The PAPERs Podcast

Episode host: Lara Varpio.

Episode 74 transcript. Enjoy PapersPodcast as a versatile learning resource the way you prefer—read, translate, and explore!

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Laying bare the methods in our research madness.

One of the questions I recurringly get is about the many different kinds of literature reviews that we see, often, in health professions education:  

• Scoping 
• Systematic 
• Realist  
• Narrative 
• State of the art 
• Meta ethnographic 

How do you know which one to pick when you are conducting a review? Today, we will delve into how I think about the different types of literature reviews and how I explain the factors that weigh to make a decision.  

Understanding the Foundations 

Literature reviews are not one-size-fits-all. Each type of review comes with its own expectations about rigor, knowledge generation, and credibility. Your first step is understanding these differences. Visualize a continuum: 

• At one end lies the objectivist approach, where the goal is to create unbiased, comprehensive summaries of the existing literature. 
• At the other is the subjectivist approach, emphasizing interpretation, critique, and contextual insights shaped by the researcher’s perspective. 

This continuum provides a framework for choosing the type of review that aligns with your research aims. 

The Objectivist Approach 

For those seeking to answer narrow, focused questions, systematic reviews are the gold standard. These reviews treat the literature like a database, using explicit methods to identify, assess, and synthesize findings. The result? An objective synthesis that answers specific research questions with clarity and precision. 

The Subjectivist Approach 

If your research leans toward interpretation and critique, narrative reviews offer a rich, flexible approach. Under this umbrella, you’ll find options like: 

Scoping Reviews: These map out the available literature on a phenomenon, highlighting trends and gaps. Just as a map highlights some features while omitting others, a scoping review reflects what matters most to the researcher. 

State-of-the-Art Reviews: These summarize the evolution of knowledge, addressing three key questions:

• Where are we now?
• How did we get here?
• Where should we go next?

The answers depend on the researcher’s interpretations and expertise. 

Critical Reviews: These challenge existing perspectives by applying theories or evidence from other fields, offering transformative insights into a phenomenon. 

Finding your path

The key to selecting the right review lies in two fundamental questions: 

1. Do you aim for an objective synthesis or a subjective interpretation? 
2. What do you want your review to contribute to the field? 

Your answers will guide you toward the appropriate review type and ensure your research aligns with its intended purpose. 

Insights and tools

This episode also introduces an essential resource: articles from The Journal of Graduate Medical Education. Notably, “Understanding the Differences that Differentiate,” co-authored by Robyn Parker, Anna MacLeod, and myself, provides a practical model for choosing the right type of literature review. It even includes a figure mapping of various review types along the objectivist–subjectivist continuum, which is an invaluable tool for any researcher. 

References

Varpio, L., Parker, R., & MacLeod, A. (2024). Understanding the Differences That Differentiate: A Model for Deciding Which Literature Review to Conduct. Journal of Graduate Medical Education, 16(2), 146–150.

The Journal of Graduate Medical Education’s series of literature reviews: JGME Literature Review Series

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Transcript of Episode 74

This transcript is made by an autogenerated text tool and some manual editing by the Papers Podcast team. Read more under “Acknowledgment”.

Lara Varpio

Start

[music]

Lara Varpio:  Hi everybody and welcome to another episode of the Papers Podcast. It is time for another methods consult where I try to lay bare the methods in our research madness. Now, when I sit down to record one of these consults, I often have the same dilemma. What am I going to talk about? Sincerely, I spend a lot of time worrying about what might be useful for our community.

What am I sufficiently knowledgeable about in order to speak up to you about this without having to prepare for weeks in advance, maybe just a few days in advance? So when I pick a topic, there’s a lot of things I take into consideration. But what I usually do is I go into my collection of emails from all of you, our listeners.

Where I keep a list of the topics you request that I cover over these methods consults. Just so you know, I also keep a list of things that my co-hosts ask me about on the regular. The topic I picked today is one that has frequently shown up in the emails. And so today, we’re going to talk about literature reviews, but we’re going to talk specifically about answering a question.

 And that question is, Dear Lara, how do I know which type of literature review I should be doing? So that’s one of the questions I get a lot. And I understand why. There are all kinds of different types of literature reviews that we use in health professions education. It is not uncommon to open the pages of a journal and see scoping, systematic reviews, realist or narrative reviews.

 We’re increasingly seeing state-of-the-art reviews and meta-ethnographic literature reviews. And that’s just a few of them. There’s so many more. And the question’s a really… good one. How do you know which one to pick? You know, and I get these great emails from so many of you that give me a short synopsis of the phenomenon you’re interested.

Then you say, so given that, what kind of research should I do? And I have a very unsatisfying response to those emails because I end up writing, it depends. And I find that very frustrating to write. And I can’t even imagine what it must be like to receive that. So today, what I’m going to try to do is talk about why it depends. What are the factors to consider?

Now, before I get into this, I’m going to direct you to a collection of articles that really does hold so much of what you need to know. It covers eight different kinds of literature reviews. I’m going to put the link in the show notes.

You’re going to go to the Journal Of Graduate Medical Education, and at the top of the website, there’s a little heading that says Collections. You’re going to click on that, and one of the collections that’s listed is called JGME Literature Review Series.

That is where you want to go. Like I said, I’ll put the link in the show notes and that’ll take you right to where you need to be. Then you’ll find a huge set of resources. So with that said, how do you pick between different kinds of literature reviews?

 First thing we have to talk about is expectations. Every literature review has built within it a set of expectations about the kind of knowledge you’re going to be able to develop about what will be considered rigorous and… adequate and credible research from within those traditions.

 So before you do any literature review, the first thing is to figure out your expectations. How do you do that? Okay, little thought experiment here. I’d like you to have a little imagination moment. Imagine a continuum. At one end of the continuum, we’re going to put the word objectivist. And at the other end of the continuum, we’re going to put the word subjectivist.

Now, let’s start at the objectivist end. This end of the lit review spectrum is familiar to many listeners because it’s commonly employed in the natural sciences. It’s the foundation for a lot of the knowledge we have in medicine. Objectivist research tries to generate unbiased knowledge about a phenomenon.

They treat that phenomenon as an external thing we can look at, observe, measure. And the literature reviews that work in the objectivist space, they want to summarize the evidence available in the literature in an unbiased kind of way. Fine. Now let’s swing over to the subjectivist end of the continuum.

In the subjectivist space, we try to understand the meaning people make about a phenomenon. So literature reviews at that end of the continuum summarize available evidence to offer an interpretation of the literature. From a particular perspective. The review generates insights that are intimately connected with the subjective perspective of the researcher carrying out the synthesis.

So from the objectivist orientation, literature reviews are looking to objectively summarize synthesized data in the literature. At the other end, the subjectivist end, literature reviews are offering an interpretation of the literature based on their expertise and insights and perspectives of the people doing the research.

Fine. So when someone asks what kind of literature review I should do, when I say it depends, part of what it depends on is how you’re going to approach the work of the review. Do you want to create an objective summary and synthesis of what’s in the literature? Or are you going to offer an interpretation of what’s in the literature?

Once you have a sense of which pole you’re working at, which end, now you have started narrowing down your choices. Quick word. It is a continuum. There are review methods that sit between, but for the purposes of this short synthesis today, I’m just going to focus on the two ends, okay?

If you want to create an objectivist review, you’re probably going to think systematic reviews. It’s the canonical example of objectivist literature reviews.

In contrast, if you’re working from the subjectivist orientation, now you’re looking at a whole family of narrative reviews. Narrative literature reviews, narrative reviews, that’s an umbrella word under which sit many different kinds of literature reviews that take a subjectivist orientation.

So now we’re starting to get somewhere, right? If you’re thinking about an objective literature review, your canonical example is a systematic review.

Systematic review, let’s start there, asks a really narrow question of the literature available on a topic, right? When you do a systematic review, you’re kind of treating the literature that’s available like a database where a lot of data is collected. You ask a narrow question and you judge the quality of the studies and you decide which ones have data that are worthy of inclusion.

You use explicit and pre-specified methods to identify and select and assess and summarize all the findings in all these separate studies. You bring them all together to synthesize and summarize. To answer your very narrow, specific question. Perfect. Ask a narrow question, get a specific answer. Gorge.

But when you swing over to the subjectivist side of the house, you’re going to find that you’re doing literature reviews in a really different way. The review types that sit under that umbrella of narrative reviews, they want to summarize, interpret, and critique the literature. The researcher offers that interpretation from their unique, specific subjective position.

So under the narrative umbrella, like, sincerely, there’s a lot of different literature review types that sit under there. Let’s cover a few of them. I can’t do all of them, but I’ll cover a few. So for instance, one of those would be scoping reviews. That is a type of narrative review. Why? Because scoping reviews offer a synthesis about the literature, about a phenomenon by creating a map, right?

We’re going to map the literature. We’re going to map what’s known. Now here’s the interesting thing about maps. A map highlights some things, but fails to highlight others. So for instance, if you’re about to take a trip, you might look at a map of the major roads and freeways that will help you get from point A to point B.

Alternatively, if you’re going to be all athletic and hike that distance, then you might be interested in a map that demonstrates elevations. So you know when you’re going to be going uphill and when you’re going to be going downhill.

Or if you’re like me, you’ll be looking for a list of hotels where you can stay in comfort along that trip and chart a path via the nicest dog friendliest hotels.

What I’m saying here is that when you’re creating a map, each person will emphasize different things. It depends on who you are and what you care about. Similarly, when you’re making a scoping review, the map you create reflects what you care about. Do you care about where the researchers are geographically situated? Do you care about if they use quant or qual data?

 Do you care about the nature of the theories they use to help inform their studies? There are as many different ways of mapping the literature as there are researchers. And that’s why scoping reviews are a narrative type of literature review.

Doing a scoping review means you’re making a map, and that map reflects what you, subjectively, consider important enough to map. You’ll create a map based on the things you think are important about the literature.

Fine. Another kind of narrative review is the state-of-the-art literature review. A state-of-the-art literature review creates a summary of the literature across history, across a timeline. It essentially generates a three-part argument. Part one says, this is where we are. Part two says, this is how we got here. And part three says, this is where we should be going.

This is a subjectivist review. Because the determinations of where we are and how we got here and where we’re going, that’s based on the researcher’s interpretations. The researcher looks at the literature across the timeline and identifies along that history turning points or salient moments of big events or important papers that changed our way of thinking and acting about a phenomenon.

It’s subjectivist because if you look at the literature, you might see three turning points that are significant. In contrast, when I look at the literature, I might identify three completely different points that are turning points in literature. Why? Because we use our expertise and our insights to make decisions and interpret the literature to identify sentinel moments.

You might see the literature in one way, and I’ll see it in a different way. Neither is better or worse. They’re just different perspectives available on the literature. So a state-of-the-art literature review looks at the literature across a timeline, makes statements about where we are now, how we got here, and where we’re going, based on the perspectives of the researchers carrying out the synthesis.

The last type of narrative review that I’ll spend a minute on that sits at the narrative umbrella is the critical review. And I kind of think the critical review is really cool. And super interesting. It’s a form of literature review that critiques literature about a phenomenon by drawing on knowledge and insights or theories from other places, often other fields.

So the critical review essentially says, if I use this piece of evidence from over here, or this theory from over there, and I use it like a lens, like a pair of glasses to look through that lens at the literature on this phenomenon, if I look at it through that lens, I see the literature differently than we do right now.

 So a critical review is a way of saying the theory or the piece of evidence that we have, it offers us a perspective that can help us see the phenomenon in new and important and generative ways.

And that’ll help us move the field forward in ways we hadn’t perhaps been thinking about before.

A critical review is exciting because it’s a bit of a promise, right? It says… I promise you that if you just take the minute and look at the literature on Phenomenon X from this other orientation, from this perspective over here, I promise you, you’re going to see things that matter. And we’re going to see things that to date we haven’t been thinking about.

And I think that’s really exciting because often in science, it’s really hard to see something in new ways, in new light. And a critical review offers us that change of perspective. That’s exciting, right? A critical review is like an argument that says, I appreciate. Everything we’ve done. It’s good.

I’m grateful. But if we look at it from this angle, maybe we can see something new that can help us move forward in ways we hadn’t anticipated, in ways that might be really important, really useful for the future of our field. Love that. So the point of this podcast was to answer the question, what kind of literature review should I do?

And I hope I’ve started to help you understand how to answer that question, because you first need to ask yourself about your expectations. You need to ask yourself, am I working from an objectivist orientation or a sub-objectivist orientation? Then, depending on where you’re working from, you can start to narrow down your choices.

There’s an article in that JGME series that… I mentioned this with a little hesitation because I really try very hard not to promote papers that I first authored. But in that JGME series is a manuscript I first authored called “Understanding the Differences that Differentiate.

A model for deciding which literature review to conduct. “And I was so lucky to work with two extremely talented scholars, Robin Parker and Anna McLeod, who are both out in Halifax at Dalhousie.

 We wrote this paper in response to that question, which literature review type should I choose? And that’s why I reference it for you. Because that manuscript has a figure, it has a picture that illustrates where different literature review types sit along that continuum between objectivist to subject.

I also really want to encourage you, dear listener, to look at the JGME articles that are in that literature review series. That series is so useful because it has two papers for each of eight different kinds of literature reviews. So the series covers systematic, realist, narrative, scoping, state-of-the-art, meta-ethnographic, critical, and theoretical integrated reviews.

And for each of those different types, the series offers two papers that walk you through how to think about the review and how to do it. Take the two minutes, find that JGME collection. Pin it on your electronic dashboard. It will be useful in the years to come, I promise. It also has all the citations for everything you need to do the work. A great series by some really wonderful authors.

Now, before I sign off, just a few final thoughts. I really do hope this helps you, dear listener, as you try to figure out what kind of lit review to conduct. I find literature reviews really humbling. No matter how long I’ve worked in this field, every time I do a literature review, I walk away feeling like there’s so much to know.

And all I’ve done is create a tentative and small scope understanding of a phenomenon. And it’s a tentative small scope understanding of a really complex topic of which there’s like so much to know. Julie, I think if you do a literature review well, you’re probably walking away from that experience feeling the weight of just how much we don’t know.

Truly, I find it really humbling work. And that’s both a blessing and a curse. The blessing is you’ve done all this reading and you have a great understanding of what’s known and you have an appreciation for the breadth and depth of it all. On the other hand, you walk away knowing that beyond that breadth and depth, there is just so much more for us to think about and care about and study.

It’s humbling, but you know, it’s also exciting because that means there’s always a next frontier. So friends, with that said. I hope this methods consult has been useful for you. Please write and let me know. Make comments, offer critiques. Truly, I believe feedback is the breakfast of champions.

So tell me what you think so I can learn and do better. Because like my back pain, I will be back with another methods consult and I hope to pick a topic that you care about. So what’s elusive for you? What are you struggling with to understand? What makes no sense? What are you curious about?

Write to us. You can reach us at thepaperspodcast@gmail.com. Or look for us on the web at paperspodcast.ki.se. Until next time, friends, I hope you have a great rest of your day. May your educational adventures be nothing but fun and exciting. Until next time, I’ll talk to you later.

Jason Frank: You’ve been listening to the Papers Podcast. We hope we made you just slightly smarter. The podcast is a production of the Unit For Teaching And Learning at the Karolinska Institutet. The executive producer today was my friend, Teresa Sörö. The technical producer today was Samuel Lundberg.

You can learn more about the Papers Podcast and contact us at www.thepaperspodcast.com. Thank you for listening, everybody. Thank you for all you do. Take care.

Acknowledgment

This transcript was generated using machine transcription technology, followed by manual editing for accuracy and clarity. While we strive for precision, there may be minor discrepancies between the spoken content and the text. We appreciate your understanding and encourage you to refer to the original podcast for the most accurate context.