literature review on value education

• Library databases
• Library website

Education Literature Review: Education Literature Review

What does this guide cover.

Writing the literature review is a long, complex process that requires you to use many different tools, resources, and skills.

This page provides links to the guides, tutorials, and webinars that can help you with all aspects of completing your literature review.

The Basic Process

These resources provide overviews of the entire literature review process. Start here if you are new to the literature review process.

• Literature Reviews Overview : Writing Center
• How to do a Literature Review : Library
• Video: Common Errors Made When Conducting a Lit Review (YouTube)  

The Role of the Literature Review

Your literature review gives your readers an understanding of the evolution of scholarly research on your topic.

In your literature review you will:

• survey the scholarly landscape
• provide a synthesis of the issues, trends, and concepts
• possibly provide some historical background

Review the literature in two ways:

• Section 1: reviews the literature for the Problem
• Section 3: reviews the literature for the Project

The literature review is NOT an annotated bibliography. Nor should it simply summarize the articles you've read. Literature reviews are organized thematically and demonstrate synthesis of the literature.

For more information, view the Library's short video on searching by themes:

Short Video: Research for the Literature Review

(4 min 10 sec) Recorded August 2019 Transcript 

Search for Literature

The iterative process of research:

• Find an article.
• Read the article and build new searches using keywords and names from the article.
• Mine the bibliography for other works.
• Use “cited by” searches to find more recent works that reference the article.
• Repeat steps 2-4 with the new articles you find.

These are the main skills and resources you will need in order to effectively search for literature on your topic:

• Subject Research: Education by Jon Allinder Last Updated Aug 7, 2023 4310 views this year
• Keyword Searching: Finding Articles on Your Topic by Lynn VanLeer Last Updated Sep 12, 2023 20650 views this year
• Google Scholar by Jon Allinder Last Updated Aug 16, 2023 14049 views this year
• Quick Answer: How do I find books and articles that cite an article I already have?
• Quick Answer: How do I find a measurement, test, survey or instrument?

Video: Education Databases and Doctoral Research Resources

(6 min 04 sec) Recorded April 2019 Transcript 

Staying Organized

The literature review requires organizing a variety of information. The following resources will help you develop the organizational systems you'll need to be successful.

• Organize your research
• Citation Management Software

You can make your search log as simple or complex as you would like.  It can be a table in a word document or an excel spread sheet.  Here are two examples.  The word document is a basic table where you can keep track of databases, search terms, limiters, results and comments.  The Excel sheet is more complex and has additional sheets for notes, Google Scholar log; Journal Log, and Questions to ask the Librarian.  

• Search Log Example Sample search log in Excel
• Search Log Example Sample search log set up as a table in a word document.
• Literature Review Matrix with color coding Sample template for organizing and synthesizing your research

Writing the Literature Review

The following resources created by the Writing Center and the Academic Skills Center support the writing process for the dissertation/project study. 

• Critical Reading
• What is Synthesis 
• Walden Templates
• Quick Answer: How do I find Walden EdD (Doctor of Education) studies?
• Quick Answer: How do I find Walden PhD dissertations?

Beyond the Literature Review

The literature review isn't the only portion of a dissertation/project study that requires searching. The following resources can help you identify and utilize a theory, methodology, measurement instruments, or statistics.

• Education Theory by Jon Allinder Last Updated May 17, 2024 534 views this year
• Tests & Measures in Education by Kimberly Burton Last Updated Nov 18, 2021 45 views this year
• Education Statistics by Jon Allinder Last Updated Feb 22, 2022 60 views this year
• Office of Research and Doctoral Services

Books and Articles about the Lit Review

The following articles and books outline the purpose of the literature review and offer advice for successfully completing one.

• Chen, D. T. V., Wang, Y. M., & Lee, W. C. (2016). Challenges confronting beginning researchers in conducting literature reviews. Studies in Continuing Education, 38(1), 47-60. https://doi.org/10.1080/0158037X.2015.1030335 Proposes a framework to conceptualize four types of challenges students face: linguistic, methodological, conceptual, and ontological.
• Randolph, J.J. (2009). A guide to writing the dissertation literature review. Practical Assessment, Research & Evaluation 14(13), 1-13. Provides advice for writing a quantitative or qualitative literature review, by a Walden faculty member.
• Torraco, R. J. (2016). Writing integrative literature reviews: Using the past and present to explore the future. Human Resource Development Review, 15(4), 404–428. https://doi.org/10.1177/1534484316671606 This article presents the integrative review of literature as a distinctive form of research that uses existing literature to create new knowledge.
• Wee, B. V., & Banister, D. (2016). How to write a literature review paper?. Transport Reviews, 36(2), 278-288. http://doi.org/10.1080/01441647.2015.1065456 Discusses how to write a literature review with a focus on adding value rather and suggests structural and contextual aspects found in outstanding literature reviews.
• Winchester, C. L., & Salji, M. (2016). Writing a literature review. Journal of Clinical Urology, 9(5), 308-312. https://doi.org/10.1177/2051415816650133 Reviews the use of different document types to add structure and enrich your literature review and the skill sets needed in writing the literature review.
• Xiao, Y., & Watson, M. (2017). Guidance on conducting a systematic literature review. Journal of Planning Education and Research. https://doi.org/10.1177/0739456X17723971 Examines different types of literature reviews and the steps necessary to produce a systematic review in educational research.

• Office of Student Disability Services

Walden Resources

Departments.

• Academic Residencies
• Academic Skills
• Career Planning and Development
• Customer Care Team
• Field Experience
• Military Services
• Student Success Advising
• Writing Skills

Centers and Offices

• Center for Social Change
• Office of Academic Support and Instructional Services
• Office of Degree Acceleration
• Office of Student Affairs

Student Resources

• Doctoral Writing Assessment
• Form & Style Review
• Quick Answers
• ScholarWorks
• SKIL Courses and Workshops
• Walden Bookstore
• Walden Catalog & Student Handbook
• Student Safety/Title IX
• Legal & Consumer Information
• Website Terms and Conditions
• Cookie Policy
• Accessibility
• Accreditation
• State Authorization
• Net Price Calculator
• Contact Walden

Walden University is a member of Adtalem Global Education, Inc. www.adtalem.com Walden University is certified to operate by SCHEV © 2024 Walden University LLC. All rights reserved.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• J Grad Med Educ
• v.8(3); 2016 Jul

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

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

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

The Literature Review Defined

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

• A literature review forms the basis for high-quality medical education research and helps maximize relevance, originality, generalizability, and impact.
• A literature review provides context, informs methodology, maximizes innovation, avoids duplicative research, and ensures that professional standards are met.
• Literature reviews take time, are iterative, and should continue throughout the research process.
• Researchers should maximize the use of human resources (librarians, colleagues), search tools (databases/search engines), and existing literature (related articles).
• Keeping organized is critical.

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

Purpose and Importance of the Literature Review

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

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

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

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

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

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

Approaching the Literature Review

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

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

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

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

Locating and Organizing the Literature

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

Human Resources

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

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

Strategies for Finding Related Researcher Publications in Databases and Search Engines

Search Tools and Related Literature

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

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

Box Information Resources

• Web of Science a
• Education Resource Information Center (ERIC)
• Cumulative Index of Nursing & Allied Health (CINAHL) a
• Google Scholar

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

Getting Organized

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

Citation Managers

Knowing When to Say When

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

Putting It All Together

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

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

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

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

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

Chapter 1: Introduction

Learning objectives.

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

• Identify the purpose of the literature review in  the research process
• Distinguish between different types of literature reviews

1.1 What is a Literature Review?

Pick up nearly any book on research methods and you will find a description of a literature review.  At a basic level, the term implies a survey of factual or nonfiction books, articles, and other documents published on a particular subject.  Definitions may be similar across the disciplines, with new types and definitions continuing to emerge.  Generally speaking, a literature review is a:

• “comprehensive background of the literature within the interested topic area…” ( O’Gorman & MacIntosh, 2015, p. 31 ).
• “critical component of the research process that provides an in-depth analysis of recently published research findings in specifically identified areas of interest.” ( House, 2018, p. 109 ).
• “written document that presents a logically argued case founded on a comprehensive understanding of the current state of knowledge about a topic of study” ( Machi & McEvoy,  2012, p. 4 ).

As a foundation for knowledge advancement in every discipline, it is an important element of any research project.  At the graduate or doctoral level, the literature review is an essential feature of thesis and dissertation, as well as grant proposal writing.  That is to say, “A substantive, thorough, sophisticated literature review is a precondition for doing substantive, thorough, sophisticated research…A researcher cannot perform significant research without first understanding the literature in the field.” ( Boote & Beile, 2005, p. 3 ).  It is by this means, that a researcher demonstrates familiarity with a body of knowledge and thereby establishes credibility with a reader.  An advanced-level literature review shows how prior research is linked to a new project, summarizing and synthesizing what is known while identifying gaps in the knowledge base, facilitating theory development, closing areas where enough research already exists, and uncovering areas where more research is needed. ( Webster & Watson, 2002, p. xiii )

A graduate-level literature review is a compilation of the most significant previously published research on your topic. Unlike an annotated bibliography or a research paper you may have written as an undergraduate, your literature review will outline, evaluate and synthesize relevant research and relate those sources to your own thesis or research question. It is much more than a summary of all the related literature.

It is a type of writing that demonstrate the importance of your research by defining the main ideas and the relationship between them. A good literature review lays the foundation for the importance of your stated problem and research question.

Literature reviews:

• define a concept
• map the research terrain or scope
• systemize relationships between concepts
• identify gaps in the literature ( Rocco & Plathotnik, 2009, p. 128 )

The purpose of a literature review is to demonstrate that your research question  is meaningful. Additionally, you may review the literature of different disciplines to find deeper meaning and understanding of your topic. It is especially important to consider other disciplines when you do not find much on your topic in one discipline. You will need to search the cognate literature before claiming there is “little previous research” on your topic.

Well developed literature reviews involve numerous steps and activities. The literature review is an iterative process because you will do at least two of them: a preliminary search to learn what has been published in your area and whether there is sufficient support in the literature for moving ahead with your subject. After this first exploration, you will conduct a deeper dive into the literature to learn everything you can about the topic and its related issues.

Literature Review Tutorial

1.2 Literature Review Basics

An effective literature review must:

• Methodologically analyze and synthesize quality literature on a topic
• Provide a firm foundation to a topic or research area
• Provide a firm foundation for the selection of a research methodology
• Demonstrate that the proposed research contributes something new to the overall body of knowledge of advances the research field’s knowledge base. ( Levy & Ellis, 2006 ).

All literature reviews, whether they are qualitative, quantitative or both, will at some point:

• Introduce the topic and define its key terms
• Establish the importance of the topic
• Provide an overview of the amount of available literature and its types (for example: theoretical, statistical, speculative)
• Identify gaps in the literature
• Point out consistent finding across studies
• Arrive at a synthesis that organizes what is known about a topic
• Discusses possible implications and directions for future research

1.3 Types of Literature Reviews

There are many different types of literature reviews, however there are some shared characteristics or features.  Remember a comprehensive literature review is, at its most fundamental level, an original work based on an extensive critical examination and synthesis of the relevant literature on a topic. As a study of the research on a particular topic, it is arranged by key themes or findings, which may lead up to or link to the  research question.  In some cases, the research question will drive the type of literature review that is undertaken.

The following section includes brief descriptions of the terms used to describe different literature review types with examples of each.   The included citations are open access, Creative Commons licensed or copyright-restricted.

1.3.1 Types of Review

1.3.1.1 conceptual.

Guided by an understanding of basic issues rather than a research methodology. You are looking for key factors, concepts or variables and the presumed relationship between them. The goal of the conceptual literature review is to categorize and describe concepts relevant to your study or topic and outline a relationship between them. You will include relevant theory and empirical research.

Examples of a Conceptual Review:

• Education : The formality of learning science in everyday life: A conceptual literature review. ( Dohn, 2010 ).
• Education : Are we asking the right questions? A conceptual review of the educational development literature in higher education. ( Amundsen & Wilson, 2012 ).

1.3.1.2 Empirical

An empirical literature review collects, creates, arranges, and analyzes numeric data reflecting the frequency of themes, topics, authors and/or methods found in existing literature. Empirical literature reviews present their summaries in quantifiable terms using descriptive and inferential statistics.

Examples of an Empirical Review:

• Nursing : False-positive findings in Cochrane meta-analyses with and without application of trial sequential analysis: An empirical review. ( Imberger, Thorlund, Gluud, & Wettersley, 2016 ).
• Education : Impediments of e-learning adoption in higher learning institutions of Tanzania: An empirical review ( Mwakyusa & Mwalyagile, 2016 ).

1.3.1.3 Exploratory

Unlike a synoptic literature review, the purpose here is to provide a broad approach to the topic area. The aim is breadth rather than depth and to get a general feel for the size of the topic area. A graduate student might do an exploratory review of the literature before beginning a synoptic, or more comprehensive one.

Examples of an Exploratory Review:

• Education : University research management: An exploratory literature review. ( Schuetzenmeister, 2010 ).
• Education : An exploratory review of design principles in constructivist gaming learning environments. ( Rosario & Widmeyer, 2009 ).

1.3.1.4 Focused

A type of literature review limited to a single aspect of previous research, such as methodology. A focused literature review generally will describe the implications of choosing a particular element of past research, such as methodology in terms of data collection, analysis and interpretation.

Examples of a Focused Review:

• Nursing : Clinical inertia in the management of type 2 diabetes mellitus: A focused literature review. ( Khunti, Davies, & Khunti, 2015 ).
• Education : Language awareness: Genre awareness-a focused review of the literature. ( Stainton, 1992 ).

1.3.1.5 Integrative

Critiques past research and draws overall conclusions from the body of literature at a specified point in time. Reviews, critiques, and synthesizes representative literature on a topic in an integrated way. Most integrative reviews are intended to address mature topics or  emerging topics. May require the author to adopt a guiding theory, a set of competing models, or a point of view about a topic.  For more description of integrative reviews, see Whittemore & Knafl (2005).

Examples of an Integrative Review:

• Nursing : Interprofessional teamwork and collaboration between community health workers and healthcare teams: An integrative review. ( Franklin,  Bernhardt, Lopez, Long-Middleton, & Davis, 2015 ).
• Education : Exploring the gap between teacher certification and permanent employment in Ontario: An integrative literature review. ( Brock & Ryan, 2016 ).

1.3.1.6 Meta-analysis

A subset of a  systematic review, that takes findings from several studies on the same subject and analyzes them using standardized statistical procedures to pool together data. Integrates findings from a large body of quantitative findings to enhance understanding, draw conclusions, and detect patterns and relationships. Gather data from many different, independent studies that look at the same research question and assess similar outcome measures. Data is combined and re-analyzed, providing a greater statistical power than any single study alone. It’s important to note that not every systematic review includes a meta-analysis but a meta-analysis can’t exist without a systematic review of the literature.

Examples of a Meta-Analysis:

• Education : Efficacy of the cooperative learning method on mathematics achievement and attitude: A meta-analysis research. ( Capar & Tarim, 2015 ).
• Nursing : A meta-analysis of the effects of non-traditional teaching methods on the critical thinking abilities of nursing students. ( Lee, Lee, Gong, Bae, & Choi, 2016 ).
• Education : Gender differences in student attitudes toward science: A meta-analysis of the literature from 1970 to 1991. ( Weinburgh, 1995 ).

1.3.1.7 Narrative/Traditional

An overview of research on a particular topic that critiques and summarizes a body of literature. Typically broad in focus. Relevant past research is selected and synthesized into a coherent discussion. Methodologies, findings and limits of the existing body of knowledge are discussed in narrative form. Sometimes also referred to as a traditional literature review. Requires a sufficiently focused research question. The process may be subject to bias that supports the researcher’s own work.

Examples of a Narrative/Traditional Review:

• Nursing : Family carers providing support to a person dying in the home setting: A narrative literature review. ( Morris, King, Turner, & Payne, 2015 ).
• Education : Adventure education and Outward Bound: Out-of-class experiences that make a lasting difference. ( Hattie, Marsh, Neill, & Richards, 1997 ).
• Education : Good quality discussion is necessary but not sufficient in asynchronous tuition: A brief narrative review of the literature. ( Fear & Erikson-Brown, 2014 ).
• Nursing : Outcomes of physician job satisfaction: A narrative review, implications, and directions for future research. ( Williams & Skinner, 2003 ).

1.3.1.8 Realist

Aspecific type of literature review that is theory-driven and interpretative and is intended to explain the outcomes of a complex intervention program(s).

Examples of a Realist Review:

• Nursing : Lean thinking in healthcare: A realist review of the literature. ( Mazzacato, Savage, Brommels, 2010 ).
• Education : Unravelling quality culture in higher education: A realist review. ( Bendermacher, Egbrink, Wolfhagen, & Dolmans, 2017 ).

1.3.1.9 Scoping

Tend to be non-systematic and focus on breadth of coverage conducted on a topic rather than depth. Utilize a wide range of materials; may not evaluate the quality of the studies as much as count the number. One means of understanding existing literature. Aims to identify nature and extent of research; preliminary assessment of size and scope of available research on topic. May include research in progress.

Examples of a Scoping Review:

• Nursing : Organizational interventions improving access to community-based primary health care for vulnerable populations: A scoping review. ( Khanassov, Pluye, Descoteaux, Haggerty,  Russell, Gunn, & Levesque, 2016 ).
• Education : Interdisciplinary doctoral research supervision: A scoping review. ( Vanstone, Hibbert, Kinsella, McKenzie, Pitman, & Lingard, 2013 ).
• Nursing : A scoping review of the literature on the abolition of user fees in health care services in Africa. ( Ridde, & Morestin, 2011 ).

1.3.1.10 Synoptic

Unlike an exploratory review, the purpose is to provide a concise but accurate overview of all material that appears to be relevant to a chosen topic. Both content and methodological material is included. The review should aim to be both descriptive and evaluative. Summarizes previous studies while also showing how the body of literature could be extended and improved in terms of content and method by identifying gaps.

Examples of a Synoptic Review:

• Education : Theoretical framework for educational assessment: A synoptic review. ( Ghaicha, 2016 ).
• Education : School effects research: A synoptic review of past efforts and some suggestions for the future. ( Cuttance, 1981 ).

1.3.1.11 Systematic Review

A rigorous review that follows a strict methodology designed with a presupposed selection of literature reviewed.  Undertaken to clarify the state of existing research, the evidence, and possible implications that can be drawn from that.  Using comprehensive and exhaustive searching of the published and unpublished literature, searching various databases, reports, and grey literature.  Transparent and reproducible in reporting details of time frame, search and methods to minimize bias.  Must include a team of at least 2-3 and includes the critical appraisal of the literature.  For more description of systematic reviews, including links to protocols, checklists, workflow processes, and structure see “ A Young Researcher’s Guide to a Systematic Review “.

Examples of a Systematic Review:

• Education : The potentials of using cloud computing in schools: A systematic literature review ( Hartmann, Braae, Pedersen, & Khalid, 2017 )
• Nursing : Is butter back? A systematic review and meta-analysis of butter consumption and risk of cardiovascular disease, diabetes, and total mortality. ( Pimpin, Wu, Haskelberg, Del Gobbo, & Mozaffarian, 2016 ).
• Education : The use of research to improve professional practice: a systematic review of the literature. ( Hemsley-Brown & Sharp, 2003 ).
• Nursing : Using computers to self-manage type 2 diabetes. ( Pal, Eastwood, Michie, Farmer, Barnard, Peacock, Wood, Inniss, & Murray, 2013 ).

1.3.1.12 Umbrella/Overview of Reviews

Compiles evidence from multiple systematic reviews into one document. Focuses on broad condition or problem for which there are competing interventions and highlights reviews that address those interventions and their effects. Often used in recommendations for practice.

Examples of an Umbrella/Overview Review:

• Education : Reflective practice in healthcare education: An umbrella review. ( Fragknos, 2016 ).
• Nursing : Systematic reviews of psychosocial interventions for autism: an umbrella review. ( Seida, Ospina, Karkhaneh, Hartling, Smith, & Clark, 2009 ).

For a brief discussion see “ Not all literature reviews are the same ” (Thomson, 2013).

1.4 Why do a Literature Review?

The purpose of the literature review is the same regardless of the topic or research method. It tests your own research question against what is already known about the subject.

1.4.1 First – It’s part of the whole. Omission of a literature review chapter or section in a graduate-level project represents a serious void or absence of critical element in the research process.

The outcome of your review is expected to demonstrate that you:

• can systematically explore the research in your topic area
• can read and critically analyze the literature in your discipline and then use it appropriately to advance your own work
• have sufficient knowledge in the topic to undertake further investigation

1.4.2 Second – It’s good for you!

• You improve your skills as a researcher
• You become familiar with the discourse of your discipline and learn how to be a scholar in your field
• You learn through writing your ideas and finding your voice in your subject area
• You define, redefine and clarify your research question for yourself in the process

1.4.3 Third – It’s good for your reader. Your reader expects you to have done the hard work of gathering, evaluating and synthesizes the literature.  When you do a literature review you:

• Set the context for the topic and present its significance
• Identify what’s important to know about your topic – including individual material, prior research, publications, organizations and authors.
• Demonstrate relationships among prior research
• Establish limitations of existing knowledge
• Analyze trends in the topic’s treatment and gaps in the literature

1.4.4 Why do a literature review?

• To locate gaps in the literature of your discipline
• To avoid reinventing the wheel
• To carry on where others have already been
• To identify other people working in the same field
• To increase your breadth of knowledge in your subject area
• To find the seminal works in your field
• To provide intellectual context for your own work
• To acknowledge opposing viewpoints
• To put your work in perspective
• To demonstrate you can discover and retrieve previous work in the area

1.5 Common Literature Review Errors

Graduate-level literature reviews are more than a summary of the publications you find on a topic.  As you have seen in this brief introduction, literature reviews are a very specific type of research, analysis, and writing.  We will explore these topics more in the next chapters.  Some things to keep in mind as you begin your own research and writing are ways to avoid the most common errors seen in the first attempt at a literature review.  For a quick review of some of the pitfalls and challenges a new researcher faces when he/she begins work, see “ Get Ready: Academic Writing, General Pitfalls and (oh yes) Getting Started! ”.

As you begin your own graduate-level literature review, try to avoid these common mistakes:

• Accepts another researcher’s finding as valid without evaluating methodology and data
• Contrary findings and alternative interpretations are not considered or mentioned
• Findings are not clearly related to one’s own study, or findings are too general
• Insufficient time allowed to define best search strategies and writing
• Isolated statistical results are simply reported rather than synthesizing the results
• Problems with selecting and using most relevant keywords, subject headings and descriptors
• Relies too heavily on secondary sources
• Search methods are not recorded or reported for transparency
• Summarizes rather than synthesizes articles

In conclusion, the purpose of a literature review is three-fold:

• to survey the current state of knowledge or evidence in the area of inquiry,
• to identify key authors, articles, theories, and findings in that area, and
• to identify gaps in knowledge in that research area.

A literature review is commonly done today using computerized keyword searches in online databases, often working with a trained librarian or information expert. Keywords can be combined using the Boolean operators, “and”, “or” and sometimes “not”  to narrow down or expand the search results. Once a list of articles is generated from the keyword and subject heading search, the researcher must then manually browse through each title and abstract, to determine the suitability of that article before a full-text article is obtained for the research question.

Literature reviews should be reasonably complete, and not restricted to a few journals, a few years, or a specific methodology or research design. Reviewed articles may be summarized in the form of tables, and can be further structured using organizing frameworks such as a concept matrix.

A well-conducted literature review should indicate whether the initial research questions have already been addressed in the literature, whether there are newer or more interesting research questions available, and whether the original research questions should be modified or changed in light of findings of the literature review.

The review can also provide some intuitions or potential answers to the questions of interest and/or help identify theories that have previously been used to address similar questions and may provide evidence to inform policy or decision-making. ( Bhattacherjee, 2012 ).

Read Abstract 1.  Refer to Types of Literature Reviews.  What type of literature review do you think this study is and why?  See the Answer Key for the correct response.

Nursing : To describe evidence of international literature on the safe care of the hospitalised child after the World Alliance for Patient Safety and list contributions of the general theoretical framework of patient safety for paediatric nursing.

An integrative literature review between 2004 and 2015 using the databases PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science and Wiley Online Library, and the descriptors Safety or Patient safety, Hospitalised child, Paediatric nursing, and Nursing care.

Thirty-two articles were analysed, most of which were from North American, with a descriptive approach. The quality of the recorded information in the medical records, the use of checklists, and the training of health workers contribute to safe care in paediatric nursing and improve the medication process and partnerships with parents.

General information available on patient safety should be incorporated in paediatric nursing care. ( Wegner, Silva, Peres, Bandeira, Frantz, Botene, & Predebon, 2017 ).

Read Abstract 2.  Refer to Types of Literature Reviews.  What type of lit review do you think this study is and why?  See the Answer Key for the correct response.

Education : The focus of this paper centers around timing associated with early childhood education programs and interventions using meta-analytic methods. At any given assessment age, a child’s current age equals starting age, plus duration of program, plus years since program ended. Variability in assessment ages across the studies should enable everyone to identify the separate effects of all three time-related components. The project is a meta-analysis of evaluation studies of early childhood education programs conducted in the United States and its territories between 1960 and 2007. The population of interest is children enrolled in early childhood education programs between the ages of 0 and 5 and their control-group counterparts. Since the data come from a meta-analysis, the population for this study is drawn from many different studies with diverse samples. Given the preliminary nature of their analysis, the authors cannot offer conclusions at this point. ( Duncan, Leak, Li, Magnuson, Schindler, & Yoshikawa, 2011 ).

Test Yourself

See Answer Key for the correct responses.

The purpose of a graduate-level literature review is to summarize in as many words as possible everything that is known about my topic.

A literature review is significant because in the process of doing one, the researcher learns to read and critically assess the literature of a discipline and then uses it appropriately to advance his/her own research.

Read the following abstract and choose the correct type of literature review it represents.

Nursing: E-cigarette use has become increasingly popular, especially among the young. Its long-term influence upon health is unknown. Aim of this review has been to present the current state of knowledge about the impact of e-cigarette use on health, with an emphasis on Central and Eastern Europe. During the preparation of this narrative review, the literature on e-cigarettes available within the network PubMed was retrieved and examined. In the final review, 64 research papers were included. We specifically assessed the construction and operation of the e-cigarette as well as the chemical composition of the e-liquid; the impact that vapor arising from the use of e-cigarette explored in experimental models in vitro; and short-term effects of use of e-cigarettes on users’ health. Among the substances inhaled by the e-smoker, there are several harmful products, such as: formaldehyde, acetaldehyde, acroleine, propanal, nicotine, acetone, o-methyl-benzaldehyde, carcinogenic nitrosamines. Results from experimental animal studies indicate the negative impact of e-cigarette exposure on test models, such as ascytotoxicity, oxidative stress, inflammation, airway hyper reactivity, airway remodeling, mucin production, apoptosis, and emphysematous changes. The short-term impact of e-cigarettes on human health has been studied mostly in experimental setting. Available evidence shows that the use of e-cigarettes may result in acute lung function responses (e.g., increase in impedance, peripheral airway flow resistance) and induce oxidative stress. Based on the current available evidence, e-cigarette use is associated with harmful biologic responses, although it may be less harmful than traditional cigarettes. (J ankowski, Brożek, Lawson, Skoczyński, & Zejda, 2017 ).

• Meta-analysis
• Exploratory

Education: In this review, Mary Vorsino writes that she is interested in keeping the potential influences of women pragmatists of Dewey’s day in mind while presenting modern feminist re readings of Dewey. She wishes to construct a narrowly-focused and succinct literature review of thinkers who have donned a feminist lens to analyze Dewey’s approaches to education, learning, and democracy and to employ Dewey’s works in theorizing on gender and education and on gender in society. This article first explores Dewey as both an ally and a problematic figure in feminist literature and then investigates the broader sphere of feminist pragmatism and two central themes within it: (1) valuing diversity, and diverse experiences; and (2) problematizing fixed truths. ( Vorsino, 2015 ).

Image Attributions

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

Share This Book

Education Resources and Services: Literature Review: Overview

• General Education
• Education Websites
• Literature Review: Overview
• APA Citations This link opens in a new window

What is a Literature Review?

A literature review evaluates the information within any published literature related to the topic or research question you choose. The literature review is meant to analyze the published literature related to your topic. A literature reviews reflects upon what has already been written about (methodical or theoretical), what the existing literature contributes to the field, and how your topic corresponds with the literature. If your topic exposes a gap in the existing research in your field, make note of that in the literature review.

This page will help you get started on how to conduct a literature review.

Resources About Literature Reviews

• Literature Reviews: Tips & Tools -- UNC - Chapel Hill
• Literature Review Tips -- UW - Madison

Why are Literature Reviews Written?

Here are some of the reasons why a literature review is important:

• Provides background information on the research produced around a topic.
• Helps focus your own research questions or problems.
• Discovers similarities between research already conducted.
• Identifies major themes, concepts, researches related to a topic as well as the significance of the research.
• Challenges biases and assumptions related to the subject matter.
• Identifies critical gaps, points of disagreement, or potentially flawed methodology or theoretical approaches. This can help with future research ideas.

Literature Review vs. Annotated Bibliography vs. Research Paper

Literature reviews are often confused with annotated bibliographies and research papers.

Literature review: reviews the existing literature on your topic, identifies major themes and concepts, examines critical research gaps for the field, and sets the scene for what your research topic will discuss.

Annotated Bibliography: summarizes each article you reviewed for your paper under its citation, and explains why the information in the article is useful for your argument.

Research Paper: Creates an argument to support one side of your research topic and selects articles and other resources to support your argument.

Planning Your Literature Review

Knowing where to begin with literature reviews is not always the easiest. Keep in mind that leaving enough time to develop your research question and reviewing your sources is essential. It is best to start early in your process. 

Here are some tips to help guide your planning and writing process:

• Explore various research questions that touch upon topics you are interested in.
• Choose your topic and define a research question.
• Some databases to search: ProQuest Education Journals , ERIC (Educational Resource Information Center) , and JSTOR .
• Read through and analyze the literature you found. Seek out similar themes or other information you are looking for.
• Write your review!

Developing Your Research Question

Brainstorming about your research question is important. Here are some questions to consider when reading through the literature you chose and finalizing your research question:

• What interested you in this topic? What are you  curious  about when thinking of this topic?
• What is already known about the topic?
• How much research has been conducted on this topic?
• Are there any gaps in research that you noticed?
• What do you want to focus on?
• Is there a specific time frame you are limiting this review to? (e.g. Last 10 years, last 5 years, etc.)

There are many more questions you could ask, but these are just a few to get you started.

• << Previous: Education Websites
• Next: APA Citations >>
• Last Updated: May 22, 2023 10:46 AM
• URL: https://wssu.libguides.com/education

Advertisement

Understanding the value of inclusive education and its implementation: A review of the literature

• Published: 07 September 2020
• Volume 49 , pages 135–152, ( 2020 )

Cite this article

• Anthoula Kefallinou 1 ,
• Simoni Symeonidou 1 , 2 &
• Cor J. W. Meijer 1  

8988 Accesses

43 Citations

11 Altmetric

Explore all metrics

European countries are increasingly committed to human rights and inclusive education. However, persistent educational and social inequalities indicate uneven implementation of inclusive education. This article reviews scholarly evidence on inclusion and its implementation, to show how inclusive education helps ensure both quality education and later social inclusion. Structurally, the article first establishes a conceptual framework for inclusive education, next evaluates previous research methodologies, and then reviews the academic and social benefits of inclusion. The fourth section identifies successful implementation strategies. The article concludes with suggestions on bridging the gap between inclusive education research, policy, and practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price includes VAT (Russian Federation)

Instant access to the full article PDF.

Rent this article via DeepDyve

Institutional subscriptions

Similar content being viewed by others

Inclusive education: Developments and challenges in South Africa

Full-Service Schools and Inclusion in South Africa

The justification for inclusive education in australia.

Ainscow, M. (1999). Understanding the development of inclusive schools . London: Falmer.

Google Scholar  

Ainscow, M. (2020). Promoting inclusion and equity in education: Lessons from international experiences. Nordic Journal of Studies in Educational Policy, 6 (1), 7–16.

Ainscow, M., Booth, T., & Dyson, A. (2004). Understanding and developing inclusive practices in schools: A collaborative action research network. International Journal of Inclusive Education, 8 (2), 125–139.

Ainscow, M., Dyson, A., Goldrick, S., & West, M. (2012). Making schools effective for all: Rethinking the task. School Leadership & Management, 32 (3), 197–213.

Ainscow, M., & Sandill, A. (2010). Developing inclusive education systems: The role of organisational cultures and leadership. International Journal of Inclusive Education, 14 (4), 401–416.

Allan, J. (2014). Inclusive education and the arts. Cambridge Journal of Education, 44 (4), 511–523.

Baer, R. M., Daviso, A. W., Flexer, R. W., McMahan Queen, R., & Meindl, R. S. (2011). Students with intellectual disabilities: Predictors of transition outcomes. Career Development and Transition for Exceptional Individuals, 34 (3), 132–141.

Baker, E. T., Wang, M. C., & Walberg, H. J. (1994/95). The effects of inclusion on learning. Educational Leadership, 52 (4), 33–35.

Båtevik, F. O., & Myklebust, J. O. (2006). The road to work for former students with special educational needs: Different paths for young men and young women? Scandinavian Journal of Disability Research, 8 (1), 38–52.

Bele, I. V., & Kvalsund, R. (2015). On your own within a network? Vulnerable youths’ social networks in transition from school to adult life. Scandinavian Journal of Disability Research, 17 (3), 195–220.

Bele, I. V., & Kvalsund, R. (2016). A longitudinal study of social relationships and networks in the transition to and within adulthood for vulnerable young adults at ages 24, 29 and 34 years: Compensation, reinforcement or cumulative disadvantages? European Journal of Special Needs Education, 31 (3), 314–329.

Benz, M., Lindstrom, L., & Yovanoff, P. (2000). Improving graduation and employment outcomes of students with disabilities: Predictive factors and student perspectives. Exceptional Children, 66 (4), 509–529.

Blatchford, P., Russell, A., & Webster, R. (2012). Reassessing the impact of teaching assistants: How research challenges practice and policy . Abingdon, OX: Routledge.

Blatchford, P., Russell, A., & Webster, R. (2016). Maximising the impact of teaching assistants: Guidance for school leaders and teachers (2nd ed.). Abingdon, OX: Routledge.

Booth, T. (2009). Keeping the future alive: Maintaining inclusive values in education and society. In M. Alur & V. Timmons (Eds.), Inclusive education across cultures: Crossing boundaries, sharing ideas (pp. 121–134). Los Angeles, CA: Sage.

Campbell, C. (2011). How to involve hard-to-reach parents: Encouraging meaningful parental involvement with schools . Nottingham: National College for School Leadership.

Carlberg, C., & Kavale, K. (1980). The efficacy of special versus regular class placement for exceptional children: A meta-analysis. The Journal of Special Education, 14 (3), 295–309.

Cimera, R. E. (2010). Can community-based high school transition programs improve the cost-efficiency of supported employment? Career Development and Transition for Exceptional Individuals, 33 (1), 4–12.

Cimera, R. E. (2011). Does being in sheltered workshops improve the employment outcomes of supported employees with intellectual disabilities? Journal of Vocational Rehabilitation, 35, 21–27.

Cobb, R. B., Lipscomb, S., Wolgemuth, J., Schulte, T., Veliquette, A., Alwell, M., et al. (2013). Improving post-high school outcomes for transition-age students with disabilities: An evidence review (NCEE 201 3–4011) . Washington, DC: National Center for Education Evaluation and Regional Assistance, Institute of Education Sciences.

Cobigo, V., Ouelette-Kuntz, H., Lysaght, R., & Martin, L. (2012). Shifting our conceptualization of social inclusion. Stigma Research and Action, 2 (2), 74–84.

Council of Europe Commissioner for Human Rights (2017). Fighting school segregation in Europe through inclusive education: A position paper . rm.coe.int/fighting-school-segregationin-europe-throughinclusive-education-a-posi/168073fb65.

Council of the European Union (2018a). Council recommendation on promoting common values, inclusive education and the European dimension of teaching . https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32018H0607(01)&from=EN .

Council of the European Union (2018b). Council conclusions on moving towards a vision of a European Education Area . https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52018XG0607(01)&rid=5 .

CRPD [United Nations Committee on the Rights of Persons with Disabilities] (2016). General comment no. 4 (2016), Article 24: Right to inclusive education . https://www.refworld.org/docid/57c977e34.html .

Day, C., Gu, Q., & Sammons, P. (2016). The impact of leadership on student outcomes: How successful school leaders use transformational and instructional strategies to make a difference. Educational Administration Quarterly, 52 (2), 221–258.

de Graaf, G., Van Hove, G., & Haveman, M. (2013). More academics in regular schools? The effect of regular versus special school placement on academic skills in Dutch primary school students with Down syndrome. Journal of Intellectual Disability Research, 57 (1), 21–38.

De Vroey, A., Struyf, E., & Petry, K. (2015). Secondary schools included: A literature review. International Journal of Inclusive Education, 20 (2), 109–135.

Dessemontet, R. S., Bless, G., & Morin, D. (2012). Effects of inclusion on the academic achievement and adaptive behaviour of children with intellectual disabilities. Journal of Intellectual Disability Research, 56 (6), 579–587.

Dweck, C. (2006). Mindset: The new psychology of success. How we can learn to fulfil our potential . New York, NY: Ballantine Books.

Dyson, A., Howes, A., & Roberts, B. (2002). A systematic review of the effectiveness of school-level actions for promoting participation by all students. In Research evidence in education library . London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London. http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=276 .

Dyson, D., Howes, A., Roberts, B., & Mitchell, D. (Eds.) (2005). What do we really know about inclusive schools? A systematic review of the research evidence. In Special educational needs and inclusive education: Major themes in education . London: Routledge.

Dyssegaard, C. B., & Larsen, M. S. (2013). Evidence on inclusion. Danish clearinghouse for educational research. Copenhagen: Department of Education, Aarhus University.

Erskine, H. E., Norman, R. E., Ferrari, A. J., Chan, G. C., Copeland, W. E., Whiteford, H. A., et al. (2016). Long-term outcomes of attention-deficit/hyperactivity disorder and conduct disorder: A systematic review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 55 (10), 841–850.

European Agency for Development in Special Needs Education (2003). Inclusive education and classroom practice: Summary report . Odense, Denmark. https://www.european-agency.org/sites/default/files/inclusive-education-and-classroom-practices_iecp-en.pdf .

European Agency for Development in Special Needs Education (2013). Organisation of provision to support inclusive education – Literature review . Odense, Denmark. https://www.european-agency.org/resources/publications/organisation-provision-support-inclusive-education-literature-review .

European Agency for Special Needs and Inclusive Education (2015). Agency position on inclusive education systems . https://www.european-agency.org/sites/default/files/PositionPaper-EN.pdf .

European Agency for Special Needs and Inclusive Education (2016a). Raising the achievement of all learners in inclusive education—Literature review (A. Kefallinou, Ed.). Odense, Denmark. https://www.european-agency.org/resources/publications/raising-achievement-all-learners-inclusive-education-literature-review .

European Agency for Special Needs and Inclusive Education (2016b). Early school leaving and learners with disabilities and/or special educational needs: A review of the research evidence focusing on Europe (A. Dyson & G. Squires, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/early-school-leaving-and-learners-disabilities-andor-special-educational-0 .

European Agency for Special Needs and Inclusive Education (2017a). Early school leaving and learners with disabilities and/or special educational needs: To what extent is research reflected in European Union policies? (G. Squires & A. Dyson, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/early-school-leaving-and-learners-disabilities-andor-special-educational .

European Agency for Special Needs and Inclusive Education (2017b). Raising the achievement of all learners in inclusive education: Lessons from European policy and practice (A. Kefallinou & V. J. Donnelly, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/raising-achievement-all-learners-project-overview .

European Agency for Special Needs and Inclusive Education (2018a). Evidence of the link between inclusive education and social inclusion: A review of the literature (S. Symeonidou, Ed.). Odense, Denmark. https://www.european-agency.org/resources/publications/evidence-literature-review .

European Agency for Special Needs and Inclusive Education (2018b). Key actions for raising achievement: Guidance for teachers and leaders (V. Donnelly & A. Kefallinou, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/key-actions-raising-achievement-guidance-teachers-and-leaders .

European Agency for Special Needs and Inclusive Education (2018c). Supporting inclusive school leadership: Literature review (E. Óskarsdóttir, V. J. Donnelly and M. Turner-Cmuchal, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/supporting-inclusive-school-leadership-literature-review .

European Agency for Special Needs and Inclusive Education (2019a). Preventing school failure: A review of the literature (G. Squires & A. Kefallinou, Eds.). Odense, Denmark. https://www.european-agency.org/resources/publications/preventing-school-failure-literature-review .

European Agency for Special Needs and Inclusive Education (2019b). Preventing school failure: Examining the potential of inclusive education policies at system and individual levels (A. Kefallinou, Ed.). Odense, Denmark. https://www.european-agency.org/resources/publications/preventing-school-failure-synthesis-report .

European Union Agency for Fundamental Rights (2020). Fundamental rights report —2020. https://fra.europa.eu/sites/default/files/fra_uploads/fra-2020-fundamental-rights-report-2020_en.pdf .

Farrell, P., Alborz, A., Howes, A., & Pearson, D. (2010). The impact of teaching assistants on improving pupils’ academic achievement in mainstream schools: A review of the literature. Educational Review, 62 (4), 435–448.

Farrell, P., Dyson, A., Polat, F., Hutcheson, G., & Gallannaugh, F. (2007). Inclusion and achievement in mainstream schools. European Journal of Special Needs Education, 22 (2), 131–145. https://doi.org/10.1080/08856250701267808 .

Article   Google Scholar  

Faubert, B. (2012). A literature review of school practices to overcome school failure. OECD Education Working Paper no. 68. Paris: OECD. http://dx.doi.org/10.1787/5k9flcwwv9tk-en .

Flecha, R. (2015). Successful educational actions for inclusion and social cohesion in Europe . Cham: Springer.

Flexer, R. W., Daviso, A. W., Baer, R. M., McMahan Queen, R., & Meindl, R. S. (2011). An epidemiological model of transition and postschool outcomes. Career Development and Transition for Exceptional Individuals, 34 (2), 83–94.

Florian, L., & Black-Hawkins, K. (2011). Exploring inclusive pedagogy. British Educational Research Journal, 37 (5), 813–828.

Francis, B., Archer, L., Hodgen, J., Pepper, D., Taylor, B., & Travers, M. C. (2017). Exploring the relative lack of impact of research on ‘ability grouping’ in England: A discourse analytic account. Cambridge Journal of Education, 47 (1), 1–17.

Fullan, M. (2002). The change. Educational Leadership, 59 (8), 16–20.

Gill, M. (2005). The myth of transition: Contractualizing disability in the sheltered workshop. Disability & Society, 20 (6), 613–623.

Göransson, K., & Nilholm, C. (2014). Conceptual diversities and empirical shortcomings—A critical analysis of research on inclusive education. European Journal of Special Needs Education, 29 (3), 265–280.

Gross, J. M. S., Haines, S. J., Hill, C., Francis, G. L., Blue-Banning, M., & Turnbull, A. P. (2015). Strong school–community partnerships in inclusive schools are “part of the fabric of the school… we count on them”. School Community Journal, 25 (2), 9–34.

Haines, S. J., Gross, J. M., Blue-Banning, M., Francis, G. L., & Turnbull, A. P. (2015). Fostering family–school and community–school partnerships in inclusive schools: Using practice as a guide. Research and Practice for Persons with Severe Disabilities, 40 (3), 227–239.

Harris, A. (2012). Leading system-wide improvement. International Journal of Leadership in Education, 15 (3), 395–401.

Hattie, J. A. C. (2009). Visible learning: A synthesis of 800+ meta-analyses on achievement . Abingdon, OX: Routledge.

Hehir, T., Grindal, T., Freeman, B., Lamoreau, R., Borquaye, Y., & Burke, S. (2016). A summary of the evidence on inclusive education . Cambridge: ABT Associates.

Hill, N. E., & Tyson, D. F. (2009). Parental involvement in middle school: A meta-analytic assessment of the strategies that promote achievement. Developmental Psychology, 45 (3), 740–763.

Jeynes, W. H. (2005). A meta-analysis of the relation of parental involvement to urban elementary school student academic achievement. Urban Education, 40 (3), 237–269.

Jeynes, W. H. (2007). The relationship between parental involvement and urban secondary school student academic achievement: A meta-analysis. Urban Education, 42 (1), 82–110.

Kalambouka, A., Farrell, P., Dyson, A., & Kaplan, I. (2007). The impact of placing pupils with special educational needs in mainstream schools on the achievement of their peers. Educational Research, 49 (4), 365–382.

Kinsella, W., & Senior, J. (2008). Developing inclusive schools: A systemic approach. International Journal of Inclusive Education, 12 (5–6), 651–665.

Kools, M., & Stoll, L. (2016). What makes a school a learning organisation? OECD Education Working Paper no. 137. Paris: OECD. https://doi.org/10.1787/5jlwm62b3bvh-en .

Kvalsund, R., & Bele, I. V. (2010a). Students with special educational needs—Social inclusion or marginalisation? Factors of risk and resilience in the transition between school and early adult life. Scandinavian Journal of Educational Research, 54 (1), 15–35.

Kvalsund, R., & Bele, I. V. (2010b). Adaptive situations and social marginalization in early adult life: Students with special educational needs. Scandinavian Journal of Disability Research, 12 (1), 59–76.

Lang, R., Kett, M., Groce, N., & Trani, J. F. (2011). Implementing the United Nations Convention on the rights of persons with disabilities: Principles, implications, practice and limitations. ALTER-European Journal of Disability Research/Revue Européenne de Recherche sur le Handicap, 5 (3), 206–220.

Lin-Siegler, X., Dweck, C. S., & Cohen, G. L. (2016). Instructional interventions that motivate classroom learning. Journal of Educational Psychology, 108 (3), 295.

Looney, J. W. (2011). Integrating formative and summative assessment: Progress toward a seamless system? OECD Education Working Paper no. 58. Paris: OECD.

Loreman, T., Forlin, C., & Sharma, U. (2014). Measuring indicators of inclusive education: A systematic review of the literature. Measuring Inclusive Education, 3, 165–187.

Lunt, N., & Thornton, P. (1994). Disability and employment: Towards an understanding of discourse and policy. Disability & Society, 9 (2), 223–238.

Mitchell, D. (2014). What really works in special and inclusive education: Using evidence-based teaching strategies . London: Routledge.

Muskin, J. A. (2015). Student learning assessment and the curriculum: Issues and implications for policy, design and implementation. In-Progress Reflection no. 1. Geneva: UNESCO International Bureau of Education (IBE).

Myklebust, J. O. (2006). Class placement and competence attainment among students with special educational needs. British Journal of Special Education, 33 (2), 76–81.

Myklebust, J. O. (2007). Diverging paths in upper secondary education: Competence attainment among students with special educational needs. International Journal of Inclusive Education, 11 (2), 215–231.

Myklebust, J. O., & Båtevik, F. O. (2005). Economic independence for adolescents with special educational needs. European Journal of Special Needs Education, 20 (3), 271–286.

Myklebust, J. O., & Båtevik, F. O. (2014). Economic independence among former students with special educational needs: Changes and continuities from their late twenties to their mid-thirties. European Journal of Special Needs Education, 29 (3), 387–401.

OECD (2012). Equity and quality in education: Supporting disadvantaged students and schools . Paris: OECD.

Oh-Young, C., & Filler, J. (2015). A meta-analysis of the effects of placement on academic and social skill outcome measures of students with disabilities. Research in Developmental Disabilities, 47, 80–92.

Pagán, R. (2009). Self-employment among people with disabilities: Evidence for Europe. Disability & Society, 24 (2), 217–229.

Pallisera, M., Vilà, M., & Fullana, J. (2012). Beyond school inclusion: Secondary school and preparing for labour market inclusion for young people with disabilities in Spain. International Journal of Inclusive Education, 16 (11), 1115–1129.

Priestley, M. (2000). Adults only: Disability, social policy and the life course. Journal of Social Policy, 29 (3), 421–439.

Rea, P., Mclaughlin, V., & Walther-Thomas, C. (2002). Outcomes for students with learning disabilities in inclusive and pullout programs. Exceptional Children, 68 (2), 203–223.

Rowe, N., Wilkin, A., & Wilson, R. (2012). Mapping of seminal reports on good teaching (NFER Research Programme: Developing the Education Workforce) . Slough: National Foundation for Educational Research.

Ruijs, N. M., & Peetsma, T. T. D. (2009). Effects of inclusion on students with and without special educational needs reviewed. Educational Research Review, 4 (2), 67–79. https://doi.org/10.1016/j.edurev.2009.02.002 .

Salend, S. J., & Garrick Duhaney, L. M. (1999). The impact of inclusion on students with and without disabilities and their educators. Remedial and Special Education, 20 (2), 114–126.

Sebba, J., Brown, N., Steward, S., Galton, M., & James, M. (2007). An investigation of personalised learning approaches used by schools . Nottingham: Department for Education and Skills Publications.

Shandra, C. L., & Hogan, D. (2008). School-to-work program participation and the post-high school employment of young adults with disabilities. Journal of Vocational Rehabilitation, 29 (2), 117–130.

Sharma, U., & Salend, S. J. (2016). Teaching assistants in inclusive classrooms: A systematic analysis of the international research. Australian Journal of Teacher Education, 41 (8), 118–134.

Simplican, S. C., Leader, G., Kosciulek, J., & Leahy, M. (2015). Defining social inclusion of people with intellectual and developmental disabilities: An ecological model of social networks and community participation. Research in Developmental Disabilities, 38 , 18–29.

Skjong, G., & Myklebust, J. O. (2016). Men in limbo: former students with special educational needs caught between economic independence and social security dependence. European Journal of Special Needs Education, 31 (3), 302–313.

Swann, M., Peacock, A., Hart, S., & Drummond, M. J. (2012). Creating learning without limits . Maidenhead: Open University Press.

SWIFT [Schoolwide Integrated Framework for Transformation] (2017). Equity as a basis for inclusive educational systems change, research to practice brief . Lawrence, KS: Sailor Wayne.

Symeonidou, S., & Mavrou, K. (2019). Problematising disabling discourses on the assessment and placement of learners with disabilities: Can interdependence inform an alternative narrative for inclusion? European Journal of Special Needs Education, 35 (1), 70–84.

Szumski, G., Smogorzewska, J., & Karwowski, M. (2017). Academic achievement of students without special educational needs in inclusive classrooms: A meta-analysis. Educational Research Review, 21, 33–54.

UNESCO (2009). Policy guidelines on inclusion in education . Paris: UNESCO. https://unesdoc.unesco.org/ark:/48223/pf0000177849 .

UNESCO (2017). A guide for ensuring inclusion and equity in education . Paris: UNESCO. https://unesdoc.unesco.org/ark:/48223/pf0000248254 .

UNICEF (2017). Inclusive education: Including children with disabilities in quality learning: What needs to be done? https://www.unicef.org/eca/sites/unicef.org.eca/files/IE_summary_accessible_220917_brief.pdf .

United Nations (2006). Convention on the rights of persons with disabilities . www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities/convention-on-the-rights-of-persons-with-disabilities-2.html .

United Nations (2015). Transforming our world. The 2030 agenda for sustainable development . https://sustainabledevelopment.un.org/content/documents/21252030%20Agenda%20for%20Sustainable%20Development%20web.pdf .

Vescio, V., Ross, D., & Adams, A. (2008). A review of research on the impact of professional learning communities on teaching practice and student learning. Teaching and Teacher Education, 24 (1), 80–91.

Waldron, N. L., & McLeskey, J. (2010a). Inclusive school placements and surplus/deficit in performance for students with intellectual disabilities: Is there a connection? Life Span and Disability, 13 (1), 29–42.

Waldron, N. L., & McLeskey, J. (2010b). Establishing a collaborative school culture through comprehensive school reform. Journal of Educational and Psychological Consultation, 20 (1), 58–74.

Download references

Author information

Authors and affiliations.

European Agency for Special Needs and Inclusive Education, Østre Stationsvej 33, 5000, Odense C, Denmark

Anthoula Kefallinou, Simoni Symeonidou & Cor J. W. Meijer

Department of Education, University of Cyprus, P.O. Box 20537, 1678, Nicosia, Cyprus

Simoni Symeonidou

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Anthoula Kefallinou .

Additional information

Publisher's note.

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

The development of the article was supported by the European Agency for Special Needs and Inclusive Education.

About this article

Kefallinou, A., Symeonidou, S. & Meijer, C.J.W. Understanding the value of inclusive education and its implementation: A review of the literature. Prospects 49 , 135–152 (2020). https://doi.org/10.1007/s11125-020-09500-2

Download citation

Published : 07 September 2020

Issue Date : November 2020

DOI : https://doi.org/10.1007/s11125-020-09500-2

Share this article

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

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

Provided by the Springer Nature SharedIt content-sharing initiative

• Inclusive education
• Academic outcomes
• Social inclusion
• Inclusive practice
• Find a journal
• Publish with us
• Track your research

• Open access
• Published: 06 June 2024

Challenges and opportunities for competency-based health professional education in Bangladesh: an interview, observation and mapping study

• Lucie Byrne-Davis 1 ,
• Natalie Carr 1 ,
• Tapash Roy 2 ,
• Salim Chowdhury 3 ,
• Usmaan Omer 1 ,
• Saher Nawaz 1 ,
• Dolce Advani 1 ,
• Olivia Byrne 1 &
• Jo Hart 1  

BMC Medical Education volume  24 , Article number:  629 ( 2024 ) Cite this article

109 Accesses

Metrics details

Bangladesh has a shortfall of health professionals. The World Health Organization states that improving education will increase recruitment and retention of health workers. Traditional learning approaches, in medical education particularly, focus on didactic teaching, teaching of subjects and knowledge testing. These approaches have been superseded in some programmes, with a greater focus on active learning, integrated teaching and learning of knowledge, application, skills and attitudes or values and associated testing of competencies as educational outcomes. In addition, some regions do not have continuous professional development or clinical placements for health worker students, contributing to difficulties in retention of health workers. This study aims to explore the experiences of health professional education in Bangladesh, focusing on what is through observation of health professional education sessions and experiences of educators.

This mixed method study included 22 observations of teaching sessions in clinical and educational settings, detailed analysis of 8 national curricula documents mapped to Global Competency and Outcomes Framework for Universal Health Coverage and 15 interviews of professionals responsible for health education. An observational checklist was created based on previous literature which assessed training of within dimensions of basic clinical skills; diagnosis and management; professionalism; professional development; and effective communication. Interviews explored current practices within health education in Bangladesh, as well as barriers and facilitators to incorporating different approaches to learning.

Observations revealed a variety of approaches and frameworks followed across institutions. Only one observation included all sub-competencies of the checklist. National curricula documents varied in their coverage of the Global Competency and Outcomes Framework domains. Three key themes were generated from a thematic analysis of interview transcripts: (1) education across the career span; (2) challenges for health professional education; (3) contextual factors and health professional education. Opportunities for progression and development post qualification are limited and certain professions are favoured over others.

Traditional approaches seem to predominate but there is some enthusiasm for a more clinical focus to education and for more competency based approaches to teaching, learning and assessment.

Peer Review reports

Well performing health workforces are fundamental to increasing equity and sustainability in health services and health outcomes globally, and achieving Universal Health Coverage (UHC) [ 1 , 2 ]. Workforces that lack competent health professionals can lead to poor quality of care and thwarts UHC progression [ 3 ]. A workforce which comprises of experienced health professionals who adapt to tomorrow’s ageing populations and epidemiological transformations are crucial to implementing the Sustainable Development Goals (SDGs) [ 4 ]. However, recruitment and retention of high quality, experienced doctors in low- or middle-income countries (LMICs) is problematic due to a global shortage of doctors, particularly in rural areas [ 5 , 6 , 7 , 8 ].

Bangladesh has a critical shortage of doctors, nurses and midwives [ 9 ], with the number of doctors per health workers falling far below the recommended number for the population [ 10 , 11 ]. Numbers are worse in rural areas where healthcare professionals are often semi-qualified or unqualified [ 12 , 13 ]. Bangladesh also experiences a high turnover of doctors and nurses, reportedly due to funding, lack of promotion, and career progression [ 3 , 12 , 14 , 15 ]. Global policies to address retention issues include recommending clinical rotations to rural areas during studies, curricula revisions to reflect the issues in rural areas, and continuous professional development (CPD) for health workers practising in rural locations [ 16 , 17 ].

Traditionally, particularly in medical education, programmes have focused on learning individual (usually predominantly biomedical) subjects in the early years before moving to a separate clinical education later in the programme. In some programmes, the more specific competencies are not included early on and, when they are included, they are mainly procedural. Testing for progression in such programmes is often based on the knowledge learned rather than the competencies developed. In particular, competencies that are harder to assess, such as clinical reasoning, professionalism and those related to psychosocial models, ethics and law are less of a focus in teaching and assessment. Traditional approaches have been criticised for failing to define outcomes i.e., what is desired as an end point of learning in practical terms, as well as neglecting some competencies while focusing on others [ 18 , 19 , 20 ].

Competency-based education, where it is adopted, aims to produce health professionals proficient in competencies that are driven by societal and patient needs [ 21 ]. Competency-based education focuses on gaining mastery of competencies to produce highly skilled and qualified health professionals [ 22 , 23 ]. For its implementation, therefore, stakeholders should agree competency definition, assessment and regulation to ensure key domains are not neglected, minimising the risk of educational institutions focusing on their own agenda and definitions [ 23 , 24 ]. For our purposes, the term ‘competency-based education’ applies to both specifying outcomes by competencies and delivering education explicitly to develop competencies. Many countries have adopted competency based education and have produced documents detailing the outcomes e.g., CANMEDS, GMC OfG [ 25 ].

Integration of competency-based frameworks for health worker education created by HICs into resource poor settings have sometimes been unsuccessful due to particular health and education systems nurturing some competencies and not others [ 24 ]. The harder to test competencies of, for example, professionalism and communication must consider the context perhaps to a greater extent as this varies considerably across countries [ 24 ]. In dental education in Bangladesh, insufficient community placements, shorter training times and little supervisory feedback has resulted in unachieved competencies in undergraduates [ 26 ]. Previous research recommended increased incentives for rural postings, a transparent system for career development in rural areas, and national policies about rural retention to improve retention of doctors [ 27 ]. Therefore, there is a need to further explore competency-based education for health workers in Bangladesh pre and post qualification.

This project aims to explore the context, challenges and opportunities for competency-based education in health workers in Bangladesh. There are national curricula for the different health professions in Bangladesh and a full documentary analysis of the extent to which these are competency-based would be useful but is beyond the scope of this study. Rather, the objectives of this study were to: (1) discover how a variety of health professional programmes are currently operating in terms of development of some standard competencies in Bangladesh; and (2) identify the barriers and facilitators to changing health professional educational approaches and particularly to explore how integration of newer approaches into the current undergraduate and postgraduate teaching curricula could be achieved to enhance the quality of education received by healthcare students from different cadres.

Research design

The study adopted a qualitative pragmatic mixed methods approach to explore and understand the quantity and quality of health worker education in Bangladesh. This included:

Mapping of health professional education curricula documents. Documents were mapped against the Global Competency Framework for UHC [ 28 ] to assess how embedded competency-based education is within health professional education curricula in Bangladesh.

To interview key informants about health professional education in Bangladesh. We selected interviews here as we wanted to explore the perceptions of key staff members as they are the people charged with implementing education and we wanted to have a rich understanding of how they think and feel about competency-based education and its implementation.

Observations of teaching sessions across a variety of programmes and regions in Bangladesh. Observations were selected in addition to curricula mapping and interviews to explore real world implementation of competency-based education. Firstly, we thought that whilst some documents might indicate competency-based education, this might not be enacted in real education and training. Secondly, although we have a stated definition of competency-based education, we thought that interviewing people, who might have a different working definition themselves, might lead to an over or under statement regarding the focus on competency based education.

Curricula mapping

Bangladesh national health professional curricula documents were sourced through the research team, and from interviewees.

Participants were individuals responsible for health professional education in Bangladesh and were invited for interview via email through snowball sampling via professional networks. A total of 15 key informant interviews were conducted by UO, a male post-doctoral researcher with previous experience of conducting interviews during PhD and post-doctoral research positions, who had no prior relationship with interviewees. Interviews took place virtually; therefore, it was not possible to know if anybody else was present. Semi structured interviews explored features of health professional education, facilitators and barriers to establishing CBE and health professional competency in practice. Recruitment ceased once data saturation (the point at which additional data would fail to generate new information) had been reached [ 29 , 30 ]. We developed the observational checklist through a combination of suggestions across the literature (see Fig.  1 ) [ 24 , 31 , 32 , 33 ].We based the competencies in the observational checklist on prior research and feedback from researchers TR and SC, through discussions with the wider research team, and later modified following publication of the Global Competency and Outcomes Framework for UHC [ 28 ]. The interview topic guide is included as supplementary file 1 .

Observational Checklist for use during observations of teaching sessions. Note The observational checklist was designed based on literature by Edwards & Frey [ 36 ], Gonczi [ 37 ], Gruppen & colleagues [ 18 ], and Smith & colleagues [ 35 ]. It was adapted following discussions of preliminary findings with the research team

Observations

Twenty-two teaching sessions were observed by SC/TR (both male, medical doctors and experienced researchers) in both clinical settings and classroom lectures across various health and medical education institutions in Dhaka, Chattogram, Sher-E-Bangla, Sylhet, and Sunamganj. Undergraduate and postgraduate courses were observed in nursing, midwifery, medicine, pharmacy and dentistry. Educational stakeholders identified participants eligible for observation. Structured observations allowed for behaviour to be observed in situ whilst considering the context of the clinical setting or educational facility where the participant was observed, and also permitted a fairly rapid data analysis as the competencies were already pre-determined [ 34 , 29 , 30 , 24 , 31 , 32 , 33 , 28 ].

Braun and Clarke [ 35 , 36 ].

Curriculum mapping

SN and DA mapped the content of the written curricula documents against the domains of the Global Competency Framework for Universal Health Coverage WHO [ 28 ]. They looked to any curricular elements that related to each domain by reading the curriculum explanation and using the statements under each domain. A judgement was made about whether the domains were represented. The first document was coded together, discussing each domain and curriculum element to reach a consensus understanding. The remaining curricula was then coded separately. Codings were shared with JH and LBD who checked them for sense and clarity.

The domains of the Global Competency Framework for Universal Health Coverage [ 28 ] are:

Domain 1: people centredness

Places people at the centre of all practice.

Promotes individual and community engagement.

Provides culturally sensitive, respectful and compassionate care.

Incorporates a holistic approach to health.

Domain 2: decision making

Takes an adaptive, collaborative and rigorous approach.

Incorporates a systems approach to decision making.

Takes a solutions-oriented approach to problem solving.

Adapts to unexpected or changing situations.

Domain 3: communication

Proactively manages interactions with others.

Adapts communication to the goals, needs… of the interaction.

Listens actively and attentively.

Conveys information purposefully.

Manages information sharing and documentation.

Domain 4: collaboration

Engages in collaborative practice.

Builds and maintains trusting partnerships.

Learns from, with and about others.

Constructively manages tensions and conflicts.

Domain 5: evidence-informed practice

Applies the principles of evidence-informed practice.

Assesses data and information from a range of sources.

Contributes to a culture of safety and continuous improvement.

Domain 6: Personal Conduct

Works within the limits of competence and scope of practice.

Demonstrates high standards of ethical conduct.

Engages in lifelong learning and reflective practice.

Manages own health and well-being.

Interview transcripts were analysed using an inductive approach to thematic analysis, following guidelines by Braun and Clarke [ 35 ]. Thematic analysis allowed patterns to be identified across the data and themes to be generated following systematic coding [ 36 ]. Familiarisation of transcripts took place before data was coded in NVivo 12 by UO. Codes were frequently revisited and edited to represent key concepts in the data and identify recurrent patterns. Similar codes were grouped together by SN into preliminary themes which were reviewed and modified with the wider research team until consensus was reached.

TR and SC separately observed teaching sessions. The coding of observations was qualitatively synthesised by JH and LBD and descriptive analyses were made where appropriate. SN and DA subsequently mapped the observations to the Global Competency Framework for Universal Health Coverage [ 28 ].

Triangulation of data

Interviews were conducted by UO, curriculum mapping by SN and DA and observations by SC and TR. These were done contemporaneously and discussed across all authors during and after completion. Results were combined by LBD and circulated for comments and edits to all authors,

Reflexivity

LBD and JH are health psychologists who work in a UK medical school and conduct health workforce and medical education research. They both have experience of delivering competency-based education to health workers, specifically doctors and specifically communication and behavioural and social sciences education and training. SC and TR are medical doctors who work in Bangladesh and conduct and lead research in health and healthcare. OB was an undergraduate in psychology. DA and SN were studying for an MSc in health psychology. NC is a PhD student in psychology and global health workforce. SC and TR both live in Dhaka and recruited for the observations from their personal networks. This will have influenced which sessions were able to be observed. Equally, the educators knew they were being observed by a medical doctor, which might have influenced how they conducted their sessions. LBD, JH, OB, NC, SN and DA all have a focus psychology and so will have been considering psychological aspects of barriers and facilitators when analysing interviews, This might have led to less of a focus on policy and structural barriers and facilitators, although we were aware of this and tried to consider these wider contexts throughout analysis.

Eight national curricula documents were analysed: 4 from nursing/midwifery, pharmacy, medicine and 2 postgraduate medicine. All curricula were created in Dhaka and were produced between 2006 to 2019.(see Table  1 ).

Table  2 provides a summary of coverage of the UHC domains. In general, people centredness and evidence informed practice were the most covered domains, collaboration was the least covered. The medical MBBS and Diploma in Midwifery had the largest coverage of the UHC domains/competencies.

Participants

Nineteen professionals working in medical education in Bangladesh from both the UK or Bangladesh were invited for interview, with four from the UK and 11 from Bangladesh agreeing to interview giving a total of 15 participants. Interviews varied between seven and 37 min in duration. Higher education, government and private sector facilities were reported as the primary work locations, although many participants reported working across multiple sectors. Participants varied in stages of career, with one reporting having worked in medical education for five years and the longest over 40 years. Work roles of participants included professors of medical education and pharmacology, lecturers of midwifery, nursing, palliative care, dentistry, development studies and global health.

We identified three key themes from the interview data: education across the career span; challenges for education; and contextual factors and health professional education. These themes are further explored in detail below with the use of illustrative examples from the interviews.

Theme 1: education across the career span

For many participants, working abroad is more appealing than continuing to work in Bangladesh upon graduation. Some attributed this to career pathway opportunities available overseas in comparison to Bangladesh, where there appears to be an indistinct or “no career pathway system" Participant (P) 004 . For example, qualified doctors “have to be a doctor" P004 and cannot change professions. Furthermore, “sometimes, people become unemployable, because they’ve been trained for the export market" P009 , indicating a conflict between education for a career in Bangladesh or overseas.

Employment was different for doctors and other health professions within Bangladesh. Midwifery was described as a “ very new profession ” P004 , with a limited number of employment opportunities. Obtaining jobs for doctors is challenging due to the extensive number of doctors in comparison to nursing, where there are more jobs available. However, there are insufficient nurses to fill these roles, with one participant highlighting there are “ four doctors to one nurse ” P005 which further impacts the ability of healthcare workers to meet population demands as the “ need is far greater than capacity to deliver. ” P008 .

Opportunities to develop skills beyond education were highlighted as lacking. Participants reported “ no ongoing education ” P009 available after qualification. Others described competency-based education as being found mostly post-qualification. One expressed doctors and nurses “ are provided with competency-based training ” P001 post-graduation. Another discussed how healthcare professionals have to engage in CPD “ in their own time ” P009 due their busy schedules. Others reported education was highly valued by health workers who were very keen to develop their skills and knowledge further. Incentives such as “ certificates of awards and recognition ” P009 were suggested to facilitate CPD.

Differences were reported in the number of opportunities available in public versus private sectors. Although “ government jobs … [are] very, very popular ” P009 , there are more private jobs available. These jobs are easier to attain than government jobs in healthcare which appear coveted as they require individuals to undergo a series of exams making the process more complicated and potentially stressful.

…after that [exam] you can do the job in private sector, not the government sector. Because if you wanted to do a job in government sector, you have to pass another [exam].” P004 .

Despite the ease at which private jobs can be attained, they do not appear to be desirable as “ there’s no regulation [or] no training. ” P009 However, one participant mentioned that the private healthcare sector is “ much more competency based. ” P003 .

Health education and training appears centralised in major cities, particularly in Dhaka. Many healthcare professionals choose to work “ in the capital ” and not “ go to the rural sides. ” P012 Curricula and training resources were thought to “evolve in Dhaka” first and then spread to other areas many months later. The shortage of health workers in rural areas, as a result, means that “ poorer communities… [do not have access] to primary health care. ” P012 However, attempts are being made to decentralise by ensuring “ nurses are spread out, and non-doctoral level positions are available. ” P002 .

Theme 2: challenges for health professional education

Participants identified various challenges to health professional education in Bangladesh. A common barrier to teaching was the limited resources and funding. This was particularly evident in post-qualification teaching, where staff were busy, and participants thought teaching was not prioritised. This was a particular issue given that participants said post-qualification teaching is where competency-based education was more likely to happen.

Educational materials being available only in English was another challenge.

” Most of the education particularly in the physician undergraduate, [and] also in the nursing and midwifery books, all books are available in English.” P001 .

The participant then discusses a lack of English vocabulary amongst nursing, midwifery and other health professionals, describing the training curriculum as developed in Bangla, but books referenced are usually written in English. Despite the openness to change, a lot of the teaching was reported to be rooted within traditional methods and “ very old fashioned.” P009 .

Many participants discussed the hierarchical system within healthcare. Senior members were unlikely to be influenced by junior members who had been taught to think and practice differently. One participant describes how others become defensive when new ideas are presented.

“So, introducing change in the traditional cultures of health care is very difficult anywhere in the country, which is very hierarchical.” P009 .

This was seen as a limitation, as staff learning in a competency-based way would not be able to apply their learning in practice.

Additionally, some professions were seen as more important than others. One participant describes a lack of employment and further education opportunities within midwifery whilst other professions have greater prospects for additional education:

… the nursing and the doctors’ profession…a direct entry to bachelor’s… they have a system master’s programme, Masters of Public Health…[they] participate in the national international forum…most of the doctors and nurses do the PhD also in other country.” P004 .

They then suggest the divide amongst cadres is exacerbated on a governmental level.

Political pressure like…she [prime minister] created lots of posts posted in government sector for doctors and nurses. ” P004 .

Employment opportunities have been created in government for doctors and nurses but not midwives. Similarly, a lack of trust between cadres was identified, with nurses unable to exercise their skills.

Now, the doctors themselves are not highly competent, but they don’t trust the nurses to do things like take blood pressure… the nurses believed the doctor must have been more accurate at taking the blood pressure.” P009 .

Many emphasised the need to modernise teaching and healthcare systems. One participant suggested educational approaches to improving healthcare education, including doing “ more case studies.” P005 Additionally, “ knowledge sharing” P001 through partnership work was viewed positively to learn how healthcare education is delivered in other places to improve the quality of health education in Bangladesh. Participants also valued the prospect of collaborating with other countries to “exchange their ideas” P013 with visiting healthcare professionals which could bring benefits to healthcare practice in Bangladesh.

Theme 3: contextual factors and health professional education

Reportedly, the attitudes of learners and teachers of health professional education were highly positive, with many participants suggesting Bengali learners demonstrate enthusiasm and passion towards their learning as they “love to receive training.” P001 Furthermore, the country was praised as “being open to development” P010 and progress.

I don’t think there are any barriers in terms of people’s willingness, interest, competence, capability, none of that.” P010 . CBE is becoming more prominent in Bangladesh, and participants acknowledge the benefits associated with CBE, such as getting to “ experience the practical side, as well as a theoretical side .” P012 .

Nursing is reported as a low status profession, “ seen as dirty work. ” P009 Arguably, this has been an issue with recruitment and retention of high-quality candidates for education, and therefore a general challenge.

Beyond health professional education, one participant reported an “ emphasis on memorisation ” P009 during primary and secondary education, rather than focusing on critical thinking skills. They discussed how developing critical thinking was then difficult in tertiary education.

Attempts being made to introduce ways in which “ competency-based training…could be started ” P001 have identified the lack of educators and trainers available with a grounding in competency-based education. Many of the trainers are practising health professionals; therefore, due to their busy schedules, they are unavailable to supervise the training.

“Because this is being done in the clinical side, the trainers are all busy clinicians. So, they don’t spend time with the trainees…training, competency-based training doesn’t actually get implemented by itself.” P001 .

The novelty of a competency-based approach and the heavy workload of practicing health professionals make a system where there are “few people capable of teaching.” P009 .

There are also many challenges associated with competency-based education (CBE). However, most CBE is taught and introduced to health workers in the clinical setting upon graduation rather than embedded within the primary undergraduate or post-graduate curriculum.

Observations of teaching sessions lasted between 30 and 120 min and were evenly split between SC and TR. The aims of the teaching sessions involved education or discussions of various clinical presentations, and practical clinical sessions. (see Table  3 for further detail)

Observations varied in the extent to which the sessions adhered to the sub-competencies. Competency-based education was evident (with over 60% of competencies covered) in 10 out of the 22 sessions (45% of observations). Clinical sessions involving patient interactions and examinations fulfilled more of the checklist than lecture-based sessions (Table  2 ). However, clinical sessions differed in how much they fulfilled the competencies and would significantly benefit from being competency based as they involved assessing patient needs or conditions and used simple clinical procedures that required students to demonstrate good patient communication to deliver optimal care. For some clinical sessions, patient privacy was compromised due to poor interactions by students and instructors who conducted examinations without consent. Most competencies were fulfilled through discussions and demonstrations led by the instructor via traditional methods with limited use of IT and videos and some active involvement of students, mainly if they were assessed during the session.

Observations revealed a significant lack of competency-based education, with only one session (002) fulfilling all sub-competencies. There was a lack of patient education, active listening and counselling, critical appraisal, and ability to adapt to the latest IT requirements for patient care. There were many missed opportunities for instructors and teachers to incorporate more competencies into teaching, which would support students’ knowledge and skills and prepare them for clinical practice. A sub sample, six observations were examined against the Global Competency and Outcomes Framework for UHC [ 28 ] to explore why those observations did not meet the competencies. Table  4 provides a summary of the findings. A lack of communication and collaboration both with patients and between health professionals across various cadres was found. Additionally, students were not encouraged to adapt their teaching styles or bring novel approaches forward, with little acknowledgement for self-development. Mapping competencies against pooled observations (see Table  5 ) enables us to see that sub competencies within professionalism, professional development and effective communication were most commonly observed.

This research explored how current curricula follow a competency-based framework and key informant opinions on the incorporation of newer education methods and principles. Observations and curriculum mapping allowed an exploration of competency-based education incorporated into teaching. Interviewing participants highlighted issues across the career span and contextual factors affecting health worker education.

Interviewees commented how a more competency-based approach was present in post qualification health worker education than to undergraduate education. This is problematic because opportunities for health professionals to enhance knowledge and skills during and after education vary depending on the type of profession, location, and the sector they choose to enter. Lack of CPD can inhibit competence and negatively impacts job satisfaction, recruitment and retention [ 37 ]. Limited English language fluency and the reduced number of high-quality trainers, resources and funding all hinder the quality of health worker education. Furthermore, life-long learning practice, a key competency, is rarely explicitly present (as observed through the personal conduct domain of the observation mapping). There was evidence of an increase in competency-based approaches in Bangladesh through curriculum changes and international collaborations, which the health professional educators of Bangladesh are making. A positive workplace which encourages health professionals to engage in CPD allows the transition of learning into practice and enables strong leadership [ 38 ]. Therefore, changes such as embedded systems for training and development to continue throughout the career, with protected time during working hours for training might increase .

Much of the findings reflect previous research in LMICs like Bangladesh. The stark differences in the number of human resources and health worker education across rural and urban areas examined in this study, alongside the limited CPD opportunities support previous findings by Darkwa, Newman [ 27 ] and Hossin, Faruque [ 26 ] and calls for an increase in training outside of Dhaka.

The lack of certainty around career pathways and opportunities available for new graduates across different disciplines like nursing and midwifery were reported as contributors to the maldistribution of healthcare professionals. Overseas work is becoming more appealing, leading to more significant shortages of health workers as previous research identifies increased international migration of health workers from LMICs, like Bangladesh, to HICs [ 39 , 40 ]. Thus, providing and developing opportunities which appeal to different health workers across the country ensures the retention of health workers to strengthen the health workforce and meet SDGs. Globally, social marketing campaigns have increased the attractiveness of health professional careers [ 41 ]. To address concerns about nursing as a profession in Bangladesh, further research should explore public perceptions of nursing which contribute to the development of social marketing campaigns that address how valued nurses are and includes examples of successful careers and career pathways.

Although there was some evidence of competency-based approaches, there continues to be an absence of specific components like evidence-based practice and holistic care across most curricula. Specific curricula are not regularly updated to incorporate new information frequently, a finding similar to Frenk, Chen [ 22 ], as traditional teaching methods focusing on the acquisition, not the application of knowledge, dominate health worker education. Updating the curriculum and using various teaching methods that focus on developing competencies will ensure the creation of a health workforce that can meet population needs quickly and effectively in a society that faces multiple health threats. Nevertheless, competency can be perceived differently around the world and thorough work to consider implementation of international standards would be a natural next step. Moreover, through bringing leaders of nursing education together to discuss different ways of teaching and learning, they can be empowered to lead change. For example, the Nursing Now programme fosters international relationships to support and empower nursing leaders, as well as develop new nursing leaders.

Limitations

Although we sampled across three regions and 28 programmes, Bangladesh has a very large population and many health professional programmes, that could be segmented in many ways. We were unable, within the scope of this study, to representatively sample programmes and sessions to observe. Therefore, we cannot draw conclusions about the reach and spread of newer methods of teaching and learning. We can, however, with that limitation state that we attempted to sample widely and that the predominance of traditional methods and content is worth of further exploration.

Both UHC and increasing migration of the Bangladesh health workforce could be further enhanced by stepping away from traditional modes of teaching and incorporating a more competency-based approach (tailored for the Bangladesh context) which covers all competencies and assesses students based on the skills they need for clinical practice, in addition to the knowledge they have acquired. The quality of health worker education depends upon the availability of various resources that can be lacking or unevenly distributed across the country. Many countries see global health workforce development as a good export for the future.

Data availability

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

Abbreviations

• Competency-based education

Continuing professional development

High income country

Low- or middle-income country

Sustainable Development Goals

Tropical Health and Education Trust

Universal Health Coverage

World Health Organization

Jimba M, Cometto G, Yamamoto T, Shiao L, Huicho L, Sheikh M, editors. Health workforce: the critical pathway to universal health coverage. World Health Organization, editor First Global Symposium on Health Systems Research Montreux, Switzerland: WHO; 2010.

WHO. Everybody’s business: strenthening health systems to improve health outcomes. Geneva: World Health Organization. 2007 [Available from: Everybody’s business -- strengthening health systems to improve health outcomes (who.int).

Bashar F, Islam R, Khan SM, Hossain S, Sikder AA, Yusuf SS, et al. Making doctors stay: rethinking doctor retention policy in a contracted-out primary healthcare setting in urban Bangladesh. PLoS ONE. 2022;17(1):e0262358.

Article   Google Scholar  

WHO. Health workforce 2030: towards a global strategy on human resources for health Geneva, Switzerland: World Health Organization. 2015 [ https://apps.who.int/iris/bitstream/handle/10665/330092/9789241508629-eng.pdf .

Russell DJ, Humphreys JS, McGrail MR, Cameron WI, Williams PJ. The value of survival analyses for evidence-based rural medical workforce planning. Hum Resour Health. 2013;11(1):1–9.

Kroezen M, Dussault G, Craveiro I, Dieleman M, Jansen C, Buchan J, et al. Recruitment and retention of health professionals across Europe: a literature review and multiple case study research. Health Policy. 2015;119(12):1517–28.

Dayrit MM, Dolea C, Dreesch N. Addressing the human resources for health HRH crisis in countries: how far have we gone? What can we expect to achieve by 2015? Revista peruana de medicina experimental y salud publica. 2011;28(2):327–36.

Castro Lopes S, Guerra-Arias M, Buchan J, Pozo-Martin F, Nove A. A rapid review of the rate of attrition from the health workforce. Hum Resour Health. 2017;15(1):21.

WHO. The world health report: 2006: working together for health Geneva: World Health Organization. 2006 [ https://www.who.int/publications/i/item/the-world-health-report---2006---working-together-for-health .

WHO. World health statistics 2018: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization Geneva: World Health Organization; 2018 [Available from: World health statistics 2018: monitoring health for the SDGs, sustainable development goals (who.int).

WHO. Global Global strategy on human resources for health: workforce 2030. Geneva: World Health Organization. 2016 [ https://apps.who.int/iris/bitstream/handle/10665/250368/9789241511131-eng.pdf .

Ahmed SM, Evans TG, Standing H, Mahmud S. Harnessing pluralism for better health in Bangladesh. Lancet. 2013;382(9906):1746–55.

Ahmed SM, Hossain MA, RajaChowdhury AM, Bhuiya AU. The health workforce crisis in Bangladesh: shortage, inappropriate skill-mix and inequitable distribution. Hum Resour Health. 2011;9(1):3.

Cockcroft A, Milne D, Oelofsen M, Karim E, Andersson N. Health services reform in Bangladesh: hearing the views of health workers and their professional bodies. BMC Health Serv Res. 2011;11(2):S8.

Chaudhury N, Hammer JS. Ghost doctors: Absenteeism in Rural Bangladeshi Health facilities. World Bank Econ Rev. 2004;18(3):423–41.

Buchan J, Couper ID, Tangcharoensathien V, Thepannya K, Jaskiewicz W, Perfilieva G, et al. Early implementation of WHO recommendations for the retention of health workers in remote and rural areas. Bull World Health Organ. 2013;91:834–40.

WHO. Increasing access to health workers in remote and rural areas through improved retention Geneva: World Health Organization. 2010 [ https://apps.who.int/iris/bitstream/handle/10665/44369/?sequence=1 .

Gruppen LD, Burkhardt JC, Fitzgerald JT, Funnell M, Haftel HM, Lypson ML, et al. Competency-based education: programme design and challenges to implementation. Med Educ. 2016;50(5):532–9.

Carraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C. Shifting paradigms: from Flexner to competencies. Acad Med. 2002;77(5):361–7.

Carraccio CL, Englander R. From Flexner to competencies: reflections on a Decade and the Journey ahead. Acad Med. 2013;88(8):1067–73.

Frank JR, Mungroo R, Ahmad Y, Wang M, De Rossi S, Horsley T. Toward a definition of competency-based education in medicine: a systematic review of published definitions. Med Teach. 2010;32(8):631–7.

Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376(9756):1923–58.

Hawkins RE, Welcher CM, Holmboe ES, Kirk LM, Norcini JJ, Simons KB, et al. Implementation of competency-based medical education: are we addressing the concerns and challenges? Med Educ. 2015;49(11):1086–102.

Gruppen LD, Mangrulkar RS, Kolars JC. The promise of competency-based education in the health professions for improving global health. Hum Resour Health. 2012;10(1):43.

Iobst WF, Sherbino J, Cate OT, Richardson DL, Dath D, Swing SR, et al. Competency-based medical education in postgraduate medical education. Med Teach. 2010;32(8):651–6.

Hossin MI, Faruque M, Talukder MHK, Ahmad MR, Al Harun MA, Chowdhury DKP. Competency based internship training programme in undergraduate dental education in Bangladesh: clinical teachers and intern doctors’ perception. Bangladesh J Med Educ. 2017;8(1):9–13.

Darkwa EK, Newman MS, Kawkab M, Chowdhury ME. A qualitative study of factors influencing retention of doctors and nurses at rural healthcare facilities in Bangladesh. BMC Health Serv Res. 2015;15(1):344.

WHO. Global Competency Framework for Universal Health Coverage. [Available from: global competency framework for universal health coverage. Geneva: World Health Organization; 2022. (who.int).

Google Scholar  

Morse JM. The significance of saturation. Sage publications Sage CA: Thousand Oaks, CA; 1995. pp. 147-9.

Sandelowski M. Sample size in qualitative research. Res Nurs Health. 1995;18(2):179–83.

Smith SR, Dollase RH, Boss JA. Assessing students’ performances in a competency-based Curriculum. Acad Med. 2003;78(1):97–107.

Edwards FD, Frey KA. The future of residency education: implementing a competency-based educational model. FAMILY MEDICINE-KANSAS CITY-. 2007;39(2):116.

Gonczi A. Competency-based approaches: linking theory and practice in professional education with particular reference to health education. Educational Philos Theory. 2013;45(12):1290–306.

Cohen L. Research methods in Education. Routledge; 2017.

Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3(2):77–101.

Braun V, Clarke V. Thematic analysis: a practical guide. London: SAGE; 2022.

Book   Google Scholar  

Coventry TH, Maslin-Prothero SE, Smith G. Organizational impact of nurse supply and workload on nurses continuing professional development opportunities: an integrative review. J Adv Nurs. 2015;71(12):2715–27.

King R, Taylor B, Talpur A, Jackson C, Manley K, Ashby N, et al. Factors that optimise the impact of continuing professional development in nursing: a rapid evidence review. Nurse Educ Today. 2021;98:104652.

Aluttis C, Bishaw T, Frank MW. The workforce for health in a globalized context–global shortages and international migration. Global Health Action. 2014;7(1):23611.

Abubakar I, Aldridge RW, Devakumar D, Orcutt M, Burns R, Barreto ML, et al. The UCL–Lancet Commission on Migration and Health: the health of a world on the move. Lancet. 2018;392(10164):2606–54.

Farsi D. Social Media and Health Care, Part I: Literature Review of Social Media Use by Health Care Providers. J Med Internet Res. 2021;23(4):e23205.

Download references

Acknowledgements

The researchers would like to thank everyone who participated in this study. Thank you particularly to Interactive Research and Development (IRD-Global) and Tropical Health and Education Trust (THET) for their support.

The study was funded by the British Council.

Author information

Authors and affiliations.

Division of Medical Education, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK

Lucie Byrne-Davis, Natalie Carr, Usmaan Omer, Saher Nawaz, Dolce Advani, Olivia Byrne & Jo Hart

Interactive Research and Development (IRD), Florida Castle, Dhaka, Bangladesh

Tropical Health & Education Trust, Dhaka, Bangladesh

Salim Chowdhury

You can also search for this author in PubMed   Google Scholar

Contributions

JH acquired the funding as Chief Investigator. LBD, JH, TR and SC conceived the study design. UO, TR and SC collected the data. LBD, JH, SN, DA and OB conducted qualitative analyses with support from JH and LBD. NC contributed to the analysis and writing of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jo Hart .

Ethics declarations

Ethics approval and consent to participate.

All methods were performed in accordance with the relevant guidelines and regulation, including the WMA Declaration of Helsinki – ethical principles for medical research involving human subjects. This study has received ethical approval from the University of Manchester University Proportionate Review Ethics Committee (Reference: 2021-11796-19280) and the Centre for Injury Prevention and Research Bangladesh (CIPRB) (Reference: CIPRB/ERC/2021/05). Participants were informed of their right to withdraw from the study before, during and immediately after the interview/observations. Interviews: All participants were audio recorded providing informed consent. Audio recordings of interviews were stored on an encrypted, password protected folder only available to the research team. Recordings were transcribed verbatim and anonymised to protect the identity of participants.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note.

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

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Supplementary material 2, rights and permissions.

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

Reprints and permissions

About this article

Cite this article.

Byrne-Davis, L., Carr, N., Roy, T. et al. Challenges and opportunities for competency-based health professional education in Bangladesh: an interview, observation and mapping study. BMC Med Educ 24 , 629 (2024). https://doi.org/10.1186/s12909-024-05558-0

Download citation

Received : 25 April 2023

Accepted : 15 May 2024

Published : 06 June 2024

DOI : https://doi.org/10.1186/s12909-024-05558-0

Share this article

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

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

Provided by the Springer Nature SharedIt content-sharing initiative

• Health professional education

BMC Medical Education

ISSN: 1472-6920

• Submission enquiries: [email protected]
• General enquiries: [email protected]

The Book Review’s Best Books Since 2000

Looking for your next great read? We’ve got 3,228. Explore the best fiction and nonfiction fiction nonfiction Short stories Historical fiction Poetry Thrillers Science fiction Mysteries Experimental fiction Horror Speculative fiction Satire Fantasy Romance Graphic novels Climate fiction Fiction Anthologies History Biographies Memoirs Science Narrative nonfiction Essays Investigative reporting Music Religion Sociology Politics True crime Sports Travel Art Letters Philosophy Food Media Current Events Climate change Nonfiction Anthologies from 2000 – 2023 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 chosen by our editors.

The 10 Best Books of 2023

Notable Books of 2023

You’ve just seen The Notable Books . See the entire list of best and notable books from every year.

• Share full article

Advertisement

• SUGGESTED TOPICS
• The Magazine
• Newsletters
• Managing Yourself
• Managing Teams
• Work-life Balance
• The Big Idea
• Data & Visuals
• Reading Lists
• Case Selections
• HBR Learning
• Topic Feeds
• Account Settings
• Email Preferences

In Defense of Degrowth

• Christopher Marquis

Deconstructing the myth that infinite economic growth could ever be truly sustainable.

There is a critical need to reassess the focus on continuous growth in the global economic system. The concept of “degrowth” challenges the necessity of perpetual economic expansion for human prosperity, suggesting it contradicts ecological sustainability on a planet with finite resources. Despite some resistance, especially from the business sector, the arguments supporting degrowth underscore the inextricable link between economic growth and environmental degradation, proposing a shift toward more sustainable business practices and a reevaluation of the myths surrounding “sustainable growth,” such as the effectiveness of energy transitions and efficiency improvements, which often overlook significant environmental impacts and dependencies on existing energy infrastructures. The article advocates for a societal movement toward reducing consumption and over-production, while embracing values of care and redistribution, challenging traditional market-first ideologies.

In May 2023, the Beyond Growth conference was held at the EU Parliament in Brussels. Headlined by government leaders and academics, its agenda was the urgent need to change the current economic system. The culmination was a manifesto that stated: “Our world is facing an eco-social crisis…driven by the global capitalist system, centered around perpetual economic expansion (growth) and accumulation. Our obsession with economic expansion clashes with finite planetary boundaries.”

• Christopher Marquis is Sinyi Professor of Chinese Management at Cambridge Judge Business School.

Partner Center

Reference Examples

More than 100 reference examples and their corresponding in-text citations are presented in the seventh edition Publication Manual . Examples of the most common works that writers cite are provided on this page; additional examples are available in the Publication Manual .

To find the reference example you need, first select a category (e.g., periodicals) and then choose the appropriate type of work (e.g., journal article ) and follow the relevant example.

When selecting a category, use the webpages and websites category only when a work does not fit better within another category. For example, a report from a government website would use the reports category, whereas a page on a government website that is not a report or other work would use the webpages and websites category.

Also note that print and electronic references are largely the same. For example, to cite both print books and ebooks, use the books and reference works category and then choose the appropriate type of work (i.e., book ) and follow the relevant example (e.g., whole authored book ).

Examples on these pages illustrate the details of reference formats. We make every attempt to show examples that are in keeping with APA Style’s guiding principles of inclusivity and bias-free language. These examples are presented out of context only to demonstrate formatting issues (e.g., which elements to italicize, where punctuation is needed, placement of parentheses). References, including these examples, are not inherently endorsements for the ideas or content of the works themselves. An author may cite a work to support a statement or an idea, to critique that work, or for many other reasons. For more examples, see our sample papers .

Reference examples are covered in the seventh edition APA Style manuals in the Publication Manual Chapter 10 and the Concise Guide Chapter 10

Related handouts

• Common Reference Examples Guide (PDF, 147KB)
• Reference Quick Guide (PDF, 225KB)

Textual Works

Textual works are covered in Sections 10.1–10.8 of the Publication Manual . The most common categories and examples are presented here. For the reviews of other works category, see Section 10.7.

• Journal Article References
• Magazine Article References
• Newspaper Article References
• Blog Post and Blog Comment References
• UpToDate Article References
• Book/Ebook References
• Diagnostic Manual References
• Children’s Book or Other Illustrated Book References
• Classroom Course Pack Material References
• Religious Work References
• Chapter in an Edited Book/Ebook References
• Dictionary Entry References
• Wikipedia Entry References
• Report by a Government Agency References
• Report with Individual Authors References
• Brochure References
• Ethics Code References
• Fact Sheet References
• ISO Standard References
• Press Release References
• White Paper References
• Conference Presentation References
• Conference Proceeding References
• Published Dissertation or Thesis References
• Unpublished Dissertation or Thesis References
• ERIC Database References
• Preprint Article References

Data and Assessments

Data sets are covered in Section 10.9 of the Publication Manual . For the software and tests categories, see Sections 10.10 and 10.11.

• Data Set References
• Toolbox References

Audiovisual Media

Audiovisual media are covered in Sections 10.12–10.14 of the Publication Manual . The most common examples are presented together here. In the manual, these examples and more are separated into categories for audiovisual, audio, and visual media.

• Artwork References
• Clip Art or Stock Image References
• Film and Television References
• Musical Score References
• Online Course or MOOC References
• Podcast References
• PowerPoint Slide or Lecture Note References
• Radio Broadcast References
• TED Talk References
• Transcript of an Audiovisual Work References
• YouTube Video References

Online Media

Online media are covered in Sections 10.15 and 10.16 of the Publication Manual . Please note that blog posts are part of the periodicals category.

• Facebook References
• Instagram References
• LinkedIn References
• Online Forum (e.g., Reddit) References
• TikTok References
• X References
• Webpage on a Website References
• Clinical Practice References
• Open Educational Resource References
• Whole Website References

Information

• Author Services

Initiatives

You are accessing a machine-readable page. In order to be human-readable, please install an RSS reader.

All articles published by MDPI are made immediately available worldwide under an open access license. No special permission is required to reuse all or part of the article published by MDPI, including figures and tables. For articles published under an open access Creative Common CC BY license, any part of the article may be reused without permission provided that the original article is clearly cited. For more information, please refer to https://www.mdpi.com/openaccess .

Feature papers represent the most advanced research with significant potential for high impact in the field. A Feature Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for future research directions and describes possible research applications.

Feature papers are submitted upon individual invitation or recommendation by the scientific editors and must receive positive feedback from the reviewers.

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

Original Submission Date Received: .

• Active Journals
• Find a Journal
• Proceedings Series
• For Authors
• For Reviewers
• For Editors
• For Librarians
• For Publishers
• For Societies
• For Conference Organizers
• Open Access Policy
• Institutional Open Access Program
• Special Issues Guidelines
• Editorial Process
• Research and Publication Ethics
• Article Processing Charges
• Testimonials
• Preprints.org
• SciProfiles
• Encyclopedia

Article Menu

• Subscribe SciFeed
• Recommended Articles
• Author Biographies
• Google Scholar
• on Google Scholar
• Table of Contents

Find support for a specific problem in the support section of our website.

Please let us know what you think of our products and services.

Visit our dedicated information section to learn more about MDPI.

JSmol Viewer

Social value trends in construction research: a bibliometric review of the past decade.

Share and Cite

Gyadu-Asiedu, N.A.A.; Aigbavboa, C.; Ametepey, S.O. Social Value Trends in Construction Research: A Bibliometric Review of the Past Decade. Sustainability 2024 , 16 , 4983. https://doi.org/10.3390/su16124983

Gyadu-Asiedu NAA, Aigbavboa C, Ametepey SO. Social Value Trends in Construction Research: A Bibliometric Review of the Past Decade. Sustainability . 2024; 16(12):4983. https://doi.org/10.3390/su16124983

Gyadu-Asiedu, Nana Akua Asabea, Clinton Aigbavboa, and Simon Ofori Ametepey. 2024. "Social Value Trends in Construction Research: A Bibliometric Review of the Past Decade" Sustainability 16, no. 12: 4983. https://doi.org/10.3390/su16124983

Article Metrics

Article access statistics, further information, mdpi initiatives, follow mdpi.

Subscribe to receive issue release notifications and newsletters from MDPI journals