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Significance of the Study – Examples and Writing Guide

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Significance of the Study

Definition:

Significance of the study in research refers to the potential importance, relevance, or impact of the research findings. It outlines how the research contributes to the existing body of knowledge, what gaps it fills, or what new understanding it brings to a particular field of study.

In general, the significance of a study can be assessed based on several factors, including:

• Originality : The extent to which the study advances existing knowledge or introduces new ideas and perspectives.
• Practical relevance: The potential implications of the study for real-world situations, such as improving policy or practice.
• Theoretical contribution: The extent to which the study provides new insights or perspectives on theoretical concepts or frameworks.
• Methodological rigor : The extent to which the study employs appropriate and robust methods and techniques to generate reliable and valid data.
• Social or cultural impact : The potential impact of the study on society, culture, or public perception of a particular issue.

Types of Significance of the Study

The significance of the Study can be divided into the following types:

Theoretical Significance

Theoretical significance refers to the contribution that a study makes to the existing body of theories in a specific field. This could be by confirming, refuting, or adding nuance to a currently accepted theory, or by proposing an entirely new theory.

Practical Significance

Practical significance refers to the direct applicability and usefulness of the research findings in real-world contexts. Studies with practical significance often address real-life problems and offer potential solutions or strategies. For example, a study in the field of public health might identify a new intervention that significantly reduces the spread of a certain disease.

Significance for Future Research

This pertains to the potential of a study to inspire further research. A study might open up new areas of investigation, provide new research methodologies, or propose new hypotheses that need to be tested.

How to Write Significance of the Study

Here’s a guide to writing an effective “Significance of the Study” section in research paper, thesis, or dissertation:

• Background : Begin by giving some context about your study. This could include a brief introduction to your subject area, the current state of research in the field, and the specific problem or question your study addresses.
• Identify the Gap : Demonstrate that there’s a gap in the existing literature or knowledge that needs to be filled, which is where your study comes in. The gap could be a lack of research on a particular topic, differing results in existing studies, or a new problem that has arisen and hasn’t yet been studied.
• State the Purpose of Your Study : Clearly state the main objective of your research. You may want to state the purpose as a solution to the problem or gap you’ve previously identified.
• Contributes to the existing body of knowledge.
• Addresses a significant research gap.
• Offers a new or better solution to a problem.
• Impacts policy or practice.
• Leads to improvements in a particular field or sector.
• Identify Beneficiaries : Identify who will benefit from your study. This could include other researchers, practitioners in your field, policy-makers, communities, businesses, or others. Explain how your findings could be used and by whom.
• Future Implications : Discuss the implications of your study for future research. This could involve questions that are left open, new questions that have been raised, or potential future methodologies suggested by your study.

Significance of the Study in Research Paper

The Significance of the Study in a research paper refers to the importance or relevance of the research topic being investigated. It answers the question “Why is this research important?” and highlights the potential contributions and impacts of the study.

The significance of the study can be presented in the introduction or background section of a research paper. It typically includes the following components:

• Importance of the research problem: This describes why the research problem is worth investigating and how it relates to existing knowledge and theories.
• Potential benefits and implications: This explains the potential contributions and impacts of the research on theory, practice, policy, or society.
• Originality and novelty: This highlights how the research adds new insights, approaches, or methods to the existing body of knowledge.
• Scope and limitations: This outlines the boundaries and constraints of the research and clarifies what the study will and will not address.

Suppose a researcher is conducting a study on the “Effects of social media use on the mental health of adolescents”.

The significance of the study may be:

“The present study is significant because it addresses a pressing public health issue of the negative impact of social media use on adolescent mental health. Given the widespread use of social media among this age group, understanding the effects of social media on mental health is critical for developing effective prevention and intervention strategies. This study will contribute to the existing literature by examining the moderating factors that may affect the relationship between social media use and mental health outcomes. It will also shed light on the potential benefits and risks of social media use for adolescents and inform the development of evidence-based guidelines for promoting healthy social media use among this population. The limitations of this study include the use of self-reported measures and the cross-sectional design, which precludes causal inference.”

Significance of the Study In Thesis

The significance of the study in a thesis refers to the importance or relevance of the research topic and the potential impact of the study on the field of study or society as a whole. It explains why the research is worth doing and what contribution it will make to existing knowledge.

For example, the significance of a thesis on “Artificial Intelligence in Healthcare” could be:

• With the increasing availability of healthcare data and the development of advanced machine learning algorithms, AI has the potential to revolutionize the healthcare industry by improving diagnosis, treatment, and patient outcomes. Therefore, this thesis can contribute to the understanding of how AI can be applied in healthcare and how it can benefit patients and healthcare providers.
• AI in healthcare also raises ethical and social issues, such as privacy concerns, bias in algorithms, and the impact on healthcare jobs. By exploring these issues in the thesis, it can provide insights into the potential risks and benefits of AI in healthcare and inform policy decisions.
• Finally, the thesis can also advance the field of computer science by developing new AI algorithms or techniques that can be applied to healthcare data, which can have broader applications in other industries or fields of research.

Significance of the Study in Research Proposal

The significance of a study in a research proposal refers to the importance or relevance of the research question, problem, or objective that the study aims to address. It explains why the research is valuable, relevant, and important to the academic or scientific community, policymakers, or society at large. A strong statement of significance can help to persuade the reviewers or funders of the research proposal that the study is worth funding and conducting.

Here is an example of a significance statement in a research proposal:

Title : The Effects of Gamification on Learning Programming: A Comparative Study

Significance Statement:

This proposed study aims to investigate the effects of gamification on learning programming. With the increasing demand for computer science professionals, programming has become a fundamental skill in the computer field. However, learning programming can be challenging, and students may struggle with motivation and engagement. Gamification has emerged as a promising approach to improve students’ engagement and motivation in learning, but its effects on programming education are not yet fully understood. This study is significant because it can provide valuable insights into the potential benefits of gamification in programming education and inform the development of effective teaching strategies to enhance students’ learning outcomes and interest in programming.

Examples of Significance of the Study

Here are some examples of the significance of a study that indicates how you can write this into your research paper according to your research topic:

Research on an Improved Water Filtration System : This study has the potential to impact millions of people living in water-scarce regions or those with limited access to clean water. A more efficient and affordable water filtration system can reduce water-borne diseases and improve the overall health of communities, enabling them to lead healthier, more productive lives.

Study on the Impact of Remote Work on Employee Productivity : Given the shift towards remote work due to recent events such as the COVID-19 pandemic, this study is of considerable significance. Findings could help organizations better structure their remote work policies and offer insights on how to maximize employee productivity, wellbeing, and job satisfaction.

Investigation into the Use of Solar Power in Developing Countries : With the world increasingly moving towards renewable energy, this study could provide important data on the feasibility and benefits of implementing solar power solutions in developing countries. This could potentially stimulate economic growth, reduce reliance on non-renewable resources, and contribute to global efforts to combat climate change.

Research on New Learning Strategies in Special Education : This study has the potential to greatly impact the field of special education. By understanding the effectiveness of new learning strategies, educators can improve their curriculum to provide better support for students with learning disabilities, fostering their academic growth and social development.

Examination of Mental Health Support in the Workplace : This study could highlight the impact of mental health initiatives on employee wellbeing and productivity. It could influence organizational policies across industries, promoting the implementation of mental health programs in the workplace, ultimately leading to healthier work environments.

Evaluation of a New Cancer Treatment Method : The significance of this study could be lifesaving. The research could lead to the development of more effective cancer treatments, increasing the survival rate and quality of life for patients worldwide.

When to Write Significance of the Study

The Significance of the Study section is an integral part of a research proposal or a thesis. This section is typically written after the introduction and the literature review. In the research process, the structure typically follows this order:

• Title – The name of your research.
• Abstract – A brief summary of the entire research.
• Introduction – A presentation of the problem your research aims to solve.
• Literature Review – A review of existing research on the topic to establish what is already known and where gaps exist.
• Significance of the Study – An explanation of why the research matters and its potential impact.

In the Significance of the Study section, you will discuss why your study is important, who it benefits, and how it adds to existing knowledge or practice in your field. This section is your opportunity to convince readers, and potentially funders or supervisors, that your research is valuable and worth undertaking.

Advantages of Significance of the Study

The Significance of the Study section in a research paper has multiple advantages:

• Establishes Relevance: This section helps to articulate the importance of your research to your field of study, as well as the wider society, by explicitly stating its relevance. This makes it easier for other researchers, funders, and policymakers to understand why your work is necessary and worth supporting.
• Guides the Research: Writing the significance can help you refine your research questions and objectives. This happens as you critically think about why your research is important and how it contributes to your field.
• Attracts Funding: If you are seeking funding or support for your research, having a well-written significance of the study section can be key. It helps to convince potential funders of the value of your work.
• Opens up Further Research: By stating the significance of the study, you’re also indicating what further research could be carried out in the future, based on your work. This helps to pave the way for future studies and demonstrates that your research is a valuable addition to the field.
• Provides Practical Applications: The significance of the study section often outlines how the research can be applied in real-world situations. This can be particularly important in applied sciences, where the practical implications of research are crucial.
• Enhances Understanding: This section can help readers understand how your study fits into the broader context of your field, adding value to the existing literature and contributing new knowledge or insights.

Limitations of Significance of the Study

The Significance of the Study section plays an essential role in any research. However, it is not without potential limitations. Here are some that you should be aware of:

• Subjectivity: The importance and implications of a study can be subjective and may vary from person to person. What one researcher considers significant might be seen as less critical by others. The assessment of significance often depends on personal judgement, biases, and perspectives.
• Predictability of Impact: While you can outline the potential implications of your research in the Significance of the Study section, the actual impact can be unpredictable. Research doesn’t always yield the expected results or have the predicted impact on the field or society.
• Difficulty in Measuring: The significance of a study is often qualitative and can be challenging to measure or quantify. You can explain how you think your research will contribute to your field or society, but measuring these outcomes can be complex.
• Possibility of Overstatement: Researchers may feel pressured to amplify the potential significance of their study to attract funding or interest. This can lead to overstating the potential benefits or implications, which can harm the credibility of the study if these results are not achieved.
• Overshadowing of Limitations: Sometimes, the significance of the study may overshadow the limitations of the research. It is important to balance the potential significance with a thorough discussion of the study’s limitations.
• Dependence on Successful Implementation: The significance of the study relies on the successful implementation of the research. If the research process has flaws or unexpected issues arise, the anticipated significance might not be realized.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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What is the Significance of a Study? Examples and Guide

If you’re reading this post you’re probably wondering: what is the significance of a study?

No matter where you’re at with a piece of research, it is a good idea to think about the potential significance of your work. And sometimes you’ll have to explicitly write a statement of significance in your papers, it addition to it forming part of your thesis.

In this post I’ll cover what the significance of a study is, how to measure it, how to describe it with examples and add in some of my own experiences having now worked in research for over nine years.

If you’re reading this because you’re writing up your first paper, welcome! You may also like my how-to guide for all aspects of writing your first research paper .

Looking for guidance on writing the statement of significance for a paper or thesis? Click here to skip straight to that section.

What is the Significance of a Study?

For research papers, theses or dissertations it’s common to explicitly write a section describing the significance of the study. We’ll come onto what to include in that section in just a moment.

However the significance of a study can actually refer to several different things.

Working our way from the most technical to the broadest, depending on the context, the significance of a study may refer to:

• Within your study: Statistical significance. Can we trust the findings?
• Wider research field: Research significance. How does your study progress the field?
• Commercial / economic significance: Could there be business opportunities for your findings?
• Societal significance: What impact could your study have on the wider society.
• And probably other domain-specific significance!

We’ll shortly cover each of them in turn, including how they’re measured and some examples for each type of study significance.

But first, let’s touch on why you should consider the significance of your research at an early stage.

Why Care About the Significance of a Study?

No matter what is motivating you to carry out your research, it is sensible to think about the potential significance of your work. In the broadest sense this asks, how does the study contribute to the world?

After all, for many people research is only worth doing if it will result in some expected significance. For the vast majority of us our studies won’t be significant enough to reach the evening news, but most studies will help to enhance knowledge in a particular field and when research has at least some significance it makes for a far more fulfilling longterm pursuit.

Furthermore, a lot of us are carrying out research funded by the public. It therefore makes sense to keep an eye on what benefits the work could bring to the wider community.

Often in research you’ll come to a crossroads where you must decide which path of research to pursue. Thinking about the potential benefits of a strand of research can be useful for deciding how to spend your time, money and resources.

It’s worth noting though, that not all research activities have to work towards obvious significance. This is especially true while you’re a PhD student, where you’re figuring out what you enjoy and may simply be looking for an opportunity to learn a new skill.

However, if you’re trying to decide between two potential projects, it can be useful to weigh up the potential significance of each.

Let’s now dive into the different types of significance, starting with research significance.

Research Significance

What is the research significance of a study.

Unless someone specifies which type of significance they’re referring to, it is fair to assume that they want to know about the research significance of your study.

Research significance describes how your work has contributed to the field, how it could inform future studies and progress research.

Where should I write about my study’s significance in my thesis?

Typically you should write about your study’s significance in the Introduction and Conclusions sections of your thesis.

It’s important to mention it in the Introduction so that the relevance of your work and the potential impact and benefits it could have on the field are immediately apparent. Explaining why your work matters will help to engage readers (and examiners!) early on.

It’s also a good idea to detail the study’s significance in your Conclusions section. This adds weight to your findings and helps explain what your study contributes to the field.

On occasion you may also choose to include a brief description in your Abstract.

What is expected when submitting an article to a journal

It is common for journals to request a statement of significance, although this can sometimes be called other things such as:

• Impact statement
• Significance statement
• Advances in knowledge section

Here is one such example of what is expected:

Impact Statement:  An Impact Statement is required for all submissions.  Your impact statement will be evaluated by the Editor-in-Chief, Global Editors, and appropriate Associate Editor. For your manuscript to receive full review, the editors must be convinced that it is an important advance in for the field. The Impact Statement is not a restating of the abstract. It should address the following: Why is the work submitted important to the field? How does the work submitted advance the field? What new information does this work impart to the field? How does this new information impact the field? Experimental Biology and Medicine journal, author guidelines

Typically the impact statement will be shorter than the Abstract, around 150 words.

Defining the study’s significance is helpful not just for the impact statement (if the journal asks for one) but also for building a more compelling argument throughout your submission. For instance, usually you’ll start the Discussion section of a paper by highlighting the research significance of your work. You’ll also include a short description in your Abstract too.

How to describe the research significance of a study, with examples

Whether you’re writing a thesis or a journal article, the approach to writing about the significance of a study are broadly the same.

I’d therefore suggest using the questions above as a starting point to base your statements on.

• Why is the work submitted important to the field?
• How does the work submitted advance the field?
• What new information does this work impart to the field?
• How does this new information impact the field?

Answer those questions and you’ll have a much clearer idea of the research significance of your work.

When describing it, try to clearly state what is novel about your study’s contribution to the literature. Then go on to discuss what impact it could have on progressing the field along with recommendations for future work.

Potential sentence starters

If you’re not sure where to start, why not set a 10 minute timer and have a go at trying to finish a few of the following sentences. Not sure on what to put? Have a chat to your supervisor or lab mates and they may be able to suggest some ideas.

• This study is important to the field because…
• These findings advance the field by…
• Our results highlight the importance of…
• Our discoveries impact the field by…

Now you’ve had a go let’s have a look at some real life examples.

Statement of significance examples

A statement of significance / impact:

Impact Statement This review highlights the historical development of the concept of “ideal protein” that began in the 1950s and 1980s for poultry and swine diets, respectively, and the major conceptual deficiencies of the long-standing concept of “ideal protein” in animal nutrition based on recent advances in amino acid (AA) metabolism and functions. Nutritionists should move beyond the “ideal protein” concept to consider optimum ratios and amounts of all proteinogenic AAs in animal foods and, in the case of carnivores, also taurine. This will help formulate effective low-protein diets for livestock, poultry, and fish, while sustaining global animal production. Because they are not only species of agricultural importance, but also useful models to study the biology and diseases of humans as well as companion (e.g. dogs and cats), zoo, and extinct animals in the world, our work applies to a more general readership than the nutritionists and producers of farm animals. Wu G, Li P. The “ideal protein” concept is not ideal in animal nutrition.  Experimental Biology and Medicine . 2022;247(13):1191-1201. doi: 10.1177/15353702221082658

And the same type of section but this time called “Advances in knowledge”:

Advances in knowledge: According to the MY-RADs criteria, size measurements of focal lesions in MRI are now of relevance for response assessment in patients with monoclonal plasma cell disorders. Size changes of 1 or 2 mm are frequently observed due to uncertainty of the measurement only, while the actual focal lesion has not undergone any biological change. Size changes of at least 6 mm or more in  T 1  weighted or  T 2  weighted short tau inversion recovery sequences occur in only 5% or less of cases when the focal lesion has not undergone any biological change. Wennmann M, Grözinger M, Weru V, et al. Test-retest, inter- and intra-rater reproducibility of size measurements of focal bone marrow lesions in MRI in patients with multiple myeloma [published online ahead of print, 2023 Apr 12].  Br J Radiol . 2023;20220745. doi: 10.1259/bjr.20220745

Other examples of research significance

Moving beyond the formal statement of significance, here is how you can describe research significance more broadly within your paper.

Describing research impact in an Abstract of a paper:

Three-dimensional visualisation and quantification of the chondrocyte population within articular cartilage can be achieved across a field of view of several millimetres using laboratory-based micro-CT. The ability to map chondrocytes in 3D opens possibilities for research in fields from skeletal development through to medical device design and treatment of cartilage degeneration. Conclusions section of the abstract in my first paper .

In the Discussion section of a paper:

We report for the utility of a standard laboratory micro-CT scanner to visualise and quantify features of the chondrocyte population within intact articular cartilage in 3D. This study represents a complimentary addition to the growing body of evidence supporting the non-destructive imaging of the constituents of articular cartilage. This offers researchers the opportunity to image chondrocyte distributions in 3D without specialised synchrotron equipment, enabling investigations such as chondrocyte morphology across grades of cartilage damage, 3D strain mapping techniques such as digital volume correlation to evaluate mechanical properties  in situ , and models for 3D finite element analysis  in silico  simulations. This enables an objective quantification of chondrocyte distribution and morphology in three dimensions allowing greater insight for investigations into studies of cartilage development, degeneration and repair. One such application of our method, is as a means to provide a 3D pattern in the cartilage which, when combined with digital volume correlation, could determine 3D strain gradient measurements enabling potential treatment and repair of cartilage degeneration. Moreover, the method proposed here will allow evaluation of cartilage implanted with tissue engineered scaffolds designed to promote chondral repair, providing valuable insight into the induced regenerative process. The Discussion section of the paper is laced with references to research significance.

How is longer term research significance measured?

Looking beyond writing impact statements within papers, sometimes you’ll want to quantify the long term research significance of your work. For instance when applying for jobs.

The most obvious measure of a study’s long term research significance is the number of citations it receives from future publications. The thinking is that a study which receives more citations will have had more research impact, and therefore significance , than a study which received less citations. Citations can give a broad indication of how useful the work is to other researchers but citations aren’t really a good measure of significance.

Bear in mind that us researchers can be lazy folks and sometimes are simply looking to cite the first paper which backs up one of our claims. You can find studies which receive a lot of citations simply for packaging up the obvious in a form which can be easily found and referenced, for instance by having a catchy or optimised title.

Likewise, research activity varies wildly between fields. Therefore a certain study may have had a big impact on a particular field but receive a modest number of citations, simply because not many other researchers are working in the field.

Nevertheless, citations are a standard measure of significance and for better or worse it remains impressive for someone to be the first author of a publication receiving lots of citations.

Other measures for the research significance of a study include:

• Accolades: best paper awards at conferences, thesis awards, “most downloaded” titles for articles, press coverage.
• How much follow-on research the study creates. For instance, part of my PhD involved a novel material initially developed by another PhD student in the lab. That PhD student’s research had unlocked lots of potential new studies and now lots of people in the group were using the same material and developing it for different applications. The initial study may not receive a high number of citations yet long term it generated a lot of research activity.

That covers research significance, but you’ll often want to consider other types of significance for your study and we’ll cover those next.

Statistical Significance

What is the statistical significance of a study.

Often as part of a study you’ll carry out statistical tests and then state the statistical significance of your findings: think p-values eg <0.05. It is useful to describe the outcome of these tests within your report or paper, to give a measure of statistical significance.

Effectively you are trying to show whether the performance of your innovation is actually better than a control or baseline and not just chance. Statistical significance deserves a whole other post so I won’t go into a huge amount of depth here.

Things that make publication in  The BMJ  impossible or unlikely Internal validity/robustness of the study • It had insufficient statistical power, making interpretation difficult; • Lack of statistical power; The British Medical Journal’s guide for authors

Calculating statistical significance isn’t always necessary (or valid) for a study, such as if you have a very small number of samples, but it is a very common requirement for scientific articles.

Writing a journal article? Check the journal’s guide for authors to see what they expect. Generally if you have approximately five or more samples or replicates it makes sense to start thinking about statistical tests. Speak to your supervisor and lab mates for advice, and look at other published articles in your field.

How is statistical significance measured?

Statistical significance is quantified using p-values . Depending on your study design you’ll choose different statistical tests to compute the p-value.

A p-value of 0.05 is a common threshold value. The 0.05 means that there is a 1/20 chance that the difference in performance you’re reporting is just down to random chance.

• p-values above 0.05 mean that the result isn’t statistically significant enough to be trusted: it is too likely that the effect you’re showing is just luck.
• p-values less than or equal to 0.05 mean that the result is statistically significant. In other words: unlikely to just be chance, which is usually considered a good outcome.

Low p-values (eg p = 0.001) mean that it is highly unlikely to be random chance (1/1000 in the case of p = 0.001), therefore more statistically significant.

It is important to clarify that, although low p-values mean that your findings are statistically significant, it doesn’t automatically mean that the result is scientifically important. More on that in the next section on research significance.

How to describe the statistical significance of your study, with examples

In the first paper from my PhD I ran some statistical tests to see if different staining techniques (basically dyes) increased how well you could see cells in cow tissue using micro-CT scanning (a 3D imaging technique).

In your methods section you should mention the statistical tests you conducted and then in the results you will have statements such as:

Between mediums for the two scan protocols C/N [contrast to noise ratio] was greater for EtOH than the PBS in both scanning methods (both  p  < 0.0001) with mean differences of 1.243 (95% CI [confidence interval] 0.709 to 1.778) for absorption contrast and 6.231 (95% CI 5.772 to 6.690) for propagation contrast. … Two repeat propagation scans were taken of samples from the PTA-stained groups. No difference in mean C/N was found with either medium: PBS had a mean difference of 0.058 ( p  = 0.852, 95% CI -0.560 to 0.676), EtOH had a mean difference of 1.183 ( p  = 0.112, 95% CI 0.281 to 2.648). From the Results section of my first paper, available here . Square brackets added for this post to aid clarity.

From this text the reader can infer from the first paragraph that there was a statistically significant difference in using EtOH compared to PBS (really small p-value of <0.0001). However, from the second paragraph, the difference between two repeat scans was statistically insignificant for both PBS (p = 0.852) and EtOH (p = 0.112).

By conducting these statistical tests you have then earned your right to make bold statements, such as these from the discussion section:

Propagation phase-contrast increases the contrast of individual chondrocytes [cartilage cells] compared to using absorption contrast. From the Discussion section from the same paper.

Without statistical tests you have no evidence that your results are not just down to random chance.

Beyond describing the statistical significance of a study in the main body text of your work, you can also show it in your figures.

In figures such as bar charts you’ll often see asterisks to represent statistical significance, and “n.s.” to show differences between groups which are not statistically significant. Here is one such figure, with some subplots, from the same paper:

In this example an asterisk (*) between two bars represents p < 0.05. Two asterisks (**) represents p < 0.001 and three asterisks (***) represents p < 0.0001. This should always be stated in the caption of your figure since the values that each asterisk refers to can vary.

Now that we know if a study is showing statistically and research significance, let’s zoom out a little and consider the potential for commercial significance.

Commercial and Industrial Significance

What are commercial and industrial significance.

Moving beyond significance in relation to academia, your research may also have commercial or economic significance.

Simply put:

• Commercial significance: could the research be commercialised as a product or service? Perhaps the underlying technology described in your study could be licensed to a company or you could even start your own business using it.
• Industrial significance: more widely than just providing a product which could be sold, does your research provide insights which may affect a whole industry? Such as: revealing insights or issues with current practices, performance gains you don’t want to commercialise (e.g. solar power efficiency), providing suggested frameworks or improvements which could be employed industry-wide.

I’ve grouped these two together because there can certainly be overlap. For instance, perhaps your new technology could be commercialised whilst providing wider improvements for the whole industry.

Commercial and industrial significance are not relevant to most studies, so only write about it if you and your supervisor can think of reasonable routes to your work having an impact in these ways.

How are commercial and industrial significance measured?

Unlike statistical and research significances, the measures of commercial and industrial significance can be much more broad.

Here are some potential measures of significance:

Commercial significance:

• How much value does your technology bring to potential customers or users?
• How big is the potential market and how much revenue could the product potentially generate?
• Is the intellectual property protectable? i.e. patentable, or if not could the novelty be protected with trade secrets: if so publish your method with caution!
• If commercialised, could the product bring employment to a geographical area?

Industrial significance:

What impact could it have on the industry? For instance if you’re revealing an issue with something, such as unintended negative consequences of a drug , what does that mean for the industry and the public? This could be:

• Reduced overhead costs
• Better safety
• Faster production methods
• Improved scaleability

How to describe the commercial and industrial significance of a study, with examples

Commercial significance.

If your technology could be commercially viable, and you’ve got an interest in commercialising it yourself, it is likely that you and your university may not want to immediately publish the study in a journal.

You’ll probably want to consider routes to exploiting the technology and your university may have a “technology transfer” team to help researchers navigate the various options.

However, if instead of publishing a paper you’re submitting a thesis or dissertation then it can be useful to highlight the commercial significance of your work. In this instance you could include statements of commercial significance such as:

The measurement technology described in this study provides state of the art performance and could enable the development of low cost devices for aerospace applications. An example of commercial significance I invented for this post

Industrial significance

First, think about the industrial sectors who could benefit from the developments described in your study.

For example if you’re working to improve battery efficiency it is easy to think of how it could lead to performance gains for certain industries, like personal electronics or electric vehicles. In these instances you can describe the industrial significance relatively easily, based off your findings.

For example:

By utilising abundant materials in the described battery fabrication process we provide a framework for battery manufacturers to reduce dependence on rare earth components. Again, an invented example

For other technologies there may well be industrial applications but they are less immediately obvious and applicable. In these scenarios the best you can do is to simply reframe your research significance statement in terms of potential commercial applications in a broad way.

As a reminder: not all studies should address industrial significance, so don’t try to invent applications just for the sake of it!

Societal Significance

What is the societal significance of a study.

The most broad category of significance is the societal impact which could stem from it.

If you’re working in an applied field it may be quite easy to see a route for your research to impact society. For others, the route to societal significance may be less immediate or clear.

Studies can help with big issues facing society such as:

• Medical applications : vaccines, surgical implants, drugs, improving patient safety. For instance this medical device and drug combination I worked on which has a very direct route to societal significance.
• Political significance : Your research may provide insights which could contribute towards potential changes in policy or better understanding of issues facing society.
• Public health : for instance COVID-19 transmission and related decisions.
• Climate change : mitigation such as more efficient solar panels and lower cost battery solutions, and studying required adaptation efforts and technologies. Also, better understanding around related societal issues, for instance this study on the effects of temperature on hate speech.

How is societal significance measured?

Societal significance at a high level can be quantified by the size of its potential societal effect. Just like a lab risk assessment, you can think of it in terms of probability (or how many people it could help) and impact magnitude.

Societal impact = How many people it could help x the magnitude of the impact

Think about how widely applicable the findings are: for instance does it affect only certain people? Then think about the potential size of the impact: what kind of difference could it make to those people?

Between these two metrics you can get a pretty good overview of the potential societal significance of your research study.

How to describe the societal significance of a study, with examples

Quite often the broad societal significance of your study is what you’re setting the scene for in your Introduction. In addition to describing the existing literature, it is common to for the study’s motivation to touch on its wider impact for society.

For those of us working in healthcare research it is usually pretty easy to see a path towards societal significance.

Our CLOUT model has state-of-the-art performance in mortality prediction, surpassing other competitive NN models and a logistic regression model … Our results show that the risk factors identified by the CLOUT model agree with physicians’ assessment, suggesting that CLOUT could be used in real-world clinicalsettings. Our results strongly support that CLOUT may be a useful tool to generate clinical prediction models, especially among hospitalized and critically ill patient populations. Learning Latent Space Representations to Predict Patient Outcomes: Model Development and Validation

In other domains the societal significance may either take longer or be more indirect, meaning that it can be more difficult to describe the societal impact.

Even so, here are some examples I’ve found from studies in non-healthcare domains:

We examined food waste as an initial investigation and test of this methodology, and there is clear potential for the examination of not only other policy texts related to food waste (e.g., liability protection, tax incentives, etc.; Broad Leib et al., 2020) but related to sustainable fishing (Worm et al., 2006) and energy use (Hawken, 2017). These other areas are of obvious relevance to climate change… AI-Based Text Analysis for Evaluating Food Waste Policies

The continued development of state-of-the art NLP tools tailored to climate policy will allow climate researchers and policy makers to extract meaningful information from this growing body of text, to monitor trends over time and administrative units, and to identify potential policy improvements. BERT Classification of Paris Agreement Climate Action Plans

Top Tips For Identifying & Writing About the Significance of Your Study

• Writing a thesis? Describe the significance of your study in the Introduction and the Conclusion .
• Submitting a paper? Read the journal’s guidelines. If you’re writing a statement of significance for a journal, make sure you read any guidance they give for what they’re expecting.
• Take a step back from your research and consider your study’s main contributions.
• Read previously published studies in your field . Use this for inspiration and ideas on how to describe the significance of your own study
• Discuss the study with your supervisor and potential co-authors or collaborators and brainstorm potential types of significance for it.

Now you’ve finished reading up on the significance of a study you may also like my how-to guide for all aspects of writing your first research paper .

Writing an academic journal paper

I hope that you’ve learned something useful from this article about the significance of a study. If you have any more research-related questions let me know, I’m here to help.

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What is the Significance of the Study?

• By DiscoverPhDs
• August 25, 2020

• what the significance of the study means,
• why it’s important to include in your research work,
• where you would include it in your paper, thesis or dissertation,
• how you write one
• and finally an example of a well written section about the significance of the study.

What does Significance of the Study mean?

The significance of the study is a written statement that explains why your research was needed. It’s a justification of the importance of your work and impact it has on your research field, it’s contribution to new knowledge and how others will benefit from it.

Why is the Significance of the Study important?

The significance of the study, also known as the rationale of the study, is important to convey to the reader why the research work was important. This may be an academic reviewer assessing your manuscript under peer-review, an examiner reading your PhD thesis, a funder reading your grant application or another research group reading your published journal paper. Your academic writing should make clear to the reader what the significance of the research that you performed was, the contribution you made and the benefits of it.

How do you write the Significance of the Study?

When writing this section, first think about where the gaps in knowledge are in your research field. What are the areas that are poorly understood with little or no previously published literature? Or what topics have others previously published on that still require further work. This is often referred to as the problem statement.

The introduction section within the significance of the study should include you writing the problem statement and explaining to the reader where the gap in literature is.

Then think about the significance of your research and thesis study from two perspectives: (1) what is the general contribution of your research on your field and (2) what specific contribution have you made to the knowledge and who does this benefit the most.

For example, the gap in knowledge may be that the benefits of dumbbell exercises for patients recovering from a broken arm are not fully understood. You may have performed a study investigating the impact of dumbbell training in patients with fractures versus those that did not perform dumbbell exercises and shown there to be a benefit in their use. The broad significance of the study would be the improvement in the understanding of effective physiotherapy methods. Your specific contribution has been to show a significant improvement in the rate of recovery in patients with broken arms when performing certain dumbbell exercise routines.

This statement should be no more than 500 words in length when written for a thesis. Within a research paper, the statement should be shorter and around 200 words at most.

Significance of the Study: An example

Building on the above hypothetical academic study, the following is an example of a full statement of the significance of the study for you to consider when writing your own. Keep in mind though that there’s no single way of writing the perfect significance statement and it may well depend on the subject area and the study content.

Here’s another example to help demonstrate how a significance of the study can also be applied to non-technical fields:

The significance of this research lies in its potential to inform clinical practices and patient counseling. By understanding the psychological outcomes associated with non-surgical facial aesthetics, practitioners can better guide their patients in making informed decisions about their treatment plans. Additionally, this study contributes to the body of academic knowledge by providing empirical evidence on the effects of these cosmetic procedures, which have been largely anecdotal up to this point.

The statement of the significance of the study is used by students and researchers in academic writing to convey the importance of the research performed; this section is written at the end of the introduction and should describe the specific contribution made and who it benefits.

A science investigatory project is a science-based research project or study that is performed by school children in a classroom, exhibition or science fair.

In Finland, all new PhD holders are given a traditional Doctoral Hat and Doctoral Sword during a Conferment Ceremony, symbolising the freedom of research.

Learn more about using cloud storage effectively, video conferencing calling, good note-taking solutions and online calendar and task management options.

Join thousands of other students and stay up to date with the latest PhD programmes, funding opportunities and advice.

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How To Write a Significance Statement for Your Research

A significance statement is an essential part of a research paper. It explains the importance and relevance of the study to the academic community and the world at large. To write a compelling significance statement, identify the research problem, explain why it is significant, provide evidence of its importance, and highlight its potential impact on future research, policy, or practice. A well-crafted significance statement should effectively communicate the value of the research to readers and help them understand why it matters.

Updated on May 4, 2023

A significance statement is a clearly stated, non-technical paragraph that explains why your research matters. It’s central in making the public aware of and gaining support for your research.

Write it in jargon-free language that a reader from any field can understand. Well-crafted, easily readable significance statements can improve your chances for citation and impact and make it easier for readers outside your field to find and understand your work.

Read on for more details on what a significance statement is, how it can enhance the impact of your research, and, of course, how to write one.

What is a significance statement in research?

A significance statement answers the question: How will your research advance scientific knowledge and impact society at large (as well as specific populations)? 

You might also see it called a “Significance of the study” statement. Some professional organizations in the STEM sciences and social sciences now recommended that journals in their disciplines make such statements a standard feature of each published article. Funding agencies also consider “significance” a key criterion for their awards.

Read some examples of significance statements from the Proceedings of the National Academy of Sciences (PNAS) here .

Depending upon the specific journal or funding agency’s requirements, your statement may be around 100 words and answer these questions:

1. What’s the purpose of this research?

2. What are its key findings?

3. Why do they matter?

4. Who benefits from the research results?

Readers will want to know: “What is interesting or important about this research?” Keep asking yourself that question.

Where to place the significance statement in your manuscript

Most journals ask you to place the significance statement before or after the abstract, so check with each journal’s guide. 

This article is focused on the formal significance statement, even though you’ll naturally highlight your project’s significance elsewhere in your manuscript. (In the introduction, you’ll set out your research aims, and in the conclusion, you’ll explain the potential applications of your research and recommend areas for future research. You’re building an overall case for the value of your work.)

Developing the significance statement

The main steps in planning and developing your statement are to assess the gaps to which your study contributes, and then define your work’s implications and impact.

Identify what gaps your study fills and what it contributes

Your literature review was a big part of how you planned your study. To develop your research aims and objectives, you identified gaps or unanswered questions in the preceding research and designed your study to address them.

Go back to that lit review and look at those gaps again. Review your research proposal to refresh your memory. Ask:

• How have my research findings advanced knowledge or provided notable new insights?
• How has my research helped to prove (or disprove) a hypothesis or answer a research question?
• Why are those results important?

Consider your study’s potential impact at two levels: 

• What contribution does my research make to my field?
• How does it specifically contribute to knowledge; that is, who will benefit the most from it?

Define the implications and potential impact

As you make notes, keep the reasons in mind for why you are writing this statement. Whom will it impact, and why?

The first audience for your significance statement will be journal reviewers when you submit your article for publishing. Many journals require one for manuscript submissions. Study the author’s guide of your desired journal to see its criteria ( here’s an example ). Peer reviewers who can clearly understand the value of your research will be more likely to recommend publication. 

Second, when you apply for funding, your significance statement will help justify why your research deserves a grant from a funding agency . The U.S. National Institutes of Health (NIH), for example, wants to see that a project will “exert a sustained, powerful influence on the research field(s) involved.” Clear, simple language is always valuable because not all reviewers will be specialists in your field.

Third, this concise statement about your study’s importance can affect how potential readers engage with your work. Science journalists and interested readers can promote and spread your work, enhancing your reputation and influence. Help them understand your work.

You’re now ready to express the importance of your research clearly and concisely. Time to start writing.

How to write a significance statement: Key elements 

When drafting your statement, focus on both the content and writing style.

• In terms of content, emphasize the importance, timeliness, and relevance of your research results. 
• Write the statement in plain, clear language rather than scientific or technical jargon. Your audience will include not just your fellow scientists but also non-specialists like journalists, funding reviewers, and members of the public. 

Follow the process we outline below to build a solid, well-crafted, and informative statement. 

Get started

Some suggested opening lines to help you get started might be:

• The implications of this study are… 
• Building upon previous contributions, our study moves the field forward because…
• Our study furthers previous understanding about…

Alternatively, you may start with a statement about the phenomenon you’re studying, leading to the problem statement.

Include these components

Next, draft some sentences that include the following elements. A good example, which we’ll use here, is a significance statement by Rogers et al. (2022) published in the Journal of Climate .

1. Briefly situate your research study in its larger context . Start by introducing the topic, leading to a problem statement. Here’s an example:

‘Heatwaves pose a major threat to human health, ecosystems, and human systems.”

2. State the research problem.

“Simultaneous heatwaves affecting multiple regions can exacerbate such threats. For example, multiple food-producing regions simultaneously undergoing heat-related crop damage could drive global food shortages.”

3. Tell what your study does to address it.

“We assess recent changes in the occurrence of simultaneous large heatwaves.”

4. Provide brief but powerful evidence to support the claims your statement is making , Use quantifiable terms rather than vague ones (e.g., instead of “This phenomenon is happening now more than ever,” see below how Rogers et al. (2022) explained it). This evidence intensifies and illustrates the problem more vividly:

“Such simultaneous heatwaves are 7 times more likely now than 40 years ago. They are also hotter and affect a larger area. Their increasing occurrence is mainly driven by warming baseline temperatures due to global heating, but changes in weather patterns contribute to disproportionate increases over parts of Europe, the eastern United States, and Asia.

5. Relate your study’s impact to the broader context , starting with its general significance to society—then, when possible, move to the particular as you name specific applications of your research findings. (Our example lacks this second level of application.) 

“Better understanding the drivers of weather pattern changes is therefore important for understanding future concurrent heatwave characteristics and their impacts.”

Refine your English

Don’t understate or overstate your findings – just make clear what your study contributes. When you have all the elements in place, review your draft to simplify and polish your language. Even better, get an expert AJE edit . Be sure to use “plain” language rather than academic jargon.

• Avoid acronyms, scientific jargon, and technical terms 
• Use active verbs in your sentence structure rather than passive voice (e.g., instead of “It was found that...”, use “We found...”)
• Make sentence structures short, easy to understand – readable
• Try to address only one idea in each sentence and keep sentences within 25 words (15 words is even better)
• Eliminate nonessential words and phrases (“fluff” and wordiness)

Enhance your significance statement’s impact

Always take time to review your draft multiple times. Make sure that you:

• Keep your language focused
• Provide evidence to support your claims
• Relate the significance to the broader research context in your field

After revising your significance statement, request feedback from a reading mentor about how to make it even clearer. If you’re not a native English speaker, seek help from a native-English-speaking colleague or use an editing service like AJE to make sure your work is at a native level.

Understanding the significance of your study

Your readers may have much less interest than you do in the specific details of your research methods and measures. Many readers will scan your article to learn how your findings might apply to them and their own research. 

Different types of significance

Your findings may have different types of significance, relevant to different populations or fields of study for different reasons. You can emphasize your work’s statistical, clinical, or practical significance. Editors or reviewers in the social sciences might also evaluate your work’s social or political significance.

Statistical significance means that the results are unlikely to have occurred randomly. Instead, it implies a true cause-and-effect relationship.

Clinical significance means that your findings are applicable for treating patients and improving quality of life.

Practical significance is when your research outcomes are meaningful to society at large, in the “real world.” Practical significance is usually measured by the study’s  effect size . Similarly, evaluators may attribute social or political significance to research that addresses “real and immediate” social problems.

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• Writing Tips

How to Discuss the Significance of Your Research

• 6-minute read
• 10th April 2023

Introduction

Research papers can be a real headache for college students . As a student, your research needs to be credible enough to support your thesis statement. You must also ensure you’ve discussed the literature review, findings, and results.

However, it’s also important to discuss the significance of your research . Your potential audience will care deeply about this. It will also help you conduct your research. By knowing the impact of your research, you’ll understand what important questions to answer.

If you’d like to know more about the impact of your research, read on! We’ll talk about why it’s important and how to discuss it in your paper.

What Is the Significance of Research?

This is the potential impact of your research on the field of study. It includes contributions from new knowledge from the research and those who would benefit from it. You should present this before conducting research, so you need to be aware of current issues associated with the thesis before discussing the significance of the research.

Why Does the Significance of Research Matter?

Potential readers need to know why your research is worth pursuing. Discussing the significance of research answers the following questions:

●  Why should people read your research paper ?

●  How will your research contribute to the current knowledge related to your topic?

●  What potential impact will it have on the community and professionals in the field?

Not including the significance of research in your paper would be like a knight trying to fight a dragon without weapons.

Where Do I Discuss the Significance of Research in My Paper?

As previously mentioned, the significance of research comes before you conduct it. Therefore, you should discuss the significance of your research in the Introduction section. Your reader should know the problem statement and hypothesis beforehand.

Steps to Discussing the Significance of Your Research

Discussing the significance of research might seem like a loaded question, so we’ve outlined some steps to help you tackle it.

Step 1: The Research Problem

The problem statement can reveal clues about the outcome of your research. Your research should provide answers to the problem, which is beneficial to all those concerned. For example, imagine the problem statement is, “To what extent do elementary and high school teachers believe cyberbullying affects student performance?”

Learning teachers’ opinions on the effects of cyberbullying on student performance could result in the following:

●  Increased public awareness of cyberbullying in elementary and high schools

●  Teachers’ perceptions of cyberbullying negatively affecting student performance

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●  Whether cyberbullying is more prevalent in elementary or high schools

The research problem will steer your research in the right direction, so it’s best to start with the problem statement.

Step 2: Existing Literature in the Field

Think about current information on your topic, and then find out what information is missing. Are there any areas that haven’t been explored? Your research should add new information to the literature, so be sure to state this in your discussion. You’ll need to know the current literature on your topic anyway, as this is part of your literature review section .

Step 3: Your Research’s Impact on Society

Inform your readers about the impact on society your research could have on it. For example, in the study about teachers’ opinions on cyberbullying, you could mention that your research will educate the community about teachers’ perceptions of cyberbullying as it affects student performance. As a result, the community will know how many teachers believe cyberbullying affects student performance.

You can also mention specific individuals and institutions that would benefit from your study. In the example of cyberbullying, you might indicate that school principals and superintendents would benefit from your research.

Step 4: Future Studies in the Field

Next, discuss how the significance of your research will benefit future studies, which is especially helpful for future researchers in your field. In the example of cyberbullying affecting student performance, your research could provide further opportunities to assess teacher perceptions of cyberbullying and its effects on students from larger populations. This prepares future researchers for data collection and analysis.

Discussing the significance of your research may sound daunting when you haven’t conducted it yet. However, an audience might not read your paper if they don’t know the significance of the research. By focusing on the problem statement and the research benefits to society and future studies, you can convince your audience of the value of your research.

Remember that everything you write doesn’t have to be set in stone. You can go back and tweak the significance of your research after conducting it. At first, you might only include general contributions of your study, but as you research, your contributions will become more specific.

You should have a solid understanding of your topic in general, its associated problems, and the literature review before tackling the significance of your research. However, you’re not trying to prove your thesis statement at this point. The significance of research just convinces the audience that your study is worth reading.

Finally, we always recommend seeking help from your research advisor whenever you’re struggling with ideas. For a more visual idea of how to discuss the significance of your research, we suggest checking out this video .

1. Do I need to do my research before discussing its significance?

No, you’re discussing the significance of your research before you conduct it. However, you should be knowledgeable about your topic and the related literature.

2. Is the significance of research the same as its implications?

No, the research implications are potential questions from your study that justify further exploration, which comes after conducting the research.

 3. Discussing the significance of research seems overwhelming. Where should I start?

We recommend the problem statement as a starting point, which reveals clues to the potential outcome of your research.

4. How can I get feedback on my discussion of the significance of my research?

Our proofreading experts can help. They’ll check your writing for grammar, punctuation errors, spelling, and concision. Submit a 500-word document for free today!

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The significance of a study is its importance . It refers to the contribution(s) to and impact of the study on a research field. The significance also signals who benefits from the research findings and how.

Purpose of writing the significance of a study

A study’s significance should spark the interest of the reader. Researchers will be able to appreciate your work better when they understand the relevance and its (potential) impact. Peer reviewers also assess the significance of the work, which will influence the decision made (acceptance/rejection) on the manuscript. 

Sections in which the significance of the study is written

Introduction.

In the Introduction of your paper, the significance appears where you talk about the potential importance and impact of the study. It should flow naturally from the problem , aims and objectives, and rationale .

The significance is described in more detail in the concluding paragraph(s) of the Discussion or the dedicated Conclusions section. Here, you put the findings into perspective and outline the contributions of the findings in terms of implications and applications.

The significance may or may not appear in the abstract . When it does, it is written in the concluding lines of the abstract.

Significance vs. other introductory elements of your paper

In the Introduction…

• The problem statement outlines the concern that needs to be addressed.
• The research aim describes the purpose of the study.
• The objectives indicate how that aim will be achieved.
• The rationale explains why you are performing the study.
• The significance tells the reader how the findings affect the topic/broad field. In other words, the significance is about how much the findings matter.

How to write the significance of the study

A good significance statement may be written in different ways. The approach to writing it also depends on the study area. In the arts and humanities , the significance statement might be longer and more descriptive. In applied sciences , it might be more direct.

a. Suggested sequence for writing the significance statement

• Think of the gaps your study is setting out to address.
• Look at your research from general and specific angles in terms of its (potential) contribution .
• Once you have these points ready, start writing them, connecting them to your study as a whole.

b. Some ways to begin your statement(s) of significance

Here are some opening lines to build on:

• The particular significance of this study lies in the… 
• We argue that this study moves the field forward because…
• This study makes some important contributions to…
• Our findings deepen the current understanding about…

c. Don’ts of writing a significance statement

• Don’t make it too long .
• Don’t repeat any information that has been presented in other sections.
• Don’t overstate or exaggerat e the importance; it should match your actual findings.

Example of significance of a study

Note the significance statements highlighted in the following fictional study.

Significance in the Introduction

The effects of Miyawaki forests on local biodiversity in urban housing complexes remain poorly understood. No formal studies on negative impacts on insect activity, populations or diversity have been undertaken thus far. In this study, we compared the effects that Miyawaki forests in urban dwellings have on local pollinator activity. The findings of this study will help improve the design of this afforestation technique in a way that balances local fauna, particularly pollinators, which are highly sensitive to microclimatic changes.

Significance in the Conclusion

[…] The findings provide valuable insights for guiding and informing Miyawaki afforestation in urban dwellings. We demonstrate that urban planning and landscaping policies need to consider potential declines.

A study’s significance usually appears at the end of the Introduction and in the Conclusion to describe the importance of the research findings. A strong and clear significance statement will pique the interest of readers, as well as that of relevant stakeholders.

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A research problem is a definite or clear expression [statement] about an area of concern, a condition to be improved upon, a difficulty to be eliminated, or a troubling question that exists in scholarly literature, in theory, or within existing practice that points to a need for meaningful understanding and deliberate investigation. A research problem does not state how to do something, offer a vague or broad proposition, or present a value question. In the social and behavioral sciences, studies are most often framed around examining a problem that needs to be understood and resolved in order to improve society and the human condition.

Bryman, Alan. “The Research Question in Social Research: What is its Role?” International Journal of Social Research Methodology 10 (2007): 5-20; Guba, Egon G., and Yvonna S. Lincoln. “Competing Paradigms in Qualitative Research.” In Handbook of Qualitative Research . Norman K. Denzin and Yvonna S. Lincoln, editors. (Thousand Oaks, CA: Sage, 1994), pp. 105-117; Pardede, Parlindungan. “Identifying and Formulating the Research Problem." Research in ELT: Module 4 (October 2018): 1-13; Li, Yanmei, and Sumei Zhang. "Identifying the Research Problem." In Applied Research Methods in Urban and Regional Planning . (Cham, Switzerland: Springer International Publishing, 2022), pp. 13-21.

Importance of...

The purpose of a problem statement is to:

• Introduce the reader to the importance of the topic being studied . The reader is oriented to the significance of the study.
• Anchors the research questions, hypotheses, or assumptions to follow . It offers a concise statement about the purpose of your paper.
• Place the topic into a particular context that defines the parameters of what is to be investigated.
• Provide the framework for reporting the results and indicates what is probably necessary to conduct the study and explain how the findings will present this information.

In the social sciences, the research problem establishes the means by which you must answer the "So What?" question. This declarative question refers to a research problem surviving the relevancy test [the quality of a measurement procedure that provides repeatability and accuracy]. Note that answering the "So What?" question requires a commitment on your part to not only show that you have reviewed the literature, but that you have thoroughly considered the significance of the research problem and its implications applied to creating new knowledge and understanding or informing practice.

To survive the "So What" question, problem statements should possess the following attributes:

• Clarity and precision [a well-written statement does not make sweeping generalizations and irresponsible pronouncements; it also does include unspecific determinates like "very" or "giant"],
• Demonstrate a researchable topic or issue [i.e., feasibility of conducting the study is based upon access to information that can be effectively acquired, gathered, interpreted, synthesized, and understood],
• Identification of what would be studied, while avoiding the use of value-laden words and terms,
• Identification of an overarching question or small set of questions accompanied by key factors or variables,
• Identification of key concepts and terms,
• Articulation of the study's conceptual boundaries or parameters or limitations,
• Some generalizability in regards to applicability and bringing results into general use,
• Conveyance of the study's importance, benefits, and justification [i.e., regardless of the type of research, it is important to demonstrate that the research is not trivial],
• Does not have unnecessary jargon or overly complex sentence constructions; and,
• Conveyance of more than the mere gathering of descriptive data providing only a snapshot of the issue or phenomenon under investigation.

Bryman, Alan. “The Research Question in Social Research: What is its Role?” International Journal of Social Research Methodology 10 (2007): 5-20; Brown, Perry J., Allen Dyer, and Ross S. Whaley. "Recreation Research—So What?" Journal of Leisure Research 5 (1973): 16-24; Castellanos, Susie. Critical Writing and Thinking. The Writing Center. Dean of the College. Brown University; Ellis, Timothy J. and Yair Levy Nova. "Framework of Problem-Based Research: A Guide for Novice Researchers on the Development of a Research-Worthy Problem." Informing Science: the International Journal of an Emerging Transdiscipline 11 (2008); Thesis and Purpose Statements. The Writer’s Handbook. Writing Center. University of Wisconsin, Madison; Thesis Statements. The Writing Center. University of North Carolina; Tips and Examples for Writing Thesis Statements. The Writing Lab and The OWL. Purdue University; Selwyn, Neil. "‘So What?’…A Question that Every Journal Article Needs to Answer." Learning, Media, and Technology 39 (2014): 1-5; Shoket, Mohd. "Research Problem: Identification and Formulation." International Journal of Research 1 (May 2014): 512-518.

Structure and Writing Style

I.  Types and Content

There are four general conceptualizations of a research problem in the social sciences:

• Casuist Research Problem -- this type of problem relates to the determination of right and wrong in questions of conduct or conscience by analyzing moral dilemmas through the application of general rules and the careful distinction of special cases.
• Difference Research Problem -- typically asks the question, “Is there a difference between two or more groups or treatments?” This type of problem statement is used when the researcher compares or contrasts two or more phenomena. This a common approach to defining a problem in the clinical social sciences or behavioral sciences.
• Descriptive Research Problem -- typically asks the question, "what is...?" with the underlying purpose to describe the significance of a situation, state, or existence of a specific phenomenon. This problem is often associated with revealing hidden or understudied issues.
• Relational Research Problem -- suggests a relationship of some sort between two or more variables to be investigated. The underlying purpose is to investigate specific qualities or characteristics that may be connected in some way.

A problem statement in the social sciences should contain :

• A lead-in that helps ensure the reader will maintain interest over the study,
• A declaration of originality [e.g., mentioning a knowledge void or a lack of clarity about a topic that will be revealed in the literature review of prior research],
• An indication of the central focus of the study [establishing the boundaries of analysis], and
• An explanation of the study's significance or the benefits to be derived from investigating the research problem.

NOTE:   A statement describing the research problem of your paper should not be viewed as a thesis statement that you may be familiar with from high school. Given the content listed above, a description of the research problem is usually a short paragraph in length.

II.  Sources of Problems for Investigation

The identification of a problem to study can be challenging, not because there's a lack of issues that could be investigated, but due to the challenge of formulating an academically relevant and researchable problem which is unique and does not simply duplicate the work of others. To facilitate how you might select a problem from which to build a research study, consider these sources of inspiration:

Deductions from Theory This relates to deductions made from social philosophy or generalizations embodied in life and in society that the researcher is familiar with. These deductions from human behavior are then placed within an empirical frame of reference through research. From a theory, the researcher can formulate a research problem or hypothesis stating the expected findings in certain empirical situations. The research asks the question: “What relationship between variables will be observed if theory aptly summarizes the state of affairs?” One can then design and carry out a systematic investigation to assess whether empirical data confirm or reject the hypothesis, and hence, the theory.

Interdisciplinary Perspectives Identifying a problem that forms the basis for a research study can come from academic movements and scholarship originating in disciplines outside of your primary area of study. This can be an intellectually stimulating exercise. A review of pertinent literature should include examining research from related disciplines that can reveal new avenues of exploration and analysis. An interdisciplinary approach to selecting a research problem offers an opportunity to construct a more comprehensive understanding of a very complex issue that any single discipline may be able to provide.

Interviewing Practitioners The identification of research problems about particular topics can arise from formal interviews or informal discussions with practitioners who provide insight into new directions for future research and how to make research findings more relevant to practice. Discussions with experts in the field, such as, teachers, social workers, health care providers, lawyers, business leaders, etc., offers the chance to identify practical, “real world” problems that may be understudied or ignored within academic circles. This approach also provides some practical knowledge which may help in the process of designing and conducting your study.

Personal Experience Don't undervalue your everyday experiences or encounters as worthwhile problems for investigation. Think critically about your own experiences and/or frustrations with an issue facing society or related to your community, your neighborhood, your family, or your personal life. This can be derived, for example, from deliberate observations of certain relationships for which there is no clear explanation or witnessing an event that appears harmful to a person or group or that is out of the ordinary.

Relevant Literature The selection of a research problem can be derived from a thorough review of pertinent research associated with your overall area of interest. This may reveal where gaps exist in understanding a topic or where an issue has been understudied. Research may be conducted to: 1) fill such gaps in knowledge; 2) evaluate if the methodologies employed in prior studies can be adapted to solve other problems; or, 3) determine if a similar study could be conducted in a different subject area or applied in a different context or to different study sample [i.e., different setting or different group of people]. Also, authors frequently conclude their studies by noting implications for further research; read the conclusion of pertinent studies because statements about further research can be a valuable source for identifying new problems to investigate. The fact that a researcher has identified a topic worthy of further exploration validates the fact it is worth pursuing.

III.  What Makes a Good Research Statement?

A good problem statement begins by introducing the broad area in which your research is centered, gradually leading the reader to the more specific issues you are investigating. The statement need not be lengthy, but a good research problem should incorporate the following features:

1.  Compelling Topic The problem chosen should be one that motivates you to address it but simple curiosity is not a good enough reason to pursue a research study because this does not indicate significance. The problem that you choose to explore must be important to you, but it must also be viewed as important by your readers and to a the larger academic and/or social community that could be impacted by the results of your study. 2.  Supports Multiple Perspectives The problem must be phrased in a way that avoids dichotomies and instead supports the generation and exploration of multiple perspectives. A general rule of thumb in the social sciences is that a good research problem is one that would generate a variety of viewpoints from a composite audience made up of reasonable people. 3.  Researchability This isn't a real word but it represents an important aspect of creating a good research statement. It seems a bit obvious, but you don't want to find yourself in the midst of investigating a complex research project and realize that you don't have enough prior research to draw from for your analysis. There's nothing inherently wrong with original research, but you must choose research problems that can be supported, in some way, by the resources available to you. If you are not sure if something is researchable, don't assume that it isn't if you don't find information right away--seek help from a librarian !

NOTE:   Do not confuse a research problem with a research topic. A topic is something to read and obtain information about, whereas a problem is something to be solved or framed as a question raised for inquiry, consideration, or solution, or explained as a source of perplexity, distress, or vexation. In short, a research topic is something to be understood; a research problem is something that needs to be investigated.

IV.  Asking Analytical Questions about the Research Problem

Research problems in the social and behavioral sciences are often analyzed around critical questions that must be investigated. These questions can be explicitly listed in the introduction [i.e., "This study addresses three research questions about women's psychological recovery from domestic abuse in multi-generational home settings..."], or, the questions are implied in the text as specific areas of study related to the research problem. Explicitly listing your research questions at the end of your introduction can help in designing a clear roadmap of what you plan to address in your study, whereas, implicitly integrating them into the text of the introduction allows you to create a more compelling narrative around the key issues under investigation. Either approach is appropriate.

The number of questions you attempt to address should be based on the complexity of the problem you are investigating and what areas of inquiry you find most critical to study. Practical considerations, such as, the length of the paper you are writing or the availability of resources to analyze the issue can also factor in how many questions to ask. In general, however, there should be no more than four research questions underpinning a single research problem.

Given this, well-developed analytical questions can focus on any of the following:

• Highlights a genuine dilemma, area of ambiguity, or point of confusion about a topic open to interpretation by your readers;
• Yields an answer that is unexpected and not obvious rather than inevitable and self-evident;
• Provokes meaningful thought or discussion;
• Raises the visibility of the key ideas or concepts that may be understudied or hidden;
• Suggests the need for complex analysis or argument rather than a basic description or summary; and,
• Offers a specific path of inquiry that avoids eliciting generalizations about the problem.

NOTE:   Questions of how and why concerning a research problem often require more analysis than questions about who, what, where, and when. You should still ask yourself these latter questions, however. Thinking introspectively about the who, what, where, and when of a research problem can help ensure that you have thoroughly considered all aspects of the problem under investigation and helps define the scope of the study in relation to the problem.

V.  Mistakes to Avoid

Beware of circular reasoning! Do not state the research problem as simply the absence of the thing you are suggesting. For example, if you propose the following, "The problem in this community is that there is no hospital," this only leads to a research problem where:

• The need is for a hospital
• The objective is to create a hospital
• The method is to plan for building a hospital, and
• The evaluation is to measure if there is a hospital or not.

This is an example of a research problem that fails the "So What?" test . In this example, the problem does not reveal the relevance of why you are investigating the fact there is no hospital in the community [e.g., perhaps there's a hospital in the community ten miles away]; it does not elucidate the significance of why one should study the fact there is no hospital in the community [e.g., that hospital in the community ten miles away has no emergency room]; the research problem does not offer an intellectual pathway towards adding new knowledge or clarifying prior knowledge [e.g., the county in which there is no hospital already conducted a study about the need for a hospital, but it was conducted ten years ago]; and, the problem does not offer meaningful outcomes that lead to recommendations that can be generalized for other situations or that could suggest areas for further research [e.g., the challenges of building a new hospital serves as a case study for other communities].

Alvesson, Mats and Jörgen Sandberg. “Generating Research Questions Through Problematization.” Academy of Management Review 36 (April 2011): 247-271 ; Choosing and Refining Topics. Writing@CSU. Colorado State University; D'Souza, Victor S. "Use of Induction and Deduction in Research in Social Sciences: An Illustration." Journal of the Indian Law Institute 24 (1982): 655-661; Ellis, Timothy J. and Yair Levy Nova. "Framework of Problem-Based Research: A Guide for Novice Researchers on the Development of a Research-Worthy Problem." Informing Science: the International Journal of an Emerging Transdiscipline 11 (2008); How to Write a Research Question. The Writing Center. George Mason University; Invention: Developing a Thesis Statement. The Reading/Writing Center. Hunter College; Problem Statements PowerPoint Presentation. The Writing Lab and The OWL. Purdue University; Procter, Margaret. Using Thesis Statements. University College Writing Centre. University of Toronto; Shoket, Mohd. "Research Problem: Identification and Formulation." International Journal of Research 1 (May 2014): 512-518; Trochim, William M.K. Problem Formulation. Research Methods Knowledge Base. 2006; Thesis and Purpose Statements. The Writer’s Handbook. Writing Center. University of Wisconsin, Madison; Thesis Statements. The Writing Center. University of North Carolina; Tips and Examples for Writing Thesis Statements. The Writing Lab and The OWL. Purdue University; Pardede, Parlindungan. “Identifying and Formulating the Research Problem." Research in ELT: Module 4 (October 2018): 1-13; Walk, Kerry. Asking an Analytical Question. [Class handout or worksheet]. Princeton University; White, Patrick. Developing Research Questions: A Guide for Social Scientists . New York: Palgrave McMillan, 2009; Li, Yanmei, and Sumei Zhang. "Identifying the Research Problem." In Applied Research Methods in Urban and Regional Planning . (Cham, Switzerland: Springer International Publishing, 2022), pp. 13-21.

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Establishing Rationale and Significance of Research

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This chapter builds on the first five chapters in this handbook that explained the research design typology. The focus here is on establishing rationale and significance of research. This chapter is intended to serve as a guide for practitioners to apply and integrate the research design typology layers into a scholarly manuscript. In contrast to the broad scope of the first five chapters, this chapter concentrates on how to integrate specific components of the typology regardless of which ideology the researcher holds on the continuum (positivist, post-positivist, pragmatist, interpretivist, or constructivist).

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Katz, M. (2010). Toward a new moral paradigm in health care delivery: Accounting for individuals. American Journal Of Law and Medicine , 36 (1), 78–135.

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Kinney, E. (1995). Protecting consumers and providers under health reform: An overview of the major administrative law issues. Health Matrix (Cleveland, Ohio: 1991) , 5 (1), 83–140.

Matteson, L. & Lacey F. M. (2011). Doing your literature review: Traditional and systematic techniques . London: Sage

Mclean, T. R. (2006). The future of telemedicine and its Faustian reliance on regulatory trade barriers for protection. Health Matrix: Journal of Law-Medicine , 16 (2), 443–509.

Saxton, J. & Johns, M. (2010). Barriers to change in engineering the system of health care delivery. Studies in Health Technology and Informatics , 15 (3), 437–463.

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Hahn, J. (2015). Establishing Rationale and Significance of Research. In: Strang, K.D. (eds) The Palgrave Handbook of Research Design in Business and Management. Palgrave Macmillan, New York. https://doi.org/10.1057/9781137484956_7

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The importance of crafting a good introduction to scholarly research: strategies for creating an effective and impactful opening statement

Mohsen tavakol.

1 Medical Education Centre, School of Medicine, The University of Nottingham, UK

David O'Brien

Introduction.

The introduction section is arguably one of the most critical elements of a written piece of research work, often setting the tone for the remainder of any dissertation or research article. The primary purpose of an introduction is to provide the reader with a clear understanding of the research question, in addition to the scope, rationale, aims and objectives of the study. This ensures the reader can more easily comprehend the context of the research, which will consequently help them better interpret and evaluate the study results. One could liken an introduction to a trailer for a movie, where the plot of the film (the research topic) is introduced by setting the scene (outlining the significance of the topic) and enticing you to watch the full movie (understanding the research and its importance).

Despite this, our experience suggests that students frequently pay insufficient attention to the introduction section of their dissertation or omit elements which we consider essential to address. This editorial aims to help researchers appreciate the importance of a comprehensive dissertation introduction in medical education research and learn how to effectively manage this key section of their work.  Although it focuses purely on the introduction section of a written research submission, readers interested in learning more about the other primary steps of the research process are encouraged to read AMEE Guide No. 90 1 , 2 textbooks on research methods and both consult and seek constructive feedback from colleagues with expertise in research methods and writing for publication.

Here we aim to provide the reader with a simple structure of how best to construct the introduction for a dissertation and recommend that this should typically include the following essential components and principles.

Background to the research topic

The purpose of providing background information in an introduction is to supply the context and other essential information concerning the research topic, and thus allow the reader to understand the significance of the specific research question and where it sits within the broader field of study. This aids the reader to better understand how the research question contributes to the existing body of knowledge and why it is, necessary to investigate this specific aspect further. For example, suppose the study concerns the effectiveness of simulation-based training in medical education. In this case, the broader field of the study may include relevant areas such as medical simulation, medical education research, health care education, standardised patients, simulation-based training, and curriculum development based on simulation training. After providing the reader with an understanding of the context and relevance of the topic of interest, the researcher must then establish a theoretical or conceptual framework. This underpins the study topic in order that the reader can understand how any research questions and objectives are formulated. It is important to distinguish between these two frameworks. A theoretical framework describes the rationale for applying a particular theory to provide support and structure for the topic being studied. In the absence of an applicable theory, a conceptual framework substantiates the significance of a particular problem, context or phenomenon within a specific area of the study by illustrating its relevance and connection to research topic. 3 A conceptual framework highlights the importance of a research topic by showing how it relates to the larger body of knowledge in a particular field. Here is an example to demonstrate the use of a theoretical framework in a research context.

When considering Social Cognitive Theory (SCT), one of the key constructs is self-efficacy, as described by Albert Bandura, 4 and refers to the belief that a person has it within their own ability to accomplish a specific task successfully. This is not related to what a person does, but more how they perceive their ability to use these skills. So, based on this construct of self-efficacy, a researcher may formulate a research hypothesis; that examiners with higher self-efficacy in OSCEs will demonstrate improved performance in subsequent exams compared to those with lower self-efficacy. Now the researcher is in a position to identify the fundamental concepts of the research, i.e., self-efficacy (personal factors), examiner performance (behavioural factors) and examination conditions and examiner scaffolding support (environmental factors). Identifying key concepts helps the researcher find the relationship between these, and develop appropriate research questions, e.g., 1) How does an examiner's self-efficacy in OSCEs affect their ability to assess students in subsequent exams? 2) How does the support provided to examiners and exam conditions influence the link between self-efficacy and examiner performance in OSCEs? 3) Do examiners with high self-efficacy provide fairer scores than those with low self-efficacy in OSCEs? By having a theoretical framework, researchers can establish a foundation for their research and provide a clear picture of the relationship between the key concepts involved in the study. Researchers must also provide any conceptual and operational definitions for key concepts or variables that will be used in the study. Clearly defining key concepts and variables in the background section of a dissertation can also help establish the significance of the research question and its relevance to the broader field of study. As the name implies, a conceptual definition refers to a variable's meaning in a conceptual, abstract, or theoretical sense. Conceptual definitions are often used to describe concepts which cannot be directly measured, such as active learning, rote learning, inter-professional learning, inter-professional education, or constructs such as clinical performance. Conversely, operational definitions define the steps researchers must take in order to collect data to measure a phenomenon or concept. 5 For example, clinical performance can be considered a conceptual construct but may also be defined operationally as the ability of students to pass 12 out of 16 stations of an OSCE. The researcher having already pre-specified specific the criteria for classifying students as pass/fail in order to determine the ability of students to perform clinically. This operational definition provides a clear method for evaluating and measuring student ability, which can then be used to give feedback and guide further learning or to establish clear expectations for students and provide a basis for evaluating and assessing their performance. In general, it can be beneficial for medical education programs to define aspects such as clinical performance operationally in this way in rather than conceptually, especially if there is a need to ensure that students meet a required standard of competence and are prepared for the demands of real-world clinical practice. These definitions can also then be used to establish the methods and criteria by which the variables of the study will subsequently be measured or altered.

Citing the existing literature to support the research aim

A literature review is the process of critically evaluating existing research and utilising it to inform and guide the research proposal under investigation. Taking this approach enables researchers to ensure that their research is not only grounded in, but also contributes meaningfully to, any existing knowledge as a whole. Critically reviewing the literature provides evidence and justification for any research and is essential when formulating a hypothesis, question, or study objectives. In addition, and perhaps most importantly, it helps identify any gaps or inconsistencies in the existing knowledge base. Determining the knowledge gap is critical in justifying the necessity for our research and advancing knowledge. A comprehensive literature review also helps establish the theoretical or conceptual frameworks to ground any subsequent research, providing researchers with guidance and direction on how best to conduct their future studies. Understanding from the literature what has worked previously and what may pose challenges or limitations assists researchers when exploring the best methods and techniques for answering new research questions. To clarify, consider a hypothetical study in which researchers wish to examine the effectiveness of a specific educational intervention in medical students to improve patient safety. Based on the existing literature, let's assume that researchers learned that most studies had only focused on short-term outcomes rather than long-term ones. The long-term effects of any intervention in medical students on patient safety therefore remain uncertain. Researchers may therefore wish to consider conducting longitudinal studies months after interventions have been carried out, rather than simply repeating research based on short-term outcomes, in order to address the current knowledge gap. A review of existing literature may highlight hitherto previously unconsidered logistical difficulties in conducting longitudinal studies in this area that the researcher may need to be aware of.

Stating the significance of the research

More than simply reporting the existing research, one of the key objectives in any literature review is to summarise and synthesise existing research on the intended topic in order to analyse the significance of the research in question. In this process, diverse ideas can be merged to form fresh new perspectives. Any gaps, limitations, or controversies in medical education can be identified, and potential future benefits and implications of the proposed research explained to the reader. Based on any potential impact or perceived importance, the introduction provides an excellent opportunity for the researcher to affirm the significance of the research study and why it should be conducted.

By way of an example, the significance of a study concerning feedback given to examiners for Objective Structured Clinical Examinations (OSCEs) is used to illustrate this point further. The potential significance of this research lies in improving the validity and reliability of OSCE scores in medical education. As a result of reviewing different types of feedback given to examiners, the research may assist in identifying the most effective strategies for improving the quality of OSCEs in medical education. By providing new insights into how feedback can improve the reliability and validity of OSCE results, the research could also contribute to the broader knowledge of assessment in general. This may result in the development of more accurate and robust medical education assessments, which in turn may potentially enhance delivery of healthcare and improve patient outcomes and safety. It may also address the current challenges and gaps in medical education assessment by providing evidence-based approaches for improving OSCE quality.

Formulating Research Questions and Objectives

Researchers formulate research questions and objectives based on the topic they are seeking to address. As noted previously, these will have already been derived as a result of a comprehensive literature review of any existing knowledge and based on a theoretical or conceptual framework. Furthermore, in medical education, the literature review provides researchers with the opportunity to formulate new research questions or research objectives to address any gaps or limitations in the existing literature and add something new to the current body of knowledge. Research questions and objectives should be stated clearly, being both specific, and measurable. These should then guide the subsequent selection of appropriate research methods, data collection and any subsequent analytical process. Clear, focused, and rigorous research questions and objectives will ensure the study is well-designed and make a valuable contribution to the existing body of knowledge.

Qualitative research questions should be open-ended and exploratory rather than focused on a specific hypothesis or proposition. It is common for qualitative studies to focus on understanding how and why certain phenomena occur, rather than simply describing what has occurred. These should be formulated to elicit rich, detailed, and context-specific data that can provide insights into the experiences, perspectives, and meanings of the participants. In contrast, quantitative research questions are more specific and are designed to test a particular hypothesis or relationship. In medical education, it is imperative to emphasise the importance of both qualitative and quantitative research questions when it comes to generating new knowledge. Combining both quantitative and qualitative research methods (mixed methods) can be particularly powerful in providing a more comprehensive understanding of any phenomena under study. Assume again that we are examining the effectiveness of feedback on the performance of medical students and adopt a mixed-methods approach using a combination of qualitative and quantitative research methods. A quantitative research question may be, what is the impact of feedback on the performance of medical students as measured by OSCE mark? How the experience of receiving feedback on performance contributes to the future professional development of medical students is a more qualitative research question. This combination of quantitative and qualitative research questions will provide an in depth understanding of the effectiveness of feedback on medical student performance. It is important to note that in qualitative research methods particularly, there can be a wide variety of research question types. For example, grounded theory researchers may ask so-called "process questions", such as 'how do students interpret and use the feedback they are given?' Phenomenologists, on the other hand, are concerned with lived experience of research subjects and frequently ask questions looking to understand the "meaning" of any such experience, often aiming to attribute feelings to this experience, for example, ‘how do students feel when they receive feedback?’ Ethnographers look to understand how culture contributes to an experience, and may ask more "descriptive questions" 5 for example, ‘how does the culture within a specific medical school affect students receiving feedback on their performance?’

For ease of reference, the key points we recommended are considered in any dissertation introduction are summarised below:

1.       Set the context for the research

2.       Establish a theoretical or conceptual framework to support your study

3.       Define key variables both conceptually and theoretically

4.       Critically appraise relevant papers during the literature review

5.       Review previous studies to identify and define the knowledge gap by assessing what has already been studied and what areas remain unexplored

6.       Clearly articulate the rationale behind your study, emphasising its importance in the intended field

7.       Clearly define your research objectives, questions, and hypotheses

Conclusions

Whilst crafting a research introduction may seem a challenging and time-consuming task, it is well worth the effort to convey your research clearly and engage potential readers. Providing sufficient background information on the research topic, conducting a comprehensive review of the existing research, determining the knowledge gap, understanding any limitations or controversies in the topic of interest, before then exploring any theoretical or conceptual frameworks to develop the research concepts, research questions and methodology are fundamental steps. Articulating any conceptual and operational definitions of key concepts and clearly defining any key terms, including explanations of how these will be used in the study is also paramount to a good introduction. It is essential to clearly present the rationale behind the research and why this is significant, clarifying what it adds to the existing body of knowledge in medical education and exploring any potential future implications. Lastly, it is vital to ensure that any research questions are clearly stated and are open-ended and exploratory in the case of qualitative studies, or specific and measurable in the case of quantitative studies.

We feel that observing these basic principles and adhering to these few simple steps will hopefully set the stage for a highly successful piece of research and will certainly go some way to achieving a favourable editorial outcome for possible subsequent publication of the work.

Conflict of Interest

The authors declare that they have no conflict of interest.

Significance of the Study: Qualitative Research

Ai generator.

Significance of the Study: Qualitative Research on Employee Engagement and Its Impact on Job Performance in the Tech Industry

1. Introduction: Employee engagement is a critical factor influencing job performance, particularly in the tech industry where innovation and productivity are paramount. This qualitative research explores the nuanced relationships between employee engagement and job performance through in-depth interviews and thematic analysis.

2. Purpose of the Study: The primary goal of this study is to understand how various aspects of employee engagement affect job performance among tech employees. The research focuses on collecting detailed personal experiences and perspectives, providing rich, contextual insights into engagement dynamics within tech companies.

3. Importance to the Field: This study significantly contributes to the academic field by offering qualitative insights into the impact of employee engagement on job performance. By integrating employee experiences and perceptions, it enhances existing theoretical models and provides a more comprehensive understanding of engagement in the tech sector. These insights are valuable for both academic researchers and industry practitioners aiming to improve employee performance through better engagement practices.

4. Practical Implications: The findings from this study have important practical implications for tech companies. Managers and HR departments can use these insights to develop more effective engagement strategies that enhance job performance. Understanding the specific drivers of engagement and their impact on performance can help in designing tailored interventions that address the unique needs of tech employees, leading to improved job satisfaction and productivity.

5. Advancement of Future Research: This qualitative research lays a solid foundation for future studies on employee engagement. By highlighting key themes and issues related to engagement and performance, it addresses gaps in the existing literature and suggests areas for further exploration. Future researchers can build on these findings to deepen our understanding of engagement’s diverse impacts across various contexts and industries.

6. Societal Impact: The study underscores the broader societal implications of improving employee engagement, such as enhanced job satisfaction, reduced turnover rates, and increased overall productivity. These insights can inform public policies and corporate strategies, promoting healthier and more productive work environments. By highlighting the benefits of high employee engagement, the research supports efforts to create work conditions that contribute to societal well-being.

7. Conclusion: By exploring the qualitative aspects of employee engagement and its impact on job performance, this study provides valuable insights that can guide tech companies in optimizing their engagement strategies. Understanding the personal experiences of engaged employees allows for the development of more effective and tailored policies and practices. Future research should continue to investigate the long-term effects of employee engagement across various industries to gain a comprehensive understanding of its implications.

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As economic outcomes for young adults with and without degrees have improved, americans hold mixed views on the value of college, table of contents.

• Labor force trends and economic outcomes for young adults
• Economic outcomes for young men
• Economic outcomes for young women
• Wealth trends for households headed by a young adult
• The importance of a four-year college degree
• Getting a high-paying job without a college degree
• Do Americans think their education prepared them for the workplace?
• Is college worth the cost?
• Acknowledgments
• The American Trends Panel survey methodology
• Current Population Survey methodology
• Survey of Consumer Finances methodology

Pew Research Center conducted this study to better understand public views on the importance of a four-year college degree. The study also explores key trends in the economic outcomes of young adults among those who have and have not completed a four-year college degree.

The analysis in this report is based on three data sources. The labor force, earnings, hours, household income and poverty characteristics come from the U.S. Census Bureau’s Annual Social and Economic Supplement of the Current Population Survey. The findings on net worth are based on the Federal Reserve’s Survey of Consumer Finances.

The data on public views on the value of a college degree was collected as part of a Center survey of 5,203 U.S. adults conducted Nov. 27 to Dec. 3, 2023. Everyone who took part in the survey is a member of Pew Research Center’s American Trends Panel (ATP), an online survey panel that is recruited through national, random sampling of residential addresses. Address-based sampling ensures that nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race, ethnicity, partisan affiliation, education and other categories. Read more about the ATP’s methodology .

Here are the questions used for this report , along with responses, and the survey’s methodology .

Young adults refers to Americans ages 25 to 34.

Noncollege adults include those who have some college education as well as those who graduated from high school but did not attend college. Adults who have not completed high school are not included in the analysis of noncollege adults. About 6% of young adults have not completed high school. Trends in some labor market outcomes for those who have not finished high school are impacted by changes in the foreign-born share of the U.S. population. The Census data used in this analysis did not collect information on nativity before 1994.

Some college includes those with an associate degree and those who attended college but did not obtain a degree.

The some college or less population refers to adults who have some college education, those with a high school diploma only and those who did not graduate high school.

A full-time, full-year worker works at least 50 weeks per year and usually 35 hours a week or more.

The labor force includes all who are employed and those who are unemployed but looking for work.

The labor force participation rate is the share of a population that is in the labor force.

Young adults living independently refers to those who are not living in the home of either of their parents.

Household income is the sum of incomes received by all members of the household ages 15 and older. Income is the sum of earnings from work, capital income such as interest and dividends, rental income, retirement income, and transfer income (such as government assistance) before payments for such things as personal income taxes, Social Security and Medicare taxes, union dues, etc. Non-cash transfers such as food stamps, health benefits, subsidized housing and energy assistance are not included. As household income is pretax, it does not include stimulus payments or tax credits for earned income and children/dependent care.

Net worth, or wealth, is the difference between the value of what a household owns (assets) and what it owes (debts).

All references to party affiliation include those who lean toward that party. Republicans include those who identify as Republicans and those who say they lean toward the Republican Party. Democrats include those who identify as Democrats and those who say they lean toward the Democratic Party.

At a time when many Americans are questioning the value of a four-year college degree, economic outcomes for young adults without a degree are improving.

After decades of falling wages, young U.S. workers (ages 25 to 34) without a bachelor’s degree have seen their earnings increase over the past 10 years. Their overall wealth has gone up too, and fewer are living in poverty today.

Things have also improved for young college graduates over this period. As a result, the gap in earnings between young adults with and without a college degree has not narrowed.

The public has mixed views on the importance of having a college degree, and many have doubts about whether the cost is worth it, according to a new Pew Research Center survey.

• Only one-in-four U.S. adults say it’s extremely or very important to have a four-year college degree in order to get a well-paying job in today’s economy. About a third (35%) say a college degree is somewhat important, while 40% say it’s not too or not at all important.
• Roughly half (49%) say it’s less important to have a four-year college degree today in order to get a well-paying job than it was 20 years ago; 32% say it’s more important, and 17% say it’s about as important as it was 20 years ago.
• Only 22% say the cost of getting a four-year college degree today is worth it even if someone has to take out loans. Some 47% say the cost is worth it only if someone doesn’t have to take out loans. And 29% say the cost is not worth it.

These findings come amid rising tuition costs and mounting student debt . Views on the cost of college differ by Americans’ level of education. But even among four-year college graduates, only about a third (32%) say college is worth the cost even if someone has to take out loans – though they are more likely than those without a degree to say this.

Four-year college graduates (58%) are much more likely than those without a college degree (26%) to say their education was extremely or very useful in giving them the skills and knowledge they needed to get a well-paying job. (This finding excludes the 9% of respondents who said this question did not apply to them.)

Views on the importance of college differ widely by partisanship. Republicans and Republican-leaning independents are more likely than Democrats and Democratic leaners to say:

• It’s not too or not at all important to have a four-year college degree in order to get a well-paying job (50% of Republicans vs. 30% of Democrats)
• A college degree is less important now than it was 20 years ago (57% vs. 43%)
• It’s extremely or very likely someone without a four-year college degree can get a well-paying job (42% vs. 26%)

At the same time that the public is expressing doubts about the value of college, a new Center analysis of government data finds young adults without a college degree are doing better on some key measures than they have in recent years.

A narrow majority of workers ages 25 to 34 do not have a four-year college degree (54% in 2023). Earnings for these young workers mostly trended downward from the mid-1970s until roughly a decade ago.

Outcomes have been especially poor for young men without a college degree. Other research has shown that this group saw falling labor force participation and sagging earnings starting in the early 1970s , but the last decade has marked a turning point.

This analysis looks at young men and young women separately because of their different experiences in the labor force.

Trends for young men

• Labor force participation: The share of young men without a college degree who were working or looking for work dropped steadily from 1970 until about 2014. Our new analysis suggests things have stabilized somewhat for this group over the past decade. Meanwhile, labor force participation among young men with a four-year degree has remained mostly flat.
• Full-time, full-year employment: The share of employed young men without a college degree who are working full time and year-round has varied somewhat over the years – trending downward during recessions. It’s risen significantly since the Great Recession of 2007-09, with the exception of a sharp dip in 2021 due to the COVID-19 pandemic. For employed young men with a college degree, the share working full time, full year has remained more stable over the years.

• Median annual earnings: Since 2014, earnings have risen for young men with some college education and for those whose highest attainment is a high school diploma. Even so, earnings for these groups remain below where they were in the early 1970s. Earnings for young men with a bachelor’s degree have also trended up, for the most part, over the past 10 years.
• Poverty: Among young men without a college degree who are living independently from their parents, the share in poverty has fallen significantly over the last decade. For example, 12% of young men with a high school diploma were living in poverty in 2023, down from a peak of 17% in 2011. The share of young men with a four-year college degree who are in poverty has also fallen and remains below that of noncollege young men.

Trends for young women

• Labor force participation: The shares of young women with and without a college degree in the labor force grew steadily from 1970 to about 1990. Among those without a college degree, the share fell after 2000, and the drop-off was especially sharp for young women with a high school diploma. Since 2014, labor force participation for both groups of young women has increased.
• Full-time, full-year employment: The shares of employed young women working full time and year-round, regardless of their educational attainment, have steadily increased over the decades. There was a decline during and after the Great Recession and again (briefly) in 2021 due to the pandemic. Today, the shares of women working full time, full year are the highest they’ve ever been across education levels.

• Median annual earnings: Median earnings for young women without a college degree were relatively flat from 1970 until about a decade ago. These women did not experience the steady decline in earnings that noncollege young men did over this period. By contrast, earnings have grown over the decades for young women with a college degree. In the past 10 years, earnings for women both with and without a college degree have risen.
• Poverty: As is the case for young men without a college degree, the share of noncollege young women living in poverty has fallen substantially over the past decade. In 2014, 31% of women with a high school diploma who lived independently from their parents were in poverty. By 2023, that share had fallen to 21%. Young women with a college degree remain much less likely to be in poverty than their counterparts with less education.

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Half of Latinas Say Hispanic Women’s Situation Has Improved in the Past Decade and Expect More Gains

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The HPV vaccine prevents head and neck cancers in men, study suggests

The HPV vaccine is linked to a drastic reduction in head and neck cancers in adolescent boys and men, new research finds. 

HPV, or human papillomavirus, is a sexually transmitted infection responsible for virtually all cases of cervical cancer . But the virus is also linked to a number of other cancers , including penile, anal and vaginal cancers. 

It also accounts for the majority — up to 70% — of head and neck cancers , which affect the throat and mouth. Men are about twice as likely to develop these cancers than women, according to the National Cancer Institute.

The HPV vaccine, initially approved for adolescent girls, protects against strains of the virus linked to cervical cancer and has been found to significantly reduce rates of the cancer . But there’s growing evidence that the vaccine also protects against other HPV-related cancers.

“We want males to be thinking about HPV vaccination not just as something that protects female patients, but also male patients,” said Jefferson DeKloe, a research fellow in the department of otolaryngology at Thomas Jefferson University, who specializes in head and neck surgery and who co-authored the research.

The findings will be presented next week at the American Society of Clinical Oncology conference and have not yet been published in a peer-reviewed journal. 

Prior research showed a downward trend in oral infections with HPV strains known to cause cancer. That was a promising sign, said Dr. Glenn J. Hanna, a medical oncologist at the Dana-Farber Cancer Institute’s Center for Head and Neck Oncology, who was not involved in the new research.

“If we can lower the infection rate, we would hope that we would see what we are seeing now, a decline in cancer rates,” Hanna said. “This is an important evolution of the story.” 

The new study analyzed health records from a national database that included nearly 3.5 million people in the United States ages 9 to 39 who had received any vaccination — HPV or otherwise — from 2010 through 2023. About 1.5 million were male, half of whom had been vaccinated against cancer-causing strains of HPV. Nearly 1 million were females who had been vaccinated against HPV. 

The researchers compared the rates of HPV-linked cancers — including head and neck, anal, penile, and cervical cancers — in people who had received the HPV vaccine to those who hadn’t. They found being vaccinated reduced the overall risk of HPV-related cancers in males by 54%, a decrease driven primarily by a drop in head and neck cancers. Females were about 30% less likely to develop any type of HPV-related cancer, including cervical cancer. 

Most cases of head and neck cancer are in people older than 50. Since the U.S. is only about a decade into widespread HPV vaccination in both males and females, the vaccinated generation hasn’t reached this age yet. HPV typically infects younger people and takes decades for chronic infection to lead to cancer.

“These are the early results of a larger phenomenon we are going to watch play out over the next 20 or 30 years,” DeKloe said, noting that experts don’t expect to see the full effect HPV vaccination has on cancer rates until the largely vaccinated generation is older. 

A second study, which will also be presented at the ASCO conference next week and is not yet published in a peer-reviewed journal, found that HPV vaccination rates have been on the rise in the U.S. from 2011 through early 2020, including in all racial and ethnic groups.

HPV vaccination wasn’t recommended for males until 2011, five years after the Centers for Disease Control and Prevention recommended the vaccine series for girls. The HPV vaccine is now recommended for all adolescents starting as young as age 9, but can also be given to adults up to age 45. 

In the new study, which included children and young adults ages 9 to 26, the increase was largely driven by growing HPV vaccine uptake among males. Although overall HPV vaccination rates among males still lag behind females — about 36% compared to about 50% of those in the 9 to 26 age group — these rates are accelerating. 

“The gap is narrowing between males and females and eventually I would hope that they would meet up,” said Dr. Danh Nguyen, a resident physician at University of Texas Southwestern Medical Center, who led the research. 

Although vaccination efforts have focused on adolescents, adults should also consider getting vaccinated if they weren’t when they were younger, said Dr. Nancy Lee, service chief of head and neck radiation oncology at Memorial Sloan Kettering Cancer Center in New York City, who was not involved with either study. 

“If you are in your 20s or 30s, you can still get the vaccination. Even if you are 45, there is no reason you cannot get vaccinated because we have a population that lives a long time,” Lee said. 

Nguyen said it’s important that conversations about HPV vaccination continue to focus on the prevention of all cancers, including head and neck cancers that are more prevalent in men, rather than solely on cervical cancer prevention.

Hanna said stigma around HPV being a sexually transmitted infection has made discussions around vaccinating adolescents a sticky subject in the past, but that clear data showing the impact vaccination rates have on HPV-related cancers is shifting the narrative. 

“HPV vaccination is cancer prevention,” Hanna said. “The bottom line is that we are preventing cancers broadly by getting people vaccinated younger.”

Kaitlin Sullivan is a contributor for NBCNews.com who has worked with NBC News Investigations. She reports on health, science and the environment and is a graduate of the Craig Newmark Graduate School of Journalism at City University of New York.

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Is Fluoridated Drinking Water Safe for Pregnant Women?

New research suggests a link between prenatal fluoride levels and behavioral issues in children. Experts are divided on the study’s significance.

By Alice Callahan and Christina Caron

A small study published Monday suggested that higher levels of fluoride consumed during the third trimester of pregnancy were associated with a greater risk of behavioral problems in the mothers’ children at 3 years old. The authors of the study, which was funded in part by the National Institutes of Health and the Environmental Protection Agency and published in the journal JAMA Network Open, believe it is the first to examine links between prenatal fluoride exposure and child development among families living in the United States, where fluoride is often added to community water supplies to prevent dental cavities.

The study’s authors and some outside researchers said that the findings should prompt policymakers to evaluate the safety of fluoride consumption during pregnancy.

“I think it’s a warning sign,” said Dr. Beate Ritz, an environmental epidemiologist at the U.C.L.A. Fielding School of Public Health.

But other experts cautioned that the study had several important limitations that made it difficult to assess the potential effects of fluoride consumption during pregnancy.

“There is nothing about this study that alarms me or would make me recommend that pregnant women stop drinking tap water,” said Dr. Patricia Braun, a professor of pediatrics at the University of Colorado School of Medicine and a spokesperson for the American Academy of Pediatrics.

The Background

Fluoride strengthens tooth enamel, and research suggests that drinking water with added fluoride can reduce cavities by up to 25 percent . Many communities in the United States have added fluoride to their water for this reason since the 1940s, a practice widely celebrated as a major public health achievement . In 2020, 63 percent of people in the United States lived in areas with at least 0.7 milligrams per liter of fluoride in the water — considered optimal for cavity prevention — though some areas have levels that are higher , in part because of naturally high fluoride in the groundwater.

In the last few years, several studies from Mexico and Canada have suggested that fluoride exposure during pregnancy is linked to slightly lower scores on intelligence tests and other measures of cognitive function in children.

But recent studies from Spain and Denmark have found no such link.

There is a “contentious debate” about water fluoridation, acknowledged Ashley Malin, an assistant professor of epidemiology in the College of Public Health and Health Professions at the University of Florida and the lead author of the new study. The issue is currently the subject of a lawsuit filed by the nonprofit Food and Water Watch and other groups against the Environmental Protection Agency. The nonprofit claims that water fluoridation poses a risk to children’s health.

The Research

The study looked at a group of 229 predominantly low-income Hispanic pregnant women in Los Angeles who were already being followed in other research. Most of the women lived in areas with fluoridated water. The researchers measured the fluoride levels in their urine in a single test during the third trimester. Then, when their children were 3 years old, the mothers filled out the Preschool Child Behavior Checklist , a measure used to detect emotional, behavioral and social problems.

Overall, 14 percent of the children had a total score in the “borderline clinical” or “clinical” range, meaning that a doctor may want to watch or evaluate them, or provide additional support, Dr. Malin said. And on average, higher fluoride levels in the mothers’ urine were correlated with a greater risk of behavioral problems in the children. The researchers found that women with urine fluoride levels at the 75th percentile were 83 percent more likely to have children with borderline or clinically significant behavioral problems than women with levels at the 25th percentile.

The main problems reported by the mothers were emotional reactivity, which is the tendency to overreact; somatic complaints, such as headaches and stomachaches; anxiety; and symptoms linked to autism (though those symptoms alone would not be enough for an autism diagnosis).

The researchers did not find an association with other behavioral symptoms like aggression or issues with concentration.

The findings are important and add to evidence suggesting prenatal fluoride consumption may affect the developing brain, said Joseph Braun, a professor of epidemiology and the director of the Center for Children’s Environmental Health at Brown University, who was not involved in the research. That said, the increases in behavioral scores were relatively small — about two points on a scale from 28 to 100 for overall behavioral problems. It’s hard to say whether such a difference might be noticeable in an individual child, he said.

But given how widespread water fluoridation is, he added, even minor behavioral changes in individual children could have a meaningful impact on the overall population.

The Limitations

The study was relatively small and didn’t include a diverse group of women. It didn’t account for many factors that can affect child development, including genetics , maternal nutrition, home environment and community support, several experts not involved in the study said.

The data would also have been stronger if the researchers had measured fluoride in urine samples from several points of time during pregnancy and collected information on tap water, bottled water and tea consumption to better understand how each contributed to the women’s fluoride levels, experts said. Black and green teas can contain high levels of fluoride.

The Preschool Child Behavior Checklist that was used to evaluate the 3-year-olds is considered a reliable measure of child behavior. But it did not take into account the fact that symptoms can change in frequency and intensity during early childhood, said Catherine Lord, an expert on autism and related disorders at the University of California, Los Angeles medical school.

Dr. Lord, who was not involved in the fluoride research, added that the checklist is not considered a reliable way to diagnose autism.

It would also be helpful to follow the children to see if the problematic behaviors persisted beyond age 3, said Melissa Melough, an assistant professor of nutrition sciences at the University of Delaware, who was not involved in the research.

What’s Next

While the experts agreed that more robust research was needed to untangle the potential effects of prenatal fluoride exposure, they had differing opinions about the study’s bottom line.

Dr. Malin said that, based on her findings and the evidence from previous studies, it might be a good idea for women to limit fluoride intake during pregnancy, a view that was echoed by Dr. Ritz and others.

“For me, the takeaway is: Protect pregnancy,” said Marcela Tamayo-Ortiz, an environmental epidemiologist at the Columbia University Mailman School of Public Health who has studied prenatal exposures for more than two decades.

But the American Dental Association said in a statement that the organization stands by its recommendation to “brush twice a day with fluoride toothpaste and drink optimally fluoridated water.”

And Dr. Nathaniel DeNicola, an OB-GYN and environmental health expert in Orange County, Calif., said he wouldn’t advise his pregnant patients to avoid fluoridated water based on the study, because “it’s not conclusive.”

Dr. Melough said she didn’t think women should be alarmed by the findings. But, she added, while it’s clear that fluoride helps to reduce cavities, it’s possible that adding it to the water “could have some unintended consequences,” and policymakers should continually evaluate the practice as new science emerges.

You can find out what the fluoride levels are in your local water by contacting your water utility or checking the C.D.C.’s My Water’s Fluoride website . If you want to reduce your fluoride consumption, experts said, limit how much black or green tea you drink. You can also purchase certain water filters that remove some fluoride. There’s no reason to stop brushing your teeth with fluoride toothpaste — just don’t swallow it.

Alice Callahan is a Times reporter covering nutrition and health. She has a Ph.D. in nutrition from the University of California, Davis. More about Alice Callahan

Christina Caron is a Times reporter covering mental health. More about Christina Caron

• Open access
• Published: 27 May 2024

The importance and feasibility of hospital interventions to prevent and manage patient aggression and violence against physicians in China: a Delphi study

• Yuhan Wu   ORCID: orcid.org/0000-0003-4340-4390 1 ,
• Martina Buljac-Samardzic 1 ,
• Dahai Zhao 2 &
• C. T. B. Ahaus 1  

Human Resources for Health volume  22 , Article number:  34 ( 2024 ) Cite this article

Metrics details

Aggression and violence by patient (and their relatives/friends) is widely acknowledged as a serious occupational hazard, with physicians being particularly susceptible to witnessing and experiencing such incidents within hospitals. Research has shown that the negative consequences of such aggression and violence are not only felt at the individual level, but also at the team and organizational levels. Understanding how to prevent and manage this behavior towards physicians in hospitals is urgent and not fully researched. While there are many potentially effective interventions, it is unclear which ones would be valuable and feasible for Chinese hospitals. Because patient aggression and violence may occur more frequently in Chinese hospitals than in other countries, this suggests that cultural differences play a role and that tailored interventions may be needed.

We conducted a Delphi study to reach a consensus on the importance and feasibility of hospital interventions to prevent and manage patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. Seventeen experts in China were invited to complete online questionnaires over three rounds.

After three rounds, consensus was achieved concerning 44 interventions, five other interventions were rejected, and no consensus was reached on another two. These interventions were clustered into eight categories: environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-event actions, and hospital policy. Each category is considered important in preventing and managing patient (and their relatives/friends) aggression and violence towards physicians in Chinese hospitals. This study also investigated the feasibility of the suggested interventions and found that 36 of the 44 interventions were considered not only relevant, but also feasible for implementation in Chinese hospitals.

Conclusions

This study provides an overview of interventions that can be implemented in Chinese hospitals to prevent and manage patient (and their relatives/friends) aggression and violence before, during, and after a violent incident occurs.

Peer Review reports

Introduction

Workplace violence in healthcare settings is recognized as a serious occupational hazard, and especially in hospitals [ 1 , 2 ]. Many healthcare professionals worldwide experience verbal and physical violence at some point in their careers [ 3 , 4 ]. Among healthcare professionals, physicians are particularly likely to witness and experience aggression and violence in the workplace [ 4 , 5 ]. Although physicians encounter violence from different sources, patient and their relatives/friends have been identified as the most prevalent source of aggression and violence in hospitals [ 6 , 7 ]. Consequently, this study focuses on patient (and their relatives/friends) aggressive and violent actions against physicians in hospitals.

The risk factors for the occurrence of aggression and violence are present at multiple levels, such as patient-related factors (e.g., under the influence of alcohol) physician-related factors (e.g., poor medical skills), and patient–physician interactions factors (e.g., poor physician–patient communication) [ 8 ]. Although inadequate services can also have negative impact on the patient [ 9 ], this study focuses on the multifaceted negative consequences for hospitals. At the individual level, it can have severe adverse effects on physicians’ psychology, emotions, work functioning (e.g., reduced job satisfaction, higher level of stress, and loss of confidence) [ 10 , 11 , 12 ] and even extend into their personal lives, resulting in an increasing need for family support and negative interactions with family members [ 6 , 9 ]. Although the individual-level consequences have received most attention, this aggression and violence also affects behavior and performance at the team and organizational levels such as in influencing the team climate, lowering performance, increasing compensation costs, and reputational damage [ 13 , 14 , 15 ].

Given the detrimental impact of aggression and violence in healthcare settings, numerous studies have concentrated on preventing and managing workplace violence. The World Health Organization (WHO) proposed a guideline framework to prevent and manage workplace violence in healthcare that addressed preconditions, organizational interventions, environment interventions, individual-focused interventions, and after-the-event interventions [ 16 ]. The US Occupational Safety and Health Administration (OSHA) provided five guidelines for preventing workplace violence in healthcare that addressed: management commitment and worker participation, worksite analysis and hazard identification, hazard prevention and control, safety and health training, and recordkeeping and program evaluation [ 17 ]. Kumari et al. also suggested possible interventions to reduce workplace violence against physicians: at the individual level (e.g., training and communication skills); the organizational level (e.g., infrastructure changes and management policies); and the societal level (e.g., unbiased media reporting) in their review [ 18 ].

However, there is a lack of evidence on the effectiveness of these interventions. Therefore, Morpet et al. in a scoping review reviewed the effectiveness of interventions adopted by hospitals and identified risk assessment, staff education, and aggression management teams as evidence-based interventions that can reduce consumer-perpetrated violence [ 19 ]. Another systematic review categorized evidence-based interventions into three categories: pre-event preventive measures (e.g., violence prevention programs and risk assessment), interventions during the event (e.g., staying calm and applying de-escalation techniques), and post-incident measures (e.g., reflecting on incidents and organizational support) [ 1 ].

Given that the scope of workplace violence is broader than patient aggression and violence, including internal violence (violence from leaders/colleagues) and external violence (violence from patients/visitors) [ 20 ], it is sensible to place a particular emphasis on focused interventions for preventing and managing a specific source of violence against a specific type of healthcare professionals. The unique nature of patient (and their relatives/friends) aggression and violence against physicians necessitates tailored interventions to effectively address its challenges and negative effects.

Compared to European countries, physicians working in Asian countries experience more patient aggression and violence [ 21 ]. In the specific context of China, this problem has unique dimensions and challenges that require comprehensive investigation and addressing. Surveys conducted by the Chinese Hospital Management Society in 2005 revealed that the majority (over 73%) of healthcare staff in China were victims of such violence, including threats and taunts from patients and their relatives within hospital settings [ 21 ]. Furthermore, over the past few decades, the prevalence of patient aggression and violence against physicians has increased in China [ 22 ]. A recent systematic review conducted in China found that 62.4% of Chinese healthcare workers reported experiencing actual workplace violence, and particularly from patients [ 23 ].

The distinctive cultural, socioeconomic, and healthcare system factors in China underscore the need for a thorough examination of the importance and feasibility of hospital interventions tailored to the Chinese healthcare system. Although there are many suggested interventions, and some studies have examined the effectiveness of interventions elsewhere, it is not clear which are relevant and feasible in China given its cultural differences. Therefore, it is important to examine the importance and feasibility of interventions suggested in the literature in China.

As such, the main objective of this study is to reach a consensus regarding the importance and feasibility of hospital interventions to curtail and manage patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. For these reasons, a Delphi study was conducted, aiming to contribute valuable insights and evidence-based recommendations that can enhance the safety and well-being of both patients and healthcare providers in China’s evolving healthcare landscape.

Methodology

Based on the above analysis and given the scarcity and difficulty of experiment-based studies on interventions to prevent and manage patient (and their relatives/friends) aggression and violence [ 24 , 25 ], this study opted to conduct a Delphi study. The Delphi method is mainly adopted when the existing knowledge is incomplete or subject to uncertainty and higher levels of evidence cannot be provided using other methods [ 26 ]. In this, we were aiming to reach a consensus among Chinese experts on the importance of hospital interventions, and to explore their feasibility to counter patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. Three rounds were sufficient to reach consensus.

The panel of experts were recruited using authors’ own network and contained four types of participants: (1) management team members of Chinese hospitals and dedicated staff members (e.g., HR manager, quality and safety advisor) who hold the portfolio of patient aggression and violent behavior; (2) experts with experience in developing hospital policies on workplace violence (e.g., national/local health commission of China); (3) scientists who were specialized in patient–physician relationship (e.g., patient aggression and violence, patient–physician communication) in Chinese healthcare settings (scientists with a PhD degree and/or working experience > 10 years); (4) physicians who had experienced/witnessed patient (and their relatives/friends) aggression and violence in Chinese hospitals. We invited a maximum of two experts per region, hospital and research organization to ensure diversity of data sources. Since our aim was to derive hospital-level interventions, patients were not a target group.

The initial list of interventions (as presented in the first round of our Delphi study) was based on the results of our published systematic review about patient aggression and violence against physicians in hospitals, and that aimed to investigate the prevalence, risk factors, consequences, and prevention and management of patient (and their relatives/friends) aggression and violence against physicians in hospitals [ 8 ]. We started with an inventory of interventions mentioned in papers we had identified for our review plus additional papers found through a snowballing technique. Eventually, a list of 47 interventions were extracted from 32 related articles. Drawing on the WHO and OSHA guidelines [ 16 , 17 ], we grouped the 47 measures into eight categories: (1) environment design, (2) access and entrance, (3) staffing and working practices, (4) leadership and culture, (5) training and education, (6) support, (7) during/after-the-event actions, and (8) hospital policy. All the interventions were translated from English into Chinese using the standard translation/back-translation technique by two researchers before each round of data collection [ 27 ].

The respondents completed online questionnaires during three Delphi rounds, where they rated each intervention as to ‘how important and how feasible is the intervention to prevent, cope, and/or manage patient (and their relatives/friends) aggression and/or violence against physicians in Chinese hospitals?’. More specifically, experts were asked to rate the importance and feasibility of each intervention relative to each other. A four-point scale was used (1 = not important to 4 = very important; and 1 = not feasible to 4 = very feasible). The first round took place in June 2023, the second in July 2023, and the third in August 2023. In each round, respondents were allowed three weeks to complete the questionnaire. After rating each intervention’s importance and feasibility, respondents had the opportunity to reformulate the intervention. At the end of each round, respondents also had the opportunity to add new interventions. In the second and third Delphi rounds, the list of interventions was based on the responses given in the previous round, including newly added, reformulated, and unchanged interventions that had scored somewhere between definite inclusion and exclusion (i.e., importance scores between 51 and 80%). The rules adopted for inclusion and exclusion of items were consistent with other Delphi studies [ 28 , 29 , 30 ].

Interventions that were rated as ‘very important’, or ‘important’ by at least 80% of the experts were immediately retained in the final list and those that were rated as ‘not important’, or only ‘moderately important’ by more than 50% the experts were excluded. New interventions, as well as interventions deemed important by 51% to 80% of the experts, were retained for re-evaluation in the next round of the Delphi study. This method, which includes feedback and the opportunity to reconsider initial answers, allowed the experts to reach consensus on all the interventions. In the third round, interventions that were not perceived as important by at least 80% of the experts were categorized as not achieving a consensus. Note that the exclusion and inclusion criteria in this study were based on the importance scores and not on the feasibility scores as it is not meaningful for hospitals to adopt feasible but unimportant interventions. However, our method can provide insight into the boundary implementation conditions for important but infeasible interventions.

Seventeen experts participated in all three rounds of this Delphi study, with no dropouts (response rate = 100%). Detailed information on the respondents is presented in Table  1 .

Table 2 shows the flow of items through this Delphi study. During the three rounds, the panel added four new interventions to the list of 47 elements that we had gathered during the literature study. After three rounds, saturation was achieved with a final list including 44 items.

Table 3 shows the 44 interventions that made it through to the final list, together with their mean, level of agreement, SD, and assigned category. The interventions that were excluded or on which no consensus (NC) was reached are provided in Table  4 . We discuss the level of importance in relationship to the level of feasibility of the included interventions, and particularly highlight differences in importance and feasibility.

Environment design There were seven suggested interventions in this category that were perceived as important and viable, referring to “hospital security”, “alarm system”, “assigning security personnel”, “surveillance cameras”, “adequate air conditioning” and “relaxing and attractive colors”. Four interventions (i.e., separation of dangerous patients from other patients, escape routes and safe rooms dedicated to physicians, protective measures in contact moments between physician and patient (and their relatives/friends), and electronic boards indicating approximate waiting times) were deemed important but less feasible. One expert suggested that interventions to separate dangerous patients from other patients, especially in emergency departments, is infeasible because it is difficult to identify potentially dangerous patients and execute separation measures without aggravating the patient. Although the intervention referring to applying odor control was rejected by the panel, one expert suggested that Chinese hospitals should increasingly prioritize enhancing the overall patient experience through environmental design, including plans for future improvements in waiting areas, dining spaces, and restroom facilities.

Access and entrance The interventions referring to security checks and risk assessment of patients were important, but the feasibility of the latter was questioned by most of the panel. In response to the feasibility of risk assessment, the experts had two points of concern. First, some experts commented that risk assessment was important, but that this intervention would require a complex linking of information between hospitals, and that this would currently be challenging to implement. Second, some experts expressed concerns that flagging patients based on a risk assessment might lead to patient stigmatization and the infringement of patient privacy, potentially exacerbating physician–patient conflicts and mistrust. This contradicted the view of some experts who believe that hospitals should construct blacklists based on risk assessments. Two interventions, referring to a ‘one patient–one accompanying person policy’ and ‘restricting visiting hours’, failed to achieve a consensus.

Staffing and working practices The interventions referring to gaining valid consent from patients (and their relatives, if necessary) before treatment and the adequate presence of staff at peak periods were important, but no consensus was reached on the feasibility of the latter. One expert explained that the number of physicians in hospitals was fixed, and the adequate presence of staff in this area might increase the workload of other physicians. Two interventions that referred to escorting physicians were rejected by the panel.

Leadership and culture All the interventions in this category were perceived as both important and feasible. Leadership plays a pivotal role in managing and coping with patient (and their relatives/friends) aggression and violence. Leaders can facilitate the establishment of an organizational safety climate by paying attention to the negative effects of aggression and violence for physicians, encouraging physicians to report violent incidents, and providing support to physicians who experience aggression and violence.

Training and education Most of the interventions related to training and education to prevent and manage patient (and their relatives/friends) aggression and violence were considered important and feasible. One expert suggested that training should encompass more than just managing and coping with aggressive and violent patients (and relatives/friends), and that identifying potentially aggressive and violent patients is also vital. Only two interventions (i.e., training physicians in self-defense, and informing patients and their relatives/friends of the consequences of their aggression and/or violence against physicians) did not achieve a full consensus on their feasibility. One expert commented that it is hard to inform patients and their relatives/friends at the hospital level because public education largely relies on government initiatives, social media campaigns, and other external channels. In addition, one expert commented that hospitals should recruit professionals or experienced physicians for training activities.

Support According to the panel, seeking support from both peers and organizations is not only important, but also feasible. One expert suggested that support from leaders is crucial since China is characterized by a high power-distance culture.

During/after-the-event actions All the identified interventions in this category were perceived as important and feasible.

Hospital policy All the related interventions were perceived as important and feasible by the panel. Two experts had the same comments on the ‘zero-tolerance policy regarding patient (and their family/relatives) aggression and/or violence’: that any zero-tolerance policy needs to be backed up at the national legal level, and is difficult for individual hospitals to implement.

The aim of this Delphi study was to explore the importance and feasibility of hospital interventions related to patient (and their relatives/friends) aggression and violence towards physicians in China. Consensus was reached on 44 interventions that were perceived as important for the prevention and management of patient (and their relatives/friends) aggression and violence against physicians in Chinese hospitals. These interventions were clustered into eight categories: environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-events actions, and hospital policy. Our findings indicated that all these intervention categories are important in preventing and managing patient aggression and violence. Saturation was reached after three rounds, as in the third round, the panel did not reformulate or put forward new interventions. There were only two interventions on which a consensus was not achieved. This study also investigated their feasibility and found that most of the important interventions were also considered feasible for implementation in Chinese hospitals.

In terms of environment design, respondents could consider two types of interventions: environmental factors and workplace design in hospitals. Among environment-related factors, our study found that air conditioning and color schemes (i.e., adequate air condition, and relaxing and attractive colors) in the hospital were considered both important and feasible. These supportive environmental factors have an influence not only on patient outcomes, but also on the satisfaction levels of both patients and physicians [ 31 , 32 ], reducing the likelihood of patient aggression and violence. In terms of workplace design, hospitals should focus on security, alarm systems, reliable response systems, and surveillance cameras with video recording. These interventions also are widely reported elsewhere as part of a workplace violence prevention strategy in healthcare settings [ 33 , 34 ]. The effectiveness of adopting surveillance cameras has also been considered in other studies [ 18 , 19 , 35 ]. More specifically, physical violence is decreased by the introduction of surveillance cameras and continuous monitoring of surveillance footage allows for the quick identification and rapid response to escalating behavior [ 35 ].

In terms of the interventions in the access and entrance category, security checks (e.g., metal detectors) at a hospital’s main entrance should be considered by Chinese hospitals since this intervention was perceived as important and feasible. This result is consistent with previous research which emphasizes security services at the main entrance and using weapon and metal detectors [ 16 , 36 ]. However, whether patient risk assessments can be used in Chinese hospitals needs further consideration. Although our study deemed this intervention important, its feasibility was questioned by the experts. The same concerns are reflected in previous studies. Risk assessment advocates claim that risk assessments can be employed by hospitals to safeguard physicians and to reduce the incidence of violence [ 19 , 35 , 37 ]. However, its opponents are concerned that applying policies and procedures that flag individuals would lead to patient stigmatization and damage patient privacy [ 38 , 39 ]. Although implementation of patient risk assessments is controversial, some countries have adopted practical measures to flag patient based on risk assessment. For example, the methods of flagging patient in some Canadian hospitals include a combination of symbols and colors (e.g., ‘purple dot’ sticker on patient charts) to indicate the risk [ 38 ]. However, such interventions are not straightforwardly translatable from one context to another since aggression and violence in healthcare settings is a culturally dependent concept [ 40 ]. Therefore, to enhance the feasibility of patient risk assessments in Chinese hospitals requires further research.

Leadership plays a pivotal role in preventing and managing patient aggression and violence in hospitals. Leaders should encourage physicians to report a violent incident as this has also been identified as an important and feasible intervention in other studies. More specifically, incident reporting is a key method for identifying trends in the causes of violence and factors for prevention [ 1 , 41 , 42 ]. Reported data can inform the development of appropriate and relevant prevention and response strategies for hospitals [ 42 , 43 ]. Reflecting Chinese culture, which can be characterized as having a high power-distance [ 44 ], we found that support from managers and hospital administration is significant at the hospital level. This finding is in line with previous studies that emphasize the benefits of senior management support for safety programs in fostering hospital safety climates [ 45 ]. The Braverman seven-step workplace violence-prevention plan similarly stresses that getting support from the top is an essential step in workplace violence prevention [ 46 ].

In addition to support from leaders, this study showed that support from peers is also important and feasible, which is in line with other studies. Previous research has shown that implementing a peer support program for assaulted employees can lead to a reduction in the frequency of aggression and violence [ 47 ]. The buffering effect of support is significant when physicians experience patient aggression and violence [ 48 ]. Seeking peer support may provide the emotional support necessary to navigate challenging working conditions [ 14 ]. Further, having supportive and collaborative coworkers can foster motivation, increase job satisfaction, and enhance overall well-being in the workplace [ 49 ].

Moreover, providing training and education is seen as a key approach to preventing and managing patient aggression and violence in Chinese hospitals. Our study found that enhancing physicians’ skills including de-escalation techniques and communication skills, and in managing and coping with aggressive and violent patients (and relatives/friends) is important and feasible. These results are in line with other studies. In this regard, communication, de-escalation, and recognizing risky behaviors and triggers were identified as core elements to be addressed in training, and recognized as effective and person-centered mitigation strategies to reduce aggression and violence [ 1 , 19 ]. Notably, our finding that self-defense techniques were not feasible has been similarly shown in other studies. Physicians have difficulty in applying self-defense techniques learned in training [ 50 , 51 ] and there is no evidence that self-defense training reduces the incidence of violence in hospitals [ 19 ].

Furthermore, hospital policies for patient (and their relatives/friends) aggression and violence are also needed. A weapons prohibition policy for patients and visitors, and respecting patient’s privacy, were considered significant and viable methods for reducing patient aggression and violence, again a finding consistent with previous studies [ 16 , 19 ]. Although having a zero-tolerance policy was perceived as important and feasible in our study, the effectiveness of this has been questioned in other studies. A major concern with a zero-tolerance policy is that it fails to discriminate between different causes of violence. This has resulted in employees in many healthcare settings not applying their ‘Refusal to Treat’ policy [ 19 ]. It has been recognized that zero-tolerance policies have not effectively reduced workplace violence among healthcare workers in Britain [ 52 ].

Importantly, the experiences of the experts in our study suggest a vital role for support staff within Chinese hospitals. Unlike patients in Western countries who often initially seek help from their general practitioner (GP) before they are admitted to a hospital, Chinese patients typically go directly to hospitals for treatment. This can lead to healthcare staff being overloaded in Chinese hospitals, especially in tertiary hospitals [ 53 ]. Consequently, patients without a GP referral and diagnosis have to rely heavily on support staff working on information and registration desks and on triage staff to guide them to the appropriate department for consultation and treatment. Mistakes made by support staff, such as directing patients to the wrong department, can easily trigger patient frustration and even violence towards physicians. Therefore, clarifying the responsibilities of support staff, standardizing workflows, and enhancing work accuracy to prevent such negative patient emotions and potential violence is considered an important intervention to avoid triggering violent patient behavior in China.

Implications and limitations

Our study has practical implications for Chinese hospitals in terms of preventing and managing patient (and their relatives/friends) aggression and violence in different stages. To manage the period before violent events potentially occur, hospitals should provide professional training for physicians, especially in communication skills, skills on identifying potentially aggressive patients, and de-escalation approaches. Hospital policy should be established with the primary purpose of protecting the safety of physicians and clarifying when incidents of aggression and/or violence by patients (and their relatives/friends) fall under civil law. In addition, the design of the hospital environment, its access and entrance (e.g., security checks), and staff assignment should be considered in preventing and mitigating patient (and their relatives/ friends) aggression and violence before it takes place. During ongoing violent events, actions should focus on comforting measures for patient (and their relatives/friends), and de-escalation techniques. After such violent events, hospitals should provide support to physicians who have experienced aggression and violence in the workplace, in the form of leader support, peer support, and management support (e.g., representation and legal aid and medical support).

Our study has limitations that should be acknowledged. At first, since experts were recruited using authors’ own network, a selection bias might have occurred. The severity of the selection bias is limited as respondents were selected from a broad network of two authors and therefore include a diversity of participants from multiple hospitals, regions, and research organizations. In addition, it is crucial to note that patient aggression and violence are highly context-dependent phenomena. Therefore, interventions should take account of the specific national context, including the underlying risk factors associated with aggression and violence within Chinese hospitals. This contextual consideration is essential for ensuring the practical relevance and effectiveness of any interventions. Consequently, the generalizability of our findings to other cultures and contexts is limited. Nevertheless, this study can serve as starting point for other developing countries.

This investigation, by conducting a three-round Delphi study, identified a broad consensus among experts on the importance and feasibility of hospital-based interventions for mitigating patient aggression and violence against physicians in China. In total, 44 interventions, later clustered in eight categories (i.e., environment design, access and entrance, staffing and working practices, leadership and culture, training and education, support, during/after-the-events actions, and hospital policy) were considered important. All the identified interventions that fall within the categories of leadership and culture, support, during/after-the-events actions, and hospital policy were deemed both important and feasible.

Availability of data and materials

The data collection scales and datasets created and/or analyzed through the present study are available from the corresponding author upon reasonable request.

Abbreviations

The World Health Organization

Occupational Safety and Health Administration

No consensus

General practitioner

Raveel A, Schoenmakers B. Interventions to prevent aggression against doctors: a systematic review. BMJ Open. 2019;9(9): e028465.

Article   PubMed   PubMed Central   Google Scholar  

Caruso R, Toffanin T, Folesani F, et al. Violence against physicians in the workplace: trends, causes, consequences, and strategies for intervention. Curr Psychiatry Rep. 2022;24(12):911–24.

Volz NB, Fringer R, Walters B, Kowalenko T. Prevalence of horizontal violence among emergency attending physicians, residents, and physician assistants. Western J Emerg Med. 2007;18(2):213.

Article   Google Scholar  

Anand T, Grover S, Kumar R, Kumar M. Workplace violence against resident doctors in a tertiary care hospital in Delhi. Natl Med J India. 2016;29(6):344–8.

PubMed   Google Scholar  

Bilici R, Sercan M, Izci F. Levels of the Staff’s exposure to violence at locked psychiatric clinics: a comparison by occupational groups. Issues Ment Health Nurs. 2016;37(7):501–6.

Article   PubMed   Google Scholar  

Hills D, Joyce C. A review of research on the prevalence, antecedents, consequences and prevention of workplace aggression in clinical medical practice. Aggress Violent Beh. 2013;18(5):554–69.

Kowalenko T, Walters BL, Khare RK, Compton S. Michigan College of Emergency Physicians Workplace Violence Task Force Workplace violence: a survey of emergency physicians in the state of Michigan. Ann Emerg Med. 2005;46(2):142–7.

Wu Y, Strating M, Ahaus K, Buljac-Samardzic M. Prevalence, risk factors, consequences, and prevention and management of patient aggression and violence against physicians in hospitals: a systematic review. Aggress Violent Behav. 2024;74:101892.

Lanctot N, Guay S. The aftermath of workplace violence among healthcare workers: a systematic literature review of the consequences. Aggress Violent Behav. 2014;19:492–501.

Zafar W, Khan U, Siddiqui S, Jamali S, Razzak J. Workplace violence and self-reported psychological health: coping with post-traumatic stress, mental distress, and burnout among physicians working in the emergency departments compared to other specialties in Pakistan. J Emerg Med. 2016;50(1):167–77.

Rosenthal L, Ashley B, Adrienne T, Martinovich Z. Impact and prevalence of physical and verbal violence toward healthcare workers. Psychosomatics. 2018;59(6):584–90.

Oztok B, Icme F, Sahin KH, Pamukcu G, Sener A, Kurtoglu G. Evaluation of violence against emergency physicians in Turkey. Eurasian J Emerg Med. 2018;17(4):182–6.

Wong AH, Sabounchi NS, Roncallo HR, Ray JM, Heckmann R. A qualitative system dynamics model for effects of workplace violence and clinician burnout on agitation management in the emergency department. BMC Health Serv Res. 2022;22(1):75.

van Emmerik JH, Euwema MC, Bakker AB. Threats of workplace violence and the buffering effect of social support. Group Org Manag. 2007;32(2):152–75.

Mento C, Silvestri MC, Bruno A, Muscatello A, Cedro C, Pandolfo G, Zoccali A. Workplace violence against healthcare professionals: a systematic review. Aggress Violent Behav. 2020;51: 101381.

ILO/ICN/WHO/PSI Joint Programme on Workplace Violence in the Health Sector. Framework guidelines for addressing workplace violence in the health sector / Joint Programme on Workplace Violence in the Health Sector. 2002. https://www.who.int/publications/i/item/9221134466 .

Occupational Safety and Health Administration. Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers. 2016. https://www.osha.gov/sites/default/files/publications/osha3148.pdf .

Kumari A, Kaur T, Ranjan P, Chopra S, Sarkar S, Baitha U. Workplace violence against doctors: characteristics, risk factors, and mitigation strategies. J Postgrad Med. 2020;66(3):149–54.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Morphet J, Griffiths D, Beattie J, Velasquez D, Innes K. Prevention and management of occupational violence and aggression in healthcare: a scoping review. Collegian. 2018;25(6):621–32.

Dillon BL. Workplace violence: impact, causes, and prevention. Work. 2012;42(1):15–20.

Liu J, Gan Y, Jiang H, et al. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occup Environ Med. 2019;76(12):927–37.

Hesketh T, Wu D, Mao L, Ma N. Violence against doctors in China. BMJ Clin Res. 2012;345: e5730.

Google Scholar  

Lu L, Dong M, Wang SB, et al. Prevalence of workplace violence against health-care professionals in China: a comprehensive meta-analysis of observational surveys. Trauma Violence Abuse. 2020;21(3):498–509.

Kelly E, Mullen J. Organizational response to workplace violence. In: Kelloway EK, Barling J, Hurrell J Jr, editors. Handbook of workplace violence. Thousand Oaks, CA: Sage; 2006. p. 493–515.

Chapter   Google Scholar  

Lipscomb J, Silverstein B, Slavin TJ, Cody E, Jenkins L. Perspectives on legal strategies to prevent workplace violence. J Law Med Ethics. 2002;30:166–72.

Niederberger M, Spranger J. Delphi technique in health sciences: a map. Front Public Health. 2020;8:457.

Behling O, Law KS. Translating questionnaires and other research instruments: problems and solutions. Thousand Oaks, CA: Sage; 2000.

Book   Google Scholar  

Steinmann G, Delnoij D, Van De Bovenkamp H, et al. Expert consensus on moving towards a value-based healthcare system in the Netherlands: a Delphi study. BMJ Open. 2021;11(4): e043367.

Veenstra GL, Ahaus K, Welker GA, et al. Rethinking clinical governance: healthcare professionals’ views: a Delphi study. BMJ Open. 2017;7(1): e012591.

Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67(4):401–9.

Jamshidi S, Parker JS, Hashemi S. The effects of environmental factors on the patient outcomes in hospital environments: a review of literature. Front Archit Res. 2020;9(2):249–63.

Mroczek J, Mikitarian G, Vieira EK, et al. Hospital design and staff perceptions: an exploratory analysis. Health Prog. 2005;24(3):233–44.

Farrell GA, Shafiei T, Chan SP. Patient and visitor assault on nurses and midwives: an exploratory study of employer ‘protective’ factors. Int J Ment Health Nurs. 2014;23(1):88–96.

Morken T, Johansen IH, Alsaker K. Dealing with workplace violence in emergency primary health care: a focus group study. BMC Fam Pract. 2015;16(1):1–7.

Adamson MA, Vincent AA, Cundiff J. Common ground, not a battle ground: violence prevention at a detoxification facility. J Psychosoc Nurs Ment Health Serv. 2009;47(8):28–35.

Behnam M, Tillotson RD, Davis SM, et al. Violence in the emergency department: a national survey of emergency medicine residents and attending physicians. J Emerg Med. 2011;40(5):565–79.

Kling RN, Yassi A, Smailes E, et al. Evaluation of a violence risk assessment system (the Alert System) for reducing violence in an acute hospital: a before and after study. Int J Nurs Stud. 2011;48(5):534–9.

Ferron EM, Kosny A, Tonima S. Workplace violence prevention: flagging practices and challenges in hospitals. Workplace Health & Safety. 2022;70(3):126–35.

Paterson J, Fernandes J, Hunter K, et al. Embedding psychiatric risk flags within an electronic health record: initial findings and lessons learned. Healthcare quarterly (Toronto, Ont). 2019;21(4):54–60.

Najafi F, Fallahi-Khoshknab M, Ahmadi F, et al. Antecedents and consequences of workplace violence against nurses: a qualitative study. J Clin Nurs. 2018;27(1–2):e116–28.

Arnetz JE, Aranyos D, Ager J, et al. Development and application of a population-based system for workplace violence surveillance in hospitals. Am J Ind Med. 2011;54(12):925–34.

Gilligan T, Alamgir H. Bridging the knowledge gap: an innovative surveillance system to monitor the health of British Columbia’s healthcare workforce. Can J Public Health. 2008;99:478–82.

Arnetz JE, Hamblin L, Essenmacher L, et al. Understanding patient-to-worker violence in hospitals: a qualitative analysis of documented incident reports. J Adv Nurs. 2015;71(2):338–48.

Matusitz J, Musambira G. Power distance, uncertainty avoidance, and technology: analyzing Hofstede’s dimensions and human development indicators. J Technol Hum Serv. 2013;31(1):42–60.

Gershon RM, Karkashian CD, Grosch JW, et al. Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. Am J Infect Control. 2000;28(3):211–21.

Article   CAS   PubMed   Google Scholar  

Braverman M. Preventing workplace violence: a guide for employers and practitioners. SAGE Publications Inc; 1998.

Joa TS, Morken T. Violence towards personnel in out-of-hours primary care: a cross-sectional study. Scand J Prim Health Care. 2012;30(1):55–60.

Schat ACH, Kelloway EK. Reducing the adverse consequences of workplace aggression and violence: the buffering effects of organizational support. J Occup Health Psychol. 2003;8(2):110.

Van Emmerik IH. Gender differences in the effects of coping assistance on the reduction of burnout in academic staff. Work Stress. 2002;16(3):251–63.

Dickens G, Rogers G, Rooney C, et al. An audit of the use of breakaway techniques in a large psychiatric hospital: a replication study. J Psychiatr Ment Health Nurs. 2009;16(9):777–83.

Rogers P, Ghroum P, Benson R, et al. Is breakaway training effective? An audit of one medium secure unit. J Forensic Psychiatry Psychol. 2006;17(4):593–602.

Design Council. Reducing violence and aggression in A&E through a better patient experience (2015) London, United Kingdom: Design Council and Department of Health, United Kingdom. 2011.

Zhao D. Theoretical explanation and control strategy on violence against healthcare workers. J SJTU (Philosophy and Social Sciences). 2023;31:46–56.

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Acknowledgements

We extend our heartfelt gratitude to the participants who generously contributed to this study. Their invaluable insights have significantly enriched our understanding of hospital interventions addressing patient aggression and violence. Furthermore, we would like to express our appreciation to Hujie Wang for his invaluable assistance in translating English into Chinese for each round of this study.

This work was supported by the China Scholarship Council (No. 202107720007; receiver: Yuhan Wu). This funder had no role in the study design, data collection and analysis, interpretation of data, or writing the manuscript.

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YW: conceptualization, data collection and analysis, writing—original draft. KA: methodology, writing—review and editing, supervision, project administration. MB: methodology, writing—review and editing. DZ: contacting participants, editing.

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Wu, Y., Buljac-Samardzic, M., Zhao, D. et al. The importance and feasibility of hospital interventions to prevent and manage patient aggression and violence against physicians in China: a Delphi study. Hum Resour Health 22 , 34 (2024). https://doi.org/10.1186/s12960-024-00914-z

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Characterization of highly pathogenic avian influenza virus in retail dairy products in the US

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In March 2024 Clade 2.3.4.4b H5N1 highly pathogenic avian influenza virus (HPAIV) was detected in dairy cattle in the US and it was discovered that the virus could be detected in raw milk. Although affected cow’s milk is diverted from human consumption and current pasteurization requirements are expected to reduce or eliminate HPAIV from the milk supply, a study was conducted to characterize whether the virus could be detected by quantitative real-time RT-PCR (qrRT-PCR) in pasteurized retail dairy products and if detected, to determine whether the virus was viable. From April 18 to 22, 2024 a total of 297 samples of Grade A pasteurized retail milk products (23 product types) were collected from 17 US states and represented products from 132 processors in 38 states. Viral RNA was detected in 60 samples (20.2%) with titer equivalents of up to 5.4log 10 50% egg infectious doses (EID 50 ) per ml, with a mean and median of 3.0log 10 /ml and 2.9log 10 /ml respectively. Samples that were positive for type A influenza by qrRT-PCR were confirmed to be clade 2.3.4.4 H5 HPAIV by qrRT-PCR. No infectious virus was detected in any of the qrRT-PCR positive samples in embryonating chicken eggs. Further studies are needed to monitor the milk supply but these results provide evidence that infectious virus did not enter the US pasteurized milk supply before control measures for HPAIV were implemented in dairy cattle.

Importance Highly pathogenic avian influenza virus (HPAIV) infections in US dairy cattle were first confirmed in March 2024. Because the virus could be detected in raw milk a study was conducted to determine whether it had entered the retail food supply. Pasteurized dairy products were collected from 17 states in April 2024. Viral RNA was detected in 1 in 5 samples but infectious virus was not detected. This provides a snap-shot of HPAIV in milk products early in the event and reinforces that with numerous safety measures, infectious virus in milk is unlikely to enter the food supply.

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The authors have declared no competing interest.

Funding Statement

This study was funded by the US Dept of Agriculture project # 6040-32000-081-00D and the US Food and Drug Administration project # pending.

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I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Data Availability

All data produced in the present work are contained in the manuscript and supplemental data.

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Supplementary Material

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