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  • J Grad Med Educ
  • v.8(3); 2016 Jul

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

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

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

The Literature Review Defined

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

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

Purpose and Importance of the Literature Review

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

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

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

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

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

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

Approaching the Literature Review

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

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

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

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

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Locating and Organizing the Literature

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

Human Resources

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

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

Strategies for Finding Related Researcher Publications in Databases and Search Engines

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Search Tools and Related Literature

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

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

Box Information Resources

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

Getting Organized

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

Citation Managers

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Knowing When to Say When

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

Putting It All Together

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

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

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

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

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Home » Office of Curriculum » Medical Student Scholarship » III Scholarship Start Here » Scholarship of Integration » Key Steps in a Literature Review

Key Steps in a Literature Review

The 5 key steps  below are most relevant to narrative reviews. Systematic reviews include the additional step of using a standardized scoring system to assess the quality of each article. More information on  Step 1 can be found  here  and Step 5  here .

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What are Systematic Reviews?

Systematic Literature Reviews: Steps & Resources

review of the medical literature

These steps for conducting a systematic literature review are listed below . 

Also see subpages for more information about:

Literature Review & Systematic Review Steps

1. Develop a Focused   Question 

Consider the PICO Format: Population/Problem, Intervention, Comparison, Outcome

Focus on defining the Population or Problem and Intervention (don't narrow by Comparison or Outcome just yet!)

"What are the effects of the Pilates method for patients with low back pain?"

Tools & Additional Resources:

2. Scope the Literature

A "scoping search" investigates the breadth and/or depth of the initial question or may identify a gap in the literature. 

Eligible studies may be located by searching in:

When searching, if possible, translate terms to controlled vocabulary of the database. Use text word searching when necessary.

Use Boolean operators to connect search terms:

Search:  pilates AND ("low back pain"  OR  backache )

Download a Boolean worksheet (PDF)

3. Refine & Expand Your Search

Expand your search strategy with synonymous search terms harvested from:


(pilates OR exercise movement techniques) AND ("low back pain" OR backache* OR sciatica OR lumbago OR spondylosis)

As you develop a final, reproducible strategy for each database, save your strategies in a:

4. Limit Your Results

Use database filters to limit your results based on your defined inclusion/exclusion criteria.  In addition to relying on the databases' categorical filters, you may also need to manually screen results.  

NOTE: Many databases allow you to filter to "Full Text Only".  This filter is  not recommended . It excludes articles if their full text is not available in that particular database (CINAHL, PubMed, etc), but if the article is relevant, it is important that you are able to read its title and abstract, regardless of 'full text' status. The full text is likely to be accessible through another source (a different database, or Interlibrary Loan).  

5. Download Citations

Selected citations and/or entire sets of search results can be downloaded from the database into a citation management tool. If you are conducting a systematic review that will require reporting according to PRISMA standards, a citation manager can help you keep track of the number of articles that came from each database, as well as the number of duplicate records.

In Zotero, you can create a Collection for the combined results set, and sub-collections for the results from each database you search.  You can then use Zotero's 'Duplicate Items" function to find and merge duplicate records.

File structure of a Zotero library, showing a combined pooled set, and sub folders representing results from individual databases.

6. Abstract and Analyze

Covidence is a web-based tool that enables you to work with a team to screen titles/abstracts and full text for inclusion in your review, as well as extract data from the included studies.

Screenshot of the Covidence interface, showing Title and abstract screening phase.

7. Create Flow Diagram

The PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) flow diagram is a visual representation of the flow of records through different phases of a systematic review.  It depicts the number of records identified, included and excluded.  It is best used in conjunction with the PRISMA checklist .

Example PRISMA diagram showing number of records identified, duplicates removed, and records excluded.

Example from: Stotz, S. A., McNealy, K., Begay, R. L., DeSanto, K., Manson, S. M., & Moore, K. R. (2021). Multi-level diabetes prevention and treatment interventions for Native people in the USA and Canada: A scoping review. Current Diabetes Reports, 2 (11), 46. https://doi.org/10.1007/s11892-021-01414-3

8. Synthesize & Report Results

There are a number of reporting guideline available to guide the synthesis and reporting of results in systematic literature reviews.

It is common to organize findings in a matrix, also known as a Table of Evidence (ToE).

Example of a review matrix, using Microsoft Excel, showing the results of a systematic literature review.

Steps modified from: 

Cook, D. A., & West, C. P. (2012). Conducting systematic reviews in medical education: a stepwise approach.   Medical Education , 46 (10), 943–952.

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Writing in the Health Sciences: Welcome

The Preston Smith Library provides a wide variety of services to assist students and faculty in their research efforts.  This subject guide is a specific tool aimed at helping health sciences professionals successfully  articulate and refine their ideas. It is intended as a guide for writing and deals with aspects of preparing research for publication rather than with the actual publishing process. A separate guide for Publishing in the Medial Sciences is available for this purpose.

Writing in the Health Sciences discusses the various components of composing a scientific research report. Most particularly this involves characterizing the systematic, formal approach to scientific writing and how to prepare a manuscript for publication. In addition to discussing the basics of selecting a topic and what questions to answer in your manuscript, this guide  will identify the process of:

review of the medical literature

The below links reference the preliminary guidelines for writing and presenting scholarly work in the sciences.

ICMJE Recommendations: Authors and Authorship  - The International Committee of Medical Journal Editors ( ICMJE ) provides some brief tools and recommendations for authors publishing in the biomedical sciences.

The Equator Network  -  Equator  is an international collection of guidelines and policy documents related to health research. Its numerous toolkits and resources effectively apply the standards of writing to various EBM studies in order to enhance the reliability of medical research literature.

PLoS Reporting Guidelines  - While PLoS deals mostly with open access publishing, its  reporting guidelines allow writers of health science papers to keep up to date on the essential strategies and trends in review articles.

AACC Guide to Scientific Writing  - The American Association for Clinical Chemistry (AACC) offers a very thorough and systematic guide to scientific writing, formatted as a series of educational articles on how to design and write scientific research papers for publication.

Guidelines on Style for Scientific Writing  -  A very generalized guide for creating and formatting your research report. It also acknowledges the guidelines from various institutional and open access resources.

Writing a Scientific Research Article  -  A brief overview and outline of the research report. This short summary also provides tips on tense and verbiage.

S cientific Reports  - This is not only a helpful hints section for articulating your  ideas,  but offers a step-by-step, timed method by which writers can effectively communicate and evaluate their work.

Duke University Scientific Writing Resource  - This is a separate research guide dedicated to writing for the sciences. It offers help with executing the research and drafting phase of your work. 

Scitable's English Communication for Scientists - Published by the Nature group, this resource is an interactive tool for young writers who need help navigating the preliminary steps of scientific writing.

On Scientific Writing

Scientific Writing Tips

Scientific Writing Process in Brief

review of the medical literature

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Literature Reviews (Health Sciences)

What is a literature review, types of reviews.

Still have questions about reviews?

Fill out the form below and a librarian will contact you shortly!

A literature review provides an overview of what's been written about a specific topic. There are many different types of literature reviews. They  vary in terms of scope, comprehensiveness, time constraints, and types of studies included.

review of the medical literature

A traditional narrative/literature review provides a quick overview of current studies. It helps explain why your study is important in the context of the literature, and can also help you identify areas that need further research. The rest of this guide will cover some basic steps to consider when conducting a traditional literature review. Click on the right thumbnail to see an excerpt from this type of literature review.

review of the medical literature

A scoping review involves a broad research question that explores the current evidence base ( Armstrong, Hall, Doyle, & Waters, 2011 ). It can help inform areas that are appropriate for a systematic review. Click on the right thumbnail to see an excerpt from this type of literature review.

review of the medical literature

Integrative reviews "synthesize findings from different approaches, like experimental and non-experimental studies" ( Whittemore & Knafl, 2005 ).  This approach allows for the integration of qualitative studies with quantitative studies.   They m ay or may not be systematic reviews. Click on the right thumbnail to see an excerpt from this type of literature review.

review of the medical literature

A systematic review is a research method that aims to answer question(s) by analyzing studies meeting a specific criteria (Glasziou, Iwirg, Bain & Corditz, 2001) .  Systematic reviews synthesize high quality empirical information to answer a given research question ( The Cochrane Collaboration, n.d. ). Conducting a systematic review involves following rigorous, predefined protocols that " minimise  bias and ensure transparency" ( Glanville  & McCool, n.d. ). See one of our Librarians for more information on what they are and how to conduct one. Click on the right thumbnail to see an excerpt from this type of literature review.

review of the medical literature

Meta-analyses are "the statistical integration of separate studies" ( Egger & Smith, 1997 ). They involve identifying similar studies and pooling their data to obtain a more accurate estimate of true effect size. A systematic review can include a meta-analysis. Click on the right thumbnail to see an excerpt from this type of literature review.

review of the medical literature

Both these reviews investigate implementation of interventions across real world contexts as they synthesize research that seeks an explanatory focus answering the question "what about a programme works for whom and in what circumstances?" (Pawson, 2005, p.22)  They can be categorized as "What works, for whom, in what circumstances ... and why" (Pawson, 2012, p. 178). More and more realist reviews are being indexed in PubMed. Please access more information about Realist Reviews in the Sophie Newsletter, May 2013.

Medical Students Scholarly Project Course

What is a literature review?

Systematic reviews vs literature reviews, literature reviews - articles, writing literature reviews, frequently used journal article databases.

The literature review is the qualitative summary of evidence on a topic using informal or subjective methods to collect and interpret studies.The literature review can inform a particular research project or can result in a review article publication.

review of the medical literature

review of the medical literature

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Intended for healthcare professionals


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Performing a literature review

A necessary skill for any doctor

What causes disease, which drug is best, does this patient need surgery, and what is the prognosis? Although experience helps in answering these questions, ultimately they are best answered by evidence based medicine. But how do you assess the evidence? As a medical student, and throughout your career as a doctor, critical appraisal of published literature is an important skill to develop and refine. At medical school you will repeatedly appraise published literature and write literature reviews. These activities are commonly part of a special study module, research project for an intercalated degree, or another type of essay based assignment.

Formulating a question

Literature reviews are most commonly performed to help answer a particular question. While you are at medical school, there will usually be some choice regarding the area you are going to review.

Once you have identified a subject area for review, the next step is to formulate a specific research question. This is arguably the most important step because a clear question needs to be defined from the outset, which you aim to answer by doing the review. The clearer the question, the more likely it is that the answer will be clear too. It is important to have discussions with your supervisor when formulating a research question as his or her input will be invaluable. The research question must be objective and concise because it is easier to search through the evidence with a clear question. The question also needs to be feasible. What is the point in having a question for which no published evidence exists? Your supervisor’s input will ensure you are not trying to answer an unrealistic question. Finally, is the research question clinically important? There are many research questions that may be answered, but not all of them will …

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review of the medical literature

Melbourne Medical School

Literature review

Literature reviews are a way of identifying what is already known about a research area and what the gaps are. To do a literature review, you will need to identify relevant literature, often through searching academic databases, and then review existing literature. Most often, you will do the literature review at the beginning of your research project, but it is iterative, so you may choose to change the literature review as you move through your project.

Searching the literature

The University of Melbourne Library has some resources about searching the literature. Leonie spoke about how she met with a librarian about searching the literature. You may also want to meet face-to-face with a librarian or attend a class at the library to learn more about literature searching. When you search the literature, you may find journal articles, reports, books and other materials.

Filing, categorising and managing literature

In order to manage the literature you have identified through searches, you may choose to use a reference manager. The University of Melbourne has access to RefWorks and Endnote. Further information about accessing this software is available through the University of Melbourne Library .

Writing a literature review

The purpose of the literature review is to identify what is already known about a particular research area and critically analyse prior studies. It will also help you to identify any gaps in the research and situate your research in what is already known about a particular topic.


Medicine Guide: Literature Reviews

Writing the Literature Review (Part 1)

Writing the Literature Review (Part 2)

Writing a literature review

Your Liaison Librarian will be able to provide support and advice when you are doing your literature review, so make an appointment with your librarian when you start your research.

Literature review books @ JCU Library

review of the medical literature

Acknowledgement of Country


  1. Guide on How to Write a Literature Review Medicine

    review of the medical literature

  2. 😎 Medical literature review. 10+ Literature Review Outline Templates. 2019-01-09

    review of the medical literature

  3. Guide on How to Write a Literature Review Medicine

    review of the medical literature

  4. 😎 Medical literature review. 10+ Literature Review Outline Templates. 2019-01-09

    review of the medical literature

  5. Guide on How to Write a Literature Review Medicine

    review of the medical literature

  6. Sample Example Of Literature Review

    review of the medical literature


  1. Practical Tips to Keep Up with the Medical Literature

  2. Literature Review 2

  3. Literature Review

  4. 2 Title, Summary and Introduction

  5. Literature search and review to identify research gaps

  6. Most Common in Surgery Part 5


  1. Writing an Effective Literature Review

    A literature review can be an informative, critical, and useful synthesis of a particular topic. It can identify what is known (and unknown) in the subject

  2. A Foundation for High-Quality Medical Education Research

    A literature review forms the basis for high-quality medical education research and helps maximize relevance, originality, generalizability, and impact. · A

  3. Key Steps in a Literature Review

    Identify a specific unresolved research question relevant to medicine. Consider the purpose and rationale of a review · Select studies to be included in the

  4. Literature Reviews

    Literature Review & Systematic Review Steps · 1. Develop a Focused · 2. Scope the Literature · 3. Refine & Expand Your Search · 4. Limit Your

  5. Writing in the Health Sciences: Research and Lit Reviews

    In simple terms, a literature review investigates the available information on a certain topic. It may be only a knowledge survey with an

  6. What is a Literature Review?

    A literature review provides an overview of what's been written about a specific topic. There are many different types of literature reviews

  7. Literature Review

    The literature review is the qualitative summary of evidence on a topic using informal or subjective methods to collect and interpret

  8. Performing a literature review

    Literature reviews are most commonly performed to help answer a particular question. While you are at medical school, there will usually be some

  9. Literature review

    The purpose of the literature review is to identify what is already known about a particular research area and critically analyse prior studies. It will also

  10. Medicine Guide: Literature Reviews

    This book provides a concise step-by-step guide to conducting a literature search and writing up the literature review chapter in graduate