Five strategies scholars use in writing medical review articles

In an article in the journal Academic Medicine, William McGaghie, PhD, of Loyola University Chicago Stritch School of Medicine identifies the five main strategies scholars use when writing review articles: narrative review, systematic review, scoping, critical-realist and open peer commentary.

These different approaches to synthesizing research "are not necessarily better or worse than one another, just different, " Dr. McGaghie writes. Each tradition involves hard work, and requires "polished writing to convey its message with clarity and simplicity."

Dr. McGaghie is director of the Ralph P. Leischner Jr. MD Institute for Medical Education, vice chair, Department of Medical Education and professor of medical education of Loyola University Chicago Stritch School of Medicine.

Writing a review article involves a type of scholarly work called integrative scholarship. The late educator Ernest Boyer, PhD, wrote that integrative scholarship puts isolated facts in perspective, makes connections across disciplines and illuminates data in a revealing way. Integrative scholarship, Dr. Boyer wrote, is "serious, disciplined work that seeks to interpret, draw together and bring new insight to bear on original research."

Research integration involves seven steps: formulate the problem; search the literature; gather information from studies; evaluate the quality of studies; analyze and integrate the outcomes of studies; interpret the evidence; and present the results.

Dr. McGaghie identifies the five traditions of writing review articles:

Narrative review. Until recently, this was the most common, influential and widely endorsed approach. An author or authors stakes out an area of published writing and aggregates the evidence based on expert opinion or judgment. Data are abstracted from the reviewed articles and compiled into evidence tables. An "expert" summarizes his or her understanding of the issues in a review article.

Systematic review. This is a distinct, reproducible research method requiring a testable hypothesis or focused research question. The literature search is systematic and comprehensive; articles are selected for inclusion according to criteria set in advance. As in narrative reviews, data are compiled into evidence tables. Data then are interpreted in the context of all relevant studies.

Scoping. This is a relatively new strategy. The intent is to produce a quick, narrative, descriptive account of the scope of current literature addressing a key research question.

Critical-realist. This is a hybrid of the narrative, systematic and scoping review methods. It relies simultaneously on both professional judgment and rigorous methodology.

Open peer commentary. In this approach, a journal solicits or commissions an article that is provocative, controversial or at the leading edge of science or scholarship. The peer-reviewed article is followed by commentaries that may endorse, refute, amplify or refine its methods, substance or conclusions. The author of the target article has the final say in the form of rebuttal, summary remarks and comments.

Dr. McGaghie writes: "Reviewers and editors should recognize and respect the five integrative scholarship traditions and also be ready to embrace new approaches to research synthesis such as network analysis now on the horizon."