thesis of literature study

Literary Criticism

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• thesis examples

SAMPLE THESIS STATEMENTS

These sample thesis statements are provided as guides, not as required forms or prescriptions.

______________________________________________________________________________________________________________

The thesis may focus on an analysis of one of the elements of fiction, drama, poetry or nonfiction as expressed in the work: character, plot, structure, idea, theme, symbol, style, imagery, tone, etc.

In “A Worn Path,” Eudora Welty creates a fictional character in Phoenix Jackson whose determination, faith, and cunning illustrate the indomitable human spirit.

Note that the work, author, and character to be analyzed are identified in this thesis statement. The thesis relies on a strong verb (creates). It also identifies the element of fiction that the writer will explore (character) and the characteristics the writer will analyze and discuss (determination, faith, cunning).

Further Examples:

The character of the Nurse in Romeo and Juliet serves as a foil to young Juliet, delights us with her warmth and earthy wit, and helps realize the tragic catastrophe.

The works of ecstatic love poets Rumi, Hafiz, and Kabir use symbols such as a lover’s longing and the Tavern of Ruin to illustrate the human soul’s desire to connect with God.

The thesis may focus on illustrating how a work reflects the particular genre’s forms, the characteristics of a philosophy of literature, or the ideas of a particular school of thought.

“The Third and Final Continent” exhibits characteristics recurrent in writings by immigrants: tradition, adaptation, and identity.

Note how the thesis statement classifies the form of the work (writings by immigrants) and identifies the characteristics of that form of writing (tradition, adaptation, and identity) that the essay will discuss.

Further examples:

Samuel Beckett’s Endgame reflects characteristics of Theatre of the Absurd in its minimalist stage setting, its seemingly meaningless dialogue, and its apocalyptic or nihilist vision.

A close look at many details in “The Story of an Hour” reveals how language, institutions, and expected demeanor suppress the natural desires and aspirations of women.

The thesis may draw parallels between some element in the work and real-life situations or subject matter: historical events, the author’s life, medical diagnoses, etc.

In Willa Cather’s short story, “Paul’s Case,” Paul exhibits suicidal behavior that a caring adult might have recognized and remedied had that adult had the scientific knowledge we have today.

This thesis suggests that the essay will identify characteristics of suicide that Paul exhibits in the story. The writer will have to research medical and psychology texts to determine the typical characteristics of suicidal behavior and to illustrate how Paul’s behavior mirrors those characteristics.

Through the experience of one man, the Narrative of the Life of Frederick Douglass, An American Slave, accurately depicts the historical record of slave life in its descriptions of the often brutal and quixotic relationship between master and slave and of the fragmentation of slave families.

In “I Stand Here Ironing,” one can draw parallels between the narrator’s situation and the author’s life experiences as a mother, writer, and feminist.

SAMPLE PATTERNS FOR THESES ON LITERARY WORKS

1. In (title of work), (author) (illustrates, shows) (aspect) (adjective). 

Example: In “Barn Burning,” William Faulkner shows the characters Sardie and Abner Snopes struggling for their identity.

2. In (title of work), (author) uses (one aspect) to (define, strengthen, illustrate) the (element of work).

Example: In “Youth,” Joseph Conrad uses foreshadowing to strengthen the plot.

3. In (title of work), (author) uses (an important part of work) as a unifying device for (one element), (another element), and (another element). The number of elements can vary from one to four.

Example: In “Youth,” Joseph Conrad uses the sea as a unifying device for setting, structure and theme.

4. (Author) develops the character of (character’s name) in (literary work) through what he/she does, what he/she says, what other people say to or about him/her.

Example: Langston Hughes develops the character of Semple in “Ways and Means”…

5. In (title of work), (author) uses (literary device) to (accomplish, develop, illustrate, strengthen) (element of work).

Example: In “The Masque of the Red Death,” Poe uses the symbolism of the stranger, the clock, and the seventh room to develop the theme of death.

6. (Author) (shows, develops, illustrates) the theme of __________ in the (play, poem, story).

Example: Flannery O’Connor illustrates the theme of the effect of the selfishness of the grandmother upon the family in “A Good Man is Hard to Find.”

7. (Author) develops his character(s) in (title of work) through his/her use of language.

Example: John Updike develops his characters in “A & P” through his use of figurative language.

Perimeter College, Georgia State University,  http://depts.gpc.edu/~gpcltc/handouts/communications/literarythesis.pdf

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• What is a Literature Review? | Guide, Template, & Examples

What is a Literature Review? | Guide, Template, & Examples

Published on 22 February 2022 by Shona McCombes . Revised on 7 June 2022.

What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research.

There are five key steps to writing a literature review:

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

A good literature review doesn’t just summarise sources – it analyses, synthesises, and critically evaluates to give a clear picture of the state of knowledge on the subject.

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Table of contents

Why write a literature review, examples of literature reviews, step 1: search for relevant literature, step 2: evaluate and select sources, step 3: identify themes, debates and gaps, step 4: outline your literature review’s structure, step 5: write your literature review, frequently asked questions about literature reviews, introduction.

• Quick Run-through
• Step 1 & 2

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

• Demonstrate your familiarity with the topic and scholarly context
• Develop a theoretical framework and methodology for your research
• Position yourself in relation to other researchers and theorists
• Show how your dissertation addresses a gap or contributes to a debate

You might also have to write a literature review as a stand-alone assignment. In this case, the purpose is to evaluate the current state of research and demonstrate your knowledge of scholarly debates around a topic.

The content will look slightly different in each case, but the process of conducting a literature review follows the same steps. We’ve written a step-by-step guide that you can follow below.

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

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

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

Download Word doc Download Google doc

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

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

If you are writing a literature review as a stand-alone assignment, you will have to choose a focus and develop a central question to direct your search. Unlike a dissertation research question, this question has to be answerable without collecting original data. You should be able to answer it based only on a review of existing publications.

Make a list of keywords

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

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

Search for relevant sources

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

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

You can use boolean operators to help narrow down your search:

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

To identify the most important publications on your topic, take note of recurring citations. If the same authors, books or articles keep appearing in your reading, make sure to seek them out.

You probably won’t be able to read absolutely everything that has been written on the topic – you’ll have to evaluate which sources are most relevant to your questions.

For each publication, ask yourself:

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

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

You can find out how many times an article has been cited on Google Scholar – a high citation count means the article has been influential in the field, and should certainly be included in your literature review.

The scope of your review will depend on your topic and discipline: in the sciences you usually only review recent literature, but in the humanities you might take a long historical perspective (for example, to trace how a concept has changed in meaning over time).

Remember that you can use our template to summarise and evaluate sources you’re thinking about using!

Take notes and cite your sources

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

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

You can use our free APA Reference Generator for quick, correct, consistent citations.

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

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

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

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

There are various approaches to organising the body of a literature review. You should have a rough idea of your strategy before you start writing.

Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).

Chronological

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

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

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

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

Methodological

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

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

Theoretical

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

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

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

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

If you are writing the literature review as part of your dissertation or thesis, reiterate your central problem or research question and give a brief summary of the scholarly context. You can emphasise the timeliness of the topic (“many recent studies have focused on the problem of x”) or highlight a gap in the literature (“while there has been much research on x, few researchers have taken y into consideration”).

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

As you write, make sure to follow these tips:

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

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

If the literature review is part of your dissertation or thesis, reiterate how your research addresses gaps and contributes new knowledge, or discuss how you have drawn on existing theories and methods to build a framework for your research. This can lead directly into your methodology section.

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

It is often written as part of a dissertation , thesis, research paper , or proposal .

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

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

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

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

Cite this Scribbr article

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McCombes, S. (2022, June 07). What is a Literature Review? | Guide, Template, & Examples. Scribbr. Retrieved 14 May 2024, from https://www.scribbr.co.uk/thesis-dissertation/literature-review/

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How to write a literature review in 6 steps

What is a literature review?

How to write a literature review, 1. determine the purpose of your literature review, 2. do an extensive search, 3. evaluate and select literature, 4. analyze the literature, 5. plan the structure of your literature review, 6. write your literature review, other resources to help you write a successful literature review, frequently asked questions about writing a literature review, related articles.

A literature review is an assessment of the sources in a chosen topic of research.

A good literature review does not just summarize sources. It analyzes the state of the field on a given topic and creates a scholarly foundation for you to make your own intervention. It demonstrates to your readers how your research fits within a larger field of study.

In a thesis, a literature review is part of the introduction, but it can also be a separate section. In research papers, a literature review may have its own section or it may be integrated into the introduction, depending on the field.

➡️ Our guide on what is a literature review covers additional basics about literature reviews.

• Identify the main purpose of the literature review.
• Do extensive research.
• Evaluate and select relevant sources.
• Analyze the sources.
• Plan a structure.
• Write the review.

In this section, we review each step of the process of creating a literature review.

In the first step, make sure you know specifically what the assignment is and what form your literature review should take. Read your assignment carefully and seek clarification from your professor or instructor if needed. You should be able to answer the following questions:

• How many sources do I need to include?
• What types of sources should I review?
• Should I evaluate the sources?
• Should I summarize, synthesize or critique sources?
• Do I need to provide any definitions or background information?

In addition to that, be aware that the narrower your topic, the easier it will be to limit the number of sources you need to read in order to get a good overview of the topic.

Now you need to find out what has been written on the topic and search for literature related to your research topic. Make sure to select appropriate source material, which means using academic or scholarly sources , including books, reports, journal articles , government documents and web resources.

➡️ If you’re unsure about how to tell if a source is scholarly, take a look at our guide on how to identify a scholarly source .

Come up with a list of relevant keywords and then start your search with your institution's library catalog, and extend it to other useful databases and academic search engines like:

• Google Scholar
• Science.gov

➡️ Our guide on how to collect data for your thesis might be helpful at this stage of your research as well as the top list of academic search engines .

Once you find a useful article, check out the reference list. It should provide you with even more relevant sources. Also, keep a note of the:

• authors' names
• page numbers

Keeping track of the bibliographic information for each source will save you time when you’re ready to create citations. You could also use a reference manager like Paperpile to automatically save, manage, and cite your references.

Read the literature. You will most likely not be able to read absolutely everything that is out there on the topic. Therefore, read the abstract first to determine whether the rest of the source is worth your time. If the source is relevant for your topic:

• Read it critically.
• Look for the main arguments.
• Take notes as you read.
• Organize your notes using a table, mind map, or other technique.

Now you are ready to analyze the literature you have gathered. While your are working on your analysis, you should ask the following questions:

• What are the key terms, concepts and problems addressed by the author?
• How is this source relevant for my specific topic?
• How is the article structured? What are the major trends and findings?
• What are the conclusions of the study?
• How are the results presented? Is the source credible?
• When comparing different sources, how do they relate to each other? What are the similarities, what are the differences?
• Does the study help me understand the topic better?
• Are there any gaps in the research that need to be filled? How can I further my research as a result of the review?

Tip: Decide on the structure of your literature review before you start writing.

There are various ways to organize your literature review:

• Chronological method : Writing in the chronological method means you are presenting the materials according to when they were published. Follow this approach only if a clear path of research can be identified.
• Thematic review : A thematic review of literature is organized around a topic or issue, rather than the progression of time.
• Publication-based : You can order your sources by publication, if the way you present the order of your sources demonstrates a more important trend. This is the case when a progression revealed from study to study and the practices of researchers have changed and adapted due to the new revelations.
• Methodological approach : A methodological approach focuses on the methods used by the researcher. If you have used sources from different disciplines that use a variety of research methods, you might want to compare the results in light of the different methods and discuss how the topic has been approached from different sides.

Regardless of the structure you chose, a review should always include the following three sections:

• An introduction, which should give the reader an outline of why you are writing the review and explain the relevance of the topic.
• A body, which divides your literature review into different sections. Write in well-structured paragraphs, use transitions and topic sentences and critically analyze each source for how it contributes to the themes you are researching.
• A conclusion , which summarizes the key findings, the main agreements and disagreements in the literature, your overall perspective, and any gaps or areas for further research.

➡️ If your literature review is part of a longer paper, visit our guide on what is a research paper for additional tips.

➡️ UNC writing center: Literature reviews

➡️ How to write a literature review in 3 steps

➡️ How to write a literature review in 30 minutes or less

The goal of a literature review is to asses the state of the field on a given topic in preparation for making an intervention.

A literature review should have its own independent section. You should indicate clearly in the table of contents where it can be found, and address this section as “Literature Review.”

There is no set amount of words for a literature review; the length depends on the research. If you are working with a large amount of sources, then it will be long. If your paper does not depend entirely on references, then it will be short.

Most research papers include a literature review. By assessing the available sources in your field of research, you will be able to make a more confident argument about the topic.

Literature reviews are most commonly found in theses and dissertations. However, you find them in research papers as well.

Writing a Thesis

Writing thesis in literature.

“God Speed” by Edmund Leighton, 1900

Sample Titles of Recent Theses in Literature

“Bilbo comes to the Huts of the Raft-elves” by J.R.R. Tolkien, 1973

What does a thesis do for me?

Thesis writers can be assured that they have been well prepared for graduate study, and can attest to that fact in their applications and interviews. They have also gained skills that will help them in any workplace. The intensive, self-motivated focus on one topic can be (at times) frustrating, overwhelming, and deeply gratifying: the rewards are many, and most students find their love of literature strengthened through their own efforts and dedication, as well as through the opportunity to work one-on-one with faculty scholars. The time and commitment involved in the process of writing a thesis may or may not exceed the credit hours officially accorded, but the rewards are great. This is a serious undertaking and assumes that the thesis candidate is a responsible adult, able to make deadlines and keep to them without external prodding, and ready to become a literary scholar with a mind of her own.

What do I do for my thesis?

“Donna con tavolette cerate e stilo (cosiddetta “Saffo”)/Woman with wax tablets and stylus (so-called “Sappho”)” fresco ca. 50 CE

Fall Semester: Preparatory Work

If they have not done so in the the Spring of the junior year, thesis candidates should consult with faculty prior to Registration Day to determine who would be an appropriate advisor. The thesis will eventually be read and evaluated by three faculty members: the advisor my suggest second and third readers, or may leave the decision to the student. Developing an argument takes time, but candidates should begin with a clear set of interests in mind, and ideally with background reading underway. Students may choose to focus on a particular author or literary text, or to connect several authors and texts through attention to a shared thematic or formal pattern.

Regular Supervision and Deadlines

“Beloved” by Joe Morse, 2015

Spring Semester: 12-Unit Thesis

During the spring semester, the thesis candidate signs up for the 12-unit Thesis and devotes substantial energy to expanding, completing, and revising the work. The student should continue to meet on a regular basis with the advisor, and should also be sharing draft chapters with the second and third readers as soon as possible. The thesis process involves extensive revision as well as writing, and students need to anticipate that as the semester proceeds their readers will have an increasing number of competing demands on their time from other classes: chapters may not be returned with comments and recommendations for revision until some time after being submitted, and thesis writers need to plan accordingly. A complete first draft should be submitted by the end of spring break or the beginning of April, depending on the academic calendar and the advisor’s schedule. This ensures adequate time for commentary and extensive final revision before the official Institute deadline for undergraduate theses (usually at the end of the penultimate week of classes, and listed on the official Academic Calendar).

After Completion

“Alice’s Adventures in Wonderland, The Mad Tea Party” by Sir John Tenniel, 1865

Think of yourself as a member of a jury, listening to a lawyer who is presenting an opening argument. You'll want to know very soon whether the lawyer believes the accused to be guilty or not guilty, and how the lawyer plans to convince you. Readers of academic essays are like jury members: before they have read too far, they want to know what the essay argues as well as how the writer plans to make the argument. After reading your thesis statement, the reader should think, "This essay is going to try to convince me of something. I'm not convinced yet, but I'm interested to see how I might be."

An effective thesis cannot be answered with a simple "yes" or "no." A thesis is not a topic; nor is it a fact; nor is it an opinion. "Reasons for the fall of communism" is a topic. "Communism collapsed in Eastern Europe" is a fact known by educated people. "The fall of communism is the best thing that ever happened in Europe" is an opinion. (Superlatives like "the best" almost always lead to trouble. It's impossible to weigh every "thing" that ever happened in Europe. And what about the fall of Hitler? Couldn't that be "the best thing"?)

A good thesis has two parts. It should tell what you plan to argue, and it should "telegraph" how you plan to argue—that is, what particular support for your claim is going where in your essay.

Steps in Constructing a Thesis

First, analyze your primary sources.  Look for tension, interest, ambiguity, controversy, and/or complication. Does the author contradict himself or herself? Is a point made and later reversed? What are the deeper implications of the author's argument? Figuring out the why to one or more of these questions, or to related questions, will put you on the path to developing a working thesis. (Without the why, you probably have only come up with an observation—that there are, for instance, many different metaphors in such-and-such a poem—which is not a thesis.)

Once you have a working thesis, write it down.  There is nothing as frustrating as hitting on a great idea for a thesis, then forgetting it when you lose concentration. And by writing down your thesis you will be forced to think of it clearly, logically, and concisely. You probably will not be able to write out a final-draft version of your thesis the first time you try, but you'll get yourself on the right track by writing down what you have.

Keep your thesis prominent in your introduction.  A good, standard place for your thesis statement is at the end of an introductory paragraph, especially in shorter (5-15 page) essays. Readers are used to finding theses there, so they automatically pay more attention when they read the last sentence of your introduction. Although this is not required in all academic essays, it is a good rule of thumb.

Anticipate the counterarguments.  Once you have a working thesis, you should think about what might be said against it. This will help you to refine your thesis, and it will also make you think of the arguments that you'll need to refute later on in your essay. (Every argument has a counterargument. If yours doesn't, then it's not an argument—it may be a fact, or an opinion, but it is not an argument.)

This statement is on its way to being a thesis. However, it is too easy to imagine possible counterarguments. For example, a political observer might believe that Dukakis lost because he suffered from a "soft-on-crime" image. If you complicate your thesis by anticipating the counterargument, you'll strengthen your argument, as shown in the sentence below.

Some Caveats and Some Examples

A thesis is never a question.  Readers of academic essays expect to have questions discussed, explored, or even answered. A question ("Why did communism collapse in Eastern Europe?") is not an argument, and without an argument, a thesis is dead in the water.

A thesis is never a list.  "For political, economic, social and cultural reasons, communism collapsed in Eastern Europe" does a good job of "telegraphing" the reader what to expect in the essay—a section about political reasons, a section about economic reasons, a section about social reasons, and a section about cultural reasons. However, political, economic, social and cultural reasons are pretty much the only possible reasons why communism could collapse. This sentence lacks tension and doesn't advance an argument. Everyone knows that politics, economics, and culture are important.

A thesis should never be vague, combative or confrontational.  An ineffective thesis would be, "Communism collapsed in Eastern Europe because communism is evil." This is hard to argue (evil from whose perspective? what does evil mean?) and it is likely to mark you as moralistic and judgmental rather than rational and thorough. It also may spark a defensive reaction from readers sympathetic to communism. If readers strongly disagree with you right off the bat, they may stop reading.

An effective thesis has a definable, arguable claim.  "While cultural forces contributed to the collapse of communism in Eastern Europe, the disintegration of economies played the key role in driving its decline" is an effective thesis sentence that "telegraphs," so that the reader expects the essay to have a section about cultural forces and another about the disintegration of economies. This thesis makes a definite, arguable claim: that the disintegration of economies played a more important role than cultural forces in defeating communism in Eastern Europe. The reader would react to this statement by thinking, "Perhaps what the author says is true, but I am not convinced. I want to read further to see how the author argues this claim."

A thesis should be as clear and specific as possible.  Avoid overused, general terms and abstractions. For example, "Communism collapsed in Eastern Europe because of the ruling elite's inability to address the economic concerns of the people" is more powerful than "Communism collapsed due to societal discontent."

Copyright 1999, Maxine Rodburg and The Tutors of the Writing Center at Harvard University

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• City College of San Francisco via ASCCC Open Educational Resources Initiative

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The Literary Thesis Statement

Literary essays are argumentative or persuasive essays. Their purpose is primarily analysis, but analysis for the purposes of showing readers your interpretation of a literary text. So the thesis statement is a one to two sentence summary of your essay's main argument, or interpretation.

Just like in other argumentative essays, the thesis statement should be a kind of opinion based on observable fact about the literary work.

Thesis Statements Should Be

• This thesis takes a position. There are clearly those who could argue against this idea.
• Look at the text in bold. See the strong emphasis on how form (literary devices like symbolism and character) acts as a foundation for the interpretation (perceived danger of female sexuality).
• Through this specific yet concise sentence, readers can anticipate the text to be examined ( Huckleberry Finn) , the author (Mark Twain), the literary device that will be focused upon (river and shore scenes) and what these scenes will show (true expression of American ideals can be found in nature).

Thesis Statements Should NOT Be

• While we know what text and author will be the focus of the essay, we know nothing about what aspect of the essay the author will be focusing upon, nor is there an argument here.
• This may be well and true, but this thesis does not appear to be about a work of literature. This could be turned into a thesis statement if the writer is able to show how this is the theme of a literary work (like "Girl" by Jamaica Kincaid) and root that interpretation in observable data from the story in the form of literary devices.
• Yes, this is true. But it is not debatable. You would be hard-pressed to find someone who could argue with this statement. Yawn, boring.
• This may very well be true. But the purpose of a literary critic is not to judge the quality of a literary work, but to make analyses and interpretations of the work based on observable structural aspects of that work.
• Again, this might be true, and might make an interesting essay topic, but unless it is rooted in textual analysis, it is not within the scope of a literary analysis essay. Be careful not to conflate author and speaker! Author, speaker, and narrator are all different entities! See: intentional fallacy.

Thesis Statement Formula

One way I find helpful to explain literary thesis statements is through a "formula":

Thesis statement = Observation + Analysis + Significance

• Observation: usually regarding the form or structure of the literature. This can be a pattern, like recurring literary devices. For example, "I noticed the poems of Rumi, Hafiz, and Kabir all use symbols such as the lover's longing and Tavern of Ruin "
• Analysis: You could also call this an opinion. This explains what you think your observations show or mean. "I think these recurring symbols all represent the human soul's desire." This is where your debatable argument appears.
• Significance: this explains what the significance or relevance of the interpretation might be. Human soul's desire to do what? Why should readers care that they represent the human soul's desire? "I think these recurring symbols all show the human soul's desire to connect with God. " This is where your argument gets more specific.

Thesis statement: The works of ecstatic love poets Rumi, Hafiz, and Kabir use symbols such as a lover’s longing and the Tavern of Ruin to illustrate the human soul’s desire to connect with God .

Thesis Examples

SAMPLE THESIS STATEMENTS

These sample thesis statements are provided as guides, not as required forms or prescriptions.

______________________________________________________________________________________________________________

The Literary Device Thesis Statement

The thesis may focus on an analysis of one of the elements of fiction, drama, poetry or nonfiction as expressed in the work: character, plot, structure, idea, theme, symbol, style, imagery, tone, etc.

In “A Worn Path,” Eudora Welty creates a fictional character in Phoenix Jackson whose determination, faith, and cunning illustrate the indomitable human spirit.

Note that the work, author, and character to be analyzed are identified in this thesis statement. The thesis relies on a strong verb (creates). It also identifies the element of fiction that the writer will explore (character) and the characteristics the writer will analyze and discuss (determination, faith, cunning).

The character of the Nurse in Romeo and Juliet serves as a foil to young Juliet, delights us with her warmth and earthy wit, and helps realize the tragic catastrophe.

The Genre / Theory Thesis Statement

The thesis may focus on illustrating how a work reflects the particular genre’s forms, the characteristics of a philosophy of literature, or the ideas of a particular school of thought.

“The Third and Final Continent” exhibits characteristics recurrent in writings by immigrants: tradition, adaptation, and identity.

Note how the thesis statement classifies the form of the work (writings by immigrants) and identifies the characteristics of that form of writing (tradition, adaptation, and identity) that the essay will discuss.

Samuel Beckett’s Endgame reflects characteristics of Theatre of the Absurd in its minimalist stage setting, its seemingly meaningless dialogue, and its apocalyptic or nihilist vision.

A close look at many details in “The Story of an Hour” reveals how language, institutions, and expected demeanor suppress the natural desires and aspirations of women.

Generative Questions

One way to come up with a riveting thesis statement is to start with a generative question. The question should be open-ended and, hopefully, prompt some kind of debate.

• What is the effect of [choose a literary device that features prominently in the chosen text] in this work of literature?
• How does this work of literature conform or resist its genre, and to what effect?
• How does this work of literature portray the environment, and to what effect?
• How does this work of literature portray race, and to what effect?
• How does this work of literature portray gender, and to what effect?
• What historical context is this work of literature engaging with, and how might it function as a commentary on this context?

These are just a few common of the common kinds of questions literary scholars engage with. As you write, you will want to refine your question to be even more specific. Eventually, you can turn your generative question into a statement. This then becomes your thesis statement. For example,

• How do environment and race intersect in the character of Frankenstein's monster, and what can we deduce from this intersection?

Expert Examples

While nobody expects you to write professional-quality thesis statements in an undergraduate literature class, it can be helpful to examine some examples. As you view these examples, consider the structure of the thesis statement. You might also think about what questions the scholar wondered that led to this statement!

• "Heart of Darkness projects the image of Africa as 'the other world,' the antithesis of Europe and therefore civilization, a place where man's vaunted intelligence and refinement are finally mocked by triumphant bestiality" (Achebe 3).
• "...I argue that the approach to time and causality in Boethius' sixth-century Consolation of Philosophy can support abolitionist objectives to dismantle modern American policing and carceral systems" (Chaganti 144).
• "I seek to expand our sense of the musico-poetic compositional practices available to Shakespeare and his contemporaries, focusing on the metapoetric dimensions of Much Ado About Nothing. In so doing, I work against the tendency to isolate writing as an independent or autonomous feature the work of early modern poets and dramatists who integrated bibliographic texts with other, complementary media" (Trudell 371).

Works Cited

Achebe, Chinua. "An Image of Africa" Research in African Literatures 9.1 , Indiana UP, 1978. 1-15.

Chaganti, Seeta. "Boethian Abolition" PMLA 137.1 Modern Language Association, January 2022. 144-154.

"Thesis Statements in Literary Analysis Papers" Author unknown. https://resources.finalsite.net/imag...handout__1.pdf

Trudell, Scott A. "Shakespeare's Notation: Writing Sound in Much Ado about Nothing " PMLA 135.2, Modern Language Association, March 2020. 370-377.

Contributors and Attributions

Thesis Examples. Authored by: University of Arlington Texas. License: CC BY-NC

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What is a Literature Review? How to Write It (with Examples)

A literature review is a critical analysis and synthesis of existing research on a particular topic. It provides an overview of the current state of knowledge, identifies gaps, and highlights key findings in the literature. 1 The purpose of a literature review is to situate your own research within the context of existing scholarship, demonstrating your understanding of the topic and showing how your work contributes to the ongoing conversation in the field. Learning how to write a literature review is a critical tool for successful research. Your ability to summarize and synthesize prior research pertaining to a certain topic demonstrates your grasp on the topic of study, and assists in the learning process. 

Table of Contents

• What is the purpose of literature review? 
• a. Habitat Loss and Species Extinction: 
• b. Range Shifts and Phenological Changes: 
• c. Ocean Acidification and Coral Reefs: 
• d. Adaptive Strategies and Conservation Efforts: 

How to write a good literature review 

• Choose a Topic and Define the Research Question: 
• Decide on the Scope of Your Review: 
• Select Databases for Searches: 
• Conduct Searches and Keep Track: 
• Review the Literature: 
• Organize and Write Your Literature Review: 
• How to write a literature review faster with Paperpal? 
• Frequently asked questions 

What is a literature review?

A well-conducted literature review demonstrates the researcher’s familiarity with the existing literature, establishes the context for their own research, and contributes to scholarly conversations on the topic. One of the purposes of a literature review is also to help researchers avoid duplicating previous work and ensure that their research is informed by and builds upon the existing body of knowledge.

What is the purpose of literature review?

A literature review serves several important purposes within academic and research contexts. Here are some key objectives and functions of a literature review: 2  

1. Contextualizing the Research Problem: The literature review provides a background and context for the research problem under investigation. It helps to situate the study within the existing body of knowledge. 

2. Identifying Gaps in Knowledge: By identifying gaps, contradictions, or areas requiring further research, the researcher can shape the research question and justify the significance of the study. This is crucial for ensuring that the new research contributes something novel to the field. 

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3. Understanding Theoretical and Conceptual Frameworks: Literature reviews help researchers gain an understanding of the theoretical and conceptual frameworks used in previous studies. This aids in the development of a theoretical framework for the current research. 

4. Providing Methodological Insights: Another purpose of literature reviews is that it allows researchers to learn about the methodologies employed in previous studies. This can help in choosing appropriate research methods for the current study and avoiding pitfalls that others may have encountered. 

5. Establishing Credibility: A well-conducted literature review demonstrates the researcher’s familiarity with existing scholarship, establishing their credibility and expertise in the field. It also helps in building a solid foundation for the new research. 

6. Informing Hypotheses or Research Questions: The literature review guides the formulation of hypotheses or research questions by highlighting relevant findings and areas of uncertainty in existing literature. 

Literature review example

Let’s delve deeper with a literature review example: Let’s say your literature review is about the impact of climate change on biodiversity. You might format your literature review into sections such as the effects of climate change on habitat loss and species extinction, phenological changes, and marine biodiversity. Each section would then summarize and analyze relevant studies in those areas, highlighting key findings and identifying gaps in the research. The review would conclude by emphasizing the need for further research on specific aspects of the relationship between climate change and biodiversity. The following literature review template provides a glimpse into the recommended literature review structure and content, demonstrating how research findings are organized around specific themes within a broader topic. 

Literature Review on Climate Change Impacts on Biodiversity:

Climate change is a global phenomenon with far-reaching consequences, including significant impacts on biodiversity. This literature review synthesizes key findings from various studies: 

a. Habitat Loss and Species Extinction:

Climate change-induced alterations in temperature and precipitation patterns contribute to habitat loss, affecting numerous species (Thomas et al., 2004). The review discusses how these changes increase the risk of extinction, particularly for species with specific habitat requirements. 

b. Range Shifts and Phenological Changes:

Observations of range shifts and changes in the timing of biological events (phenology) are documented in response to changing climatic conditions (Parmesan & Yohe, 2003). These shifts affect ecosystems and may lead to mismatches between species and their resources. 

c. Ocean Acidification and Coral Reefs:

The review explores the impact of climate change on marine biodiversity, emphasizing ocean acidification’s threat to coral reefs (Hoegh-Guldberg et al., 2007). Changes in pH levels negatively affect coral calcification, disrupting the delicate balance of marine ecosystems. 

d. Adaptive Strategies and Conservation Efforts:

Recognizing the urgency of the situation, the literature review discusses various adaptive strategies adopted by species and conservation efforts aimed at mitigating the impacts of climate change on biodiversity (Hannah et al., 2007). It emphasizes the importance of interdisciplinary approaches for effective conservation planning. 

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Writing a literature review involves summarizing and synthesizing existing research on a particular topic. A good literature review format should include the following elements. 

Introduction: The introduction sets the stage for your literature review, providing context and introducing the main focus of your review. 

• Opening Statement: Begin with a general statement about the broader topic and its significance in the field. 
• Scope and Purpose: Clearly define the scope of your literature review. Explain the specific research question or objective you aim to address. 
• Organizational Framework: Briefly outline the structure of your literature review, indicating how you will categorize and discuss the existing research. 
• Significance of the Study: Highlight why your literature review is important and how it contributes to the understanding of the chosen topic. 
• Thesis Statement: Conclude the introduction with a concise thesis statement that outlines the main argument or perspective you will develop in the body of the literature review. 

Body: The body of the literature review is where you provide a comprehensive analysis of existing literature, grouping studies based on themes, methodologies, or other relevant criteria. 

• Organize by Theme or Concept: Group studies that share common themes, concepts, or methodologies. Discuss each theme or concept in detail, summarizing key findings and identifying gaps or areas of disagreement. 
• Critical Analysis: Evaluate the strengths and weaknesses of each study. Discuss the methodologies used, the quality of evidence, and the overall contribution of each work to the understanding of the topic. 
• Synthesis of Findings: Synthesize the information from different studies to highlight trends, patterns, or areas of consensus in the literature. 
• Identification of Gaps: Discuss any gaps or limitations in the existing research and explain how your review contributes to filling these gaps. 
• Transition between Sections: Provide smooth transitions between different themes or concepts to maintain the flow of your literature review. 

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Conclusion: The conclusion of your literature review should summarize the main findings, highlight the contributions of the review, and suggest avenues for future research. 

• Summary of Key Findings: Recap the main findings from the literature and restate how they contribute to your research question or objective. 
• Contributions to the Field: Discuss the overall contribution of your literature review to the existing knowledge in the field. 
• Implications and Applications: Explore the practical implications of the findings and suggest how they might impact future research or practice. 
• Recommendations for Future Research: Identify areas that require further investigation and propose potential directions for future research in the field. 
• Final Thoughts: Conclude with a final reflection on the importance of your literature review and its relevance to the broader academic community. 

Conducting a literature review

Conducting a literature review is an essential step in research that involves reviewing and analyzing existing literature on a specific topic. It’s important to know how to do a literature review effectively, so here are the steps to follow: 1  

Choose a Topic and Define the Research Question:

• Select a topic that is relevant to your field of study. 
• Clearly define your research question or objective. Determine what specific aspect of the topic do you want to explore? 

Decide on the Scope of Your Review:

• Determine the timeframe for your literature review. Are you focusing on recent developments, or do you want a historical overview? 
• Consider the geographical scope. Is your review global, or are you focusing on a specific region? 
• Define the inclusion and exclusion criteria. What types of sources will you include? Are there specific types of studies or publications you will exclude? 

Select Databases for Searches:

• Identify relevant databases for your field. Examples include PubMed, IEEE Xplore, Scopus, Web of Science, and Google Scholar. 
• Consider searching in library catalogs, institutional repositories, and specialized databases related to your topic. 

Conduct Searches and Keep Track:

• Develop a systematic search strategy using keywords, Boolean operators (AND, OR, NOT), and other search techniques. 
• Record and document your search strategy for transparency and replicability. 
• Keep track of the articles, including publication details, abstracts, and links. Use citation management tools like EndNote, Zotero, or Mendeley to organize your references. 

Review the Literature:

• Evaluate the relevance and quality of each source. Consider the methodology, sample size, and results of studies. 
• Organize the literature by themes or key concepts. Identify patterns, trends, and gaps in the existing research. 
• Summarize key findings and arguments from each source. Compare and contrast different perspectives. 
• Identify areas where there is a consensus in the literature and where there are conflicting opinions. 
• Provide critical analysis and synthesis of the literature. What are the strengths and weaknesses of existing research? 

Organize and Write Your Literature Review:

• Literature review outline should be based on themes, chronological order, or methodological approaches. 
• Write a clear and coherent narrative that synthesizes the information gathered. 
• Use proper citations for each source and ensure consistency in your citation style (APA, MLA, Chicago, etc.). 
• Conclude your literature review by summarizing key findings, identifying gaps, and suggesting areas for future research. 

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How to write a literature review faster with Paperpal?

Paperpal, an AI writing assistant, integrates powerful academic search capabilities within its writing platform. With the Research feature, you get 100% factual insights, with citations backed by 250M+ verified research articles, directly within your writing interface with the option to save relevant references in your Citation Library. By eliminating the need to switch tabs to find answers to all your research questions, Paperpal saves time and helps you stay focused on your writing.   

Here’s how to use the Research feature:  

• Ask a question: Get started with a new document on paperpal.com. Click on the “Research” feature and type your question in plain English. Paperpal will scour over 250 million research articles, including conference papers and preprints, to provide you with accurate insights and citations. 
• Review and Save: Paperpal summarizes the information, while citing sources and listing relevant reads. You can quickly scan the results to identify relevant references and save these directly to your built-in citations library for later access. 
• Cite with Confidence: Paperpal makes it easy to incorporate relevant citations and references into your writing, ensuring your arguments are well-supported by credible sources. This translates to a polished, well-researched literature review. 

The literature review sample and detailed advice on writing and conducting a review will help you produce a well-structured report. But remember that a good literature review is an ongoing process, and it may be necessary to revisit and update it as your research progresses. By combining effortless research with an easy citation process, Paperpal Research streamlines the literature review process and empowers you to write faster and with more confidence. Try Paperpal Research now and see for yourself.  

Frequently asked questions

A literature review is a critical and comprehensive analysis of existing literature (published and unpublished works) on a specific topic or research question and provides a synthesis of the current state of knowledge in a particular field. A well-conducted literature review is crucial for researchers to build upon existing knowledge, avoid duplication of efforts, and contribute to the advancement of their field. It also helps researchers situate their work within a broader context and facilitates the development of a sound theoretical and conceptual framework for their studies.

Literature review is a crucial component of research writing, providing a solid background for a research paper’s investigation. The aim is to keep professionals up to date by providing an understanding of ongoing developments within a specific field, including research methods, and experimental techniques used in that field, and present that knowledge in the form of a written report. Also, the depth and breadth of the literature review emphasizes the credibility of the scholar in his or her field.  

Before writing a literature review, it’s essential to undertake several preparatory steps to ensure that your review is well-researched, organized, and focused. This includes choosing a topic of general interest to you and doing exploratory research on that topic, writing an annotated bibliography, and noting major points, especially those that relate to the position you have taken on the topic. 

Literature reviews and academic research papers are essential components of scholarly work but serve different purposes within the academic realm. 3 A literature review aims to provide a foundation for understanding the current state of research on a particular topic, identify gaps or controversies, and lay the groundwork for future research. Therefore, it draws heavily from existing academic sources, including books, journal articles, and other scholarly publications. In contrast, an academic research paper aims to present new knowledge, contribute to the academic discourse, and advance the understanding of a specific research question. Therefore, it involves a mix of existing literature (in the introduction and literature review sections) and original data or findings obtained through research methods. 

Literature reviews are essential components of academic and research papers, and various strategies can be employed to conduct them effectively. If you want to know how to write a literature review for a research paper, here are four common approaches that are often used by researchers.  Chronological Review: This strategy involves organizing the literature based on the chronological order of publication. It helps to trace the development of a topic over time, showing how ideas, theories, and research have evolved.  Thematic Review: Thematic reviews focus on identifying and analyzing themes or topics that cut across different studies. Instead of organizing the literature chronologically, it is grouped by key themes or concepts, allowing for a comprehensive exploration of various aspects of the topic.  Methodological Review: This strategy involves organizing the literature based on the research methods employed in different studies. It helps to highlight the strengths and weaknesses of various methodologies and allows the reader to evaluate the reliability and validity of the research findings.  Theoretical Review: A theoretical review examines the literature based on the theoretical frameworks used in different studies. This approach helps to identify the key theories that have been applied to the topic and assess their contributions to the understanding of the subject.  It’s important to note that these strategies are not mutually exclusive, and a literature review may combine elements of more than one approach. The choice of strategy depends on the research question, the nature of the literature available, and the goals of the review. Additionally, other strategies, such as integrative reviews or systematic reviews, may be employed depending on the specific requirements of the research.

The literature review format can vary depending on the specific publication guidelines. However, there are some common elements and structures that are often followed. Here is a general guideline for the format of a literature review:  Introduction:   Provide an overview of the topic.  Define the scope and purpose of the literature review.  State the research question or objective.  Body:   Organize the literature by themes, concepts, or chronology.  Critically analyze and evaluate each source.  Discuss the strengths and weaknesses of the studies.  Highlight any methodological limitations or biases.  Identify patterns, connections, or contradictions in the existing research.  Conclusion:   Summarize the key points discussed in the literature review.  Highlight the research gap.  Address the research question or objective stated in the introduction.  Highlight the contributions of the review and suggest directions for future research.

Both annotated bibliographies and literature reviews involve the examination of scholarly sources. While annotated bibliographies focus on individual sources with brief annotations, literature reviews provide a more in-depth, integrated, and comprehensive analysis of existing literature on a specific topic. The key differences are as follows: 

References 

• Denney, A. S., & Tewksbury, R. (2013). How to write a literature review.  Journal of criminal justice education ,  24 (2), 218-234. 
• Pan, M. L. (2016).  Preparing literature reviews: Qualitative and quantitative approaches . Taylor & Francis. 
• Cantero, C. (2019). How to write a literature review.  San José State University Writing Center . 

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How to Write a Complete Literature Review for Your Thesis/Dissertation

A literature review critically evaluates and synthesizes existing research and scholarly publications on a specific topic or research question. Its goal is to provide a comprehensive understanding of the current state of knowledge on the topic, identify gaps in the literature, and highlight areas for future research. A well-conducted literature review is an essential component of research because it helps to establish the research context, justify the need for the study, and guide the development of research questions or hypotheses.

The literature review of your thesis/dissertation is a very significant part of your paper. It provides readers with an understanding of previously published research in relation to your topic. It also highlights where your research fits into the existing literature. In other words, it provides valuable context for your readers about the field as a whole and the specific topic you have chosen to cover in your thesis/dissertation.

Literature reviews: An overview

A literature review does not only summarize what has been written about a topic already: it also offers a critical analysis of the existing literature.

Literature reviews can take different forms depending on what type of research you are doing and what your field of research is about. Literature reviews are a key part of the majority of academic articles or theses, and can even be written as articles all on their own. A literature review does not only summarize what has been written about a topic already: it also offers a critical analysis of the existing literature. In other words, you, the author, offer your analysis or critique on what has been written already. A literature review, however, should not just be a description of what has been written or a set of summaries.

The idea of reviewing and analyzing all the research that has been done on a topic can sound overwhelming; however, the task is easier than it sounds. This is also a vital step in performing the work necessary to write a good thesis. As you prepare and write your literature review, you will select and filter which sources are relevant to your work and which are not. As you review the literature, you will develop a clear understanding of the work that has come before you. This will enable you to write about it in such a way that you clearly demonstrate how you arrived at your own thesis statement or hypothesis.

A literature review can be quite short (5% of a paper) or quite long (30% of a paper) depending on the type of paper. For a thesis/dissertation, a literature review may be a full chapter, and is usually at least 10-20% of your paper.

Types of literature reviews

There are different types of literature reviews and the type you choose will be determined by the topic you are researching. Four common types of literature reviews are summarized below, but there are also other types that may be preferable depending on your thesis topic. 

Chronological

This type of literature review organizes sources and their ideas by the date of publication. For example, if you are writing about chronic Lyme disease, you would start with articles describing and identifying Lyme disease (1970s), then describe initial treatments and discoveries (1980s), increased prevalence of Lyme disease and rise of people with chronic Lyme disease (2000s), and finally discuss the current controversies and treatments (2010s).

This type is often used in social science papers such as political science or public policy. They focus on specific trends in a field and can still include a chronological component. For example, you could write about changes in approaches to early childhood education by discussing the rise and fall in popularity of public preschool, highlighting relevant case studies, and presenting arguments that there is no need for schooling so early. This is often used to highlight competing schools of thought in a field.

Methodological

This focuses less on what is said in different sources and more on how previous research has been performed. For example, a methodological review of the treatment of chronic Lyme disease might reveal that previous studies which relied solely on laboratory tests dismissed persistent Lyme symptoms as “all in the patients’ heads,” while studies that focused on interviewing patients as well as doctors classified the disease as an unidentified syndrome. Methodological studies can highlight how approaches to research have changed over time and how the approaches used in research influence the results.

Theoretical

Theoretical literature reviews are often found in fields like philosophy or humanities, but are also prevalent in social sciences. They review existing theories and their relationships, as well as what has been tested and what has not. This kind of review is quite useful in demonstrating where existing theories fall short in describing a particular phenomenon in the field.

Structuring your literature review

A literature review is usually a chapter in your thesis/dissertation and as such generally includes an introduction, main body, and conclusion. The introduction will explain:

• The type of literature review you have performed
• Why you have chosen to perform that type of literature review
• Your criteria for selecting sources

Your main body will be the actual literature review, which we will discuss further in the next section. In your conclusion, you will summarize the major arguments that you have highlighted in your literature review and center your own research among them. The conclusion of the literature review should explain why your research study is necessary (what gap in the literature it fulfils) to lead smoothly into your next thesis chapter.

How do I review the literature?

An easy way to find relevant sources is to look at the citations of papers you find that are on the topic you want to research.

Before you write a literature review, you need to:

• Become familiar with the literature
• Select which sources are relevant to your thesis topic
• Organize your sources
• Choose the type of literature review you will write
• Arrange your notes to reflect the type of literature review

How do you become familiar with the literature?

If you aren’t sure where to start, try going to Google Scholar and typing in some keywords about your topic. For example, if you’re researching chronic Lyme disease, you could type in keywords such as “chronic Lyme” “post-treatment Lyme disease syndrome” and “Lyme disease treatment” to see what results show up. As you search, you will be able to identify more keywords that are relevant to what you want to search. Making a list of these keywords can help you as you engage in this task. When you find an article that looks promising, copy the citation information from Google Scholar and save it in a file or use a reference manager like Mendeley . You will thank yourself for this later. You can then search your academic institution’s online library to download the article.

An easy way to find relevant sources is to look at the citations of papers you find that are on the topic you want to research. If you aren’t sure whether an article or paper you are reading is reputable , you can check its citation metrics using Google Scholar, which can tell you how many other people cited a particular source. Generally, it holds true that the more highly cited a source is, the more reliable and useful it is. Of course, your citation sources don’t need to be limited to journal articles. Books , news articles , interviews, and other sources are all acceptable .

Finally, as you read through sources and organize them, you will want to take notes. Don’t just save an article and hope you’ll remember why you did. Jot down a few sentences about the main argument of this source and why/how it is relevant to your research study. Once you have done this, you will want to go ahead and organize your sources in an order that reflects the type of literature review you have chosen to do. For example, if you are doing a thematic review, you should organize sources by a theme or type of argument. If you are doing a historical review, you would organize them in chronological order.

Writing the literature review

As you write your literature review, you will want to walk the reader through what has happened in the literature review and offer your analysis of it.

Now that you’ve reviewed the literature, taken notes, organized your sources and your notes, you are ready to begin! As we mentioned above, a literature review needs an introduction and a conclusion. As you write your literature review, you will want to walk the reader through what has happened in the literature review and offer your analysis of it. For example, you could say “while Yue and Xu argue that Lyme disease is a bacterial infection and should not result in symptoms resembling post-viral syndromes, others such as Scott and Zebrowski have noted the strong similarities between patients with chronic Lyme disease and the newly emerging group of COVID long-haulers. Scott and Zebrowski appear to be at the forefront of the changing perspective on chronic Lyme disease as newer evidence supports their position.”

Your literature review will include the ideas of many other people, but it should not be a lengthy chapter directly quoting other papers. You should instead paraphrase what others say. Of course you can use some quotes! They are not off limits. Short quotes like “Marx said ‘religion is the opiate of the masses’ while Mao Zedong said ‘religion is poison’” is fine. Longer blocks of text should be used only when necessary and properly indicated within the text .

Now you are ready to write your thesis literature review! Check out our site for more tips on how to write a good thesis, where to find the best thesis editing services, and more about thesis editing and proofreading services .

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Checklist for writing a literature review

Below is a list of points to remember when writing your literature review. These will help you make sure that your literature review is thorough and properly structured.

Do a thorough review of the sources in your field that are relevant to your thesis topic.

Make sure your sources are reliable and high-quality.

Take detailed notes and maintain an organized list of your sources.

Cover a wide variety of viewpoints, not just those that support or agree with your argument. Make it clear what controversies and unsettled point of views exist.

Make sure your literature review chapter has a clear introduction, main body, and conclusion.

Use quotes sparingly.

What is a literature review? +

A literature review is a summary of the major studies and sources related to your topic that already exist and provides critical analysis of these sources. A literature review is not a bibliography or a list of sources. It is written in a narrative format.

e.g. “Clowes and McKnight (2002) argue that chronic Lyme disease is analogous to post-viral syndrome.”

What kinds of sources can be included in a literature review? +

Anything you can cite in an academic paper can be included in a literature review. This includes journal articles, books, news sources, interviews, and so on. You should not include Wikipedia or your Uncle Bob as a source in the literature review (unless your Uncle Bob is a recognized expert in your topic!).

Do I really have to write a literature review? +

A literature review is part of most social science or natural science theses/dissertations. your institutional requirements inform you to, then you have to write a literature review. If you are writing a thesis/dissertation in humanities or in another field where the structure does not mandate a literature review, you may be able to skip it. Always check with your advisor and your institution about the requirements of your thesis/dissertation structure.

Literature Review Example/Sample

Detailed Walkthrough + Free Literature Review Template

If you’re working on a dissertation or thesis and are looking for an example of a strong literature review chapter , you’ve come to the right place.

In this video, we walk you through an A-grade literature review from a dissertation that earned full distinction . We start off by discussing the five core sections of a literature review chapter by unpacking our free literature review template . This includes:

• The literature review opening/ introduction section
• The theoretical framework (or foundation of theory)
• The empirical research
• The research gap
• The closing section

We then progress to the sample literature review (from an A-grade Master’s-level dissertation) to show how these concepts are applied in the literature review chapter. You can access the free resources mentioned in this video below.

PS – If you’re working on a dissertation, be sure to also check out our collection of dissertation and thesis examples here .

FAQ: Literature Review Example

Literature review example: frequently asked questions, is the sample literature review real.

Yes. The literature review example is an extract from a Master’s-level dissertation for an MBA program. It has not been edited in any way.

Can I replicate this literature review for my dissertation?

As we discuss in the video, every literature review will be slightly different, depending on the university’s unique requirements, as well as the nature of the research itself. Therefore, you’ll need to tailor your literature review to suit your specific context.

You can learn more about the basics of writing a literature review here .

Where can I find more examples of literature reviews?

The best place to find more examples of literature review chapters would be within dissertation/thesis databases. These databases include dissertations, theses and research projects that have successfully passed the assessment criteria for the respective university, meaning that you have at least some sort of quality assurance. 

The Open Access Thesis Database (OATD) is a good starting point. 

How do I get the literature review template?

You can access our free literature review chapter template here .

Is the template really free?

Yes. There is no cost for the template and you are free to use it as you wish. 

Psst… there’s more!

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

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Thesis Statements

What this handout is about.

This handout describes what a thesis statement is, how thesis statements work in your writing, and how you can craft or refine one for your draft.

Introduction

Writing in college often takes the form of persuasion—convincing others that you have an interesting, logical point of view on the subject you are studying. Persuasion is a skill you practice regularly in your daily life. You persuade your roommate to clean up, your parents to let you borrow the car, your friend to vote for your favorite candidate or policy. In college, course assignments often ask you to make a persuasive case in writing. You are asked to convince your reader of your point of view. This form of persuasion, often called academic argument, follows a predictable pattern in writing. After a brief introduction of your topic, you state your point of view on the topic directly and often in one sentence. This sentence is the thesis statement, and it serves as a summary of the argument you’ll make in the rest of your paper.

What is a thesis statement?

A thesis statement:

• tells the reader how you will interpret the significance of the subject matter under discussion.
• is a road map for the paper; in other words, it tells the reader what to expect from the rest of the paper.
• directly answers the question asked of you. A thesis is an interpretation of a question or subject, not the subject itself. The subject, or topic, of an essay might be World War II or Moby Dick; a thesis must then offer a way to understand the war or the novel.
• makes a claim that others might dispute.
• is usually a single sentence near the beginning of your paper (most often, at the end of the first paragraph) that presents your argument to the reader. The rest of the paper, the body of the essay, gathers and organizes evidence that will persuade the reader of the logic of your interpretation.

If your assignment asks you to take a position or develop a claim about a subject, you may need to convey that position or claim in a thesis statement near the beginning of your draft. The assignment may not explicitly state that you need a thesis statement because your instructor may assume you will include one. When in doubt, ask your instructor if the assignment requires a thesis statement. When an assignment asks you to analyze, to interpret, to compare and contrast, to demonstrate cause and effect, or to take a stand on an issue, it is likely that you are being asked to develop a thesis and to support it persuasively. (Check out our handout on understanding assignments for more information.)

How do I create a thesis?

A thesis is the result of a lengthy thinking process. Formulating a thesis is not the first thing you do after reading an essay assignment. Before you develop an argument on any topic, you have to collect and organize evidence, look for possible relationships between known facts (such as surprising contrasts or similarities), and think about the significance of these relationships. Once you do this thinking, you will probably have a “working thesis” that presents a basic or main idea and an argument that you think you can support with evidence. Both the argument and your thesis are likely to need adjustment along the way.

Writers use all kinds of techniques to stimulate their thinking and to help them clarify relationships or comprehend the broader significance of a topic and arrive at a thesis statement. For more ideas on how to get started, see our handout on brainstorming .

How do I know if my thesis is strong?

If there’s time, run it by your instructor or make an appointment at the Writing Center to get some feedback. Even if you do not have time to get advice elsewhere, you can do some thesis evaluation of your own. When reviewing your first draft and its working thesis, ask yourself the following :

• Do I answer the question? Re-reading the question prompt after constructing a working thesis can help you fix an argument that misses the focus of the question. If the prompt isn’t phrased as a question, try to rephrase it. For example, “Discuss the effect of X on Y” can be rephrased as “What is the effect of X on Y?”
• Have I taken a position that others might challenge or oppose? If your thesis simply states facts that no one would, or even could, disagree with, it’s possible that you are simply providing a summary, rather than making an argument.
• Is my thesis statement specific enough? Thesis statements that are too vague often do not have a strong argument. If your thesis contains words like “good” or “successful,” see if you could be more specific: why is something “good”; what specifically makes something “successful”?
• Does my thesis pass the “So what?” test? If a reader’s first response is likely to  be “So what?” then you need to clarify, to forge a relationship, or to connect to a larger issue.
• Does my essay support my thesis specifically and without wandering? If your thesis and the body of your essay do not seem to go together, one of them has to change. It’s okay to change your working thesis to reflect things you have figured out in the course of writing your paper. Remember, always reassess and revise your writing as necessary.
• Does my thesis pass the “how and why?” test? If a reader’s first response is “how?” or “why?” your thesis may be too open-ended and lack guidance for the reader. See what you can add to give the reader a better take on your position right from the beginning.

Suppose you are taking a course on contemporary communication, and the instructor hands out the following essay assignment: “Discuss the impact of social media on public awareness.” Looking back at your notes, you might start with this working thesis:

Social media impacts public awareness in both positive and negative ways.

You can use the questions above to help you revise this general statement into a stronger thesis.

• Do I answer the question? You can analyze this if you rephrase “discuss the impact” as “what is the impact?” This way, you can see that you’ve answered the question only very generally with the vague “positive and negative ways.”
• Have I taken a position that others might challenge or oppose? Not likely. Only people who maintain that social media has a solely positive or solely negative impact could disagree.
• Is my thesis statement specific enough? No. What are the positive effects? What are the negative effects?
• Does my thesis pass the “how and why?” test? No. Why are they positive? How are they positive? What are their causes? Why are they negative? How are they negative? What are their causes?
• Does my thesis pass the “So what?” test? No. Why should anyone care about the positive and/or negative impact of social media?

After thinking about your answers to these questions, you decide to focus on the one impact you feel strongly about and have strong evidence for:

Because not every voice on social media is reliable, people have become much more critical consumers of information, and thus, more informed voters.

This version is a much stronger thesis! It answers the question, takes a specific position that others can challenge, and it gives a sense of why it matters.

Let’s try another. Suppose your literature professor hands out the following assignment in a class on the American novel: Write an analysis of some aspect of Mark Twain’s novel Huckleberry Finn. “This will be easy,” you think. “I loved Huckleberry Finn!” You grab a pad of paper and write:

Mark Twain’s Huckleberry Finn is a great American novel.

You begin to analyze your thesis:

• Do I answer the question? No. The prompt asks you to analyze some aspect of the novel. Your working thesis is a statement of general appreciation for the entire novel.

Think about aspects of the novel that are important to its structure or meaning—for example, the role of storytelling, the contrasting scenes between the shore and the river, or the relationships between adults and children. Now you write:

In Huckleberry Finn, Mark Twain develops a contrast between life on the river and life on the shore.

• Do I answer the question? Yes!
• Have I taken a position that others might challenge or oppose? Not really. This contrast is well-known and accepted.
• Is my thesis statement specific enough? It’s getting there–you have highlighted an important aspect of the novel for investigation. However, it’s still not clear what your analysis will reveal.
• Does my thesis pass the “how and why?” test? Not yet. Compare scenes from the book and see what you discover. Free write, make lists, jot down Huck’s actions and reactions and anything else that seems interesting.
• Does my thesis pass the “So what?” test? What’s the point of this contrast? What does it signify?”

After examining the evidence and considering your own insights, you write:

Through its contrasting river and shore scenes, Twain’s Huckleberry Finn suggests that to find the true expression of American democratic ideals, one must leave “civilized” society and go back to nature.

This final thesis statement presents an interpretation of a literary work based on an analysis of its content. Of course, for the essay itself to be successful, you must now present evidence from the novel that will convince the reader of your interpretation.

Works consulted

We consulted these works while writing this handout. This is not a comprehensive list of resources on the handout’s topic, and we encourage you to do your own research to find additional publications. Please do not use this list as a model for the format of your own reference list, as it may not match the citation style you are using. For guidance on formatting citations, please see the UNC Libraries citation tutorial . We revise these tips periodically and welcome feedback.

Anson, Chris M., and Robert A. Schwegler. 2010. The Longman Handbook for Writers and Readers , 6th ed. New York: Longman.

Lunsford, Andrea A. 2015. The St. Martin’s Handbook , 8th ed. Boston: Bedford/St Martin’s.

Ramage, John D., John C. Bean, and June Johnson. 2018. The Allyn & Bacon Guide to Writing , 8th ed. New York: Pearson.

Ruszkiewicz, John J., Christy Friend, Daniel Seward, and Maxine Hairston. 2010. The Scott, Foresman Handbook for Writers , 9th ed. Boston: Pearson Education.

You may reproduce it for non-commercial use if you use the entire handout and attribute the source: The Writing Center, University of North Carolina at Chapel Hill

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Literature Review

What is a Literature Review?

It is…. a systematic and critical analysis of the literature on a specific topic. It describes trends, quality, relationships, inconsistencies and gaps in the research; and it details how the works enhance your understanding of the topic at large.

It is NOT…. simply an annotated bibliography that summarizes and/or assesses each article. There is not one, correct way to approach and write a literature review. It can be a stand-alone paper or part of a thesis/dissertation. Format and requirements can vary between disciplines, purpose and intended audience.

A literature review is an overview of existing literature (books, articles, dissertations, conference proceedings, and other sources) in a particular scholarly area. With a lit review, you will:

• Gather information about your topic, including the sources used by others who have previously conducted research
• Find out if your specific research question has already been answered
• Find out what areas or perspectives have not yet been covered by others on your topic
• Analyze and evaluate existing information

The literature review will assist you in considering the validity and scope of your research question so that you can do the necessary revision and fine tuning to it. It provides the foundation to formulate and present strong arguments to justify your chosen research topic.

• How to Write a Literature Review  (University of California, Santa Cruz)

Check out these books from the library for further guidance:

• Després, Carole. "The meaning of home: literature review and directions for future research and theoretical development." Journal of architectural and planning research 8, no.2, (Summer 1991): 96-155.
• Steiner, Frederick R. "Philadelphia, the holy experiment: A literature review and analysis." Ekistics , 49, (1982): 298-305.

Reckoning with Authorities

As you are developing your Lit Review, part of your objective is to identify the leading authorities within the field or who address your topic or theme. Some tips for identifying the scholars:

Old Fashioned Method:

• Keep notes on footnotes and names as you read articles, books, blogs, exhibition catalogs, etc. Are there names or works that everyone references? Use the catalog to track these reference down.
• Consider looking for state of the field articles often found either in a discipline's primary journal or in conference proceedings - keynote speakers.
• Look for book reviews.

Publication Metrics:

• These resources include information about the frequency of citations for an article/author.
• These resources are not specifically for Architecture or Planning. Remember therefore to be critical and careful about the assumptions you make with regard to the results!

The Web of Science platform currently also provides temporary access to several databases that are not part of the Core Collection, including Biosis Citation Index, Data Citation Index, and Zoological Record.

Use this link to access Google Scholar, and see our Google Scholar Guide for information on using this resource.

If you encounter a warning about the security certificate when using the FindIt@UT tool in Google Scholar, you can learn more about that using this guide .

• Last Updated: Oct 5, 2023 8:40 AM
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Home » Thesis – Structure, Example and Writing Guide

Thesis – Structure, Example and Writing Guide

Table of contents.

Definition:

Thesis is a scholarly document that presents a student’s original research and findings on a particular topic or question. It is usually written as a requirement for a graduate degree program and is intended to demonstrate the student’s mastery of the subject matter and their ability to conduct independent research.

History of Thesis

The concept of a thesis can be traced back to ancient Greece, where it was used as a way for students to demonstrate their knowledge of a particular subject. However, the modern form of the thesis as a scholarly document used to earn a degree is a relatively recent development.

The origin of the modern thesis can be traced back to medieval universities in Europe. During this time, students were required to present a “disputation” in which they would defend a particular thesis in front of their peers and faculty members. These disputations served as a way to demonstrate the student’s mastery of the subject matter and were often the final requirement for earning a degree.

In the 17th century, the concept of the thesis was formalized further with the creation of the modern research university. Students were now required to complete a research project and present their findings in a written document, which would serve as the basis for their degree.

The modern thesis as we know it today has evolved over time, with different disciplines and institutions adopting their own standards and formats. However, the basic elements of a thesis – original research, a clear research question, a thorough review of the literature, and a well-argued conclusion – remain the same.

Structure of Thesis

The structure of a thesis may vary slightly depending on the specific requirements of the institution, department, or field of study, but generally, it follows a specific format.

Here’s a breakdown of the structure of a thesis:

This is the first page of the thesis that includes the title of the thesis, the name of the author, the name of the institution, the department, the date, and any other relevant information required by the institution.

This is a brief summary of the thesis that provides an overview of the research question, methodology, findings, and conclusions.

This page provides a list of all the chapters and sections in the thesis and their page numbers.

Introduction

This chapter provides an overview of the research question, the context of the research, and the purpose of the study. The introduction should also outline the methodology and the scope of the research.

Literature Review

This chapter provides a critical analysis of the relevant literature on the research topic. It should demonstrate the gap in the existing knowledge and justify the need for the research.

Methodology

This chapter provides a detailed description of the research methods used to gather and analyze data. It should explain the research design, the sampling method, data collection techniques, and data analysis procedures.

This chapter presents the findings of the research. It should include tables, graphs, and charts to illustrate the results.

This chapter interprets the results and relates them to the research question. It should explain the significance of the findings and their implications for the research topic.

This chapter summarizes the key findings and the main conclusions of the research. It should also provide recommendations for future research.

This section provides a list of all the sources cited in the thesis. The citation style may vary depending on the requirements of the institution or the field of study.

This section includes any additional material that supports the research, such as raw data, survey questionnaires, or other relevant documents.

How to write Thesis

Here are some steps to help you write a thesis:

• Choose a Topic: The first step in writing a thesis is to choose a topic that interests you and is relevant to your field of study. You should also consider the scope of the topic and the availability of resources for research.
• Develop a Research Question: Once you have chosen a topic, you need to develop a research question that you will answer in your thesis. The research question should be specific, clear, and feasible.
• Conduct a Literature Review: Before you start your research, you need to conduct a literature review to identify the existing knowledge and gaps in the field. This will help you refine your research question and develop a research methodology.
• Develop a Research Methodology: Once you have refined your research question, you need to develop a research methodology that includes the research design, data collection methods, and data analysis procedures.
• Collect and Analyze Data: After developing your research methodology, you need to collect and analyze data. This may involve conducting surveys, interviews, experiments, or analyzing existing data.
• Write the Thesis: Once you have analyzed the data, you need to write the thesis. The thesis should follow a specific structure that includes an introduction, literature review, methodology, results, discussion, conclusion, and references.
• Edit and Proofread: After completing the thesis, you need to edit and proofread it carefully. You should also have someone else review it to ensure that it is clear, concise, and free of errors.
• Submit the Thesis: Finally, you need to submit the thesis to your academic advisor or committee for review and evaluation.

Example of Thesis

Example of Thesis template for Students:

Title of Thesis

Table of Contents:

Chapter 1: Introduction

Chapter 2: Literature Review

Chapter 3: Research Methodology

Chapter 4: Results

Chapter 5: Discussion

Chapter 6: Conclusion

References:

Appendices:

Note: That’s just a basic template, but it should give you an idea of the structure and content that a typical thesis might include. Be sure to consult with your department or supervisor for any specific formatting requirements they may have. Good luck with your thesis!

Application of Thesis

Thesis is an important academic document that serves several purposes. Here are some of the applications of thesis:

• Academic Requirement: A thesis is a requirement for many academic programs, especially at the graduate level. It is an essential component of the evaluation process and demonstrates the student’s ability to conduct original research and contribute to the knowledge in their field.
• Career Advancement: A thesis can also help in career advancement. Employers often value candidates who have completed a thesis as it demonstrates their research skills, critical thinking abilities, and their dedication to their field of study.
• Publication : A thesis can serve as a basis for future publications in academic journals, books, or conference proceedings. It provides the researcher with an opportunity to present their research to a wider audience and contribute to the body of knowledge in their field.
• Personal Development: Writing a thesis is a challenging task that requires time, dedication, and perseverance. It provides the student with an opportunity to develop critical thinking, research, and writing skills that are essential for their personal and professional development.
• Impact on Society: The findings of a thesis can have an impact on society by addressing important issues, providing insights into complex problems, and contributing to the development of policies and practices.

Purpose of Thesis

The purpose of a thesis is to present original research findings in a clear and organized manner. It is a formal document that demonstrates a student’s ability to conduct independent research and contribute to the knowledge in their field of study. The primary purposes of a thesis are:

• To Contribute to Knowledge: The main purpose of a thesis is to contribute to the knowledge in a particular field of study. By conducting original research and presenting their findings, the student adds new insights and perspectives to the existing body of knowledge.
• To Demonstrate Research Skills: A thesis is an opportunity for the student to demonstrate their research skills. This includes the ability to formulate a research question, design a research methodology, collect and analyze data, and draw conclusions based on their findings.
• To Develop Critical Thinking: Writing a thesis requires critical thinking and analysis. The student must evaluate existing literature and identify gaps in the field, as well as develop and defend their own ideas.
• To Provide Evidence of Competence : A thesis provides evidence of the student’s competence in their field of study. It demonstrates their ability to apply theoretical concepts to real-world problems, and their ability to communicate their ideas effectively.
• To Facilitate Career Advancement : Completing a thesis can help the student advance their career by demonstrating their research skills and dedication to their field of study. It can also provide a basis for future publications, presentations, or research projects.

When to Write Thesis

The timing for writing a thesis depends on the specific requirements of the academic program or institution. In most cases, the opportunity to write a thesis is typically offered at the graduate level, but there may be exceptions.

Generally, students should plan to write their thesis during the final year of their graduate program. This allows sufficient time for conducting research, analyzing data, and writing the thesis. It is important to start planning the thesis early and to identify a research topic and research advisor as soon as possible.

In some cases, students may be able to write a thesis as part of an undergraduate program or as an independent research project outside of an academic program. In such cases, it is important to consult with faculty advisors or mentors to ensure that the research is appropriately designed and executed.

It is important to note that the process of writing a thesis can be time-consuming and requires a significant amount of effort and dedication. It is important to plan accordingly and to allocate sufficient time for conducting research, analyzing data, and writing the thesis.

Characteristics of Thesis

The characteristics of a thesis vary depending on the specific academic program or institution. However, some general characteristics of a thesis include:

• Originality : A thesis should present original research findings or insights. It should demonstrate the student’s ability to conduct independent research and contribute to the knowledge in their field of study.
• Clarity : A thesis should be clear and concise. It should present the research question, methodology, findings, and conclusions in a logical and organized manner. It should also be well-written, with proper grammar, spelling, and punctuation.
• Research-Based: A thesis should be based on rigorous research, which involves collecting and analyzing data from various sources. The research should be well-designed, with appropriate research methods and techniques.
• Evidence-Based : A thesis should be based on evidence, which means that all claims made in the thesis should be supported by data or literature. The evidence should be properly cited using appropriate citation styles.
• Critical Thinking: A thesis should demonstrate the student’s ability to critically analyze and evaluate information. It should present the student’s own ideas and arguments, and engage with existing literature in the field.
• Academic Style : A thesis should adhere to the conventions of academic writing. It should be well-structured, with clear headings and subheadings, and should use appropriate academic language.

Advantages of Thesis

There are several advantages to writing a thesis, including:

• Development of Research Skills: Writing a thesis requires extensive research and analytical skills. It helps to develop the student’s research skills, including the ability to formulate research questions, design and execute research methodologies, collect and analyze data, and draw conclusions based on their findings.
• Contribution to Knowledge: Writing a thesis provides an opportunity for the student to contribute to the knowledge in their field of study. By conducting original research, they can add new insights and perspectives to the existing body of knowledge.
• Preparation for Future Research: Completing a thesis prepares the student for future research projects. It provides them with the necessary skills to design and execute research methodologies, analyze data, and draw conclusions based on their findings.
• Career Advancement: Writing a thesis can help to advance the student’s career. It demonstrates their research skills and dedication to their field of study, and provides a basis for future publications, presentations, or research projects.
• Personal Growth: Completing a thesis can be a challenging and rewarding experience. It requires dedication, hard work, and perseverance. It can help the student to develop self-confidence, independence, and a sense of accomplishment.

Limitations of Thesis

There are also some limitations to writing a thesis, including:

• Time and Resources: Writing a thesis requires a significant amount of time and resources. It can be a time-consuming and expensive process, as it may involve conducting original research, analyzing data, and producing a lengthy document.
• Narrow Focus: A thesis is typically focused on a specific research question or topic, which may limit the student’s exposure to other areas within their field of study.
• Limited Audience: A thesis is usually only read by a small number of people, such as the student’s thesis advisor and committee members. This limits the potential impact of the research findings.
• Lack of Real-World Application : Some thesis topics may be highly theoretical or academic in nature, which may limit their practical application in the real world.
• Pressure and Stress : Writing a thesis can be a stressful and pressure-filled experience, as it may involve meeting strict deadlines, conducting original research, and producing a high-quality document.
• Potential for Isolation: Writing a thesis can be a solitary experience, as the student may spend a significant amount of time working independently on their research and writing.

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Researcher, Academic Writer, Web developer

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Home > USC Columbia > Arts and Sciences > Comparative Literature > Comparative Literature Theses and Dissertations

Comparative Literature Theses and Dissertations

Theses/dissertations from 2023 2023.

Constructing Selfhood Through Fantasy: Mirror Women and Dreamscape Conversations in Olga Grushin’s Forty Rooms , Grace Marie Alger

Eugene O’Neill Returns: Theatrical Modernization and O’Neill Adaptations in 1980s China , Shuying Chen

The Supernatural in Migration: A Reflection on Senegalese Literature and Film , Rokhaya Aballa Dieng

Breaking Down the Human: Disintegration in Nineteenth-Century Fiction , Benjamin Mark Driscol

Archetypes Revisited: Investigating the Power of Universals in Soviet and Hollywood Cinema , Iana Guselnikova

Planting Rhizomes: Roots and Rhizomes in Maryse Condé’s Traversée de la Mangrove and Calixthe Beyala’s Le Petit Prince de Belleville , Rume Kpadamrophe

Violence, Rebellion, and Compromise in Chinese Campus Cinema ----- The Comparison of Cry Me a Sad River and Better Days , Chunyu Liu

Tracing Modern and Contemporary Sino-French Literary and Intellectual Relations: China, France, and Their Shifting Peripheries , Paul Timothy McElhinny

Truth And Knowledge In A Literary Text And Beyond: Lydia Chukovskaya’s Sofia Petrovna At The Intersections Between Selves, Culture, And Paratext , Angelina Rubina

From Roland to Gawain, or the Origin of Personified Knights , Clyde Tilson

Theses/Dissertations from 2022 2022

Afro-Diasporic Literatures of the United States and Brazil: Imaginaries, Counter-Narratives, and Black Feminism in the Americas , David E. S. Beek

The Pursuit of Good Food: The Alimentary Chronotope in Madame Bovary , Lauren Flinner

Form and Voice: Representing Contemporary Women’s Subaltern Experience in and Beyond China , Tingting Hu

Geography of a “Foreign” China: British Intellectuals’ Encounter With Chinese Spaces, 1920-1945 , Yuzhu Sun

Truth and Identity in Dostoevsky’s Raskolnikov and Prince Myshkin , Gwendolyn Walker

Theses/Dissertations from 2021 2021

Postcolonial Narrative and The Dialogic Imaginatio n: An Analysis of Early Francophone West African Fiction and Cinema , Seydina Mouhamed Diouf

The Rising of the Avant-Garde Movement In the 1980s People’s Republic of China: A Cultural Practice of the New Enlightenment , Jingsheng Zhang

Theses/Dissertations from 2020 2020

L’ Entre- Monde : The Cinema of Alain Gomis , Guillaume Coly

Digesting Gender: Gendered Foodways in Modern Chinese Literature, 1890s–1940s , Zhuo Feng

The Deconstruction of Patriarchal War Narratives in Svetlana Alexievich’s The Unwomanly Face of War , Liubov Kartashova

Pushing the Limits of Black Atlantic and Hispanic Transatlantic Studies Through the Exploration of Three U.S. Afro-Latio Memoirs , Julia Luján

Taiwanese Postcolonial Identities and Environmentalism in Wu Ming-Yi’s the Stolen Bicycle , Chihchi Sunny Tsai

Games and Play of Dream of the Red Chamber , Jiayao Wang

Theses/Dissertations from 2019 2019

Convertirse en Inmortal, 成仙 ChéngxiāN, Becoming Xian: Memory and Subjectivity in Cristina Rivera Garza’s Verde Shanghai , Katherine Paulette Elizabeth Crouch

Between Holy Russia and a Monkey: Darwin's Russian Literary and Philosophical Critics , Brendan G. Mooney

Emerging Populations: An Analysis of Twenty-First Century Caribbean Short Stories , Jeremy Patterson

Time, Space and Nonexistence in Joseph Brodsky's Poetry , Daria Smirnova

Theses/Dissertations from 2018 2018

Through the Spaceship’s Window: A Bio-political Reading of 20th Century Latin American and Anglo-Saxon Science Fiction , Juan David Cruz

The Representations of Gender and Sexuality in Contemporary Arab Women’s Literature: Elements of Subversion and Resignification. , Rima Sadek

Insects As Metaphors For Post-Civil War Reconstruction Of The Civic Body In Augustan Age Rome , Olivia Semler

Theses/Dissertations from 2017 2017

Flannery O’Connor’s Art And The French Renouveau Catholique: A Comparative Exploration Of Contextual Resources For The Author’s Theological Aesthetics Of Sin and Grace , Stephen Allen Baarendse

The Quixotic Picaresque: Tricksters, Modernity, and Otherness in the Transatlantic Novel, or the Intertextual Rhizome of Lazarillo, Don Quijote, Huck Finn, and The Reivers , David Elijah Sinsabaugh Beek

Piglia and Russia: Russian Influences in Ricardo Piglia’s Nombre Falso , Carol E. Fruit Diouf

Beyond Life And Death Images Of Exceptional Women And Chinese Modernity , Wei Hu

Archival Resistance: A Comparative Reading of Ulysses and One Hundred Years of Solitude , Maria-Josee Mendez

Narrating the (Im)Migrant Experience: 21st Century African Fiction in the Age of Globalization , Bernard Ayo Oniwe

Narrating Pain and Freedom: Place and Identity in Modern Syrian Poetry (1970s-1990s) , Manar Shabouk

Theses/Dissertations from 2016 2016

The Development of ‘Meaning’ in Literary Theory: A Comparative Critical Study , Mahmoud Mohamed Ali Ahmad Elkordy

Familial Betrayal And Trauma In Select Plays Of Shakespeare, Racine, And The Corneilles , Lynn Kramer

Evil Men Have No Songs: The Terrorist and Literatuer Boris Savinkov, 1879-1925 , Irina Vasilyeva Meier

Theses/Dissertations from 2015 2015

Resurrectio Mortuorum: Plato’s Use of Ἀνάγκη in the Dialogues , Joshua B. Gehling

Two Million "Butterflies" Searching for Home: Identity and Images of Korean Chinese in Ho Yon-Sun's Yanbian Narratives , Xiang Jin

The Trialectics Of Transnational Migrant Women’s Literature In The Writing Of Edwidge Danticat And Julia Alvarez , Jennifer Lynn Karash-Eastman

Unacknowledged Victims: Love between Women in the Narrative of the Holocaust. An Analysis of Memoirs, Novels, Film and Public Memorials , Isabel Meusen

Making the Irrational Rational: Nietzsche and the Problem of Knowledge in Mikhail Bulgakov's The Master and Margarita , Brendan Mooney

Invective Drag: Talking Dirty in Catullus, Cicero, Horace, and Ovid , Casey Catherine Moore

Destination Hong Kong: Negotiating Locality in Hong Kong Novels 1945-1966 , Xianmin Shen

H.P. Lovecraft & The French Connection: Translation, Pulps and Literary History , Todd David Spaulding

Female Representations in Contemporary Postmodern War Novels of Spain and the United States: Women as Tools of Modern Catharsis in the Works of Javier Cercas and Tim O'Brien , Joseph P. Weil

Theses/Dissertations from 2014 2014

Poetic Appropriations in Vergil’s Aeneid: A Study in Three Themes Comprising Aeneas’ Character Development , Edgar Gordyn

Ekphrasis and Skepticism in Three Works of Shakespeare , Robert P. Irons

Theses/Dissertations from 2013 2013

The Role of the Trickster Figure and Four Afro-Caribbean Meta-Tropes In the Realization of Agency by Three Slave Protagonists , David Sebastian Cross

Putting Place Back Into Displacement: Reevaluating Diaspora In the Contemporary Literature of Migration , Christiane Brigitte Steckenbiller

Using Singular Value Decomposition in Classics: Seeking Correlations in Horace, Juvenal and Persius against the Fragments of Lucilius , Thomas Whidden

Theses/Dissertations from 2012 2012

Decolonizing Transnational Subaltern Women: The Case of Kurasoleñas and New York Dominicanas , Florencia Cornet

Representation of Women In 19Th Century Popular Art and Literature: Forget Me Not and La Revista Moderna , Juan David Cruz

53x+m³=Ø? (Sex+Me=No Result?): Tropes of Asexuality in Literature and Film , Jana -. Fedtke

Argentina in The African Diaspora: Afro-Argentine And African American Cultural Production, Race, And Nation Building in the 19th Century , Julia Lujan

Male Subjectivity and Twenty-First Century German Cinema: Gender, National Idenity, and the Problem of Normalization , Richard Sell

Theses/Dissertations from 2011 2011

Blue Poets: Brilliant Poetry , Evangelin Grace Chapman-Wall

Sickness of the Spirit: A Comparative Study of Lu Xun and James Joyce , Liang Meng

Dryden and the Solution to Domination: Bonds of Love In the Conquest of Granada , Lydia FitzSimons Robins

Theses/Dissertations from 2010 2010

The Family As the New Collectivity of Belonging In the Fiction of Bharati Mukherjee and Jhumpa Lahiri , Sarbani Bose

Lyric Transcendence: the Sacred and the Real In Classical and Early-Modern Lyric. , Larry Grant Hamby

Abd al-Rahman Al-Kawakibi's Tabai` al-Istibdad wa Masari` al-Isti`bad (The Characteristics of Despotism and The Demises of Enslavement): A Translation and Introduction , Mohamad Subhi Hindi

Re-Visions: Nazi Germany and Fascist Italy In German and Italian Film and Literature , Kristina Stefanic Brown

Plato In Modern China: A Study of Contemporary Chinese Platonists , Leihua Weng

Making Victims: History, Memory, and Literature In Japan's Post-War Social Imaginary , Kimberly Wickham

Theses/Dissertations from 2009 2009

The Mirrored Body: Doubling and Replacement of the Feminine and androgynous Body In Hadia Said'S Artist and Haruki Murakami'S Sputnik Sweetheart , Fatmah Alsalamean

Making Monsters: The Monstrous-Feminine In Horace and Catullus , Casey Catherine Moore

Not Quite American, Not Quite European: Performing "Other" Claims to Exceptionality In Francoist Spain and the Jim Crow South , Brittany Powell

Developing Latin American Feminist Theory: Strategies of Resistance In the Novels of Luisa Valenzuela and Sandra Cisneros , Jennifer Lyn Slobodian

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The Federalist Papers

Appearing in New York newspapers as the New York Ratification Convention met in Poughkeepsie, John Jay, Alexander Hamilton and James Madison wrote as Publius and addressed the citizens of New York through the Federalist Papers.  These essays subsequently circulated and were reprinted throughout the states as the Ratification process unfolded in other states.  Initially appearing as individual items in several New York newspapers, all eighty-five essays were eventually combined and published as The Federalist .  Click here to view a chronology of the Printing and Reprintings of The Federalist .   

Considerable debate has surrounded these essays since their publication. Many suggest they represent the best exposition of the Constitution to date. Their conceptual design would affirm this view.  Others contend that they were mere propaganda to allay fears of the opposition to the Constitution. Regardless, they are often included in the canon of the world’s great political writings. A complete introduction exploring the purpose, authorship, circulation, and reactions to The Federalist  can be found here.

General Introduction

• No. 1 (Hamilton) New York Independent Journal , 27 October 1787

Concerning Dangers from Foreign Force and Influence

• No. 2 (Jay) New York Independent Journal , 31 October 1787
• No. 3 (Jay) New York Independent Journal , 3 November 1787
• No. 4 (Jay) New York Independent Journal , 7 November 1787
• No. 5 (Jay) New York Independent Journal , 10 November 1787

Concerning Dangers from Dissensions Between the States

• No. 6 (Hamilton) New York Independent Journal , 14 November 1787
• No. 7 (Hamilton) New York Independent Journal , 17 November 1787
• No. 8 (Hamilton) New York Packet , 20 November 1787
• No. 9 (Hamilton) New York Independent Journal , 21 November 1787

The Union as a Safeguard Against Domestic Faction and Insurrection

• No. 10 (Madison) New York Daily Advertiser , 22 November 1787

The Utility of the Union in Respect to Commercial Relations and a Navy

• No. 11 (Hamilton) New York Independent Journal , 24 November 1787

The Utility of the Union in Respect to Revenue

• No. 12 (Hamilton) New York Packet , 27 November 1787

Advantage of the Union in Respect to Economy in Government

• No. 13 (Hamilton) New York Independent Journal , 28 November 1787

Objections to the Proposed Constitution from Extent of Territory Answered

• No. 14 (Madison) New York Packet , 30 November 1787

The Insufficiency of the Present Confederation to Preserve the Union

• No. 15 (Hamilton) New York Independent Journal , 1 December 1787
• No. 16 (Hamilton) New York Packet , 4 December 1787
• No. 17 (Hamilton) New York Independent Journal , 5 December 1787
• No. 18 (Madison with Hamilton) New York Packet , 7 December 1787
• No. 19 (Madison with Hamilton) New York Independent Journal , 8 December 1787
• No. 20 (Madison with Hamilton) New York Packet , 11 December 1787
• No. 21 (Hamilton) New York Independent Journal , 12 December 1787
• No. 22 (Hamilton) New York Packet , 14 December 1787

The Necessity of Energetic Government to Preserve of the Union

• No. 23 (Hamilton) New York Packet , 18 December 1787

Powers Necessary to the Common Defense Further Considered

• No. 24 (Hamilton) New York Independent Journal , 19 December 1787
• No. 25 (Hamilton) New York Packet , 21 December 1787

Restraining the Legislative Authority in Regard to the Common Defense

• No. 26 (Hamilton) New York Independent Journal , 22 December 1787
• No. 27 (Hamilton) New York Packet , 25 December 1787
• No. 28 (Hamilton) New York Independent Journal , 26 December 1787

Concerning the Militia

• No. 29 (Hamilton) New York Independent Journal , 9 January 1788

Concerning the General Power of Taxation

• No. 30 (Hamilton) New York Packet , 28 December 1787
• No. 31 (Hamilton) New York Packet , 1 January 1788
• Nos. 32–33 (Hamilton) New York Independent Journal , 2 January 1788
• No. 34 (Hamilton) New York Packet , 4 January 1788
• No. 35 (Hamilton) New York Independent Journal , 5 January 1788
• No. 36 (Hamilton) New York Packet , 8 January 1788

The Difficulties of the Convention in Devising a Proper Form of Government

• No. 37 (Madison) New York Daily Advertiser , 11 January 1788
• No. 38 (Madison) New York Independent Journal , 12 January 1788

The Conformity of the Plan to Republican Principles

• No. 39 (Madison) New York Independent Journal , 16 January 1788

The Powers of the Convention to Form a Mixed Government Examined

• No. 40 (Madison) New York Packet , 18 January 1788

General View of the Powers Conferred by the Constitution

• No. 41 (Madison) New York Independent Journal , 19 January 1788
• No. 42 (Madison) New York Packet , 22 January 1788
• No. 43 (Madison) New York Independent Journal , 23 January 1788

Restrictions on the Authority of the Several States

• No. 44 (Madison) New York Packet , 25 January 1788

Alleged Danger from the Powers of the Union to the State Governments

• No. 45 (Madison) New York Independent Journal , 26 January 1788

Influence of the State and Federal Governments Compared

• No. 46 (Madison) New York Packet , 29 January 1788

Structure of the New Government and the Distribution of Powers

• No. 47 (Madison) New York Independent Journal , 30 January 1788

Departments Should Not Be So Far Separated

• No. 48 (Madison) New York Packet , 1 February 1788

Guarding Against the Encroachments of Any One Department of Government

• No. 49 (Madison) New York Independent Journal , 2 February 1788

Periodic Appeals to the People Considered

• No. 50 (Madison) New York Packet , 5 February 1788

Structure of Government Must Furnish Proper Checks and Balances

• No. 51 (Madison) New York Independent Journal , 6 February 1788

The House of Representatives

• No. 52 (Madison?) New York Packet , 8 February 1788
• No. 53 (Madison or Hamilton) New York Independent Journal , 9 February 1788

The Apportionment of Members Among the States

• No. 54 (Madison) New York Packet , 12 February 1788

The Total Number of the House of Representatives

• No. 55 (Madison?) New York Independent Journal , 13 February 1788
• No. 56 (Madison?) New York Independent Journal , 16 February 1788

The Alleged Tendency of the Plan to Elevate the Few at the Expense of the Many

• No. 57 (Madison?) New York Packet , 19 February 1788

Objection That the Numbers Will Not Be Augmented as Population Increases

• No. 58 (Madison?) New York Independent Journal , 20 February 1788

Concerning the Power of Congress to Regulate the Election of Members

• No. 59 (Hamilton) New York Packet , 22 February 1788
• No. 60 (Hamilton) New York Independent Journal , 23 February 1788
• No. 61 (Hamilton) New York Packet , 26 February 1788
• No. 62 (Madison?) New York Independent Journal , 27 February 1788
• No. 63 (Madison?) New York Independent Journal , 1 March 1788
• No. 64 (Jay) New York Independent Journal , 5 March 1788
• No. 65 (Hamilton) New York Packet , 7 March 1788

Objections to the Power of the Senate to Set as a Court for Impeachments

• No. 66 (Hamilton) New York Independent Journal , 8 March 1788

The Executive Department

• No. 67 (Hamilton) New York Packet , 11 March 1788

The Mode of Electing the President

• No. 68 (Hamilton) New York Independent Journal , 12 March 1788

The Real Character of the Executive

• No. 69 (Hamilton) New York Packet , 14 March 1788

The Executive Department Further Considered

• No. 70 (Hamilton) New York Independent Journal , 15 March 1788

The Duration in Office of the Executive

• No. 71 (Hamilton) New York Packet , 18 March 1788

Re-Eligibility of the Executive Considered

• No. 72 (Hamilton) New York Independent Journal , 19 March 1788

Provision for The Support of the Executive, and the Veto Power

• No. 73 (Hamilton) New York Packet , 21 March 1788

The Command of the Military and Naval Forces, and the Pardoning Power

• No. 74 (Hamilton) New York Packet , 25 March 1788

The Treaty Making Power of the Executive

• No. 75 (Hamilton) New York Independent Journal , 26 March 1788

The Appointing Power of the Executive

• No. 76 (Hamilton) New York Packet , 1 April 1788

Appointing Power and Other Powers of the Executive Considered

• No. 77 (Hamilton) New York Independent Journal , 2 April 1788

The Judiciary Department

• No. 78 (Hamilton) Book Edition, Volume II, 28 May 1788
• No. 79 (Hamilton) Book Edition, Volume II, 28 May 1788

The Powers of the Judiciary

• No. 80 (Hamilton) Book Edition, Volume II, 28 May 1788

The Judiciary Continued, and the Distribution of the Judicial Authority

• No. 81 (Hamilton) Book Edition, Volume II, 28 May 1788

The Judiciary Continued

• No. 82 (Hamilton) Book Edition, Volume II, 28 May 1788

The Judiciary Continued in Relation to Trial by Jury

• No. 83 (Hamilton) Book Edition, Volume II, 28 May 1788

Miscellaneous Objections to the Constitution Considered

• No. 84 (Hamilton) Book Edition, Volume II, 28 May 1788

Concluding Remarks

• No. 85 (Hamilton) Book Edition, Volume II, 28 May 1788

Congratulations to Sean Kim on a Successful Thesis Defense!

Congratulations to Sean Kim who successfully defended his thesis, entitled “Genetic and Environmental Factors Shaping Cannabis Phenotypes: A Study on Temperature Effects and Genetic Regulation of Anthocyanin Accumulation in Cannabis sativa. ”

Sean is an aspiring cannabis breeder with hopes to create natural medicine for people around the world. Sean also p lans on starting a small cannabis operation here in Wisconsin with hopes to breed new varieties and produce high quality cannabis products.

Sean will be sticking around for a TE position through the summer as a key contributor the lab’s many research projects!

Moving forward, Sean can be contacted at 608-698-4105 or [email protected]

Thank you so much, Sean!

• Open access
• Published: 15 May 2024

Learning together for better health using an evidence-based Learning Health System framework: a case study in stroke

• Helena Teede 1 , 2   na1 ,
• Dominique A. Cadilhac 3 , 4   na1 ,
• Tara Purvis 3 ,
• Monique F. Kilkenny 3 , 4 ,
• Bruce C.V. Campbell 4 , 5 , 6 ,
• Coralie English 7 ,
• Alison Johnson 2 ,
• Emily Callander 1 ,
• Rohan S. Grimley 8 , 9 ,
• Christopher Levi 10 ,
• Sandy Middleton 11 , 12 ,
• Kelvin Hill 13 &
• Joanne Enticott   ORCID: orcid.org/0000-0002-4480-5690 1  

BMC Medicine volume  22 , Article number:  198 ( 2024 ) Cite this article

2 Altmetric

Metrics details

In the context of expanding digital health tools, the health system is ready for Learning Health System (LHS) models. These models, with proper governance and stakeholder engagement, enable the integration of digital infrastructure to provide feedback to all relevant parties including clinicians and consumers on performance against best practice standards, as well as fostering innovation and aligning healthcare with patient needs. The LHS literature primarily includes opinion or consensus-based frameworks and lacks validation or evidence of benefit. Our aim was to outline a rigorously codesigned, evidence-based LHS framework and present a national case study of an LHS-aligned national stroke program that has delivered clinical benefit.

Current core components of a LHS involve capturing evidence from communities and stakeholders (quadrant 1), integrating evidence from research findings (quadrant 2), leveraging evidence from data and practice (quadrant 3), and generating evidence from implementation (quadrant 4) for iterative system-level improvement. The Australian Stroke program was selected as the case study as it provides an exemplar of how an iterative LHS works in practice at a national level encompassing and integrating evidence from all four LHS quadrants. Using this case study, we demonstrate how to apply evidence-based processes to healthcare improvement and embed real-world research for optimising healthcare improvement. We emphasize the transition from research as an endpoint, to research as an enabler and a solution for impact in healthcare improvement.

Conclusions

The Australian Stroke program has nationally improved stroke care since 2007, showcasing the value of integrated LHS-aligned approaches for tangible impact on outcomes. This LHS case study is a practical example for other health conditions and settings to follow suit.

Peer Review reports

Internationally, health systems are facing a crisis, driven by an ageing population, increasing complexity, multi-morbidity, rapidly advancing health technology and rising costs that threaten sustainability and mandate transformation and improvement [ 1 , 2 ]. Although research has generated solutions to healthcare challenges, and the advent of big data and digital health holds great promise, entrenched siloes and poor integration of knowledge generation, knowledge implementation and healthcare delivery between stakeholders, curtails momentum towards, and consistent attainment of, evidence-and value-based care [ 3 ]. This is compounded by the short supply of research and innovation leadership within the healthcare sector, and poorly integrated and often inaccessible health data systems, which have crippled the potential to deliver on digital-driven innovation [ 4 ]. Current approaches to healthcare improvement are also often isolated with limited sustainability, scale-up and impact [ 5 ].

Evidence suggests that integration and partnership across academic and healthcare delivery stakeholders are key to progress, including those with lived experience and their families (referred to here as consumers and community), diverse disciplines (both research and clinical), policy makers and funders. Utilization of evidence from research and evidence from practice including data from routine care, supported by implementation research, are key to sustainably embedding improvement and optimising health care and outcomes. A strategy to achieve this integration is through the Learning Health System (LHS) (Fig.  1 ) [ 2 , 6 , 7 , 8 ]. Although there are numerous publications on LHS approaches [ 9 , 10 , 11 , 12 ], many focus on research perspectives and data, most do not demonstrate tangible healthcare improvement or better health outcomes. [ 6 ]

Monash Learning Health System: The Learn Together for Better Health Framework developed by Monash Partners and Monash University (from Enticott et al. 2021 [ 7 ]). Four evidence quadrants: Q1 (orange) is evidence from stakeholders; Q2 (green) is evidence from research; Q3 (light blue) is evidence from data; and, Q4 (dark blue) is evidence from implementation and healthcare improvement

In developed nations, it has been estimated that 60% of care provided aligns with the evidence base, 30% is low value and 10% is potentially harmful [ 13 ]. In some areas, clinical advances have been rapid and research and evidence have paved the way for dramatic improvement in outcomes, mandating rapid implementation of evidence into healthcare (e.g. polio and COVID-19 vaccines). However, healthcare improvement is challenging and slow [ 5 ]. Health systems are highly complex in their design, networks and interacting components, and change is difficult to enact, sustain and scale up. [ 3 ] New effective strategies are needed to meet community needs and deliver evidence-based and value-based care, which reorients care from serving the provider, services and system, towards serving community needs, based on evidence and quality. It goes beyond cost to encompass patient and provider experience, quality care and outcomes, efficiency and sustainability [ 2 , 6 ].

The costs of stroke care are expected to rise rapidly in the next decades, unless improvements in stroke care to reduce the disabling effects of strokes can be successfully developed and implemented [ 14 ]. Here, we briefly describe the Monash LHS framework (Fig.  1 ) [ 2 , 6 , 7 ] and outline an exemplar case in order to demonstrate how to apply evidence-based processes to healthcare improvement and embed real-world research for optimising healthcare. The Australian LHS exemplar in stroke care has driven nationwide improvement in stroke care since 2007.

An evidence-based Learning Health System framework

In Australia, members of this author group (HT, AJ, JE) have rigorously co-developed an evidence-based LHS framework, known simply as the Monash LHS [ 7 ]. The Monash LHS was designed to support sustainable, iterative and continuous robust benefit of improved clinical outcomes. It was created with national engagement in order to be applicable to Australian settings. Through this rigorous approach, core LHS principles and components have been established (Fig.  1 ). Evidence shows that people/workforce, culture, standards, governance and resources were all key to an effective LHS [ 2 , 6 ]. Culture is vital including trust, transparency, partnership and co-design. Key processes include legally compliant data sharing, linkage and governance, resources, and infrastructure [ 4 ]. The Monash LHS integrates disparate and often siloed stakeholders, infrastructure and expertise to ‘Learn Together for Better Health’ [ 7 ] (Fig.  1 ). This integrates (i) evidence from community and stakeholders including priority areas and outcomes; (ii) evidence from research and guidelines; (iii) evidence from practice (from data) with advanced analytics and benchmarking; and (iv) evidence from implementation science and health economics. Importantly, it starts with the problem and priorities of key stakeholders including the community, health professionals and services and creates an iterative learning system to address these. The following case study was chosen as it is an exemplar of how a Monash LHS-aligned national stroke program has delivered clinical benefit.

Australian Stroke Learning Health System

Internationally, the application of LHS approaches in stroke has resulted in improved stroke care and outcomes [ 12 ]. For example, in Canada a sustained decrease in 30-day in-hospital mortality has been found commensurate with an increase in resources to establish the multifactorial stroke system intervention for stroke treatment and prevention [ 15 ]. Arguably, with rapid advances in evidence and in the context of an ageing population with high cost and care burden and substantive impacts on quality of life, stroke is an area with a need for rapid research translation into evidence-based and value-based healthcare improvement. However, a recent systematic review found that the existing literature had few comprehensive examples of LHS adoption [ 12 ]. Although healthcare improvement systems and approaches were described, less is known about patient-clinician and stakeholder engagement, governance and culture, or embedding of data informatics into everyday practice to inform and drive improvement [ 12 ]. For example, in a recent review of quality improvement collaborations, it was found that although clinical processes in stroke care are improved, their short-term nature means there is uncertainty about sustainability and impacts on patient outcomes [ 16 ]. Table  1 provides the main features of the Australian Stroke LHS based on the four core domains and eight elements of the Learning Together for Better Health Framework described in Fig.  1 . The features are further expanded on in the following sections.

Evidence from stakeholders (LHS quadrant 1, Fig.  1 )

Engagement, partners and priorities.

Within the stroke field, there have been various support mechanisms to facilitate an LHS approach including partnership and broad stakeholder engagement that includes clinical networks and policy makers from different jurisdictions. Since 2008, the Australian Stroke Coalition has been co-led by the Stroke Foundation, a charitable consumer advocacy organisation, and Stroke Society of Australasia a professional society with membership covering academics and multidisciplinary clinician networks, that are collectively working to improve stroke care ( https://australianstrokecoalition.org.au/ ). Surveys, focus groups and workshops have been used for identifying priorities from stakeholders. Recent agreed priorities have been to improve stroke care and strengthen the voice for stroke care at a national ( https://strokefoundation.org.au/ ) and international level ( https://www.world-stroke.org/news-and-blog/news/world-stroke-organization-tackle-gaps-in-access-to-quality-stroke-care ), as well as reduce duplication amongst stakeholders. This activity is built on a foundation and culture of research and innovation embedded within the stroke ‘community of practice’. Consumers, as people with lived experience of stroke are important members of the Australian Stroke Coalition, as well as representatives from different clinical colleges. Consumers also provide critical input to a range of LHS activities via the Stroke Foundation Consumer Council, Stroke Living Guidelines committees, and the Australian Stroke Clinical Registry (AuSCR) Steering Committee (described below).

Evidence from research (LHS quadrant 2, Fig.  1 )

Advancement of the evidence for stroke interventions and synthesis into clinical guidelines.

To implement best practice, it is crucial to distil the large volume of scientific and trial literature into actionable recommendations for clinicians to use in practice [ 24 ]. The first Australian clinical guidelines for acute stroke were produced in 2003 following the increasing evidence emerging for prevention interventions (e.g. carotid endarterectomy, blood pressure lowering), acute medical treatments (intravenous thrombolysis, aspirin within 48 h of ischemic stroke), and optimised hospital management (care in dedicated stroke units by a specialised and coordinated multidisciplinary team) [ 25 ]. Importantly, a number of the innovations were developed, researched and proven effective by key opinion leaders embedded in the Australian stroke care community. In 2005, the clinical guidelines for Stroke Rehabilitation and Recovery [ 26 ] were produced, with subsequent merged guidelines periodically updated. However, the traditional process of periodic guideline updates is challenging for end users when new research can render recommendations redundant and this lack of currency erodes stakeholder trust [ 27 ]. In response to this challenge the Stroke Foundation and Cochrane Australia entered a pioneering project to produce the first electronic ‘living’ guidelines globally [ 20 ]. Major shifts in the evidence for reperfusion therapies (e.g. extended time-window intravenous thrombolysis and endovascular clot retrieval), among other advances, were able to be converted into new recommendations, approved by the Australian National Health and Medical Research Council within a few months of publication. Feedback on this process confirmed the increased use and trust in the guidelines by clinicians. The process informed other living guidelines programs, including the successful COVID-19 clinical guidelines [ 28 ].

However, best practice clinical guideline recommendations are necessary but insufficient for healthcare improvement and nesting these within an LHS with stakeholder partnership, enables implementation via a range of proven methods, including audit and feedback strategies [ 29 ].

Evidence from data and practice (LHS quadrant 3, Fig.  1 )

Data systems and benchmarking : revealing the disparities in care between health services. A national system for standardized stroke data collection was established as the National Stroke Audit program in 2007 by the Stroke Foundation [ 30 ] following various state-level programs (e.g. New South Wales Audit) [ 31 ] to identify evidence-practice gaps and prioritise improvement efforts to increase access to stroke units and other acute treatments [ 32 ]. The Audit program alternates each year between acute (commencing in 2007) and rehabilitation in-patient services (commencing in 2008). The Audit program provides a ‘deep dive’ on the majority of recommendations in the clinical guidelines whereby participating hospitals provide audits of up to 40 consecutive patient medical records and respond to a survey about organizational resources to manage stroke. In 2009, the AuSCR was established to provide information on patients managed in acute hospitals based on a small subset of quality processes of care linked to benchmarked reports of performance (Fig.  2 ) [ 33 ]. In this way, the continuous collection of high-priority processes of stroke care could be regularly collected and reviewed to guide improvement to care [ 34 ]. Plus clinical quality registry programs within Australia have shown a meaningful return on investment attributed to enhanced survival, improvements in quality of life and avoided costs of treatment or hospital stay [ 35 ].

Example performance report from the Australian Stroke Clinical Registry: average door-to-needle time in providing intravenous thrombolysis by different hospitals in 2021 [ 36 ]. Each bar in the figure represents a single hospital

The Australian Stroke Coalition endorsed the creation of an integrated technological solution for collecting data through a single portal for multiple programs in 2013. In 2015, the Stroke Foundation, AuSCR consortium, and other relevant groups cooperated to design an integrated data management platform (the Australian Stroke Data Tool) to reduce duplication of effort for hospital staff in the collection of overlapping variables in the same patients [ 19 ]. Importantly, a national data dictionary then provided the common data definitions to facilitate standardized data capture. Another important feature of AuSCR is the collection of patient-reported outcome surveys between 90 and 180 days after stroke, and annual linkage with national death records to ascertain survival status [ 33 ]. To support a LHS approach, hospitals that participate in AuSCR have access to a range of real-time performance reports. In efforts to minimize the burden of data collection in the AuSCR, interoperability approaches to import data directly from hospital or state-level managed stroke databases have been established (Fig.  3 ); however, the application has been variable and 41% of hospitals still manually enter all their data.

Current status of automated data importing solutions in the Australian Stroke Clinical Registry, 2022, with ‘ n ’ representing the number of hospitals. AuSCR, Australian Stroke Clinical Registry; AuSDaT, Australian Stroke Data Tool; API, Application Programming Interface; ICD, International Classification of Diseases; RedCAP, Research Electronic Data Capture; eMR, electronic medical records

For acute stroke care, the Australian Commission on Quality and Safety in Health Care facilitated the co-design (clinicians, academics, consumers) and publication of the national Acute Stroke Clinical Care Standard in 2015 [ 17 ], and subsequent review [ 18 ]. The indicator set for the Acute Stroke Standard then informed the expansion of the minimum dataset for AuSCR so that hospitals could routinely track their performance. The national Audit program enabled hospitals not involved in the AuSCR to assess their performance every two years against the Acute Stroke Standard. Complementing these efforts, the Stroke Foundation, working with the sector, developed the Acute and Rehabilitation Stroke Services Frameworks to outline the principles, essential elements, models of care and staffing recommendations for stroke services ( https://informme.org.au/guidelines/national-stroke-services-frameworks ). The Frameworks are intended to guide where stroke services should be developed, and monitor their uptake with the organizational survey component of the Audit program.

Evidence from implementation and healthcare improvement (LHS quadrant 4, Fig.  1 )

Research to better utilize and augment data from registries through linkage [ 37 , 38 , 39 , 40 ] and to ensure presentation of hospital or service level data are understood by clinicians has ensured advancement in the field for the Australian Stroke LHS [ 41 ]. Importantly, greater insights into whole patient journeys, before and after a stroke, can now enable exploration of value-based care. The LHS and stroke data platform have enabled focused and time-limited projects to create a better understanding of the quality of care in acute or rehabilitation settings [ 22 , 42 , 43 ]. Within stroke, all the elements of an LHS culminate into the ready availability of benchmarked performance data and support for implementation of strategies to address gaps in care.

Implementation research to grow the evidence base for effective improvement interventions has also been a key pillar in the Australian context. These include multi-component implementation interventions to achieve behaviour change for particular aspects of stroke care, [ 22 , 23 , 44 , 45 ] and real-world approaches to augmenting access to hyperacute interventions in stroke through the use of technology and telehealth [ 46 , 47 , 48 , 49 ]. The evidence from these studies feeds into the living guidelines program and the data collection systems, such as the Audit program or AuSCR, which are then amended to ensure data aligns to recommended care. For example, the use of ‘hyperacute aspirin within the first 48 h of ischemic stroke’ was modified to be ‘hyperacute antiplatelet…’ to incorporate new evidence that other medications or combinations are appropriate to use. Additionally, new datasets have been developed to align with evidence such as the Fever, Sugar, and Swallow variables [ 42 ]. Evidence on improvements in access to best practice care from the acute Audit program [ 50 ] and AuSCR is emerging [ 36 ]. For example, between 2007 and 2017, the odds of receiving intravenous thrombolysis after ischemic stroke increased by 16% 9OR 1.06 95% CI 1.13–1.18) and being managed in a stroke unit by 18% (OR 1.18 95% CI 1.17–1.20). Over this period, the median length of hospital stay for all patients decreased from 6.3 days in 2007 to 5.0 days in 2017 [ 51 ]. When considering the number of additional patients who would receive treatment in 2017 in comparison to 2007 it was estimated that without this additional treatment, over 17,000 healthy years of life would be lost in 2017 (17,786 disability-adjusted life years) [ 51 ]. There is evidence on the cost-effectiveness of different system-focussed strategies to augment treatment access for acute ischemic stroke (e.g. Victorian Stroke Telemedicine program [ 52 ] and Melbourne Mobile Stroke Unit ambulance [ 53 ]). Reciprocally, evidence from the national Rehabilitation Audit, where the LHS approach has been less complete or embedded, has shown fewer areas of healthcare improvement over time [ 51 , 54 ].

Within the field of stroke in Australia, there is indirect evidence that the collective efforts that align to establishing the components of a LHS have had an impact. Overall, the age-standardised rate of stroke events has reduced by 27% between 2001 and 2020, from 169 to 124 events per 100,000 population. Substantial declines in mortality rates have been reported since 1980. Commensurate with national clinical guidelines being updated in 2007 and the first National Stroke Audit being undertaken in 2007, the mortality rates for men (37.4 deaths per 100,000) and women (36.1 deaths per 100,0000 has declined to 23.8 and 23.9 per 100,000, respectively in 2021 [ 55 ].

Underpinning the LHS with the integration of the four quadrants of evidence from stakeholders, research and guidelines, practice and implementation, and core LHS principles have been addressed. Leadership and governance have been important, and programs have been established to augment workforce training and capacity building in best practice professional development. Medical practitioners are able to undertake courses and mentoring through the Australasian Stroke Academy ( http://www.strokeacademy.com.au/ ) while nurses (and other health professionals) can access teaching modules in stroke care from the Acute Stroke Nurses Education Network ( https://asnen.org/ ). The Association of Neurovascular Clinicians offers distance-accessible education and certification to develop stroke expertise for interdisciplinary professionals, including advanced stroke co-ordinator certification ( www.anvc.org ). Consumer initiative interventions are also used in the design of the AuSCR Public Summary Annual reports (available at https://auscr.com.au/about/annual-reports/ ) and consumer-related resources related to the Living Guidelines ( https://enableme.org.au/resources ).

The important success factors and lessons from stroke as a national exemplar LHS in Australia include leadership, culture, workforce and resources integrated with (1) established and broad partnerships across the academic-clinical sector divide and stakeholder engagement; (2) the living guidelines program; (3) national data infrastructure, including a national data dictionary that provides the common data framework to support standardized data capture; (4) various implementation strategies including benchmarking and feedback as well as engagement strategies targeting different levels of the health system; and (5) implementation and improvement research to advance stroke systems of care and reduce unwarranted variation in practice (Fig.  1 ). Priority opportunities now include the advancement of interoperability with electronic medical records as an area all clinical quality registry’s programs needs to be addressed, as well as providing more dynamic and interactive data dashboards tailored to the need of clinicians and health service executives.

There is a clear mandate to optimise healthcare improvement with big data offering major opportunities for change. However, we have lacked the approaches to capture evidence from the community and stakeholders, to integrate evidence from research, to capture and leverage data or evidence from practice and to generate and build on evidence from implementation using iterative system-level improvement. The LHS provides this opportunity and is shown to deliver impact. Here, we have outlined the process applied to generate an evidence-based LHS and provide a leading exemplar in stroke care. This highlights the value of moving from single-focus isolated approaches/initiatives to healthcare improvement and the benefit of integration to deliver demonstrable outcomes for our funders and key stakeholders — our community. This work provides insight into strategies that can both apply evidence-based processes to healthcare improvement as well as implementing evidence-based practices into care, moving beyond research as an endpoint, to research as an enabler, underpinning delivery of better healthcare.

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Abbreviations

Australian Stroke Clinical Registry

Confidence interval

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Acknowledgements

The following authors hold National Health and Medical Research Council Research Fellowships: HT (#2009326), DAC (#1154273), SM (#1196352), MFK Future Leader Research Fellowship (National Heart Foundation #105737). The Funders of this work did not have any direct role in the design of the study, its execution, analyses, interpretation of the data, or decision to submit results for publication.

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Helena Teede and Dominique A. Cadilhac contributed equally.

Authors and Affiliations

Monash Centre for Health Research and Implementation, 43-51 Kanooka Grove, Clayton, VIC, Australia

Helena Teede, Emily Callander & Joanne Enticott

Monash Partners Academic Health Science Centre, 43-51 Kanooka Grove, Clayton, VIC, Australia

Helena Teede & Alison Johnson

Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Level 2 Monash University Research, Victorian Heart Hospital, 631 Blackburn Rd, Clayton, VIC, Australia

Dominique A. Cadilhac, Tara Purvis & Monique F. Kilkenny

Stroke Theme, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC, Australia

Dominique A. Cadilhac, Monique F. Kilkenny & Bruce C.V. Campbell

Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Parkville, VIC, Australia

Bruce C.V. Campbell

Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia

School of Health Sciences, Heart and Stroke Program, University of Newcastle, Hunter Medical Research Institute, University Drive, Callaghan, NSW, Australia

Coralie English

School of Medicine and Dentistry, Griffith University, Birtinya, QLD, Australia

Rohan S. Grimley

Clinical Excellence Division, Queensland Health, Brisbane, Australia

John Hunter Hospital, Hunter New England Local Health District and University of Newcastle, Sydney, NSW, Australia

Christopher Levi

School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, NSW, Australia

Sandy Middleton

Nursing Research Institute, St Vincent’s Health Network Sydney and and Australian Catholic University, Sydney, NSW, Australia

Stroke Foundation, Level 7, 461 Bourke St, Melbourne, VIC, Australia

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HT: conception, design and initial draft, developed the theoretical formalism for learning health system framework, approved the submitted version. DAC: conception, design and initial draft, provided essential literature and case study examples, approved the submitted version. TP: revised the manuscript critically for important intellectual content, approved the submitted version. MFK: revised the manuscript critically for important intellectual content, provided essential literature and case study examples, approved the submitted version. BC: revised the manuscript critically for important intellectual content, provided essential literature and case study examples, approved the submitted version. CE: revised the manuscript critically for important intellectual content, provided essential literature and case study examples, approved the submitted version. AJ: conception, design and initial draft, developed the theoretical formalism for learning health system framework, approved the submitted version. EC: revised the manuscript critically for important intellectual content, approved the submitted version. RSG: revised the manuscript critically for important intellectual content, provided essential literature and case study examples, approved the submitted version. CL: revised the manuscript critically for important intellectual content, provided essential literature and case study examples, approved the submitted version. SM: revised the manuscript critically for important intellectual content, provided essential literature and case study examples, approved the submitted version. KH: revised the manuscript critically for important intellectual content, provided essential literature and case study examples, approved the submitted version. JE: conception, design and initial draft, developed the theoretical formalism for learning health system framework, approved the submitted version. All authors read and approved the final manuscript.

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Teede, H., Cadilhac, D.A., Purvis, T. et al. Learning together for better health using an evidence-based Learning Health System framework: a case study in stroke. BMC Med 22 , 198 (2024). https://doi.org/10.1186/s12916-024-03416-w

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ANOMALY DETECTION USING MACHINE LEARNING FORINTRUSION DETECTION

This thesis examines machine learning approaches for anomaly detection in network security, particularly focusing on intrusion detection using TCP and UDP protocols. It uses logistic regression models to effectively distinguish between normal and abnormal network actions, demonstrating a strong ability to detect possible security concerns. The study uses the UNSW-NB15 dataset for model validation, allowing a thorough evaluation of the models' capacity to detect anomalies in real-world network scenarios. The UNSW-NB15 dataset is a comprehensive network attack dataset frequently used in research to evaluate intrusion detection systems and anomaly detection algorithms because of its realistic attack scenarios and various network activities.

Further investigation is carried out using a Multi-Task Neural Network built for binary and multi-class classification tasks. This method allows for the in-depth study of network data, making it easier to identify potential threats. The model is fine-tuned during successive training epochs, focusing on validation measures to ensure its generalizability. The thesis also applied early stopping mechanisms to enhance the ML model, which helps optimize the training process, reduces the risk of overfitting, and improves the model's performance on new, unseen data.

This thesis also uses blockchain technology to track model performance indicators, a novel strategy that improves data integrity and reliability. This blockchain-based logging system keeps an immutable record of the models' performance over time, which helps to build a transparent and verifiable anomaly detection framework.

In summation, this research enhances Machine Learning approaches for network anomaly detection. It proposes scalable and effective approaches for early detection and mitigation of network intrusions, ultimately improving the security posture of network systems.

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• Master of Science
• Computer and Information Technology

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• West Lafayette

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Developing a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in Medical Assistance in Dying (MAiD): a mixed method modified e-Delphi study

• Jocelyn Schroeder 1 ,
• Barbara Pesut 1 , 2 ,
• Lise Olsen 2 ,
• Nelly D. Oelke 2 &
• Helen Sharp 2  

BMC Nursing volume  23 , Article number:  326 ( 2024 ) Cite this article

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Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. Canada’s legislation is the first to permit Nurse Practitioners (NP) to serve as independent MAiD assessors and providers. Registered Nurses’ (RN) also have important roles in MAiD that include MAiD care coordination; client and family teaching and support, MAiD procedural quality; healthcare provider and public education; and bereavement care for family. Nurses have a right under the law to conscientious objection to participating in MAiD. Therefore, it is essential to prepare nurses in their entry-level education for the practice implications and moral complexities inherent in this practice. Knowing what nursing students think about MAiD is a critical first step. Therefore, the purpose of this study was to develop a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in MAiD in the Canadian context.

The design was a mixed-method, modified e-Delphi method that entailed item generation from the literature, item refinement through a 2 round survey of an expert faculty panel, and item validation through a cognitive focus group interview with nursing students. The settings were a University located in an urban area and a College located in a rural area in Western Canada.

During phase 1, a 56-item survey was developed from existing literature that included demographic items and items designed to measure experience with death and dying (including MAiD), education and preparation, attitudes and beliefs, influences on those beliefs, and anticipated future involvement. During phase 2, an expert faculty panel reviewed, modified, and prioritized the items yielding 51 items. During phase 3, a sample of nursing students further evaluated and modified the language in the survey to aid readability and comprehension. The final survey consists of 45 items including 4 case studies.

Systematic evaluation of knowledge-to-date coupled with stakeholder perspectives supports robust survey design. This study yielded a survey to assess nursing students’ attitudes toward MAiD in a Canadian context.

The survey is appropriate for use in education and research to measure knowledge and attitudes about MAiD among nurse trainees and can be a helpful step in preparing nursing students for entry-level practice.

Peer Review reports

Medical Assistance in Dying (MAiD) is permitted under an amendment to Canada’s Criminal Code which was passed in 2016 [ 1 ]. MAiD is defined in the legislation as both self-administered and clinician-administered medication for the purpose of causing death. In the 2016 Bill C-14 legislation one of the eligibility criteria was that an applicant for MAiD must have a reasonably foreseeable natural death although this term was not defined. It was left to the clinical judgement of MAiD assessors and providers to determine the time frame that constitutes reasonably foreseeable [ 2 ]. However, in 2021 under Bill C-7, the eligibility criteria for MAiD were changed to allow individuals with irreversible medical conditions, declining health, and suffering, but whose natural death was not reasonably foreseeable, to receive MAiD [ 3 ]. This population of MAiD applicants are referred to as Track 2 MAiD (those whose natural death is foreseeable are referred to as Track 1). Track 2 applicants are subject to additional safeguards under the 2021 C-7 legislation.

Three additional proposed changes to the legislation have been extensively studied by Canadian Expert Panels (Council of Canadian Academics [CCA]) [ 4 , 5 , 6 ] First, under the legislation that defines Track 2, individuals with mental disease as their sole underlying medical condition may apply for MAiD, but implementation of this practice is embargoed until March 2027 [ 4 ]. Second, there is consideration of allowing MAiD to be implemented through advanced consent. This would make it possible for persons living with dementia to receive MAID after they have lost the capacity to consent to the procedure [ 5 ]. Third, there is consideration of extending MAiD to mature minors. A mature minor is defined as “a person under the age of majority…and who has the capacity to understand and appreciate the nature and consequences of a decision” ([ 6 ] p. 5). In summary, since the legalization of MAiD in 2016 the eligibility criteria and safeguards have evolved significantly with consequent implications for nurses and nursing care. Further, the number of Canadians who access MAiD shows steady increases since 2016 [ 7 ] and it is expected that these increases will continue in the foreseeable future.

Nurses have been integral to MAiD care in the Canadian context. While other countries such as Belgium and the Netherlands also permit euthanasia, Canada is the first country to allow Nurse Practitioners (Registered Nurses with additional preparation typically achieved at the graduate level) to act independently as assessors and providers of MAiD [ 1 ]. Although the role of Registered Nurses (RNs) in MAiD is not defined in federal legislation, it has been addressed at the provincial/territorial-level with variability in scope of practice by region [ 8 , 9 ]. For example, there are differences with respect to the obligation of the nurse to provide information to patients about MAiD, and to the degree that nurses are expected to ensure that patient eligibility criteria and safeguards are met prior to their participation [ 10 ]. Studies conducted in the Canadian context indicate that RNs perform essential roles in MAiD care coordination; client and family teaching and support; MAiD procedural quality; healthcare provider and public education; and bereavement care for family [ 9 , 11 ]. Nurse practitioners and RNs are integral to a robust MAiD care system in Canada and hence need to be well-prepared for their role [ 12 ].

Previous studies have found that end of life care, and MAiD specifically, raise complex moral and ethical issues for nurses [ 13 , 14 , 15 , 16 ]. The knowledge, attitudes, and beliefs of nurses are important across practice settings because nurses have consistent, ongoing, and direct contact with patients who experience chronic or life-limiting health conditions. Canadian studies exploring nurses’ moral and ethical decision-making in relation to MAiD reveal that although some nurses are clear in their support for, or opposition to, MAiD, others are unclear on what they believe to be good and right [ 14 ]. Empirical findings suggest that nurses go through a period of moral sense-making that is often informed by their family, peers, and initial experiences with MAID [ 17 , 18 ]. Canadian legislation and policy specifies that nurses are not required to participate in MAiD and may recuse themselves as conscientious objectors with appropriate steps to ensure ongoing and safe care of patients [ 1 , 19 ]. However, with so many nurses having to reflect on and make sense of their moral position, it is essential that they are given adequate time and preparation to make an informed and thoughtful decision before they participate in a MAID death [ 20 , 21 ].

It is well established that nursing students receive inconsistent exposure to end of life care issues [ 22 ] and little or no training related to MAiD [ 23 ]. Without such education and reflection time in pre-entry nursing preparation, nurses are at significant risk for moral harm. An important first step in providing this preparation is to be able to assess the knowledge, values, and beliefs of nursing students regarding MAID and end of life care. As demand for MAiD increases along with the complexities of MAiD, it is critical to understand the knowledge, attitudes, and likelihood of engagement with MAiD among nursing students as a baseline upon which to build curriculum and as a means to track these variables over time.

Aim, design, and setting

The aim of this study was to develop a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in MAiD in the Canadian context. We sought to explore both their willingness to be involved in the registered nursing role and in the nurse practitioner role should they chose to prepare themselves to that level of education. The design was a mixed-method, modified e-Delphi method that entailed item generation, item refinement through an expert faculty panel [ 24 , 25 , 26 ], and initial item validation through a cognitive focus group interview with nursing students [ 27 ]. The settings were a University located in an urban area and a College located in a rural area in Western Canada.

Participants

A panel of 10 faculty from the two nursing education programs were recruited for Phase 2 of the e-Delphi. To be included, faculty were required to have a minimum of three years of experience in nurse education, be employed as nursing faculty, and self-identify as having experience with MAiD. A convenience sample of 5 fourth-year nursing students were recruited to participate in Phase 3. Students had to be in good standing in the nursing program and be willing to share their experiences of the survey in an online group interview format.

The modified e-Delphi was conducted in 3 phases: Phase 1 entailed item generation through literature and existing survey review. Phase 2 entailed item refinement through a faculty expert panel review with focus on content validity, prioritization, and revision of item wording [ 25 ]. Phase 3 entailed an assessment of face validity through focus group-based cognitive interview with nursing students.

Phase I. Item generation through literature review

The goal of phase 1 was to develop a bank of survey items that would represent the variables of interest and which could be provided to expert faculty in Phase 2. Initial survey items were generated through a literature review of similar surveys designed to assess knowledge and attitudes toward MAiD/euthanasia in healthcare providers; Canadian empirical studies on nurses’ roles and/or experiences with MAiD; and legislative and expert panel documents that outlined proposed changes to the legislative eligibility criteria and safeguards. The literature review was conducted in three online databases: CINAHL, PsycINFO, and Medline. Key words for the search included nurses , nursing students , medical students , NPs, MAiD , euthanasia , assisted death , and end-of-life care . Only articles written in English were reviewed. The legalization and legislation of MAiD is new in many countries; therefore, studies that were greater than twenty years old were excluded, no further exclusion criteria set for country.

Items from surveys designed to measure similar variables in other health care providers and geographic contexts were placed in a table and similar items were collated and revised into a single item. Then key variables were identified from the empirical literature on nurses and MAiD in Canada and checked against the items derived from the surveys to ensure that each of the key variables were represented. For example, conscientious objection has figured prominently in the Canadian literature, but there were few items that assessed knowledge of conscientious objection in other surveys and so items were added [ 15 , 21 , 28 , 29 ]. Finally, four case studies were added to the survey to address the anticipated changes to the Canadian legislation. The case studies were based upon the inclusion of mature minors, advanced consent, and mental disorder as the sole underlying medical condition. The intention was to assess nurses’ beliefs and comfort with these potential legislative changes.

Phase 2. Item refinement through expert panel review

The goal of phase 2 was to refine and prioritize the proposed survey items identified in phase 1 using a modified e-Delphi approach to achieve consensus among an expert panel [ 26 ]. Items from phase 1 were presented to an expert faculty panel using a Qualtrics (Provo, UT) online survey. Panel members were asked to review each item to determine if it should be: included, excluded or adapted for the survey. When adapted was selected faculty experts were asked to provide rationale and suggestions for adaptation through the use of an open text box. Items that reached a level of 75% consensus for either inclusion or adaptation were retained [ 25 , 26 ]. New items were categorized and added, and a revised survey was presented to the panel of experts in round 2. Panel members were again asked to review items, including new items, to determine if it should be: included, excluded, or adapted for the survey. Round 2 of the modified e-Delphi approach also included an item prioritization activity, where participants were then asked to rate the importance of each item, based on a 5-point Likert scale (low to high importance), which De Vaus [ 30 ] states is helpful for increasing the reliability of responses. Items that reached a 75% consensus on inclusion were then considered in relation to the importance it was given by the expert panel. Quantitative data were managed using SPSS (IBM Corp).

Phase 3. Face validity through cognitive interviews with nursing students

The goal of phase 3 was to obtain initial face validity of the proposed survey using a sample of nursing student informants. More specifically, student participants were asked to discuss how items were interpreted, to identify confusing wording or other problematic construction of items, and to provide feedback about the survey as a whole including readability and organization [ 31 , 32 , 33 ]. The focus group was held online and audio recorded. A semi-structured interview guide was developed for this study that focused on clarity, meaning, order and wording of questions; emotions evoked by the questions; and overall survey cohesion and length was used to obtain data (see Supplementary Material 2  for the interview guide). A prompt to “think aloud” was used to limit interviewer-imposed bias and encourage participants to describe their thoughts and response to a given item as they reviewed survey items [ 27 ]. Where needed, verbal probes such as “could you expand on that” were used to encourage participants to expand on their responses [ 27 ]. Student participants’ feedback was collated verbatim and presented to the research team where potential survey modifications were negotiated and finalized among team members. Conventional content analysis [ 34 ] of focus group data was conducted to identify key themes that emerged through discussion with students. Themes were derived from the data by grouping common responses and then using those common responses to modify survey items.

Ten nursing faculty participated in the expert panel. Eight of the 10 faculty self-identified as female. No faculty panel members reported conscientious objector status and ninety percent reported general agreement with MAiD with one respondent who indicated their view as “unsure.” Six of the 10 faculty experts had 16 years of experience or more working as a nurse educator.

Five nursing students participated in the cognitive interview focus group. The duration of the focus group was 2.5 h. All participants identified that they were born in Canada, self-identified as female (one preferred not to say) and reported having received some instruction about MAiD as part of their nursing curriculum. See Tables  1 and 2 for the demographic descriptors of the study sample. Study results will be reported in accordance with the study phases. See Fig.  1 for an overview of the results from each phase.

Fig. 1  Overview of survey development findings

Phase 1: survey item generation

Review of the literature identified that no existing survey was available for use with nursing students in the Canadian context. However, an analysis of themes across qualitative and quantitative studies of physicians, medical students, nurses, and nursing students provided sufficient data to develop a preliminary set of items suitable for adaptation to a population of nursing students.

Four major themes and factors that influence knowledge, attitudes, and beliefs about MAiD were evident from the literature: (i) endogenous or individual factors such as age, gender, personally held values, religion, religiosity, and/or spirituality [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ], (ii) experience with death and dying in personal and/or professional life [ 35 , 40 , 41 , 43 , 44 , 45 ], (iii) training including curricular instruction about clinical role, scope of practice, or the law [ 23 , 36 , 39 ], and (iv) exogenous or social factors such as the influence of key leaders, colleagues, friends and/or family, professional and licensure organizations, support within professional settings, and/or engagement in MAiD in an interdisciplinary team context [ 9 , 35 , 46 ].

Studies of nursing students also suggest overlap across these categories. For example, value for patient autonomy [ 23 ] and the moral complexity of decision-making [ 37 ] are important factors that contribute to attitudes about MAiD and may stem from a blend of personally held values coupled with curricular content, professional training and norms, and clinical exposure. For example, students report that participation in end of life care allows for personal growth, shifts in perception, and opportunities to build therapeutic relationships with their clients [ 44 , 47 , 48 ].

Preliminary items generated from the literature resulted in 56 questions from 11 published sources (See Table  3 ). These items were constructed across four main categories: (i) socio-demographic questions; (ii) end of life care questions; (iii) knowledge about MAiD; or (iv) comfort and willingness to participate in MAiD. Knowledge questions were refined to reflect current MAiD legislation, policies, and regulatory frameworks. Falconer [ 39 ] and Freeman [ 45 ] studies were foundational sources for item selection. Additionally, four case studies were written to reflect the most recent anticipated changes to MAiD legislation and all used the same open-ended core questions to address respondents’ perspectives about the patient’s right to make the decision, comfort in assisting a physician or NP to administer MAiD in that scenario, and hypothesized comfort about serving as a primary provider if qualified as an NP in future. Response options for the survey were also constructed during this stage and included: open text, categorical, yes/no , and Likert scales.

Phase 2: faculty expert panel review

Of the 56 items presented to the faculty panel, 54 questions reached 75% consensus. However, based upon the qualitative responses 9 items were removed largely because they were felt to be repetitive. Items that generated the most controversy were related to measuring religion and spirituality in the Canadian context, defining end of life care when there is no agreed upon time frames (e.g., last days, months, or years), and predicting willingness to be involved in a future events – thus predicting their future selves. Phase 2, round 1 resulted in an initial set of 47 items which were then presented back to the faculty panel in round 2.

Of the 47 initial questions presented to the panel in round 2, 45 reached a level of consensus of 75% or greater, and 34 of these questions reached a level of 100% consensus [ 27 ] of which all participants chose to include without any adaptations) For each question, level of importance was determined based on a 5-point Likert scale (1 = very unimportant, 2 = somewhat unimportant, 3 = neutral, 4 = somewhat important, and 5 = very important). Figure  2 provides an overview of the level of importance assigned to each item.

Ranking level of importance for survey items

After round 2, a careful analysis of participant comments and level of importance was completed by the research team. While the main method of survey item development came from participants’ response to the first round of Delphi consensus ratings, level of importance was used to assist in the decision of whether to keep or modify questions that created controversy, or that rated lower in the include/exclude/adapt portion of the Delphi. Survey items that rated low in level of importance included questions about future roles, sex and gender, and religion/spirituality. After deliberation by the research committee, these questions were retained in the survey based upon the importance of these variables in the scientific literature.

Of the 47 questions remaining from Phase 2, round 2, four were revised. In addition, the two questions that did not meet the 75% cut off level for consensus were reviewed by the research team. The first question reviewed was What is your comfort level with providing a MAiD death in the future if you were a qualified NP ? Based on a review of participant comments, it was decided to retain this question for the cognitive interviews with students in the final phase of testing. The second question asked about impacts on respondents’ views of MAiD and was changed from one item with 4 subcategories into 4 separate items, resulting in a final total of 51 items for phase 3. The revised survey was then brought forward to the cognitive interviews with student participants in Phase 3. (see Supplementary Material 1 for a complete description of item modification during round 2).

Phase 3. Outcomes of cognitive interview focus group

Of the 51 items reviewed by student participants, 29 were identified as clear with little or no discussion. Participant comments for the remaining 22 questions were noted and verified against the audio recording. Following content analysis of the comments, four key themes emerged through the student discussion: unclear or ambiguous wording; difficult to answer questions; need for additional response options; and emotional response evoked by questions. An example of unclear or ambiguous wording was a request for clarity in the use of the word “sufficient” in the context of assessing an item that read “My nursing education has provided sufficient content about the nursing role in MAiD.” “Sufficient” was viewed as subjective and “laden with…complexity that distracted me from the question.” The group recommended rewording the item to read “My nursing education has provided enough content for me to care for a patient considering or requesting MAiD.”

An example of having difficulty answering questions related to limited knowledge related to terms used in the legislation such as such as safeguards , mature minor , eligibility criteria , and conscientious objection. Students were unclear about what these words meant relative to the legislation and indicated that this lack of clarity would hamper appropriate responses to the survey. To ensure that respondents are able to answer relevant questions, student participants recommended that the final survey include explanation of key terms such as mature minor and conscientious objection and an overview of current legislation.

Response options were also a point of discussion. Participants noted a lack of distinction between response options of unsure and unable to say . Additionally, scaling of attitudes was noted as important since perspectives about MAiD are dynamic and not dichotomous “agree or disagree” responses. Although the faculty expert panel recommended the integration of the demographic variables of religious and/or spiritual remain as a single item, the student group stated a preference to have religion and spirituality appear as separate items. The student focus group also took issue with separate items for the variables of sex and gender, specifically that non-binary respondents might feel othered or “outed” particularly when asked to identify their sex. These variables had been created based upon best practices in health research but students did not feel they were appropriate in this context [ 49 ]. Finally, students agreed with the faculty expert panel in terms of the complexity of projecting their future involvement as a Nurse Practitioner. One participant stated: “I certainly had to like, whoa, whoa, whoa. Now let me finish this degree first, please.” Another stated, “I'm still imagining myself, my future career as an RN.”

Finally, student participants acknowledged the array of emotions that some of the items produced for them. For example, one student described positive feelings when interacting with the survey. “Brought me a little bit of feeling of joy. Like it reminded me that this is the last piece of independence that people grab on to.” Another participant, described the freedom that the idea of an advance request gave her. “The advance request gives the most comfort for me, just with early onset Alzheimer’s and knowing what it can do.” But other participants described less positive feelings. For example, the mature minor case study yielded a comment: “This whole scenario just made my heart hurt with the idea of a child requesting that.”

Based on the data gathered from the cognitive interview focus group of nursing students, revisions were made to 11 closed-ended questions (see Table  4 ) and 3 items were excluded. In the four case studies, the open-ended question related to a respondents’ hypothesized actions in a future role as NP were removed. The final survey consists of 45 items including 4 case studies (see Supplementary Material 3 ).

The aim of this study was to develop and validate a survey that can be used to track the growth of knowledge about MAiD among nursing students over time, inform training programs about curricular needs, and evaluate attitudes and willingness to participate in MAiD at time-points during training or across nursing programs over time.

The faculty expert panel and student participants in the cognitive interview focus group identified a need to establish core knowledge of the terminology and legislative rules related to MAiD. For example, within the cognitive interview group of student participants, several acknowledged lack of clear understanding of specific terms such as “conscientious objector” and “safeguards.” Participants acknowledged discomfort with the uncertainty of not knowing and their inclination to look up these terms to assist with answering the questions. This survey can be administered to nursing or pre-nursing students at any phase of their training within a program or across training programs. However, in doing so it is important to acknowledge that their baseline knowledge of MAiD will vary. A response option of “not sure” is important and provides a means for respondents to convey uncertainty. If this survey is used to inform curricular needs, respondents should be given explicit instructions not to conduct online searches to inform their responses, but rather to provide an honest appraisal of their current knowledge and these instructions are included in the survey (see Supplementary Material 3 ).

Some provincial regulatory bodies have established core competencies for entry-level nurses that include MAiD. For example, the BC College of Nurses and Midwives (BCCNM) requires “knowledge about ethical, legal, and regulatory implications of medical assistance in dying (MAiD) when providing nursing care.” (10 p. 6) However, across Canada curricular content and coverage related to end of life care and MAiD is variable [ 23 ]. Given the dynamic nature of the legislation that includes portions of the law that are embargoed until 2024, it is important to ensure that respondents are guided by current and accurate information. As the law changes, nursing curricula, and public attitudes continue to evolve, inclusion of core knowledge and content is essential and relevant for investigators to be able to interpret the portions of the survey focused on attitudes and beliefs about MAiD. Content knowledge portions of the survey may need to be modified over time as legislation and training change and to meet the specific purposes of the investigator.

Given the sensitive nature of the topic, it is strongly recommended that surveys be conducted anonymously and that students be provided with an opportunity to discuss their responses to the survey. A majority of feedback from both the expert panel of faculty and from student participants related to the wording and inclusion of demographic variables, in particular religion, religiosity, gender identity, and sex assigned at birth. These and other demographic variables have the potential to be highly identifying in small samples. In any instance in which the survey could be expected to yield demographic group sizes less than 5, users should eliminate the demographic variables from the survey. For example, the profession of nursing is highly dominated by females with over 90% of nurses who identify as female [ 50 ]. Thus, a survey within a single class of students or even across classes in a single institution is likely to yield a small number of male respondents and/or respondents who report a difference between sex assigned at birth and gender identity. When variables that serve to identify respondents are included, respondents are less likely to complete or submit the survey, to obscure their responses so as not to be identifiable, or to be influenced by social desirability bias in their responses rather than to convey their attitudes accurately [ 51 ]. Further, small samples do not allow for conclusive analyses or interpretation of apparent group differences. Although these variables are often included in surveys, such demographics should be included only when anonymity can be sustained. In small and/or known samples, highly identifying variables should be omitted.

There are several limitations associated with the development of this survey. The expert panel was comprised of faculty who teach nursing students and are knowledgeable about MAiD and curricular content, however none identified as a conscientious objector to MAiD. Ideally, our expert panel would have included one or more conscientious objectors to MAiD to provide a broader perspective. Review by practitioners who participate in MAiD, those who are neutral or undecided, and practitioners who are conscientious objectors would ensure broad applicability of the survey. This study included one student cognitive interview focus group with 5 self-selected participants. All student participants had held discussions about end of life care with at least one patient, 4 of 5 participants had worked with a patient who requested MAiD, and one had been present for a MAiD death. It is not clear that these participants are representative of nursing students demographically or by experience with end of life care. It is possible that the students who elected to participate hold perspectives and reflections on patient care and MAiD that differ from students with little or no exposure to end of life care and/or MAiD. However, previous studies find that most nursing students have been involved with end of life care including meaningful discussions about patients’ preferences and care needs during their education [ 40 , 44 , 47 , 48 , 52 ]. Data collection with additional student focus groups with students early in their training and drawn from other training contexts would contribute to further validation of survey items.

Future studies should incorporate pilot testing with small sample of nursing students followed by a larger cross-program sample to allow evaluation of the psychometric properties of specific items and further refinement of the survey tool. Consistent with literature about the importance of leadership in the context of MAiD [ 12 , 53 , 54 ], a study of faculty knowledge, beliefs, and attitudes toward MAiD would provide context for understanding student perspectives within and across programs. Additional research is also needed to understand the timing and content coverage of MAiD across Canadian nurse training programs’ curricula.

The implementation of MAiD is complex and requires understanding of the perspectives of multiple stakeholders. Within the field of nursing this includes clinical providers, educators, and students who will deliver clinical care. A survey to assess nursing students’ attitudes toward and willingness to participate in MAiD in the Canadian context is timely, due to the legislation enacted in 2016 and subsequent modifications to the law in 2021 with portions of the law to be enacted in 2027. Further development of this survey could be undertaken to allow for use in settings with practicing nurses or to allow longitudinal follow up with students as they enter practice. As the Canadian landscape changes, ongoing assessment of the perspectives and needs of health professionals and students in the health professions is needed to inform policy makers, leaders in practice, curricular needs, and to monitor changes in attitudes and practice patterns over time.

Availability of data and materials

The datasets used and/or analysed during the current study are not publicly available due to small sample sizes, but are available from the corresponding author on reasonable request.

Abbreviations

British Columbia College of Nurses and Midwives

Medical assistance in dying

Nurse practitioner

Registered nurse

University of British Columbia Okanagan

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Acknowledgements

We would like to acknowledge the faculty and students who generously contributed their time to this work.

JS received a student traineeship through the Principal Research Chairs program at the University of British Columbia Okanagan.

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JS made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and drafting and substantively revising the work. JS has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. BP made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and drafting and substantively revising the work. BP has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. LO made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and substantively revising the work. LO has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. NDO made substantial contributions to the conception of the work; data acquisition, analysis, and interpretation; and substantively revising the work. NDO has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. HS made substantial contributions to drafting and substantively revising the work. HS has approved the submitted version and agreed to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.

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JS conducted this study as part of their graduate requirements in the School of Nursing, University of British Columbia Okanagan.

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Schroeder, J., Pesut, B., Olsen, L. et al. Developing a survey to measure nursing students’ knowledge, attitudes and beliefs, influences, and willingness to be involved in Medical Assistance in Dying (MAiD): a mixed method modified e-Delphi study. BMC Nurs 23 , 326 (2024). https://doi.org/10.1186/s12912-024-01984-z

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Received : 24 October 2023

Accepted : 28 April 2024

Published : 14 May 2024

DOI : https://doi.org/10.1186/s12912-024-01984-z

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