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Understanding the Differences That Differentiate: A Model for Deciding Which Literature Review to Conduct
... However, such an approach brings with it the complexity of attempting to draw comparisons and contrasts based on disparate sources of information among diverse populations in different cultural contexts, which from an objectivist orientation might appear to limit the validity and generalizability of findings. And yet, from a subjectivist orientation, the scoping narrative literature review approach taken in this study confers the advantage of synthesis being informed by the researcher's previous knowledge, experiences, and subjective readings of the literature [81]. The purpose of this study, rather than to aggregate or compare data, was to integrate and synthesize rich contextual data sources that capture the breadth and depth of current knowledge regarding this topic and its elements in order to generate a more comprehensive understanding which could inform subsequent theory generation, in accordance with configurative logic [82]. ...
Background
Like other countries developing standardized general practice training, China faces the challenge of training vast numbers of new general practice faculty. However, little is known about these clinician-teachers’ motivations and perceived needs for faculty development. This review intended to explore available published data on Chinese general practice faculty development needs and motivation for ongoing professional development.
Methods
A systematic search was conducted using combinations of keyword and MeSH term searches in English in PubMed and in Chinese language CNKI and WanFang databases, followed by a qualitative narrative synthesis of relevant articles identified. Inclusion criteria: English or Chinese publications between 1990 and 2021; qualitative or quantitative research, systematic reviews, literature reviews, review or opinion articles pertaining to faculty development or professional development needs or motivations of general practice or family medicine teachers. Articles pertaining to fields outside of medicine, those with a heavy subspecialty focus or not relevant to primary care were excluded.
Results
A total of 88 full text articles were included in this review. Available data on Chinese general practice faculty development needs placed emphasis on fundamental general practice knowledge, principles, and clinical training needs more than teaching and assessment skills. Learning through teaching and a sense of responsibility were potential sources of intrinsic motivation for pursuing faculty development. Potential barriers to participation included busy workloads, inadequate organizational support, and limited finances. Mandatory participation, irrelevant content, lack of teaching experience, lack of motivation to teach, and overall job dissatisfaction appeared to negatively influence motivation to pursue faculty development.
Conclusions
Further research should explore the broader continuous professional development needs of this large population of general practice teachers. Qualitative studies are needed to clarify how individual, organizational, and contextual factors influence teachers’ motivation to pursue faculty development.
... While systematic reviews offer a precise approach to scientific evidence on a specific topic, narrative reviews allow for a broader and more general understanding of the phenomenon of interest. 62 In conclusion, the health needs of older adults, reviewed from a holistic perspective, define three dimensions of context composed of elements related to socioeconomic conditions, health services, and places of residence, which are often integrated at different points in the natural and pathological processes of aging, creating a cumulative effect over the course of life. The heterogeneity of these conditions contributes to academic, social, and political reflection for the reorganization of health services with a PHC approach. ...
The provision of inclusive health services for older adults requires a holistic approach to the health needs of the ageing population and their social environment, to deliver an effective response. To describe the health needs of older adults and their social environment, as a basis for integration of primary health care services. A non-systematic narrative review of the literature was conducted based on an electronic database covering the period 2019-2023 along with a combination of citation references. Information collection followed the principles of the thematic analysis derived from the qualitative approach. Two groups of health needs for older adults were identified: natural aging processes and disease processes. The social environment for these health needs were conceptualized in three interconnected dimensions: socioeconomic conditions, health services, and place of residence. Understanding the elements underlying the health needs which are determined by contextual conditions, supports strategies to improve services for older adults as part of the primary health care approach.
... Si bien las revisiones sistemáticas ofrecen un acercamiento preciso de la evidencia científica en un tema específico, las revisiones narrativas permiten una comprensión más amplia y general del fenómeno de interés. 62 En conclusión, las necesidades de salud de las PM revisadas desde una perspectiva holística definen tres dimensiones del contexto conformadas por elementos relacionados con las condiciones socioeconómicas, servicios de salud y lugares de residencia, que a menudo se integran en diferentes momentos de los procesos naturales y patológicos del envejecimiento, lo que genera un efecto acumulativo a largo de la vida. La heterogeneidad de estas condiciones contribuye a la reflexión académica, social y política para la reorganización de servicios de salud con enfoque de APS. ...
The provision of inclusive health services for older adults requires a holistic approach to the health needs of the ageing population and their social environment, to deliver an effective response. To describe the health needs of older adults and their social environment, as a basis for integration of primary health care services. A non-systematic narrative review of the literature was conducted based on an electronic database covering the period 2019-2023 along with a combination of citation references. Information collection followed the principles of the thematic analysis derived from the qualitative approach. Two groups of health needs for older adults were identified: natural aging processes and disease processes. The social environment for these health needs were conceptualized in three interconnected dimensions: socioeconomic conditions, health services, and place of residence. Understanding the elements underlying the health needs which are determined by contextual conditions, supports strategies to improve services for older adults as part of the primary health care approach.
As reviews become increasingly central to informing educational practice and guiding research in health professions education, the need for methodological clarity and quality has grown. This Commentary highlights three foundational principles - alignment, rigor, and transparency - that underpin high-quality reviews, regardless of type. We illustrate how these principles apply across commonly used review types, including systematic, scoping, realist, and narrative reviews. By aligning the research question with the appropriate review methodology, employing rigorous processes for evidence collection and synthesis, and maintaining transparency in methodological reporting, review teams can produce credible, transferable, and dependable findings. Embracing these principles not only enhances the trustworthiness of reviews but also supports stakeholders in applying synthesized knowledge effectively, ultimately advancing evidence-informed decision-making in health professions education.
Background
Black women and Black femme-identifying individuals (referred to as womxn) have developed alternative health practices that support their well-being when navigating oppressive systems. Within the U.S. healthcare system, Black womxn are disproportionally impacted by inequities and discriminatory practices, leading to higher incidences of chronic conditions, limited healthcare access, and higher mortality rates. Integrative medicine has not yet adequately examined or incorporated healing modalities practiced by Black womxn and therefore has not investigated its potential to foster more inclusive care.
Objectives
This critical narrative review aims to explore the contributions of Black womxn to integrative medicine, identify components of Black feminist healing modalities, and discuss future directions for integrating these practices into integrative medicine.
Methods
A critical review was conducted using databases including PubMed, JSTOR, Taylor & Francis Online, and Sage to gather academic and praxis-focused sources. Books and films related to Black womxn healing practices were also examined. Sources were selected based on their focus on non-Western, alternative, and complementary therapies developed and practiced by Black womxn in the United States.
Results
We identified three key categories of Black feminist healing modalities: (1) Communal Care and Communication, which includes practices like storytelling, gossip, and community gathering to foster resilience; (2) Art as a Form of Cultural Strengthening, which emphasizes the use of creative expression for healing and resistance; and (3) Spirituality. These modalities provide tools for Black womxn to resist systemic oppression and promote well-being.
Conclusion
Black feminist healing modalities are crucial for creating inclusive models of care that address the specific health needs of marginalized communities. Incorporating these modalities into healthcare can contribute to health equity by offering culturally relevant and holistic approaches to health for Black womxn and other historically minoritized groups. Future research should focus on developing evidence-based practices for integrating these modalities into clinical settings.
Background and objectives:
The last decade has witnessed increased recognition of the value of literature reviews for advancing understanding and decision making. This has been accompanied by an expansion in the range of methodological approaches and types of review. However, there remains uncertainty over definitions and search requirements beyond those for the 'traditional' systematic review. This study aims to characterise health related reviews by type and to provide recommendations on appropriate methods of information retrieval based on the available guidance.
Methods:
A list of review types was generated from published typologies and categorised into 'families' based on their common features. Guidance on information retrieval for each review type was identified by searching pubmed, medline and Google Scholar, supplemented by scrutinising websites of review producing organisations.
Results:
Forty-eight review types were identified and categorised into seven families. Published guidance reveals increasing specification of methods for information retrieval; however, much of it remains generic with many review types lacking explicit requirements for the identification of evidence.
Conclusions:
Defining review types and utilising appropriate search methods remain challenging. By familiarising themselves with a range of review methodologies and associated search methods, information specialists will be better equipped to select suitable approaches for future projects.
Qualitative research appears to be gaining acceptability in medical journals. Yet, little is actually known about the proportion of qualitative research and factors affecting its publication. This study describes the proportion of qualitative research over a 10 year period and correlates associated with its publication.A quantitative longitudinal examination of the proportion of original qualitative research in 67 journals of general medicine during a 10 year period (1998-2007). The proportion of qualitative research was determined by dividing original qualitative studies published (numerator) by all original research articles published (denominator). We used a generalized estimating equations approach to assess the longitudinal association between the proportion of qualitative studies and independent variables (i.e. journals' country of publication and impact factor; editorial/methodological papers discussing qualitative research; and specific journal guidelines pertaining to qualitative research).A 2.9% absolute increase and 3.4-fold relative increase in qualitative research publications occurred over a 10 year period (1.2% in 1998 vs. 4.1% in 2007). The proportion of original qualitative research was independently and significantly associated with the publication of editorial/methodological papers in the journal (b = 3.688, P = 0.012); and with qualitative research specifically mentioned in guidelines for authors (b = 6.847, P
The expansion of evidence-based practice across sectors has lead to an increasing variety of review types. However, the diversity of terminology used means that the full potential of these review types may be lost amongst a confusion of indistinct and misapplied terms. The objective of this study is to provide descriptive insight into the most common types of reviews, with illustrative examples from health and health information domains.
Following scoping searches, an examination was made of the vocabulary associated with the literature of review and synthesis (literary warrant). A simple analytical framework -- Search, AppraisaL, Synthesis and Analysis (SALSA) -- was used to examine the main review types.
Fourteen review types and associated methodologies were analysed against the SALSA framework, illustrating the inputs and processes of each review type. A description of the key characteristics is given, together with perceived strengths and weaknesses. A limited number of review types are currently utilized within the health information domain.
Few review types possess prescribed and explicit methodologies and many fall short of being mutually exclusive. Notwithstanding such limitations, this typology provides a valuable reference point for those commissioning, conducting, supporting or interpreting reviews, both within health information and the wider health care domain.
The limitations of traditional forms of systematic review in making optimal use of all forms of evidence are increasingly evident, especially for policy-makers and practitioners. There is an urgent need for robust ways of incorporating qualitative evidence into systematic reviews.
In this paper we provide a brief overview and critique of a selection of strategies for synthesising qualitative and quantitative evidence, ranging from techniques that are largely qualitative and interpretive through to techniques that are largely quantitative and integrative.
A range of methods is available for synthesising diverse forms of evidence. These include narrative summary, thematic analysis, grounded theory, meta-ethnography, meta-study, realist synthesis, Miles and Huberman's data analysis techniques, content analysis, case survey, qualitative comparative analysis and Bayesian meta-analysis. Methods vary in their strengths and weaknesses, ability to deal with qualitative and quantitative forms of evidence, and type of question for which they are most suitable.
We identify a number of procedural, conceptual and theoretical issues that need to be addressed in moving forward with this area, and emphasise the need for existing techniques to be evaluated and modified, rather than inventing new approaches.
Background
Coaching in graduate medical education provides a facilitative approach to feedback as well as opportunities for residents and fellows to engage with feedback and develop individualized improvement goals.
Objective
To explore the roles and actions of successful coaches in longitudinal coaching relationships and how they enable feedback processes.
Methods
Using interpretive description methodology, we performed semi-structured interviews with pediatrics fellows (n=11), faculty coaches (n=9), and program directors (n=2) from 2 pediatric subspecialty fellowship training programs at Ann and Robert H. Lurie Children's Hospital of Chicago. Both training programs had previously implemented longitudinal clinical coaching programs. Interview questions aimed to explore the roles and impacts of coaches within a longitudinal coaching program. Interviews took place in 2019 and 2020.
Results
We identified 4 major actions to the coaching role in longitudinal coaching relationships: (1) establish the coach-fellow relationship; (2) prepare for the coaching conversation; (3) facilitate feedback dialogue; and (4) serve as the go-to person to raise uncomfortable issues. Additionally, nearly all participants expressed support for a longitudinal coaching program to support fellows' growth and development of personalized learning goals.
Conclusions
By fulfilling these 4 key aspects to the coaching role, coaches in longitudinal relationships with coachees enable feedback processes.
Background
Rural US populations face a chronic shortage of physicians and an increasing gap in life expectancy compared to urban US populations, creating a need to understand how to increase residency graduates' desire to practice in such areas.
Objective
This study quantifies associations between the amount of rural training during family medicine (FM) residencies and subsequent rural work.
Methods
American Medical Association (AMA) Masterfile, AMA graduate medical education (GME) supplement, American Board of Family Medicine certification, Accreditation Council for Graduate Medical Education (ACGME), and Centers for Medicare and Medicaid Services hospital costs data were merged and analyzed. Multiple logistic regression measured associations between rural training and rural or urban practice in 2018 by all 12 162 clinically active physicians who completed a US FM residency accredited by the ACGME between 2008 and 2012. Analyses adjusted for key potential confounders (age, sex, program size, region, and medical school location and type) and clustering by resident program.
Results
Most (91%, 11 011 of 12 162) residents had no rural training. A minority (14%, 1721 of 12 162) practiced in a rural location in 2018. Residents with no rural training comprised 80% (1373 of 1721) of those in rural practice in 2018. Spending more than half of residency training months in rural areas was associated with substantially increased odds of rural practice (OR 5.3-6.3). Only 4% (424 of 12 162) of residents spent more than half their training in rural locations, and only 5% (26 of 436) of FM training programs had residents training mostly in rural settings or community-based clinics.
Conclusions
There is a linear gradient between increasing levels of rural exposure in FM GME and subsequent rural work.
Background
Physician burnout is pervasive within graduate medical education (GME), yet programs designed to reduce it have not been systematically evaluated. Effective approaches to burnout, aimed at addressing the impact of prolonged stress, may differ from those needed to improve wellness.
Objective
We systematically reviewed the literature of existing educational programs aimed to reduce burnout in GME.
Methods
Following the PRISMA guidelines, we identified peer-reviewed publications on GME burnout reduction programs through October 2019. Titles and abstracts were reviewed for relevance, and full-text studies were acquired for analysis. Article quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI).
Results
A total of 3534 articles met the search criteria, and 24 studies were included in the final analysis. Article quality varied, with MERSQI assessment scores varying between 8.5 and 14. Evaluation was based on participant scores on burnout reduction scales. Eleven produced significant results pertaining to burnout, 10 of which yielded a decrease in burnout. Curricula to reduce burnout among GME trainees varies. Content taught most frequently included stress management (n = 8), burnout reduction (n = 7), resilience (n = 7), and general wellness (n = 7). The most frequent pedagogical methods were discussion groups (n = 14), didactic sessions (n = 13), and small groups (n = 11). Most programs occurred during residents' protected education time.
Conclusions
There is not a consistent pattern of successful or unsuccessful programs. Further randomized controlled trials within GME are necessary to draw conclusions on which components most effectively reduce burnout.
Background
The limitations of traditional forms of systematic review in making optimal use of all forms of evidence are increasingly evident, especially for policy-makers and practitioners. There is an urgent need for robust ways of incorporating qualitative evidence into systematic reviews.
Objectives
In this paper we provide a brief overview and critique of a selection of strategies for synthesising qualitative and quantitative evidence, ranging from techniques that are largely qualitative and interpretive through to techniques that are largely quantitative and integrative.
Results
A range of methods is available for synthesising diverse forms of evidence. These include narrative summary, thematic analysis, grounded theory, meta-ethnography, meta-study, realist synthesis, Miles and Huberman's data analysis techniques, content analysis, case survey, qualitative comparative analysis and Bayesian meta-analysis. Methods vary in their strengths and weaknesses, ability to deal with qualitative and quantitative forms of evidence, and type of question for which they are most suitable.
Conclusions
We identify a number of procedural, conceptual and theoretical issues that need to be addressed in moving forward with this area, and emphasise the need for existing techniques to be evaluated and modified, rather than inventing new approaches.
Objective:
To compare and contrast different knowledge synthesis methods and map their specific steps through a scoping review to gain a better understanding of how to select the most appropriate knowledge synthesis method to answer research questions of complex evidence.
Study design and setting:
Electronic databases were searched to identify studies reporting emerging knowledge synthesis methods (e.g., Realist review) across multidisciplinary fields. Two reviewers independently selected studies and abstracted data for each article.
Results:
We synthesized diverse, often conflicting evidence to identify 12 unique knowledge synthesis methods and 13 analysis methods. We organized the 12 full knowledge synthesis methods according to their purpose, outputs and applicability for practice and policy, as well as general guidance on formulating the research question. To make sense of the overlap across these knowledge synthesis methods, we derived a conceptual algorithm to elucidate the process for selecting the optimal knowledge synthesis methods for particular research questions.
Conclusion:
These findings represent a preliminary understanding on which we will base further advancement of knowledge in this field. As part of next steps, we will convene a meeting of international leaders in the field aimed at clarifying emerging knowledge synthesis approaches.
Objective:
To systematically identify, define, and classify emerging knowledge synthesis methods through a scoping review.
Study design and setting:
MEDLINE, CINAHL, Embase, PsycINFO, the Cochrane Methodology Register, the Cochrane Database of Systematic Reviews, Social Sciences Abstracts, LISA, Philosopher's Index, and ERIC were searched to identify papers reporting emerging knowledge synthesis methods across the disciplines of health, education, sociology, and philosophy. Two reviewers independently selected studies and abstracted data for each article.
Results:
In total, 409 articles reporting on 25 knowledge synthesis methods were included after screening of 17,962 titles and abstracts and 1,010 potentially relevant full-text papers. The majority of the included articles were an application of the method (83.9%); only 3.7% were seminal articles that fully described the method (ie, operationalised the steps). Most of the included articles were published after 2005. The methods were most commonly used across the fields of nursing, health care science and services, and health policy.
Conclusion:
We found a lack of guidance on how to select a knowledge synthesis method. We propose convening an international group of leaders in the knowledge synthesis field to help clarify emerging approaches to knowledge synthesis.
Objective
To summarise articles reporting on burnout among medical students and residents (trainees) in a narrative review. MethodsMEDLINE was searched for peer-reviewed, English language articles published between 1990 and 2015 reporting on burnout among trainees. The search used combinations of Medical Subject Heading terms medical student, resident, internship and residency, and burnout, professional. Reference lists of articles were reviewed to identify additional studies. A subset of high-quality studies was selected. ResultsStudies suggest a high prevalence of burnout among trainees, with levels higher than in the general population. Burnout canundermine trainees' professional development, place patients at risk, and contribute to a variety of personal consequences, including suicidal ideation. Factors within the learning and work environment, rather than individual attributes, are the major drivers of burnout. Limited data are available regarding how to best address trainee burnout, but multi-pronged efforts, with attention to culture, the learning and work environment and individual behaviours, are needed to promote trainees' wellness and to help those in distress. Conclusion
Medical training is a stressful time. Large, prospective studies are needed to identify causeeffect relationships and the best approaches for improving the trainee experience. Discuss ideas arising from the article at discuss.
Objectives:
To highlight recent advances in knowledge synthesis methods and reporting guidelines.
Background:
Knowledge synthesis is critical to advancing practice, research, and policy, but synthesizing knowledge from an often-heterogeneous body of literature is challenging.
Methods:
A review of knowledge synthesis methods and reporting guidelines for health sciences research was completed using Google Scholar, Medline, CINAHL, and PsycInfo. Relevant information was critiqued and summarized for applicability to health science and practice.
Results:
Recent advances and guidelines pertaining to systematic reviews, meta-analysis, qualitative synthesis, mixed studies reviews, integrative reviews, scoping reviews, RE-AIM reviews, and umbrella reviews are discussed and examples of the application of each method to cardiopulmonary research are provided. Methods of quality appraisal are also presented.
Conclusions:
Advancements in knowledge synthesis and reporting guidelines enhance the quality, scope, and applicability of results; thus improving health science and clinical practice, and advancing health policy.
Why systematic review rather than narrative review?
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