different sources overlap.
• Organize your literature review by the themes you find within your sources or themes you have identified. 
• << Previous: Things To Consider
• Next: Video Tutorials >>
• Last Updated: Nov 30, 2018 4:51 PM
• URL: https://libguides.csun.edu/literature-review

Report ADA Problems with Library Services and Resources

Write a Literature Review

• Find This link opens in a new window

Get Organized

• Lit Review Prep Use this template to help you evaluate your sources, create article summaries for an annotated bibliography, and a synthesis matrix for your lit review outline.

Synthesize your Information

Synthesize: combine separate elements to form a whole.

Synthesis Matrix

A synthesis matrix helps you record the main points of each source and document how sources relate to each other.  After summarizing and evaluating your sources, arrange them in a matrix to help you see how they relate to each other, and apply to each of your themes or variables.  By arranging your sources in a matrix by theme or variable, you can see how your sources relate to each other, and can start thinking about how you weave them together to create a narrative.

• Step-by-Step Approach
• Example Matrix from NSCU
• Matrix Template
• << Previous: Summarize
• Next: Integrate >>
• Last Updated: Oct 11, 2023 12:20 PM
• URL: https://libraryguides.goucher.edu/literature-review

Literature Reviews

• 5. Synthesize your findings
• Getting started
• Types of reviews
• 1. Define your research question
• 2. Plan your search
• 3. Search the literature
• 4. Organize your results

How to synthesize

Approaches to synthesis.

• 6. Write the review
• Artificial intelligence (AI) tools
• Thompson Writing Studio This link opens in a new window
• Need to write a systematic review? This link opens in a new window

Contact a Librarian

Ask a Librarian

In the synthesis step of a literature review, researchers analyze and integrate information from selected sources to identify patterns and themes. This involves critically evaluating findings, recognizing commonalities, and constructing a cohesive narrative that contributes to the understanding of the research topic.

Here are some examples of how to approach synthesizing the literature:

💡 By themes or concepts

🕘 Historically or chronologically

📊 By methodology

These organizational approaches can also be used when writing your review. It can be beneficial to begin organizing your references by these approaches in your citation manager by using folders, groups, or collections.

Create a synthesis matrix

A synthesis matrix allows you to visually organize your literature.

Topic: ______________________________________________

Topic: Chemical exposure to workers in nail salons

• << Previous: 4. Organize your results
• Next: 6. Write the review >>
• Last Updated: Apr 3, 2024 12:40 PM
• URL: https://guides.library.duke.edu/lit-reviews

Services for...

• Faculty & Instructors
• Graduate Students
• Undergraduate Students
• International Students
• Patrons with Disabilities

• Harmful Language Statement
• Re-use & Attribution / Privacy
• Support the Libraries

Library Guides

Literature reviews: synthesis.

• Criticality

Synthesise Information

So, how can you create paragraphs within your literature review that demonstrates your knowledge of the scholarship that has been done in your field of study?  

You will need to present a synthesis of the texts you read.  

Doug Specht, Senior Lecturer at the Westminster School of Media and Communication, explains synthesis for us in the following video:  

Synthesising Texts  

What is synthesis? 

Synthesis is an important element of academic writing, demonstrating comprehension, analysis, evaluation and original creation.  

With synthesis you extract content from different sources to create an original text. While paraphrase and summary maintain the structure of the given source(s), with synthesis you create a new structure.  

The sources will provide different perspectives and evidence on a topic. They will be put together when agreeing, contrasted when disagreeing. The sources must be referenced.  

Perfect your synthesis by showing the flow of your reasoning, expressing critical evaluation of the sources and drawing conclusions.  

When you synthesise think of "using strategic thinking to resolve a problem requiring the integration of diverse pieces of information around a structuring theme" (Mateos and Sole 2009, p448). 

Synthesis is a complex activity, which requires a high degree of comprehension and active engagement with the subject. As you progress in higher education, so increase the expectations on your abilities to synthesise. 

How to synthesise in a literature review: 

Identify themes/issues you'd like to discuss in the literature review. Think of an outline.  

Read the literature and identify these themes/issues.  

Critically analyse the texts asking: how does the text I'm reading relate to the other texts I've read on the same topic? Is it in agreement? Does it differ in its perspective? Is it stronger or weaker? How does it differ (could be scope, methods, year of publication etc.). Draw your conclusions on the state of the literature on the topic.  

Start writing your literature review, structuring it according to the outline you planned.  

Put together sources stating the same point; contrast sources presenting counter-arguments or different points.  

Present your critical analysis.  

Always provide the references. 

The best synthesis requires a "recursive process" whereby you read the source texts, identify relevant parts, take notes, produce drafts, re-read the source texts, revise your text, re-write... (Mateos and Sole, 2009). 

What is good synthesis?  

The quality of your synthesis can be assessed considering the following (Mateos and Sole, 2009, p439):  

Integration and connection of the information from the source texts around a structuring theme. 

Selection of ideas necessary for producing the synthesis. 

Appropriateness of the interpretation.  

Elaboration of the content.  

Example of Synthesis

Original texts (fictitious): 

Synthesis: 

Animal experimentation is a subject of heated debate. Some argue that painful experiments should be banned. Indeed it has been demonstrated that such experiments make animals suffer physically and psychologically (Chowdhury 2012; Panatta and Hudson 2016). On the other hand, it has been argued that animal experimentation can save human lives and reduce harm on humans (Smith 2008). This argument is only valid for toxicological testing, not for tests that, for example, merely improve the efficacy of a cosmetic (Turner 2015). It can be suggested that animal experimentation should be regulated to only allow toxicological risk assessment, and the suffering to the animals should be minimised.   

Bibliography

Mateos, M. and Sole, I. (2009). Synthesising Information from various texts: A Study of Procedures and Products at Different Educational Levels. European Journal of Psychology of Education,  24 (4), 435-451. Available from https://doi.org/10.1007/BF03178760 [Accessed 29 June 2021].

• << Previous: Structure
• Next: Criticality >>
• Last Updated: Nov 18, 2023 10:56 PM
• URL: https://libguides.westminster.ac.uk/literature-reviews

CONNECT WITH US

Literature Review Basics

• What is a Literature Review?
• Synthesizing Research
• Using Research & Synthesis Tables
• Additional Resources

About the Research and Synthesis Tables

Research Tables and Synthesis Tables are useful tools for organizing and analyzing your research as you assemble your literature review. They represent two different parts of the review process: assembling relevant information and synthesizing it. Use a Research table to compile the main info you need about the items you find in your research -- it's a great thing to have on hand as you take notes on what you read! Then, once you've assembled your research, use the Synthesis table to start charting the similarities/differences and major themes among your collected items.

We've included an Excel file with templates for you to use below; the examples pictured on this page are snapshots from that file.

• Research and Synthesis Table Templates This Excel workbook includes simple templates for creating research tables and synthesis tables. Feel free to download and use!

Using the Research Table

This is an example of a  research table,  in which you provide a basic description of the most important features of the studies, articles, and other items you discover in your research. The table identifies each item according to its author/date of publication, its purpose or thesis, what type of work it is (systematic review, clinical trial, etc.), the level of evidence it represents (which tells you a lot about its impact on the field of study), and its major findings. Your job, when you assemble this information, is to develop a snapshot of what the research shows about the topic of your research question and assess its value (both for the purpose of your work and for general knowledge in the field).

Think of your work on the research table as the foundational step for your analysis of the literature, in which you assemble the information you'll be analyzing and lay the groundwork for thinking about what it means and how it can be used.

Using the Synthesis Table

This is an example of a  synthesis table  or  synthesis matrix , in which you organize and analyze your research by listing each source and indicating whether a given finding or result occurred in a particular study or article ( each row lists an individual source, and each finding has its own column, in which X = yes, blank = no). You can also add or alter the columns to look for shared study populations, sort by level of evidence or source type, etc. The key here is to use the table to provide a simple representation of what the research has found (or not found, as the case may be). Think of a synthesis table as a tool for making comparisons, identifying trends, and locating gaps in the literature.

How do I know which findings to use, or how many to include?  Your research question tells you which findings are of interest in your research, so work from your research question to decide what needs to go in each Finding header, and how many findings are necessary. The number is up to you; again, you can alter this table by adding or deleting columns to match what you're actually looking for in your analysis. You should also, of course, be guided by what's actually present in the material your research turns up!

• << Previous: Synthesizing Research
• Next: Additional Resources >>
• Last Updated: Sep 26, 2023 12:06 PM
• URL: https://usi.libguides.com/literature-review-basics

Have a language expert improve your writing

Run a free plagiarism check in 10 minutes, generate accurate citations for free.

• Knowledge Base

Methodology

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

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

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

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

There are five key steps to writing a literature review:

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

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

Instantly correct all language mistakes in your text

Upload your document to correct all your mistakes in minutes

Table of contents

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

• Quick Run-through
• Step 1 & 2

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

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

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

Here's why students love Scribbr's proofreading services

Discover proofreading & editing

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

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

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

Download Word doc Download Google doc

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

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

Make a list of keywords

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

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

Search for relevant sources

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

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

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

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

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

For each publication, ask yourself:

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

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

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

Take notes and cite your sources

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

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

The only proofreading tool specialized in correcting academic writing - try for free!

The academic proofreading tool has been trained on 1000s of academic texts and by native English editors. Making it the most accurate and reliable proofreading tool for students.

Try for free

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

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

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

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

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

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

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

As you write, you can follow these tips:

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

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

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

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

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

Open Google Slides Download PowerPoint

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

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

 Statistics

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

Research bias

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

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

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

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

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

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

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

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

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

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

McCombes, S. (2023, September 11). How to Write a Literature Review | Guide, Examples, & Templates. Scribbr. Retrieved April 9, 2024, from https://www.scribbr.com/dissertation/literature-review/

Is this article helpful?

Shona McCombes

Other students also liked, what is a theoretical framework | guide to organizing, what is a research methodology | steps & tips, how to write a research proposal | examples & templates, unlimited academic ai-proofreading.

✔ Document error-free in 5minutes ✔ Unlimited document corrections ✔ Specialized in correcting academic texts

Want to create or adapt books like this? Learn more about how Pressbooks supports open publishing practices.

Chapter 7: Synthesizing Sources

Learning objectives.

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

• synthesize key sources connecting them with the research question and topic area.

7.1 Overview of synthesizing

7.1.1 putting the pieces together.

Combining separate elements into a whole is the dictionary definition of synthesis.  It is a way to make connections among and between numerous and varied source materials.  A literature review is not an annotated bibliography, organized by title, author, or date of publication.  Rather, it is grouped by topic to create a whole view of the literature relevant to your research question.

Your synthesis must demonstrate a critical analysis of the papers you collected as well as your ability to integrate the results of your analysis into your own literature review.  Each paper collected should be critically evaluated and weighed for “adequacy, appropriateness, and thoroughness” ( Garrard, 2017 ) before inclusion in your own review.  Papers that do not meet this criteria likely should not be included in your literature review.

Begin the synthesis process by creating a grid, table, or an outline where you will summarize, using common themes you have identified and the sources you have found. The summary grid or outline will help you compare and contrast the themes so you can see the relationships among them as well as areas where you may need to do more searching. Whichever method you choose, this type of organization will help you to both understand the information you find and structure the writing of your review.  Remember, although “the means of summarizing can vary, the key at this point is to make sure you understand what you’ve found and how it relates to your topic and research question” ( Bennard et al., 2014 ).

As you read through the material you gather, look for common themes as they may provide the structure for your literature review.  And, remember, research is an iterative process: it is not unusual to go back and search information sources for more material.

At one extreme, if you are claiming, ‘There are no prior publications on this topic,’ it is more likely that you have not found them yet and may need to broaden your search.  At another extreme, writing a complete literature review can be difficult with a well-trod topic.  Do not cite it all; instead cite what is most relevant.  If that still leaves too much to include, be sure to reference influential sources…as well as high-quality work that clearly connects to the points you make. ( Klingner, Scanlon, & Pressley, 2005 ).

7.2 Creating a summary table

Literature reviews can be organized sequentially or by topic, theme, method, results, theory, or argument.  It’s important to develop categories that are meaningful and relevant to your research question.  Take detailed notes on each article and use a consistent format for capturing all the information each article provides.  These notes and the summary table can be done manually, using note cards.  However, given the amount of information you will be recording, an electronic file created in a word processing or spreadsheet is more manageable. Examples of fields you may want to capture in your notes include:

• Authors’ names
• Article title
• Publication year
• Main purpose of the article
• Methodology or research design
• Participants
• Measurement
• Conclusions

  Other fields that will be useful when you begin to synthesize the sum total of your research:

• Specific details of the article or research that are especially relevant to your study
• Key terms and definitions
• Strengths or weaknesses in research design
• Relationships to other studies
• Possible gaps in the research or literature (for example, many research articles conclude with the statement “more research is needed in this area”)
• Finally, note how closely each article relates to your topic.  You may want to rank these as high, medium, or low relevance.  For papers that you decide not to include, you may want to note your reasoning for exclusion, such as ‘small sample size’, ‘local case study,’ or ‘lacks evidence to support assertion.’

This short video demonstrates how a nursing researcher might create a summary table.

7.2.1 Creating a Summary Table

  Summary tables can be organized by author or by theme, for example:

For a summary table template, see http://blogs.monm.edu/writingatmc/files/2013/04/Synthesis-Matrix-Template.pdf

7.3 Creating a summary outline

An alternate way to organize your articles for synthesis it to create an outline. After you have collected the articles you intend to use (and have put aside the ones you won’t be using), it’s time to identify the conclusions that can be drawn from the articles as a group.

  Based on your review of the collected articles, group them by categories.  You may wish to further organize them by topic and then chronologically or alphabetically by author.  For each topic or subtopic you identified during your critical analysis of the paper, determine what those papers have in common.  Likewise, determine which ones in the group differ.  If there are contradictory findings, you may be able to identify methodological or theoretical differences that could account for the contradiction (for example, differences in population demographics).  Determine what general conclusions you can report about the topic or subtopic as the entire group of studies relate to it.  For example, you may have several studies that agree on outcome, such as ‘hands on learning is best for science in elementary school’ or that ‘continuing education is the best method for updating nursing certification.’ In that case, you may want to organize by methodology used in the studies rather than by outcome.

Organize your outline in a logical order and prepare to write the first draft of your literature review.  That order might be from broad to more specific, or it may be sequential or chronological, going from foundational literature to more current.  Remember, “an effective literature review need not denote the entire historical record, but rather establish the raison d’etre for the current study and in doing so cite that literature distinctly pertinent for theoretical, methodological, or empirical reasons.” ( Milardo, 2015, p. 22 ).

As you organize the summarized documents into a logical structure, you are also appraising and synthesizing complex information from multiple sources.  Your literature review is the result of your research that synthesizes new and old information and creates new knowledge.

7.4 Additional resources:

Literature Reviews: Using a Matrix to Organize Research / Saint Mary’s University of Minnesota

Literature Review: Synthesizing Multiple Sources / Indiana University

Writing a Literature Review and Using a Synthesis Matrix / Florida International University

 Sample Literature Reviews Grid / Complied by Lindsay Roberts

Select three or four articles on a single topic of interest to you. Then enter them into an outline or table in the categories you feel are important to a research question. Try both the grid and the outline if you can to see which suits you better. The attached grid contains the fields suggested in the video .

Literature Review Table  

Test yourself.

• Select two articles from your own summary table or outline and write a paragraph explaining how and why the sources relate to each other and your review of the literature.
• In your literature review, under what topic or subtopic will you place the paragraph you just wrote?

Image attribution

Literature Reviews for Education and Nursing Graduate Students Copyright © by Linda Frederiksen is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

Share This Book

• University of Texas Libraries
• UT Libraries

Introduction to Social Work Research

Writing a literature review.

• Background Information
• Peer Review & Evaluation
• Article Comparison
• Creating an Outline

It is important to critically think about all of the sources you've read, both background information and scholarly journal articles, and synthesize that information into new conclusions that are unique to you. A synthesis requires critical thinking about the articles, determining where themes align, what they're saying that lines up, and what they're saying that might conflict with each other. What conclusions do these conflicts cause you to draw?

This page discusses how to synthesize information from your sources.

• Literature Review: Synthesizing Multiple Sources from IUPUI's University Writing Center Walks through the process of creating a synthesis matrix.

Summarizing vs. Synthesizing

While a summary is a way of concisely relating important themes and elements from a larger work or works in a condensed form, a synthesis takes the information from a variety of works and combines them together to create something new.

Synthesis :

"Synthesis is similar to putting a puzzle together—piecing together information to create a whole. The outcome of this synthesis might be numeric, such as in an overall rating perhaps best typified in a quantitative weight and sum strategy, or through the use of meta-analysis, or the synthesis might be textual, such as in an analytic conclusion."

Synthesis. (2005). In Mathison, S. (Ed.),  Encyclopedia of evaluation . Thousand Oaks, CA: Sage Publications, Inc. doi: 10.4135/9781412950558

• Approaches to Reviewing Research in Education from Sage Knowledge

How to Synthesize

Basic steps for synthesizing information:

• Highlight the main themes/ideas of each article
• Note which themes and ideas appear across multiple articles
• Discuss how each article deals similarly or differently with each theme
• Discuss how combining the information from all three articles can better address your research question than a single article alone
• Write your deductions from combining this information in your own words using all three articles

Summary of 1 article:

By analyzing monthly cost data of 9 drugs that were approved by the FDA for Multiple Sclerosis from 1993 to 2013, Hartung, et al. determined that the cost of MS drugs is increasing far beyond inflation rates, which has a negative effect on MS patients (2015).

Summary of 2 articles:

The cost of MS drugs is increasing far beyond inflation rates, which has a negative effect on MS patients (Hartung, et al., 2015). For low income MS patients, like Shereese Hickson, this cost has proven to be more than they can pay (Hancock, 2018).

Synthesis of 2 articles:

The cost of MS drugs is increasing far beyond inflation rates, which has a negative effect on MS patients (Hartung, et al., 2015). The personal experience of Shereese Hickson shows what that negative impact looks like (Hancock, 2018). This illustrates how vulnerable populations, like low-income MS patients, can be at greater risk of experiencing the negative impacts of rising drug costs.

Hartung, D. M., Bourdette, D. N., Ahmed, S. M., & Whitham, R. H. (2015). The cost of multiple sclerosis drugs in the US and the pharmaceutical industry: Too big to fail? Neurology, 84 (21), 2185-2192. doi:10.1212/WNL.0000000000001608

Hancock, J. (2018). Chronically Ill, Traumatically Billed: $123,019 For 2 Multiple Sclerosis Treatments.  Kaiser Health News . Retrieved from  https://khn.org/news/chronically-ill-traumatically-billed-the-123k-medicine-for-ms/

Ask a Librarian

Chat With Us

EID login required

• Last Updated: Aug 28, 2023 2:28 PM
• URL: https://guides.lib.utexas.edu/sw310

How to Write a Literature Review - A Self-Guided Tutorial

• Literature Reviews: A Recap
• Reading Journal Articles
• Does it describe a Literature Review?
• 1. Identify the question
• 2. Review discipline styles
• Searching article databases - video
• Finding the article full-text
• Citation trails
• When to stop searching
• Citation Managers
• 5. Critically analyze and evaluate
• 6. Synthesize
• 7. Write literature review
• Additional Resources

You can meet with a librarian to talk about your literature review, or other library-related topics.

You can sort the literature in various ways, for example:

Synthesis Vizualization

Four examples of student writing.

In the four examples below, only ONE shows a good example of synthesis: the fourth column, or  Student D . For a web accessible version, click the link below the image.

Long description of "Four Examples of Student Writing" for web accessibility

• Download a copy of the "Four Examples of Student Writing" chart

Synthesis Matrix Example

From Jennifer Lim

Synthesis Templates

Synthesis grids are organizational tools used to record the main concepts of your sources and can help you make connections about how your sources relate to one another.

• Source Template Basic Literature Review Source Template from Walden University Writing Center to help record the main findings and concepts from different articles.
• Sample Literature Review Grids This spreadsheet contains multiple tabs with different grid templates. Download or create your own copy to begin recording notes.
• << Previous: 5. Critically analyze and evaluate
• Next: 7. Write literature review >>
• Last Updated: Mar 7, 2024 2:05 PM
• URL: https://libguides.ucmerced.edu/literature-review

• USC Libraries
• Research Guides

Organizing Your Social Sciences Research Paper

• 5. The Literature Review
• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Reading Research Effectively
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Applying Critical Thinking
• Choosing a Title
• Making an Outline
• Paragraph Development
• Research Process Video Series
• Executive Summary
• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• Scholarly vs. Popular Publications
• Qualitative Methods
• Quantitative Methods
• Insiderness
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Generative AI and Writing
• USC Libraries Tutorials and Other Guides
• Bibliography

A literature review surveys prior research published in books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated. Literature reviews are designed to provide an overview of sources you have used in researching a particular topic and to demonstrate to your readers how your research fits within existing scholarship about the topic.

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . Fourth edition. Thousand Oaks, CA: SAGE, 2014.

Importance of a Good Literature Review

A literature review may consist of simply a summary of key sources, but in the social sciences, a literature review usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

• Give a new interpretation of old material or combine new with old interpretations,
• Trace the intellectual progression of the field, including major debates,
• Depending on the situation, evaluate the sources and advise the reader on the most pertinent or relevant research, or
• Usually in the conclusion of a literature review, identify where gaps exist in how a problem has been researched to date.

Given this, the purpose of a literature review is to:

• Place each work in the context of its contribution to understanding the research problem being studied.
• Describe the relationship of each work to the others under consideration.
• Identify new ways to interpret prior research.
• Reveal any gaps that exist in the literature.
• Resolve conflicts amongst seemingly contradictory previous studies.
• Identify areas of prior scholarship to prevent duplication of effort.
• Point the way in fulfilling a need for additional research.
• Locate your own research within the context of existing literature [very important].

Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper. 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . Los Angeles, CA: SAGE, 2011; Knopf, Jeffrey W. "Doing a Literature Review." PS: Political Science and Politics 39 (January 2006): 127-132; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012.

Types of Literature Reviews

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 primary studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally among scholars that become part of the body of epistemological traditions within the 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 a number of approaches you could adopt depending upon the type of analysis underpinning your study.

Argumentative Review This form examines literature selectively in order to support or refute an argument, deeply embedded 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 make summary claims of the sort found in systematic reviews [see below].

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 or research problems. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication. This is the most common form of review in the social sciences.

Historical Review Few things rest in isolation from historical precedent. Historical literature reviews focus 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 [findings], but how they came about saying what they say [method of analysis]. Reviewing methods of analysis provides a framework of understanding at different levels [i.e. those of theory, substantive fields, research approaches, and data collection and analysis techniques], how researchers draw upon 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. This approach helps highlight ethical issues which you should be aware of and consider as you go through your own 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 analyze data from the studies that are included in the review. The goal is to deliberately document, critically evaluate, and summarize scientifically all of the research about a clearly defined research problem . 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?" This type of literature review is primarily applied to examining prior research studies in clinical medicine and allied health fields, but it is increasingly being used in the social sciences.

Theoretical Review The purpose of this form is to examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review helps to 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.

NOTE : Most often the literature review will incorporate some combination of types. For example, a review that examines literature supporting or refuting an argument, assumption, or philosophical problem related to the research problem will also need to include writing supported by sources that establish the history of these arguments in the literature.

Baumeister, Roy F. and Mark R. Leary. "Writing Narrative Literature Reviews."  Review of General Psychology 1 (September 1997): 311-320; Mark R. Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147; Petticrew, Mark and Helen Roberts. Systematic Reviews in the Social Sciences: A Practical Guide . Malden, MA: Blackwell Publishers, 2006; Torracro, Richard. "Writing Integrative Literature Reviews: Guidelines and Examples." Human Resource Development Review 4 (September 2005): 356-367; Rocco, Tonette S. and Maria S. Plakhotnik. "Literature Reviews, Conceptual Frameworks, and Theoretical Frameworks: Terms, Functions, and Distinctions." Human Ressource Development Review 8 (March 2008): 120-130; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following in support of understanding the research problem :

• An overview of the subject, issue, or theory under consideration, along with the objectives of the literature review,
• Division of works under review into themes or categories [e.g. works that support a particular position, those against, and those offering alternative approaches entirely],
• An explanation of how each work is similar to and how it varies from the others,
• Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research.

The critical evaluation of each work should consider :

• Provenance -- what are the author's credentials? Are the author's arguments supported by evidence [e.g. primary historical material, case studies, narratives, statistics, recent scientific findings]?
• Methodology -- were the techniques used to identify, gather, and analyze the data appropriate to addressing the research problem? Was the sample size appropriate? Were the results effectively interpreted and reported?
• Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
• Persuasiveness -- which of the author's theses are most convincing or least convincing?
• Validity -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

II.  Development of the Literature Review

Four Basic Stages of Writing 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources would be appropriate to include? 2.  What types of sources should I review (books, journal articles, websites; scholarly versus popular sources)? 3.  Should I summarize, synthesize, or critique sources by discussing a common theme or issue? 4.  Should I evaluate the sources in any way beyond evaluating how they relate to understanding the research problem? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature review sections. Read them to get a sense of the types of themes you might want to look for in your own research or to identify ways to organize your final review. The bibliography or reference section of sources you've already read, such as required readings in the course syllabus, are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make the act of reviewing easier if you first limit scope of the research problem. A good strategy is to begin by searching the USC Libraries Catalog for recent books about the topic and review the table of contents for chapters that focuses on specific issues. You can also review the indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict, or look in the index for the pages where Egypt is mentioned in the text. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is particularly true in disciplines in medicine and the sciences where research conducted becomes obsolete very quickly as new discoveries are made. However, when writing a review in the social sciences, a survey of the history of the literature may be required. In other words, a complete understanding the research problem requires you to deliberately examine how knowledge and perspectives have changed over time. Sort through other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to explore what is considered by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronology of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression revealed, for example, a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic [“conceptual categories”] A thematic literature review is the most common approach to summarizing prior research in the social and behavioral sciences. Thematic reviews are organized around a topic or issue, rather than the progression of time, although the progression of time may still be incorporated into a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it would still be organized chronologically reflecting technological developments in media. The difference in this example between a "chronological" and a "thematic" approach is what is emphasized the most: themes related to the role of the Internet in presidential politics. Note that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point being made. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Internet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you. However, only include what is necessary for the reader to locate your study within the larger scholarship about the research problem.

Here are examples of other sections, usually in the form of a single paragraph, you may need to include depending on the type of review you write:

• Current Situation : Information necessary to understand the current topic or focus of the literature review.
• Sources Used : Describes the methods and resources [e.g., databases] you used to identify the literature you reviewed.
• History : The chronological progression of the field, the research literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Selection Methods : Criteria you used to select (and perhaps exclude) sources in your literature review. For instance, you might explain that your review includes only peer-reviewed [i.e., scholarly] sources.
• Standards : Description of the way in which you present your information.
• Questions for Further Research : What questions about the field has the review sparked? How will you further your research as a result of the review?

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review section is, in this sense, just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence [citations] that demonstrates that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Related items that provide additional information, but that are not key to understanding the research problem, can be included in a list of further readings . Use Quotes Sparingly Some short quotes are appropriate if you want to emphasize a point, or if what an author stated cannot be easily paraphrased. Sometimes you may need to quote certain terminology that was coined by the author, is not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute for using your own words in reviewing the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each thematic paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to your own work and the work of others. Keep Your Own Voice While the literature review presents others' ideas, your voice [the writer's] should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature.

• Sources in your literature review do not clearly relate to the research problem;
• You do not take sufficient time to define and identify the most relevant sources to use in the literature review related to the research problem;
• Relies exclusively on secondary analytical sources rather than including relevant primary research studies or data;
• Uncritically accepts another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis;
• Does not describe the search procedures that were used in identifying the literature to review;
• Reports isolated statistical results rather than synthesizing them in chi-squared or meta-analytic methods; and,
• Only includes research that validates assumptions and does not consider contrary findings and alternative interpretations found in the literature.

Cook, Kathleen E. and Elise Murowchick. “Do Literature Review Skills Transfer from One Course to Another?” Psychology Learning and Teaching 13 (March 2014): 3-11; Fink, Arlene. Conducting Research Literature Reviews: From the Internet to Paper . 2nd ed. Thousand Oaks, CA: Sage, 2005; Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1998; Jesson, Jill. Doing Your Literature Review: Traditional and Systematic Techniques . London: SAGE, 2011; Literature Review Handout. Online Writing Center. Liberty University; Literature Reviews. The Writing Center. University of North Carolina; Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: SAGE, 2016; Ridley, Diana. The Literature Review: A Step-by-Step Guide for Students . 2nd ed. Los Angeles, CA: SAGE, 2012; Randolph, Justus J. “A Guide to Writing the Dissertation Literature Review." Practical Assessment, Research, and Evaluation. vol. 14, June 2009; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016; Taylor, Dena. The Literature Review: A Few Tips On Conducting It. University College Writing Centre. University of Toronto; Writing a Literature Review. Academic Skills Centre. University of Canberra.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions to a problem or gaining a new perspective. Consult with a librarian about identifying research databases in other disciplines; almost every field of study has at least one comprehensive database devoted to indexing its research literature.

Frodeman, Robert. The Oxford Handbook of Interdisciplinarity . New York: Oxford University Press, 2010.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to writing this part of your paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. Some questions to ask:

• How are they organizing their ideas?
• What methods have they used to study the problem?
• What theories have been used to explain, predict, or understand their research problem?
• What sources have they cited to support their conclusions?
• How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?

When you begin to write your literature review section, you'll be glad you dug deeper into how the research was designed and constructed because it establishes a means for developing more substantial analysis and interpretation of the research problem.

Hart, Chris. Doing a Literature Review: Releasing the Social Science Research Imagination . Thousand Oaks, CA: Sage Publications, 1 998.

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've thoroughly reviewed the literature:

• Look for repeating patterns in the research findings . If the same thing is being said, just by different people, then this likely demonstrates that the research problem has hit a conceptual dead end. At this point consider: Does your study extend current research?  Does it forge a new path? Or, does is merely add more of the same thing being said?
• Look at sources the authors cite to in their work . If you begin to see the same researchers cited again and again, then this is often an indication that no new ideas have been generated to address the research problem.
• Search Google Scholar to identify who has subsequently cited leading scholars already identified in your literature review [see next sub-tab]. This is called citation tracking and there are a number of sources that can help you identify who has cited whom, particularly scholars from outside of your discipline. Here again, if the same authors are being cited again and again, this may indicate no new literature has been written on the topic.

Onwuegbuzie, Anthony J. and Rebecca Frels. Seven Steps to a Comprehensive Literature Review: A Multimodal and Cultural Approach . Los Angeles, CA: Sage, 2016; Sutton, Anthea. Systematic Approaches to a Successful Literature Review . Los Angeles, CA: Sage Publications, 2016.

• << Previous: Theoretical Framework
• Next: Citation Tracking >>
• Last Updated: Apr 11, 2024 1:27 PM
• URL: https://libguides.usc.edu/writingguide

Harvey Cushing/John Hay Whitney Medical Library

• Collections
• Research Help

YSN Doctoral Programs: Steps in Conducting a Literature Review

• Biomedical Databases
• Global (Public Health) Databases
• Soc. Sci., History, and Law Databases
• Grey Literature
• Trials Registers
• Data and Statistics
• Public Policy
• Google Tips
• Recommended Books
• Steps in Conducting a Literature Review

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.
• << Previous: Recommended Books
• Last Updated: Jan 4, 2024 10:52 AM
• URL: https://guides.library.yale.edu/YSNDoctoral

Faculty and researchers : We want to hear from you! We are launching a survey to learn more about your library collection needs for teaching, learning, and research. If you would like to participate, please complete the survey by May 17, 2024. Thank you for your participation!

• University of Massachusetts Lowell
• University Libraries

Literature Review Step by Step

• Refining Your Understanding
• Parts of a Literature Review
• Choosing a Topic
• Search Terms
• Peer Review
• Internet Sources
• Social Media Sources
• Information Landscape

About Literature Review

• From University of North Carolina A clear verbal description of the literature review process.

What is Synthesis?

"The combination of components or elements to form a connected whole" (OED)

Forming a synthesis between various ideas is the heart of your literature review, and once done, will be the core of your research paper. As a starting point try:

• finding ideas that are common or controversial • two or three important trends in the research • the most influential theories.

As you read keep these questions in mind:

• does the writer make any assumptions not supported by evidence? • what is the researcher's method? how does she gather data? • what ideas and which researchers are frequently referred to?

Some writers of Literature Review create a matrix for organizing their research articles.

This requires you to come up with a number of categories which  grow out of your reading of the literature. As you read, write down ideas, words or controversies  that occur frequently. Ask yourself why? What question are these different papers trying to answer?

This process will generate a number of categories, You can use these to create a table. The article below offers more information on this method of organizing your process.

• Creating a Matrix for Literature Review Synthesis
• << Previous: Summarize
• Next: Integrate >>
• Last Updated: Jan 22, 2024 2:05 PM
• URL: https://libguides.uml.edu/lit_review_general

• Open access
• Published: 09 April 2024

Patient characteristics of, and remedial interventions for, complaints and medico-legal claims against doctors: a rapid review of the literature

• Timothy J. Schultz   ORCID: orcid.org/0000-0003-1419-3328 1 ,
• Michael Zhou 2 ,
• Jodi Gray 1 ,
• Jackie Roseleur 1 ,
• Richard Clark 1 , 3 ,
• Dylan A. Mordaunt 1 , 4 ,
• Peter D. Hibbert 5 , 6 ,
• Georgie Haysom 7 &
• Michael Wright 7 , 8  

Systematic Reviews volume  13 , Article number:  104 ( 2024 ) Cite this article

257 Accesses

1 Altmetric

Metrics details

It is uncertain if patient’s characteristics are associated with complaints and claims against doctors. Additionally, evidence for the effectiveness of remedial interventions on rates of complaints and claims against doctors has not been synthesised.

We conducted a rapid review of recent literature to answer: Question 1 “What are the common characteristics and circumstances of patients who are most likely to complain or bring a claim about the care they have received from a doctor?” and Question 2 “What initiatives or interventions have been shown to be effective at reducing complaints and claims about the care patients have received from a doctor?”. We used a systematic search (most recently in July 2023) of PubMed, Scopus, Web of Science and grey literature. Studies were screened against inclusion criteria and critically appraised in duplicate using standard tools. Results were summarised using narrative synthesis.

From 8079 search results, we reviewed the full text of 250 studies. We included 25 studies: seven for Question 1 (6 comparative studies with controls and one systematic review) and 18 studies for Question 2 (14 uncontrolled pre-post studies, 2 comparative studies with controls and 2 systematic reviews). Most studies were set in hospitals across a mix of medical specialties.

Other than for patients with mental health conditions (two studies), no other patient characteristics demonstrated either a strong or consistent effect on the rate of complaints or claims against their treating doctors.

Risk management programs (6 studies), and communication and resolution programs (5 studies) were the most studied of 6 intervention types. Evidence for reducing complaints and medico-legal claims, costs or premiums and more timely management was apparent for both types of programs. Only 1 to 3 studies were included for peer programs, medical remediation, shared decision-making, simulation training and continuing professional development, with few generalisable results.

Few patient characteristics can be reliably related to the likelihood of medico-legal complaints or claims. There is some evidence that interventions can reduce the number and costs of claims, the number of complaints, and the timeliness of claims. However, across both questions, the strength of the evidence is very weak and is based on only a few studies or study designs that are highly prone to bias.

Peer Review reports

Up to 10% of hospital patients experience an adverse event [ 1 ]. Medical negligence or the failure to meet the standard of care reasonably expected of an ‘average’ doctor is a contributing factor to a small proportion of adverse events [ 1 , 2 ]. Medico-legal claims seeking compensation for medical negligence may be filed against doctors by patients through civil litigation. For less serious events or to express dissatisfaction with care, patients may also make a formal complaint, either directly to their care provider or the provider’s employer or to medical and other regulators and health complaints entities [ 3 ].

Doctors’ demographic (e.g. gender, age, years spent in practice) and workplace-related factors (e.g. greater number of patient lists) are associated with the risk of complaints and malpractice claims [ 4 , 5 ]. It is less clear what, if any, patient characteristics are associated with complaints and claims, and anecdotal evidence suggests that the rate of complaints and claims is rising [ 6 ]. Though females may be more likely to complain, and complaints and claims are often raised by patients’ living or bereaved relatives [ 7 , 8 ], there are no relevant systematic reviews on this topic. This led to the following review question (Question 1) “What are the common characteristics and circumstances of patients who are most likely to complain or bring a claim about the care they have received from a doctor?”.

In addition to the impact on patient wellbeing, doctors involved in adverse events experience serious emotional and psychological impacts [ 9 ]. Additionally, the financial cost to health systems from medico-legal claims is significant, potentially jeopardising the long-term financial sustainability of some public health systems [ 10 ]. Doctors, hospitals, health services, health regulators, representative medical organisations and medical insurers are therefore all highly motivated to provide safe, high-quality care that minimises complaints and claims against them, their staff, stakeholders and members. For example, medical colleges, practitioner regulation boards and medical indemnity insurers maintain professional standards of their members and conduct activities such as continuing professional development (CPD) [ 11 ], remediation programs [ 12 ] and communication and resolution programs (CRPs) [ 13 ]. Despite a recent scoping review describing how remediation programs are delivered to regulated health professionals [ 14 ], there is no substantive review of the literature across the wide range of stakeholders and potential interventions applicable to reduce complaints and claims against doctors. We therefore posed the following additional review question (Question 2): “What initiatives or interventions have been shown to be effective at reducing complaints and claims about the care patients have received from a doctor?” [ 6 ].

Review objective and research questions

The purpose of this review was to provide an evidence-based foundation to understand which patient factors influence complaints or claims and what interventions can support a reduction in complaints or claims [ 6 ]. This information could be used by clinicians, hospital administrators, healthcare regulators and medical indemnity insurers to inform their practice and policy. For the purposes of this study, a “claim” was defined as an assertion of wrongdoing that forms the basis for a request for compensation [ 15 ]; an “unwarranted” claim occurred when the care provided had not been below the expected standard and the complaint was not otherwise warranted [ 6 ].

A protocol defining the scope of the review (PEO/PICO, inclusion and exclusion criteria, search strategy and limits) was developed according to Sax Institute guidelines [ 16 ] but was not prospectively registered. The review was conducted according to guidance provided by the Cochrane Rapid Review method [ 17 ] and the SelecTing Approaches for Rapid Reviews (STARR) approach [ 18 ]. The updated Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to report review findings [ 19 ].

Scope of the review

The review focussed on health systems of high-income Commonwealth countries including Australia, New Zealand, Canada and the United Kingdom (UK). Additionally, studies from the United States of Amercia (USA), Ireland and Western Europe were included to inform the review. The review focussed on the peer-reviewed literature although grey literature of similar quality was also searched. The review was conducted over an 8-week period from September to October 2022. The search was repeated in September 2023.

Inclusion and exclusion criteria

The inclusion and exclusion criteria for Question 1 and Question 2 are included in Table  1 . The settings were hospitals (excluding the emergency department), primary care and secondary care. Regulatory complaints, complaints to practices or hospitals and claims for compensation were included, while complaints on social media were excluded. For Question 1, the review focussed on correlations between the ‘exposure’ (e.g. patient characteristics) and the number, type or nature of complaints/claims. For Question 2, the review included interventions implemented primarily to reduce the number of complaints/claims against doctors, although other secondary outcomes included the costs of claims or insurance premiums, the duration of the claims management process, doctor risk profile or performance, doctor confidence/knowledge/satisfaction, workplace culture, and patient outcomes (e.g. morbidity) or patient satisfaction.

Only English language studies using quantitative study designs included in the National Health and Medical Research Council (NHRMC) guidelines [ 20 ] were included (e.g. ranging from level I systematic review, level II randomised controlled trial, level III pseudorandomised trial/comparative study with or without concurrent controls, and level IV case series with either post-test or pre-test/post-test outcomes). Cross-sectional studies were excluded.

Search strategy and selection criteria

Given the aetiological nature of studies relevant to Question 1 in particular, we used a PEO approach (Participant, Exposure, Outcome) [ 21 ] to frame the search strategy (see Supplementary Table S 1 , S 2 , S 3 ). Terms relating to ‘participants’ included doctors and health services. Terms relating to ‘exposure’ included patient characteristics (such as demographics, socio-economic status, and health literacy) for Question 1, and patient safety interventions (such as checklists, care bundles and teamwork) or clinical risk management programs (such as medical education, risk mitigation, peer program and communication and resolution) for Question 2. Terms relating to ‘outcomes’ included malpractice, negligence, complaint, claim management and medico-legal.

We searched three bibliographic databases (PubMed, Scopus and Web of Science) and grey literature sources (Google, Proquest Theses, GreyLit.org and Mednar) for relevant studies. The reference lists and citation searching of included studies were included as other search methods. To ensure applicability to a modern healthcare system only studies published since 2011 were included. The search was conducted first in September 2022 and then repeated in July 2023.

Screening based on title and abstract was conducted independently in pairs by four members of the research team (TS, MZ, JG, JR) following training on two sets of 100 studies.

Quality appraisal

The quality of included studies was appraised independently in pairs by four members of the research team (TS, JG, JR, PH) using AMSTAR 2 for systematic reviews [ 22 ] and National Institute of Health tools for case–control studies and uncontrolled pre-post studies [ 23 ]. These tools include 16 items (systematic reviews) or 12 items (case–control studies and uncontrolled pre-post), which were scored as ‘Yes’, ‘No’, ‘Not applicable’ or ‘Cannot determine’ [ 23 ], AMSTAR 2 also uses ‘Probably yes’.

Data collection

Data was extracted from each paper into a Microsoft Excel spreadsheet that had been pilot tested by three reviewers. Extraction was conducted by a single reviewer (TS or MZ) and then checked by a second reviewer (JG, JR).

A narrative synthesis was used to describe the key findings for both review questions. For review Question 1, results are presented separately for each patient characteristic, grouped according to patient demographics (e.g. age, sex, complainant), patient risk factors (e.g. American Society of Anaesthesiologists’ (ASA) score, the existence of a mental disorder, re-operation) and the therapeutic context (e.g. aspects of treatment, diagnosis, setting and/or phase of care including length of stay (LOS) and complications). For review Question 2, results are presented for seven different types of programs implemented to reduce the number of complaints and/or claims against doctors. The consistency, clinical impact, generalisability, and applicability of study findings were appraised using the NHRMC matrix which ranks each component’s strength using a four-point scale (excellent, good, satisfactory and poor) [ 20 ].

Literature search

Nearly 8900 studies were identified across the search strategy, of which 255 full texts were reviewed (Fig.  1 ). Of these, 230 were excluded as not relevant or due to an ineligible study design. A total of seven studies were included for Question 1, and 18 studies were included for Question 2 (Supplementary Table S 4 ).

PRISMA study flow diagram [ 19 ]. * filters applied to these search results (Australia, New Zealand, Canada, UK)

The characteristics of the studies included for Question 1 are presented in Table  2 . There were six comparative studies with concurrent controls (three from the USA [ 24 , 25 , 26 ], two from the UK [ 27 , 28 ]) and one from Italy [ 29 ] and one systematic reviews of non-randomised control trials [ 3 ]. The in-patient hospital setting was most common ( n  = 5) across a range of specialties and conditions, most commonly surgery. In total, there were 27 variables reported across the seven studies, 17 of these were included in multiple studies. Sex ( n  = 6) and age ( n  = 5) were the most frequently recorded patient demographics. For patient risk factors, ASA score, mental disorders, tobacco use and body mass index (BMI) > 30 were measured in two studies. For therapeutic context, LOS, setting, complications and treatment were measured in two studies.

Quality assessment is summarised in Table  2 , Supplementary Table S 5 (comparative studies) and Supplementary Table S 6 (systematic reviews). For the 6 comparative studies, 6 to 10 (mean 8.3, SD = 1.4) of 12 criteria were met; for the systematic review, 4 of the 16 criteria were met (or probably met).

In general, there was very limited evidence for the existence of significant relationships between patient characteristics and the rate of complaints or claims (Table  3 ). For demographics, one study identified that a 10-year increase in the age of paediatric surgery patients led to a near 50% greater odds (OR = 1.47, CI 1.04–2.08) of a complaint and that male gender reduced odds of a complaint in adults by 34% (OR = 0.66, CI 0.47–0.92) [ 25 ]. However, sex and age were not significant predictors in five and four other studies, respectively. A systematic review of 36 studies (comprising 44,211 complaints) estimated that 64% of complainants were patients and 26% were family members; the remaining 10% was not specified [ 3 ]. Of patient risk factors, patients with mental, behavioural, or neurodevelopmental disorders were significantly more likely to complain following hand and upper extremity surgery [ 24 ] and spine surgery [ 26 ] (Table  3 ).

In terms of therapeutic context, there were lower odds of a complaint for two procedural features: (i) use of a general anaesthetic in both paediatric and adult populations provided odds ratios, respectively, of 0.22 (CI 0.07–0.62) and 0.67 (CI 0.47–0.95) compared to no general anaesthetic, and (ii) a 1-h delay in actual start time led to slightly higher odds of a complaint, more notably in paediatrics (OR = 1.27, CI 1.10–1.47) than in adults (OR = 1.05, CI 0.95–1.16) [ 25 ]. The odds of a complaint were seven times greater for patients undergoing surgery (CI 5.2–9.6) [ 26 ]. The overuse of non-beneficial interventions and underuse of treatment escalation plans predicted complaints from the next-of-kin of patients who died in hospital [ 28 ]. For example, treatment escalation limitation plans were used significantly less frequently in complaints (23.8% versus 47.2%, P  = 0.013) [ 28 ]. Other components of therapeutic context, including LOS, setting, and experiencing complications and harms, were not significant predictors of complaints (Table  3 ).

Uncontrolled pre-post studies ( n  = 14) were the most common study design included for Question 2, followed by comparative studies with concurrent controls ( n  = 2) and systematic reviews ( n  = 2) (Table  4 ). Studies were set in the USA ( n  = 12) [ 13 , 15 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ], Canada ( n  = 2) [ 40 , 41 ], the UK [ 12 ], Ireland [ 42 ] and New Zealand [ 43 ] ( n  = 1, each). The studies addressed malpractice claims ( n  = 9), complaints ( n  = 5), and regulatory notifications ( n  = 2) and a mix of outcomes ( n  = 1). In-patient hospital ( n  = 11) was the most common setting, followed by mixed ( n  = 4), primary care and secondary care ( n  = 1, each). There were seven types of interventions for Question 2 studies: risk management ( n  = 6), CRPs ( n  = 5) (note one study [ 31 ] assessed both), medical remediation ( n  = 3), peer program ( n  = 2) and, CPD, simulation training and shared decision-making ( n  = 1, each). Quality assessment is summarised in Table  3 , Supplementary Table S 5 (comparative studies), Table S 7 (uncontrolled pre-post studies) and Supplementary Table S 6 (systematic reviews). Eight of the 12 criteria were met for the one comparative study; 3 to 11 of the 12 criteria were met for the 14 uncontrolled pre-post studies (mean 7.6, SD = 2.6); and 8 and 11 of the 16 criteria were met for the two systematic reviews.

Findings and definitions for Question 2 across the seven types of interventions and eight included outcomes are presented in Table  5 . No studies examined doctor satisfaction or patient outcomes (such as mortality or morbidity).

The six studies of risk management programs [ 31 , 32 , 34 , 38 , 40 , 42 ], also called risk reduction programs, were heterogeneous in nature, and included enhanced evaluation of, and response to, complaints [ 42 ], active engagement of physicians in risk assessment [ 32 ], lectures followed by a mock lawsuit [ 34 ], and education [ 38 , 40 ]. Evidence from these studies of risk management programs supported reductions in claims, complaints and claims costs (Table  5 ). Other benefits included more timely complaints management, improved patient safety culture and staff confidence.

Evidence for communication and resolution programs (CRPs, five studies [ 13 , 15 , 31 , 33 , 35 ]) was consistent across four studies. There were lower rates of claims and complaints, lower claim amounts, and faster resolution of claims following the implementation of CRPs (Table  5 ) [ 15 , 31 , 33 , 35 ]. However, results were less supportive in a study using an interrupted time series (ITS) design [ 13 ]. One study demonstrated improved patient satisfaction [ 33 ].

Three studies of medical remediation showed either a reduction in claims rates [ 12 ] or an improved doctor risk profile [ 29 , 43 ].

Two studies of peer review, or the use of peer messengers, demonstrated a reduction in either complaint rates [ 36 ] or improved doctor risk profile [ 37 ] (Table  5 ).

A systematic review of five studies concluded that there was insufficient evidence to determine whether or not shared decision-making reduces claims [ 44 ]. A retrospective pre-post program evaluation of simulation training on malpractice claims among obstetrician-gynaecologists reported that the rate of claims after simulation training was halved to 5.7 claims per 100 physician years of coverage. Attending more sessions was associated with a greater reduction in claims, although there was no difference in the total costs of paid claims before and after the training [ 39 ].

In one included study of CPD, doctors who reported participation in CPD activities were significantly less likely (OR 0.60; CI 0.39 to 0.95) to receive quality of care-related complaints than those who did not report participating in CPD [ 41 ]. Participants in group-based CPD were less likely (OR 0.68; CI 0.47 to 0.98) to receive quality of care-related complaints than individual or assessment-based CPD [ 41 ].

Summary of the evidence

A summary of the included studies’ evidence base, consistency, clinical impact, generalisability and applicability is included in Table  6 . The evidence base was rated as poor for both Question 1 and 2 (Table  6 ). Consistency and clinical impact were slightly higher for Question 2 than Question 1, whereas generalisability and applicability were satisfactory for both Question 1 and Question 2.

This review has identified a clear lack of recent high-quality studies to inform an in-depth understanding of either review Question 1 or Question 2. For Question 1, seven patient characteristics were associated with patients’ likelihood to complain or make a medico-legal claim against a doctor; however, only one of these findings (presence of a mental disorder) was replicated. This may be related to the paucity of studies, for example, only half of the patient characteristics were evaluated in more than one study. While more studies were included for Question 2, the low quality of the predominant study design (case series) severely limits the strength of the review’s findings.

The main finding for Question 1 of a relationship between a patient’s mental health status and complaint behaviour may reflect non-modifiable associations between underlying mental health conditions, poorer outcomes and reduced satisfaction after surgery [ 24 , 26 ]. Alternatively, the finding may reflect the impact of stigma experienced by these patients in healthcare settings. Mental illness-related stigma is prevalent in healthcare [ 51 ]. Stigma creates barriers to accessing healthcare, such as delays in help-seeking, treatment discontinuation, suboptimal therapeutic relationships, patient safety concerns and poorer quality care [ 52 ]. The presence of these barriers may be associated with a complaint about a healthcare provider.

Findings for Question 2 offer some evidence to support most of the included interventions, particularly risk management programs and CRPs. Some of the commonly occurring attributes of risk management programs were the evaluation and analysis of complaints and claims, targeted medico-legal education, and implementation of patient safety measures. The majority of the risk management programs were developed and delivered internally, either at the level of hospital department [ 38 ], hospital-wide [ 32 , 34 ] or general practice-level [ 42 ]. Local contextualisation, incorporating the site-specific nature of malpractice claims and legislation, and delivery of risk management programs apparently enhance the acceptability of risk management programs for surgeons, in particular [ 53 , 54 , 55 ]. Nevertheless, in one study, the Society of Obstetricians and Gynaecologists of Canada partnered with a healthcare insurance representative body to support the international expansion of a risk management program [ 40 ].

Studies of CRPs were generally consistent in showing lower rates of claims and complaints, lower claim amounts, and faster resolution of claims following the implementation of CRPs. However, limited adherence to the key components of CRP, including a proliferation of partial apology laws, may detract from the effectiveness of CRP in meeting the needs of injured patients [ 56 , 57 , 58 ]. Patients involved in CRP have expressed a greater desire for information provision from hospitals about efforts to prevent recurrences of the event [ 59 ].

Interventions such as caps on compensation, attorney fees, and alternative payment systems and liabilities [ 31 ] were excluded from the review as they are not doctor-directed interventions. The impacts of these medical malpractice reforms have been recently summarised [ 60 , 61 ].

The small number of included studies (Question 1) and the low quality of included studies (Question 2) represent major gaps in the evidence. For Question 1, there were a large number of excluded studies that were uncontrolled or unadjusted cross-sectional studies of complaints or claims that simply report the underlying characteristics of a claims database. Due to the lack of a control group, these studies do not provide particularly useful insights into the relationship between patient characteristics and the rate of complaints or claims. While more studies were included for Question 2, the predominant study design (i.e. uncontrolled pre-post) is weak as it does not permit adjustments for other secular trends in claims or confounders, or include control sites. Therefore, very little strength could be offered for recommendations emanating from either Question 1 or Question 2.

For Question 1, only one study specified whether a complaint was warranted or unwarranted [ 41 ]. No study included both types of complaints to determine predictors of successful interventions targeting unwarranted claims/complaints. The finding that a substantial subset of complaints originate from non-patient sources is likely to reduce the predictive value of patient characteristics for claims and complaints in this analysis. For Question 2, no studies assessed staff satisfaction or patient outcomes, such as mortality or morbidity. Additionally, there is rarely any evidence provided about generalisability or the potential for implementation and sustainability of the intervention, and most studies are limited to a single hospital/health service. Only one included study reported on the impact on organisational culture [ 40 ] or patient satisfaction [ 33 ].

All stages of the rapid review were conducted independently in duplicate to minimise the risk of errors. However, we only included studies published since 2011. This may have excluded relevant, older literature, which may be a limitation to this rapid review. Additionally, we filtered search results from the Scopus and Web of Science databases to countries with similar health systems (Australia, New Zealand, Canada and the UK) and screened out studies with ‘emergency’ in the title.

Conclusions

Despite substantial efforts made to collect information about patient complaints and claims, research has generally failed to robustly determine patient characteristics associated with complaints and claims. There is a small amount of evidence that patients with mental health conditions are more likely to complain.

The evidence for the effectiveness of interventions to reduce the likelihood of a doctor receiving a complaint or claim is also weak, as it is dominated by low-quality, uncontrolled pre-post studies. Only one or two studies were included for five types of programs (peer programs, medical remediation, shared decision-making, simulation training and CPD). More evidence, however, offers support for the effectiveness of risk management programs and CRPs in reducing complaints and claims.

Availability of data and materials

The datasets analysed during the current study are available from the corresponding author on reasonable request.

Runciman W, Merry A, Walton M. Safety and Ethics in Healthcare: A Guide to Getting it Right. Aldershot: Ashgate; 2007.

Google Scholar  

Grober ED, Bohnen JMA. Defining medical error. Can J Surg. 2005;48(1):39–44.

PubMed   PubMed Central   Google Scholar  

Reader TW, Gillespie A, Roberts J. Patient complaints in healthcare systems: a systematic review and coding taxonomy. BMJ Qual Saf. 2014;23(8):678–89.

Article   PubMed   PubMed Central   Google Scholar  

Austin EE, Do V, Nullwala R, Fajardo Pulido D, Hibbert PD, Braithwaite J, et al. Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance. BMJ Open. 2021;11(8):e050377.

Unwin E, Woolf K, Wadlow C, Potts HWW, Dacre J. Sex differences in medico-legal action against doctors: a systematic review and meta-analysis. BMC Med. 2015;13(1):172.

Institute S. Evidence Check: Doctors challenges and Patient complaints. Sydney: Sax Insititute; 2022.

Daniel AE, Burn RJ, Horarlk S. Patients’ complaints about medical practice. MJA. 1999;170(12):598–602.

CAS   PubMed   Google Scholar  

Vincent C, Young M, Phillips A. Why do people sue doctors? A study of patients and relatives taking legal action. Lancet. 1994;343(8913):1609–13.

Article   CAS   PubMed   Google Scholar  

Wu AW. Medical error: the second victim. BMJ. 2000;320(7237):726.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Forrest C, O'Donoghue K, Collins DC, O'Reilly S. Current Irish medicolegal landscape: an unsustainable trajectory. BMJ Open Qual. 2023;12(3).

Forsetlund L, O'Brien MA, Forsén L, Mwai L, Reinar LM, Okwen MP, et al. Continuing education meetings and workshops: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews. 2021(9).

O’Brien M, Dinwoodie M, Hartwig B, Blaney D. The Clinical Communication Program: an effective intervention for reducing future risk for high-risk physicians. Asia Pacific J Health Manage. 2014;9(1):8–13.

Kachalia A, Sands K, Niel MV, Dodson S, Roche S, Novack V, et al. Effects of a communication-and-resolution program on hospitals’ malpractice claims and costs. Health Aff. 2018;37(11):1836–44.

Article   Google Scholar  

Kennedy G, Jacobs N, Freemark L, Madan S, Chan N, Tran Y, et al. Remediation programs for regulated health care professionals: a scoping review. J Contin Educ Health Prof. 2022;42(1):36–46.

Article   PubMed   Google Scholar  

Adams MA, Elmunzer BJ, Scheiman JM. Effect of a health system’s medical error disclosure program on gastroenterology-related claims rates and costs. Am J Gastroenterol. 2014;109(4):460–4.

Sax Institute. Evidence Check: a fast and accurate summary of the latest health evidence. Sydney: Sax Institute; 2022. [Available from: https://www.saxinstitute.org.au/wp-content/uploads/2022-Evidence-Check-Flyer.pdf .

Garritty C, Gartlehner G, Nussbaumer-Streit B, King VJ, Hamel C, Kamel C, et al. Cochrane rapid reviews methods group offers evidence-informed guidance to conduct rapid reviews. J Clin Epidemiol. 2021;130:13–22.

Pandor A, Kaltenthaler E, Martyn-St James M, Wong R, Cooper K, Dimairo M, et al. Delphi consensus reached to produce a decision tool for SelecTing Approaches for Rapid Reviews (STARR). J Clin Epidemiol. 2019;114:22–9.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.

National Health and Medical Research Council. NHMRC levels of evidence and grades for recommendations for guideline developers. Canberra: NHMRC; 2009.

Moola S, Munn Z, Sears K, Sfetcu R, Currie M, Lisy K, et al. Conducting systematic reviews of association (etiology): the Joanna Briggs Institute’s approach. Int J Evid Based Healthc. 2015;13(3):163–9.

Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008.

NIH. Study Quality Assessment Tools 2021. Available from: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools .

Grandizio LC, Barreto Rocha DF, Piper JP, Hayes DS, Klena JC. An analysis of formal patient complaints and malpractice events involving hand and upper extremity surgeons. J Am Acad Orthop Surg. 2021;29(15):659–65.

Kynes JM, Schildcrout JS, Hickson GB, Pichert JW, Han X, Ehrenfeld JM, et al. An analysis of risk factors for patient complaints about ambulatory anesthesiology care. Anesth Analg. 2013;116(6):1325–32.

Rae M, Barreto Rocha DF, Hayes DS, Haak M, Maniar H, Grandizio LC. Formal Patient Complaints and Malpractice Events Involving Orthopedic Spine Surgeons: A Ten-Year Analysis. Spine (Phila Pa 1976). 2022;47(14):E521-e6.

Jones K, Davies B, Stubbs DJ, Komashie A, Burnstein RM, Hutchinson P, et al. Can compliment and complaint data inform the care of individuals with chronic subdural haematoma (cSDH)? BMJ Open Qual. 2021;10(3).

Robin Taylor D, Bouttell J, Campbell JN, Lightbody CJ. A case-controlled study of relatives’ complaints concerning patients who died in hospital: the role of treatment escalation/limitation planning. Int J Qual Health C. 2020;32(3):212–8.

Facchin F, Pagani A, Perozzo FAG, Scarpa C, Bassetto F, Vindigni V. Litigation Cases After Post-Bariatric Surgery: Lesson from the Past. Aesthetic Plast Surg. 2023.

Cosman BC, Alverson AD, Boal PA, Owens EL, Norcross WA. Assessment and remedial clinical education of surgeons in California. Arch Surg. 2011;146(12):1411–5.

Cardoso R, Zarin W, Nincic V, Barber SL, Gulmezoglu AM, Wilson C, et al. Evaluative reports on medical malpractice policies in obstetrics: a rapid scoping review. Syst Rev. 2017;6(1):181.

Diraviam SP, Sullivan PG, Sestito JA, Nepps ME, Clapp JT, Fleisher LA. Physician engagement in malpractice risk reduction: A UPHS case study. Jt Comm J Qual Patient Saf. 2018;44(10):605–12.

PubMed   Google Scholar  

Fustino NJ, Moore P, Viers S, Cheyne K. Improving patient experience of care providers in a multispecialty ambulatory pediatrics practice. Clin Pediatr (Phila). 2019;58(1):50–9.

Juo YY, Lewis C, Hanna C, Reber HA, Tillou A. An innovative approach for familiarizing surgeons with malpractice litigation. J Surg Educ. 2019;76(1):127–33.

LeCraw FR, Montanera D, Jackson JP, Keys JC, Hetzler DC, Mroz TA. Changes in liability claims, costs, and resolution times following the introduction of a communication-and-resolution program in Tennessee. J Patient Saf Risk Manage. 2018;23(1):13–8.

Nassiri AM, Pichert JW, Domenico HJ, Galloway MB, Cooper WO, Bennett ML. Unsolicited patient complaints among otolaryngologists. Otolaryngol Head Neck Surg. 2019;160(5):810–7.

Pichert JW, Moore IN, Karrass J, Jay JS, Westlake MW, Catron TF, et al. An intervention model that promotes accountability: peer messengers and patient/family complaints. Jt Comm J Qual Patient Saf. 2013;39(10):435–46.

Raper SE, Rose D, Nepps ME, Drebin JA. Taking the initiative: risk-reduction strategies and decreased malpractice costs. J Am Coll Surg. 2017;225(5):612–21.

Schaffer AC, Babayan A, Einbinder JS, Sato L, Gardner R. Association of simulation training with rates of medical malpractice claims among obstetrician-gynecologists. Obstet Gynecol. 2021;138(2):246–52.

Milne JK, Walker DE, Vlahaki D. Reflections on the Canadian MORE(OB) obstetrical risk management programme. Best Pract Res Clin Obstet Gynaecol. 2013;27(4):563–9.

Wenghofer EF, Campbell C, Marlow B, Kam SM, Carter L, McCauley W. The effect of continuing professional development on public complaints: a case-control study. Med Educ. 2015;49(3):264–75.

Barragry RA, Varadkar LE, Hanlon DK, Bailey KF, O’Dowd TC, O’Shea BJ. An analytic observational study on complaints management in the general practice out of hours care setting: who complains, why, and what can we do about it? BMC Fam Pract. 2016;17(1):87.

Lillis S, Takai N, Francis S. Long-term outcomes of a remedial education program for doctors with clinical performance deficits. J Contin Educ Heal Prof. 2014;34(2):96–101.

Durand MA, Moulton B, Cockle E, Mann M, Elwyn G. Can shared decision-making reduce medical malpractice litigation? A systematic review. BMC Health Serv Res. 2015;15.

Price T, Archer J. UK policy on doctor remediation: trajectories and challenges. J Contin Educ Health Prof. 2017;37(3):207–11.

Price T, Brennan N, Wong G, Withers L, Cleland J, Wanner A, et al. Remediation programmes for practising doctors to restore patient safety: the RESTORE realist review. Health Serv Deliv Res. 2021;9(11):1–116.

Rout A, Roberts P. Peer review in nursing and midwifery: a literature review. J Clin Nurs. 2008;17(4):427–42.

Travaglia J, Debono D. Peer review in medicine: a comprehensive review of the literature. Sydney: Centre for Clinical Governance Research in Health; 2009.

Lateef F. Simulation-based learning: Just like the real thing. J Emerg Trauma Shock. 2010;3(4):348–52.

Royal Australasian College of Physicians. Continuing Professional Development (CPD) Participation Policy. Sydney: RACP; 2020.

Corrigan PW, Druss BG, Perlick DA. The impact of mental illness stigma on seeking and participating in mental health care. Psychol Sci Public Interest. 2014;15(2):37–70.

Knaak S, Mantler E, Szeto A. Mental illness-related stigma in healthcare: barriers to access and care and evidence-based solutions. Healthc Manage Forum. 2017;30(2):111–6.

Raper SE, Gupta M, Okusanya O, Morris JB. Improving communication skills: a course for academic medical center surgery residents and faculty. J Surg Educ. 2015;72(6):e202–11.

Raper SE, Joseph J, Seymour WG, Sullivan PG. Tipping the scales: educating surgeons about medical malpractice. J Surg Res. 2016;206(1):206–13.

Raper SE, Joseph J. Informed consent for academic surgeons: a curriculum-based update. MedEdPORTAL. 2020;16:10985.

Ross NE, Newman WJ. The role of apology laws in medical malpractice. J Am Acad Psychiatry Law. 2021;49(3):406–14.

Fields AC, Mello MM, Kachalia A. Apology laws and malpractice liability: what have we learned? BMJ Qual Saf. 2021;30(1):64–7.

Gallagher TH, Mello MM, Sage WM, Bell SK, McDonald TB, Thomas EJ. Can communication-and-resolution programs achieve their potential? Five key questions Health Affairs. 2018;37(11):1845–52.

Moore J, Bismark M, Mello MM. Patients’ experiences with communication-and-resolution programs after medical injury. JAMA Intern Med. 2017;177(11):1595–603.

Liu J, Hyman DA. The impact of medical malpractice reforms. Annual Rev Law Soc Sci. 2020. p. 405–19.

Agarwal R, Gupta A, Gupta S. The impact of tort reform on defensive medicine, quality of care, and physician supply: A systematic review. Health Services Research. 2019 2019/08//:851+.

Download references

Acknowledgements

We acknowledge the support of Eileen Goldberg and Richa Jaswal who brokered the review through the Sax Institute.

The project was funded by Avant Insurance Limited, Australia, which advised on the study protocol and approved publication. The authors alone are responsible for the views expressed in this review, and they do not necessarily represent the decisions, policies, or views of Avant Insurance Limited, Australia.

Author information

Authors and affiliations.

College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia

Timothy J. Schultz, Jodi Gray, Jackie Roseleur, Richard Clark & Dylan A. Mordaunt

College of Nursing and Health Sciences, Flinders University, Adelaide, Australia

Michael Zhou

HealthFX, Melbourne, Australia

Richard Clark

Southern Adelaide Local Health Network, Adelaide, Australia

Dylan A. Mordaunt

Australian Institute of Health Innovation, Macquarie University, Sydney, Australia

Peter D. Hibbert

IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia

Avant Mutual, Sydney, Australia

Georgie Haysom & Michael Wright

Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia

Michael Wright

You can also search for this author in PubMed   Google Scholar

Contributions

TJS obtained funding, developed review methods, conducted the search, screened, critically appraised, extracted data, interpreted results, and wrote the manuscript. MZ screened, extracted data, interpreted results, and wrote the manuscript. JG and JR screened, critically appraised, extracted data; RC and DAM interpreted results. PDH critically appraised, interpreted results. GH and MW developed the protocol and interpreted results. All authors reviewed the manuscript and approved the submitted version. All authors are personally accountable for their own contributions.

Corresponding author

Correspondence to Timothy J. Schultz .

Ethics declarations

Ethics approval and consent to participate.

Not applicable.

Consent for publication

Competing interests.

Authors TJS, MZ, JG, JR, RC, DAM, and PDH declare no competing interests.

Authors GH and MW are employees of Avant Insurance Limited, Australia, a provider of medico-legal insurance.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Additional file 1: table s1..

Pubmed search - 8 September 2022. Table S2. Scopus search - 8 September 2022. Table S3. Web of Science - 8 September 2022. Table S4. Summary of study design for included studies for Question 1 and 2 using NHMRC levels of evidence [20]. Table S5. Summary of quality appraisal for eight comparative studies with concurrent controls, six for Question 1 (Q1) and two for Question 2 (Q2). Table S6. Summary of quality appraisal for three systematic reviews (one for Question 1 (Q1) and two for Question 2 (Q2)). Table S7. Summary of quality appraisal for 14 uncontrolled pre-post studies for Question 2 (Q2).

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Schultz, T.J., Zhou, M., Gray, J. et al. Patient characteristics of, and remedial interventions for, complaints and medico-legal claims against doctors: a rapid review of the literature. Syst Rev 13 , 104 (2024). https://doi.org/10.1186/s13643-024-02501-8

Download citation

Received : 14 December 2023

Accepted : 20 February 2024

Published : 09 April 2024

DOI : https://doi.org/10.1186/s13643-024-02501-8

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Medico-legal claims
• Communication and resolution program
• Risk management program
• Patient characteristics
• Patient safety

Systematic Reviews

ISSN: 2046-4053

• Submission enquiries: Access here and click Contact Us
• General enquiries: [email protected]