apa research paper literature review

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Literature Review: Conducting & Writing

• Sample Literature Reviews
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• Finding "The Literature"
• Organizing/Writing
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How to Write a Literature Review: Writing a Literature Review in APA Format

• Writing a Literature Review in APA Format
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Writing a Literature Review in APA

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Table of contents

What is the purpose of 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, free lecture slides, other interesting articles, frequently asked questions, introduction.

• Quick Run-through
• Step 1 & 2

When you write a thesis , dissertation , or research paper , you will likely 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 its scholarly context
• Develop a theoretical framework and methodology for your research
• Position your work in relation to other researchers and theorists
• Show how your research addresses a gap or contributes to a debate
• Evaluate the current state of research and demonstrate your knowledge of the scholarly debates around your topic.

Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.

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See an example

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 problem and questions .

Make a list of keywords

Start by creating a list of keywords related to your research question. 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 as 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 useful 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 also use boolean operators to help narrow down your search.

Make sure to 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.

You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.

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?
• 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 use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.

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 is important to keep track of your sources with citations to avoid plagiarism . It can be helpful to make an annotated bibliography , where you compile full citation 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.

Prevent plagiarism. Run a free check.

To begin organizing your literature review’s argument and structure, be sure you 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 organizing the body of a literature review. 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 summarizing sources in order.

Try to analyze 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 organize 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.

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, you can follow these tips:

• Summarize and synthesize: give an overview of the main points of each source and combine them into a coherent whole
• Analyze and interpret: don’t just paraphrase other researchers — add your own interpretations where possible, 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 transition words and topic sentences to draw connections, comparisons and contrasts

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

When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !

This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.

Scribbr slides are free to use, customize, and distribute for educational purposes.

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If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

• Sampling methods
• Simple random sampling
• Stratified sampling
• Cluster sampling
• Likert scales
• Reproducibility

 Statistics

• Null hypothesis
• Statistical power
• Probability distribution
• Effect size
• Poisson distribution

Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
• Anchoring bias
• Explicit bias

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 thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.

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

• To familiarize 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 thesis or dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .

A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other  academic texts , with an introduction , a main body, and a conclusion .

An  annotated bibliography is a list of  source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a  paper .  

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Writing Center Literature Reviews: Literature Reviews

Literature reviews.

A literature review is a summary of published information in a subject area; sometimes limited to a specific time period. Researchers benefit from literature reviews since they provide critical evaluation of what has been published on a topic by accredited scholars and researchers. Oftentimes a literature review will highlight disagreements between different scholars or schools of thought. The following literature review examples are just two types found in scholarly literature and does not reflect the format you may need to produce for your assignment. 

Example: Literature Review in a Standalone Article

A literature review can be a standalone document that provides a survey of current research in a particular field or subject. Notice this entire article is dedicated to reviewing literature on the topic.

Example: Literature Review in Original Research

A literature review may also be located at the beginning of an original research article. Notice this article's literature review is located only in the beginning of the article before the Methodology section.

Literature Review

Literature review provides a narrative summary and evaluation of the findings or theories within a literature base. The literature base may include qualitative, quantitative, and/or mixed methods research. Literature reviews capture trends in the literature. 

When writing a literature review, here are some things to consider

Consider what the assignment prompt is asking you to highlight within your literature review. 

Is it part of a research paper (usually found after the introduction) or

Are you asked to summarize previous literature to inform readers of the state of the research?

You may need to identify relations, contradictions, gaps, and inconsistencies in the literature.

Parts of a literature review may include: 

An Introduction, Body, & Conclusion.

A literature review may be organized 

Chronological - to identify the development of the topic

Thematic - grouping research on the basis of similarity in the topic and concepts. 

Methodological - if you are pulling together information from various fields that use different research methods. 

Theoretical - in order to discuss different theories, models, and key concepts. 

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Types of APA Papers

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Copyright ©1995-2018 by The Writing Lab & The OWL at Purdue and Purdue University. All rights reserved. This material may not be published, reproduced, broadcast, rewritten, or redistributed without permission. Use of this site constitutes acceptance of our terms and conditions of fair use.

Note:  This page reflects the latest version of the APA Publication Manual (i.e., APA 7), which released in October 2019. The equivalent resource for the older APA 6 style  can be found here .

There are two common types of papers written in fields using APA Style: the literature review and the experimental report. Each has unique requirements concerning the sections that must be included in the paper.

Literature review

A literature review is a critical summary of what the scientific literature says about your specific topic or question. Often student research in APA fields falls into this category. Your professor might ask you to write this kind of paper to demonstrate your familiarity with work in the field pertinent to the research you hope to conduct.

A literature review typically contains the following sections:

• Introduction section
• List of references

Some instructors may also want you to write an abstract for a literature review, so be sure to check with them when given an assignment. Also, the length of a literature review and the required number of sources will vary based on course and instructor preferences.

NOTE: A literature review and an annotated bibliography are not synonymous. If you are asked to write an annotated bibliography, you should consult the Publication Manual of the American Psychological Association for the APA Format for Annotated Bibliographies.

Experimental report

In many of the social sciences, you will be asked to design and conduct your own experimental research. If so, you will need to write up your paper using a structure that is more complex than that used for just a literature review. We have a complete resource devoted to writing an experimental report in the field of psychology here .

This structure follows the scientific method, but it also makes your paper easier to follow by providing those familiar cues that help your reader efficiently scan your information for:

• Why the topic is important (covered in your introduction)
• What the problem is (also covered in your introduction)
• What you did to try to solve the problem (covered in your methods section)
• What you found (covered in your results section)
• What you think your findings mean (covered in your discussion section)

Thus an experimental report typically includes the following sections.

• Introduction
• Appendices(if necessary)
• Tables and/or figures (if necessary)

Make sure to check the guidelines for your assignment or any guidelines that have been given to you by an editor of a journal before you submit a manuscript containing the sections listed above.

As with the literature review, the length of this report may vary by course or by journal, but most often it will be determined by the scope of the research conducted.

Other papers

If you are writing a paper that fits neither of these categories, follow the guidelines about General Format , consult your instructor, or look up advice in the Publication Manual of the American Psychological Association .

When submitting a manuscript to a journal, make sure you follow the guidelines described in the submission policies of that publication, and include as many sections as you think are applicable to presenting your material. Remember to keep your audience in mind as you are making this decision. If certain information is particularly pertinent for conveying your research, then ensure that there is a section of your paper that adequately addresses that information.

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• Steps in Conducting a Literature Review

What is a literature review?

A literature review is an integrated analysis -- not just a summary-- of scholarly writings and other relevant evidence related directly to your research question.  That is, it represents a synthesis of the evidence that provides background information on your topic and shows a association between the evidence and your research question.

A literature review may be a stand alone work or the introduction to a larger research paper, depending on the assignment.  Rely heavily on the guidelines your instructor has given you.

Why is it important?

A literature review is important because it:

• Explains the background of research on a topic.
• Demonstrates why a topic is significant to a subject area.
• Discovers relationships between research studies/ideas.
• Identifies major themes, concepts, and researchers on a topic.
• Identifies critical gaps and points of disagreement.
• Discusses further research questions that logically come out of the previous studies.

APA7 Style resources

APA Style Blog - for those harder to find answers

1. Choose a topic. Define your research question.

Your literature review should be guided by your central research question.  The literature represents background and research developments related to a specific research question, interpreted and analyzed by you in a synthesized way.

• Make sure your research question is not too broad or too narrow.  Is it manageable?
• Begin writing down terms that are related to your question. These will be useful for searches later.
• If you have the opportunity, discuss your topic with your professor and your class mates.

2. Decide on the scope of your review

How many studies do you need to look at? How comprehensive should it be? How many years should it cover? 

• This may depend on your assignment.  How many sources does the assignment require?

3. Select the databases you will use to conduct your searches.

Make a list of the databases you will search. 

Where to find databases:

• use the tabs on this guide
• Find other databases in the Nursing Information Resources web page
• More on the Medical Library web page
• ... and more on the Yale University Library web page

4. Conduct your searches to find the evidence. Keep track of your searches.

• Use the key words in your question, as well as synonyms for those words, as terms in your search. Use the database tutorials for help.
• Save the searches in the databases. This saves time when you want to redo, or modify, the searches. It is also helpful to use as a guide is the searches are not finding any useful results.
• Review the abstracts of research studies carefully. This will save you time.
• Use the bibliographies and references of research studies you find to locate others.
• Check with your professor, or a subject expert in the field, if you are missing any key works in the field.
• Ask your librarian for help at any time.
• Use a citation manager, such as EndNote as the repository for your citations. See the EndNote tutorials for help.

Review the literature

Some questions to help you analyze the research:

• What was the research question of the study you are reviewing? What were the authors trying to discover?
• Was the research funded by a source that could influence the findings?
• What were the research methodologies? Analyze its literature review, the samples and variables used, the results, and the conclusions.
• Does the research seem to be complete? Could it have been conducted more soundly? What further questions does it raise?
• If there are conflicting studies, why do you think that is?
• How are the authors viewed in the field? Has this study been cited? If so, how has it been analyzed?

Tips: 

• Review the abstracts carefully.  
• Keep careful notes so that you may track your thought processes during the research process.
• Create a matrix of the studies for easy analysis, and synthesis, across all of the studies.
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How To Write A Literature Review - A Complete Guide

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A literature review is much more than just another section in your research paper. It forms the very foundation of your research. It is a formal piece of writing where you analyze the existing theoretical framework, principles, and assumptions and use that as a base to shape your approach to the research question.

Curating and drafting a solid literature review section not only lends more credibility to your research paper but also makes your research tighter and better focused. But, writing literature reviews is a difficult task. It requires extensive reading, plus you have to consider market trends and technological and political changes, which tend to change in the blink of an eye.

Now streamline your literature review process with the help of SciSpace Copilot. With this AI research assistant, you can efficiently synthesize and analyze a vast amount of information, identify key themes and trends, and uncover gaps in the existing research. Get real-time explanations, summaries, and answers to your questions for the paper you're reviewing, making navigating and understanding the complex literature landscape easier.

In this comprehensive guide, we will explore everything from the definition of a literature review, its appropriate length, various types of literature reviews, and how to write one.

What is a literature review?

A literature review is a collation of survey, research, critical evaluation, and assessment of the existing literature in a preferred domain.

Eminent researcher and academic Arlene Fink, in her book Conducting Research Literature Reviews , defines it as the following:

“A literature review surveys books, scholarly articles, and any other sources relevant to a particular issue, area of research, or theory, and by so doing, provides a description, summary, and critical evaluation of these works in relation to the research problem being investigated.

Literature reviews are designed to provide an overview of sources you have explored while researching a particular topic, and to demonstrate to your readers how your research fits within a larger field of study.”

Simply put, a literature review can be defined as a critical discussion of relevant pre-existing research around your research question and carving out a definitive place for your study in the existing body of knowledge. Literature reviews can be presented in multiple ways: a section of an article, the whole research paper itself, or a chapter of your thesis.

A literature review does function as a summary of sources, but it also allows you to analyze further, interpret, and examine the stated theories, methods, viewpoints, and, of course, the gaps in the existing content.

As an author, you can discuss and interpret the research question and its various aspects and debate your adopted methods to support the claim.

What is the purpose of a literature review?

A literature review is meant to help your readers understand the relevance of your research question and where it fits within the existing body of knowledge. As a researcher, you should use it to set the context, build your argument, and establish the need for your study.

What is the importance of a literature review?

The literature review is a critical part of research papers because it helps you:

• Gain an in-depth understanding of your research question and the surrounding area
• Convey that you have a thorough understanding of your research area and are up-to-date with the latest changes and advancements
• Establish how your research is connected or builds on the existing body of knowledge and how it could contribute to further research
• Elaborate on the validity and suitability of your theoretical framework and research methodology
• Identify and highlight gaps and shortcomings in the existing body of knowledge and how things need to change
• Convey to readers how your study is different or how it contributes to the research area

How long should a literature review be?

Ideally, the literature review should take up 15%-40% of the total length of your manuscript. So, if you have a 10,000-word research paper, the minimum word count could be 1500.

Your literature review format depends heavily on the kind of manuscript you are writing — an entire chapter in case of doctoral theses, a part of the introductory section in a research article, to a full-fledged review article that examines the previously published research on a topic.

Another determining factor is the type of research you are doing. The literature review section tends to be longer for secondary research projects than primary research projects.

What are the different types of literature reviews?

All literature reviews are not the same. There are a variety of possible approaches that you can take. It all depends on the type of research you are pursuing.

Here are the different types of literature reviews:

Argumentative review

It is called an argumentative review when you carefully present literature that only supports or counters a specific argument or premise to establish a viewpoint.

Integrative review

It is a type of literature review focused on building a comprehensive understanding of a topic by combining available theoretical frameworks and empirical evidence.

Methodological review

This approach delves into the ''how'' and the ''what" of the research question —  you cannot look at the outcome in isolation; you should also review the methodology used.

Systematic review

This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research and collect, report, and analyze data from the studies included in the review.

Meta-analysis review

Meta-analysis uses statistical methods to summarize the results of independent studies. By combining information from all relevant studies, meta-analysis can provide more precise estimates of the effects than those derived from the individual studies included within a review.

Historical review

Historical literature reviews focus on examining research throughout a period, often starting with the first time an issue, concept, theory, or phenomenon emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and identify future research's likely directions.

Theoretical Review

This form aims to examine the corpus of theory accumulated regarding an issue, concept, theory, and phenomenon. The theoretical literature review helps to establish what theories exist, the relationships between them, the degree the existing approaches have been investigated, and to develop new hypotheses to be tested.

Scoping Review

The Scoping Review is often used at the beginning of an article, dissertation, or research proposal. It is conducted before the research to highlight gaps in the existing body of knowledge and explains why the project should be greenlit.

State-of-the-Art Review

The State-of-the-Art review is conducted periodically, focusing on the most recent research. It describes what is currently known, understood, or agreed upon regarding the research topic and highlights where there are still disagreements.

Can you use the first person in a literature review?

When writing literature reviews, you should avoid the usage of first-person pronouns. It means that instead of "I argue that" or "we argue that," the appropriate expression would be "this research paper argues that."

Do you need an abstract for a literature review?

Ideally, yes. It is always good to have a condensed summary that is self-contained and independent of the rest of your review. As for how to draft one, you can follow the same fundamental idea when preparing an abstract for a literature review. It should also include:

• The research topic and your motivation behind selecting it
• A one-sentence thesis statement
• An explanation of the kinds of literature featured in the review
• Summary of what you've learned
• Conclusions you drew from the literature you reviewed
• Potential implications and future scope for research

Here's an example of the abstract of a literature review

Is a literature review written in the past tense?

Yes, the literature review should ideally be written in the past tense. You should not use the present or future tense when writing one. The exceptions are when you have statements describing events that happened earlier than the literature you are reviewing or events that are currently occurring; then, you can use the past perfect or present perfect tenses.

How many sources for a literature review?

There are multiple approaches to deciding how many sources to include in a literature review section. The first approach would be to look level you are at as a researcher. For instance, a doctoral thesis might need 60+ sources. In contrast, you might only need to refer to 5-15 sources at the undergraduate level.

The second approach is based on the kind of literature review you are doing — whether it is merely a chapter of your paper or if it is a self-contained paper in itself. When it is just a chapter, sources should equal the total number of pages in your article's body. In the second scenario, you need at least three times as many sources as there are pages in your work.

Quick tips on how to write a literature review

To know how to write a literature review, you must clearly understand its impact and role in establishing your work as substantive research material.

You need to follow the below-mentioned steps, to write a literature review:

• Outline the purpose behind the literature review
• Search relevant literature
• Examine and assess the relevant resources
• Discover connections by drawing deep insights from the resources
• Structure planning to write a good literature review

1. Outline and identify the purpose of  a literature review

As a first step on how to write a literature review, you must know what the research question or topic is and what shape you want your literature review to take. Ensure you understand the research topic inside out, or else seek clarifications. You must be able to the answer below questions before you start:

• How many sources do I need to include?
• What kind of sources should I analyze?
• How much should I critically evaluate each source?
• Should I summarize, synthesize or offer a critique of the sources?
• Do I need to include any background information or definitions?

Additionally, you should know that the narrower your research topic is, the swifter it will be for you to restrict the number of sources to be analyzed.

2. Search relevant literature

Dig deeper into search engines to discover what has already been published around your chosen topic. Make sure you thoroughly go through appropriate reference sources like books, reports, journal articles, government docs, and web-based resources.

You must prepare a list of keywords and their different variations. You can start your search from any library’s catalog, provided you are an active member of that institution. The exact keywords can be extended to widen your research over other databases and academic search engines like:

• Google Scholar
• Microsoft Academic
• Science.gov

Besides, it is not advisable to go through every resource word by word. Alternatively, what you can do is you can start by reading the abstract and then decide whether that source is relevant to your research or not.

Additionally, you must spend surplus time assessing the quality and relevance of resources. It would help if you tried preparing a list of citations to ensure that there lies no repetition of authors, publications, or articles in the literature review.

3. Examine and assess the sources

It is nearly impossible for you to go through every detail in the research article. So rather than trying to fetch every detail, you have to analyze and decide which research sources resemble closest and appear relevant to your chosen domain.

While analyzing the sources, you should look to find out answers to questions like:

• What question or problem has the author been describing and debating?
• What is the definition of critical aspects?
• How well the theories, approach, and methodology have been explained?
• Whether the research theory used some conventional or new innovative approach?
• How relevant are the key findings of the work?
• In what ways does it relate to other sources on the same topic?
• What challenges does this research paper pose to the existing theory
• What are the possible contributions or benefits it adds to the subject domain?

Be always mindful that you refer only to credible and authentic resources. It would be best if you always take references from different publications to validate your theory.

Always keep track of important information or data you can present in your literature review right from the beginning. It will help steer your path from any threats of plagiarism and also make it easier to curate an annotated bibliography or reference section.

4. Discover connections

At this stage, you must start deciding on the argument and structure of your literature review. To accomplish this, you must discover and identify the relations and connections between various resources while drafting your abstract.

A few aspects that you should be aware of while writing a literature review include:

• Rise to prominence: Theories and methods that have gained reputation and supporters over time.
• Constant scrutiny: Concepts or theories that repeatedly went under examination.
• Contradictions and conflicts: Theories, both the supporting and the contradictory ones, for the research topic.
• Knowledge gaps: What exactly does it fail to address, and how to bridge them with further research?
• Influential resources: Significant research projects available that have been upheld as milestones or perhaps, something that can modify the current trends

Once you join the dots between various past research works, it will be easier for you to draw a conclusion and identify your contribution to the existing knowledge base.

5. Structure planning to write a good literature review

There exist different ways towards planning and executing the structure of a literature review. The format of a literature review varies and depends upon the length of the research.

Like any other research paper, the literature review format must contain three sections: introduction, body, and conclusion. The goals and objectives of the research question determine what goes inside these three sections.

Nevertheless, a good literature review can be structured according to the chronological, thematic, methodological, or theoretical framework approach.

Literature review samples

1. Standalone

2. As a section of a research paper

How SciSpace Discover makes literature review a breeze?

SciSpace Discover is a one-stop solution to do an effective literature search and get barrier-free access to scientific knowledge. It is an excellent repository where you can find millions of only peer-reviewed articles and full-text PDF files. Here’s more on how you can use it:

Find the right information

Find what you want quickly and easily with comprehensive search filters that let you narrow down papers according to PDF availability, year of publishing, document type, and affiliated institution. Moreover, you can sort the results based on the publishing date, citation count, and relevance.

Assess credibility of papers quickly

When doing the literature review, it is critical to establish the quality of your sources. They form the foundation of your research. SciSpace Discover helps you assess the quality of a source by providing an overview of its references, citations, and performance metrics.

Get the complete picture in no time

SciSpace Discover’s personalized suggestion engine helps you stay on course and get the complete picture of the topic from one place. Every time you visit an article page, it provides you links to related papers. Besides that, it helps you understand what’s trending, who are the top authors, and who are the leading publishers on a topic.

Make referring sources super easy

To ensure you don't lose track of your sources, you must start noting down your references when doing the literature review. SciSpace Discover makes this step effortless. Click the 'cite' button on an article page, and you will receive preloaded citation text in multiple styles — all you've to do is copy-paste it into your manuscript.

Final tips on how to write a literature review

A massive chunk of time and effort is required to write a good literature review. But, if you go about it systematically, you'll be able to save a ton of time and build a solid foundation for your research.

We hope this guide has helped you answer several key questions you have about writing literature reviews.

Would you like to explore SciSpace Discover and kick off your literature search right away? You can get started here .

Frequently Asked Questions (FAQs)

1. how to start a literature review.

• What questions do you want to answer?

• What sources do you need to answer these questions?

• What information do these sources contain?

• How can you use this information to answer your questions?

2. What to include in a literature review?

• A brief background of the problem or issue

• What has previously been done to address the problem or issue

• A description of what you will do in your project

• How this study will contribute to research on the subject

3. Why literature review is important?

The literature review is an important part of any research project because it allows the writer to look at previous studies on a topic and determine existing gaps in the literature, as well as what has already been done. It will also help them to choose the most appropriate method for their own study.

4. How to cite a literature review in APA format?

To cite a literature review in APA style, you need to provide the author's name, the title of the article, and the year of publication. For example: Patel, A. B., & Stokes, G. S. (2012). The relationship between personality and intelligence: A meta-analysis of longitudinal research. Personality and Individual Differences, 53(1), 16-21

5. What are the components of a literature review?

• A brief introduction to the topic, including its background and context. The introduction should also include a rationale for why the study is being conducted and what it will accomplish.

• A description of the methodologies used in the study. This can include information about data collection methods, sample size, and statistical analyses.

• A presentation of the findings in an organized format that helps readers follow along with the author's conclusions.

6. What are common errors in writing literature review?

• Not spending enough time to critically evaluate the relevance of resources, observations and conclusions.

• Totally relying on secondary data while ignoring primary data.

• Letting your personal bias seep into your interpretation of existing literature.

• No detailed explanation of the procedure to discover and identify an appropriate literature review.

7. What are the 5 C's of writing literature review?

• Cite - the sources you utilized and referenced in your research.

• Compare - existing arguments, hypotheses, methodologies, and conclusions found in the knowledge base.

• Contrast - the arguments, topics, methodologies, approaches, and disputes that may be found in the literature.

• Critique - the literature and describe the ideas and opinions you find more convincing and why.

• Connect - the various studies you reviewed in your research.

8. How many sources should a literature review have?

When it is just a chapter, sources should equal the total number of pages in your article's body. if it is a self-contained paper in itself, you need at least three times as many sources as there are pages in your work.

9. Can literature review have diagrams?

• To represent an abstract idea or concept

• To explain the steps of a process or procedure

• To help readers understand the relationships between different concepts

10. How old should sources be in a literature review?

Sources for a literature review should be as current as possible or not older than ten years. The only exception to this rule is if you are reviewing a historical topic and need to use older sources.

11. What are the types of literature review?

• Argumentative review

• Integrative review

• Methodological review

• Systematic review

• Meta-analysis review

• Historical review

• Theoretical review

• Scoping review

• State-of-the-Art review

12. Is a literature review mandatory?

Yes. Literature review is a mandatory part of any research project. It is a critical step in the process that allows you to establish the scope of your research, and provide a background for the rest of your work.

But before you go,

• Six Online Tools for Easy Literature Review
• Evaluating literature review: systematic vs. scoping reviews
• Systematic Approaches to a Successful Literature Review
• Writing Integrative Literature Reviews: Guidelines and Examples

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Literature review guidelines

Developed by James O'Neill with assistance from Ronald Levant, Rod Watts, Andrew Smiler, Michael Addis, and Stephen Wester.

General considerations

• A good review should summarize the state of knowledge on a well-defined topic in the psychology of men and masculinity in concise and clear ways. This means that the review is written with exceptional clarity, cohesiveness, conciseness, and comprehensiveness.
• A good review should describe in detail the systematic process or method that was used in doing the literature review. There are articulated ways to do "narrative reviews" just as there are ways of doing experiments or meta-analyses (Baumeister & Leary, 1997; Bem, 1995).

Essential elements for a review

• Focus on an important, relevant, and operationally defined topic in the psychology of men and masculinity, and make a strong case for why a literature review of this topic is important.
• Include a critical and inclusive review of previous theory related to the relevant topic. "Critical" means that the literature review reveals problems, contradictions, controversies, strengths, next steps, and potentials in the theories. "Inclusive" means that there is an active evaluation of all of the theory relevant to the topic.
• Include a critical and inclusive review of previous empirical research related to the relevant topic.
• Critically analyze the distinction between authors' interpretation of their data and the actual empirical evidence presented. A good review critically analyses how accurately previous authors have reported their findings and whether they have refrained from asserting conclusions not supported by data.
• Discuss the methodological diversity of studies reported in the literature review and the implications of this diversity for new knowledge or future research.
• Raise provocative and innovative questions on the topic not discussed before in the literature.
• Write the review so that theoretical knowledge and empirical research is significantly advanced in the psychology of men and masculinity, and that there is an overall contribution to the field's theory, research, and clinical practice.
• Include many "take home messages" (Sternberg, 1991) that generate new theories and empirical research.

Sections that might be included in a review

• Provide a historical account or background of the development of the theory or research program reviewed.
• Include persuasive arguments and articulated points of view on the topic from both theoretical and empirical perspectives.
• Propose novel conceptualizations or theories based on reviews of previous theories and empirical research.
• Propose new research paradigms or testable hypotheses that advance future research.
• Propose new therapeutic paradigms or testable hypotheses that advance clinical practice/psychoeducational programming with men.
• Address the frequent gap between reporting theory/research and interpreting the meaning of the theory and research.

It is not expected that reviews will be able to meet all of the above-listed criteria, but authors should meet many of them.

• Bem, D. J. (1995). Writing a review article for Psychological Bulletin. Psychological Bulletin, 118 , 172–177.
• Baumeister, R. F., & Leary, M. R. (1997). Writing narrative literature reviews. Review of General Psychology, 1 , 311–320.
• Sternberg, R. J. (1991). Editorial. Psychological Bulletin, 109, 3–4.

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• Call for papers: Advancements in research methods in the psychology of men and masculinities

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The role of emotions in academic performance of undergraduate medical students: a narrative review

• Open access
• Published: 23 August 2024
• Volume 24 , article number  907 , ( 2024 )

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• Nora Alshareef 1 , 2 ,
• Ian Fletcher 2 &
• Sabir Giga 2  

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This paper is devoted to a narrative review of the literature on emotions and academic performance in medicine. The review aims to examine the role emotions play in the academic performance of undergraduate medical students.

Eight electronic databases were used to search the literature from 2013 to 2023, including Academic Search Ultimate, British Education Index, CINAHL, Education Abstract, ERIC, Medline, APA Psych Articles and APA Psych Info. Using specific keywords and terms in the databases, 3,285,208 articles were found. After applying the predefined exclusion and inclusion criteria to include only medical students and academic performance as an outcome, 45 articles remained, and two reviewers assessed the quality of the retrieved literature; 17 articles were selected for the narrative synthesis.

The findings indicate that depression and anxiety are the most frequently reported variables in the reviewed literature, and they have negative and positive impacts on the academic performance of medical students. The included literature also reported that a high number of medical students experienced test anxiety during their study, which affected their academic performance. Positive emotions lead to positive academic outcomes and vice versa. However, Feelings of shame did not have any effect on the academic performance of medical students.

The review suggests a significant relationship between emotions and academic performance among undergraduate medical students. While the evidence may not establish causation, it underscores the importance of considering emotional factors in understanding student performance. However, reliance on cross-sectional studies and self-reported data may introduce recall bias. Future research should concentrate on developing anxiety reduction strategies and enhancing mental well-being to improve academic performance.

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Introduction

Studying medicine is a multi-dimensional process involving acquiring medical knowledge, clinical skills, and professional attitudes. Previous research has found that emotions play a significant role in this process [ 1 , 2 ]. Different types of emotions are important in an academic context, influencing performance on assessments and evaluations, reception of feedback, exam scores, and overall satisfaction with the learning experience [ 3 ]. In particular, medical students experience a wide range of emotions due to many emotionally challenging situations, such as experiencing a heavy academic workload, being in the highly competitive field of medicine, retaining a large amount of information, keeping track of a busy schedule, taking difficult exams, and dealing with a fear of failure [ 4 , 5 , 6 ].Especially during their clinical years, medical students may experience anxiety when interacting with patients who are suffering, ill, or dying, and they must work with other healthcare professionals. Therefore, it is necessary to understand the impact of emotions on medical students to improve their academic outcomes [ 7 ].

To distinguish the emotions frequently experienced by medical students, it is essential to define them. Depression is defined by enduring emotions of sadness, despair, and a diminished capacity for enjoyment or engagement in almost all activities [ 4 ]. Negative emotions encompass unpleasant feelings such as anger, fear, sadness, and anxiety, and they frequently cause distress [ 8 ]. Anxiety is a general term that refers to a state of heightened nervousness or worry, which can be triggered by various factors. Test anxiety, on the other hand, is a specific type of anxiety that arises in the context of taking exams or assessments. Test anxiety is characterised by physiological arousal, negative self-perception, and a fear of failure, which can significantly impair a student’s ability to perform well academically [ 9 , 10 ]. Shame is a self-conscious emotion that arises from the perception of having failed to meet personal or societal standards. It can lead to feelings of worthlessness and inadequacy, severely impacting a student’s motivation and academic performance [ 11 , 12 ]. In contrast, positive emotions indicate a state of enjoyable involvement with the surroundings, encompassing feelings of happiness, appreciation, satisfaction, and love [ 8 ].

Academic performance generally refers to the outcomes of a student’s learning activities, often measured through grades, scores, and other formal assessments. Academic achievement encompasses a broader range of accomplishments, including mastery of skills, attainment of knowledge, and the application of learning in practical contexts. While academic performance is often quantifiable, academic achievement includes qualitative aspects of a student’s educational journey [ 13 ].

According to the literature, 11–40% of medical students suffer from stress, depression, and anxiety due to the intensity of medical school, and these negative emotions impact their academic achievement [ 14 , 15 ]. Severe anxiety may impair memory function, decrease concentration, lead to a state of hypervigilance, and interfere with judgment and cognitive function, further affecting academic performance [ 16 ]. However, some studies have suggested that experiencing some level of anxiety has a positive effect and serves as motivation that can improve academic performance [ 16 , 17 ].

Despite the importance of medical students’ emotions and their relation to academic performance, few studies have been conducted in this area. Most of these studies have focused on the prevalence of specific emotions without correlating with medical students’ academic performance. Few systematic reviews have addressed the emotional challenges medical students face. However, there is a lack of comprehensive reviews that discuss the role of emotions and academic outcomes. Therefore, this review aims to fill this gap by exploring the relationship between emotions and the academic performance of medical students.

Aim of the study

This review aims to examine the role emotions play in the academic performance of undergraduate medical students.

A systematic literature search examined the role of emotions in medical students’ academic performance. The search adhered to the concepts of a systematic review, following the criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [ 18 ]. Then, narrative synthesise was done to analyse the retrieved literature and synthesise the results. A systematic literature search and narrative review provide complete coverage and flexibility to explore and understand findings. Systematic search assures rigour and reduces bias, while narrative synthesis allows for flexible integration and interpretation. This balance improves review quality and utility.

Eligibility criteria

Inclusion criteria.

The study’s scope was confined to January 2013 to December 2023, focusing exclusively on undergraduate medical students. The research encompassed articles originating within medical schools worldwide, accepting content from all countries. The criteria included only full-text articles in English published in peer-reviewed journals. Primary research was considered, embracing quantitative and mixed-method research. The selected studies had to explicitly reference academic performance, test results, or GPA as key outcomes to address the research question.

Exclusion criteria

The study excluded individuals beyond the undergraduate medical student demographic, such as students in other health fields and junior doctors. There was no imposed age limit for the student participants. The research specifically focused on articles within medical schools, excluding those from alternative settings. It solely considered full-text articles in English-language peer-reviewed journals. Letters or commentary articles were excluded, and the study did not limit itself to a particular type of research. Qualitative studies were excluded from the review because they did not have the quantitative measures required to answer the review’s aim. This review excluded articles on factors impacting academic performance, those analysing nursing students, and gender differences. The reasons and numbers for excluding articles are shown in Table  1 .

Information sources

Eight electronic databases were used to search the literature. These were the following: Academic Search Ultimate, British Education Index, CINAHL, Education Abstract, ERIC, Medline, APA Psych Articles and APA Psych Info. The databases were chosen from several fields based on relevant topics, including education, academic evaluation and assessment, medical education, psychology, mental health, and medical research. Initially, with the help of a subject librarian, the researcher used all the above databases; the databases were searched with specific keywords and terms, and the terms were divided into the following concepts emotions, academic performance and medical students. Google Scholar, EBSCOhost, and the reference list of the retrieved articles were also used to identify other relevant articles.

Search strategy

This review started with a search of the databases. Eight electronic databases were used to search the literature from 2013 to 2023. Specific keywords and terms were used to search the databases, resulting in 3,285,208 articles. After removing duplicates, letters and commentary, this number was reduced to 1,637 articles. Exclusion and inclusion criteria were then applied, resulting in 45 articles. After two assessors assessed the literature, 17 articles were selected for the review. The search terms are as follows:

Keywords: Emotion, anxiety, stress, empathy, test anxiety, exam anxiety, test stress, exam stress, depression, emotional regulation, test scores, academic performance, grades, GPA, academic achievement, academic success, test result, assessment, undergraduate medical students and undergraduate medical education.

Emotions: TI (Emotion* OR Anxiety OR Stress OR empathy) OR emotion* OR (test anxiety or exam anxiety or test stress or exam stress) OR (depression) OR AB ((Emotion* OR Anxiety OR Stress OR empathy) OR emotion* OR (test anxiety or exam anxiety or test stress or exam stress)) (MH “Emotions”) OR (MH “Emotional Regulation”) DE “EMOTIONS”.

Academic performance: TI (test scores or academic performance or grades or GPA) OR (academic achievement or academic performance or academic success) OR (test result* OR assessment*) OR AB (test scores or academic performance or grades or GPA) OR (academic achievement or academic performance or academic success) OR test result* OR assessment*.

Medical Students: TI (undergraduate medical students OR undergraduate medical education) OR AB (undergraduate medical students OR undergraduate medical education), TI “medical students” OR AB “medical students” DE “Medical Students”.

Selection process

This literature review attempts to gather only peer-reviewed journal articles published in English on undergraduate medical students’ negative and positive emotions and academic performance from January 2013 to December 2023. Their emotions, including depression, anxiety, physiological distress, shame, happiness, joy, and all emotions related to academic performance, were examined in quantitative research and mixed methods.

Moreover, to focus the search, the author specified and defined each keyword using advanced search tools, such as subject headings in the case of the Medline database. The author used ‘MeSH 2023’ as the subject heading, then entered the term ‘Emotion’ and chose all the relevant meanings. This method was applied to most of the keywords.

Studies were included based on predefined criteria related to study design, participants, exposure, outcomes, and study types. Two independent reviewers screened each record, and the report was retrieved. In the screening process, reviewers independently assessed each article against the inclusion criteria, and discrepancies were resolved through consensus during regular team meetings. In cases of persistent disagreement, a third reviewer was consulted. Endnote library program was used for the initial screening phase. This tool was used to identify duplicates, facilitated the independent screening of titles and abstracts and helped to retrieve the full-text articles. The reasons for excluding the articles are presented in Table  1 .

Data collection process

Two independent reviewers extracted data from the eligible studies, with any discrepancies resolved through discussion and consensus. If the two primary reviewers could not agree, a third reviewer served as an arbitrator. For each included study, the following information was extracted and recorded in a standardised database: first author name, publication year, study design, sample characteristics, details of the emotions exposed, outcome measures, and results.

Academic performance as an outcome for medical students was defined to include the following: Exam scores (e.g., midterm, final exams), Clinical assessments (e.g., practical exams, clinical rotations), Overall grade point average (GPA) or any other relevant indicators of academic achievement.

Data were sought for all outcomes, including all measures, time points, and analyses within each outcome domain. In cases where studies reported multiple measures or time points, all relevant data were extracted to provide a comprehensive overview of academic performance. If a study reported outcomes beyond the predefined domains, inclusion criteria were established to determine whether these additional outcomes would be included in the review. This involved assessing relevance to the primary research question and alignment with the predefined outcome domains.

Quality assessment

The quality and risk of bias in included studies were assessed using the National Institute of Health’s (NIH) critical appraisal tool. The tool evaluates studies based on the following domains: selection bias, performance bias, detection bias, attrition bias, reporting bias, and other biases. Two independent reviewers assessed the risk of bias in each included study. Reviewers worked collaboratively to reach a consensus on assessments. Discrepancies were resolved through discussion and consensus. In cases of persistent disagreement, a third reviewer was consulted.

To determine the validity of eligible articles, all the included articles were critically appraised, and all reviewers assessed bias. The validity and reliability of the results were assessed by using objective measurement. Each article was scored out of 14, with 14 indicating high-quality research and 1 indicating low-quality research. High-quality research, according to the NIH (2013), includes a clear and focused research question, defines the study population, features a high participation rate, mentions inclusion and exclusion criteria, uses clear and specific measurements, reports results in detail, lists the confounding factors and lists the implications for the local community. Therefore, an article was scored 14 if it met all criteria of the critical appraisal tool. Based on scoring, each study was classified into one of three quality categories: good, fair or poor. The poorly rated articles mean their findings were unreliable, and they will not be considered, including two articles [ 16 , 19 ]. Seventeen articles were chosen after critical appraisal using the NIH appraisal tool, as shown in Table  2 .

Effect measures

For each outcome examined in the included studies, various effect measures were utilised to quantify the relationship between emotions and academic performance among undergraduate medical students. The effect measures commonly reported across the studies included prevalence rat, correlation coefficients, and mean differences. The reviewer calculated the effect size for the studies that did not report the effect. The choice of effect measure depended on the nature of the outcome variable and the statistical analysis conducted in each study. These measures were used to assess the strength and direction of the association between emotional factors and academic performance.

The synthesis method

The findings of individual studies were summarised to highlight crucial characteristics. Due to the predicted heterogeneity, the synthesis involved pooling effect estimates and using a narrative method. A narrative synthesis approach was employed in the synthesis of this review to assess and interpret the findings from the included studies qualitatively. The narrative synthesis involved a qualitative examination of the content of each study, focusing on identifying common themes. This synthesis was employed to categorise and interpret data, allowing for a nuanced understanding of the synthesis. Themes related to emotions were identified and extracted for synthesis. Control-value theory [ 20 ] was used as an overarching theory, providing a qualitative synthesis of the evidence and contributing to a deeper understanding of the research question. If the retrieved articles include populations other than medical, such as dental students or non-medical students, the synthesis will distinguish between them and summarise the findings of the medical students only, highlighting any differences or similarities.

The Control-Value Theory, formulated by Pekrun (2006), is a conceptual framework that illustrates the relationship between emotions and academic achievement through two fundamental assessments: control and value. Control pertains to the perceived ability of a learner to exert influence over their learning activities and the results they achieve. Value relates to a student’s significance to these actions and results. The theory suggests that students are prone to experiencing good feelings, such as satisfaction and pride when they possess a strong sense of control and importance towards their academic assignments. On the other hand, individuals are prone to encountering adverse emotions (such as fear and embarrassment) when they perceive a lack of control or worth in these particular occupations. These emotions subsequently impact students’ motivation, learning strategies, and, eventually, their academic achievement. The relevance of control-value theory in reviewing medical student emotions and their influence on academic performance is evident for various reasons. This theory offers a complete framework that facilitates comprehending the intricate connection between emotions and academic achievement. It considers positive and negative emotions, providing a comprehensive viewpoint on how emotions might influence learning and performance. The relevance of control and value notions is particularly significant for medical students due to their frequent exposure to high-stakes tests and difficult courses. Gaining insight into the students’ perception of their power over academic assignments and the importance they attach to their medical education might aid in identifying emotional stimuli and devising remedies. Multiple research has confirmed the theory’s assertions, showing the critical influence of control and value evaluations on students’ emotional experiences and academic achievements [ 21 , 22 ].

Data extraction

For this step, a data extraction sheet was developed using the data extraction template provided by the Cochrane Handbook. To ensure the review is evidence-based and bias-free, the Cochrane Handbook strongly suggests that more than one reviewer review the data. Therefore, the main researcher extracted the data from the included studies, and another reviewer checked the included, excluded and extracted data. Any disagreements were resolved via discussion by a third reviewer. The data extraction Table  2 identified all study features, including the author’s name, the year of publication, the method used the aim of the study, the number and description of participants, data collection tools, and study findings.

Finalisation of references and study characteristics

Prisma sheet and the summary of final studies that have been used for the review.

When the keywords and search terms related to emotions, as mentioned above, in the eight databases listed, 3,285,208 articles were retrieved. After using advanced search and subject headings, the number of articles increased to 3,352,371. Similarly, searching for the second keyword, ‘academic performance,’ using all the advanced search tools yielded 8,119,908 articles. Searching for the third keyword, ‘medical students’, yielded 145,757 articles. All terms were searched in article titles and abstracts. After that, the author combined all search terms by using ‘AND’ and applied the time limit from 2013 to 2023; the search narrowed to 2,570 articles. After duplicates, letters and commentary were excluded, the number was reduced to 1,637 articles. After reading the title and abstract to determine relevance to the topic and applying the exclusion and inclusion criteria mentioned above, 45 articles remained; after the quality of the retrieved literature was assessed by two reviewers, 17 articles were selected for the review. The PRISMA flow diagram summarising the same is presented in Fig.  1 . Additionally, One article by Ansari et al. (2018) was selected for the review; it met most inclusion and exclusion criteria except that the outcome measure is cognitive function and not academic performance. Therefore, it was excluded from the review. Figure  1 shows the Prisma flow diagram (2020) of studies identified from the databases.

Prisma flow diagram (2020)

Study characteristics

Table  2 , summarising the characteristics of the included studies, is presented below.

Findings of the study

Country of the study.

Many of the studies were conducted in developing countries, with the majority being conducted in Europe ( n  = 4), followed by Pakistan ( n  = 2), then Saudi Arabia ( n  = 2), and the United States ( n  = 2). The rest of the studies were conducted in South America ( n  = 1), Morocco ( n  = 1), Brazil ( n  = 1), Australia ( n  = 1), Iran ( n  = 1), South Korea ( n  = 1) and Bosnia and Herzegovina ( n  = 1). No included studies were conducted in the United Kingdom.

Study design

Regarding study design, most of the included articles used a quantitative methodology, including 12 cross-sectional studies. There were two randomised controlled trials, one descriptive correlation study, one cohort study, and only one mixed-method study.

Population and study setting

Regarding population and setting, most of the studies focused on all medical students studying in a medical school setting, from first-year medical students to those in their final year. One study compared medical students with non-medical students; another combined medical students with dental students.

The study aims varied across the included studies. Seven studies examined the prevalence of depression and anxiety among medical students and their relation to academic performance. Four studies examined the relationship between test anxiety and academic performance in medical education. Four studies examined the relationship between medical students’ emotions and academic achievements. One study explored the influence of shame on medical students’ learning.

Study quality

The studies were assessed for quality using tools created by the NIH (2013) and then divided into good, fair, and poor based on these results. Nine studies had a high-quality methodology, seven achieved fair ratings, and only three achieved poor ratings. The studies that were assigned the poor rating were mainly cross-sectional studies, and the areas of weakness were due to the study design, low response rate, inadequate reporting of the methodology and statistics, invalid tools, and unclear research goals.

Outcome measures

Most of the outcome measures were heterogenous and self-administered questionnaires; one study used focus groups and observation ward assessment [ 23 ]. All the studies used the medical students’ academic grades.

Results of the study

The prevalence rate of psychological distress in the retrieved articles.

Depression and anxiety are the most common forms of psychological distress examined concerning academic outcomes among medical students. Studies consistently show concerningly high rates, with prevalence estimates ranging from 7.3 to 66.4% for anxiety and 3.7–69% for depression. These findings indicate psychological distress levels characterised as moderate to high based on common cut-off thresholds have a clear detrimental impact on academic achievement [ 16 , 24 , 25 , 26 ].

The studies collectively examine the impact of psychological factors on academic performance in medical education contexts, using a range of effect sizes to quantify their findings. Aboalshamat et al. (2015) identified a small effect size ( η 2 = 0.018) for depression’s impact on academic performance, suggesting a modest influence. Mihailescu (2016) found a significant negative correlation between levels of depression/anxiety (rho=-0.14, rho=-0.19), academic performance and GPA among medical students. Burr and Beck Dallaghan (2019) reported professional efficacy explaining 31.3% of the variance in academic performance, indicating a significant effect size. However, Del-Ben (2013) et al. did not provide the significant impact of affective changes on academic achievement, suggesting trivial effect sizes for these factors.

In conclusion, anxiety and depression, both indicators of psychological discomfort, are common among medical students. There is a link between distress and poor academic performance results, implying that this relationship merits consideration. Table  3 below shows the specific value of depression and anxiety in retrieved articles.

Test anxiety

In this review, four studies examined the relationship between test anxiety and academic performance in medical education [ 27 , 28 , 29 , 30 ]. The studies found high rates of test anxiety among medical students, ranging from 52% [ 27 ] to as high as 81.1% [ 29 ]. Final-year students tend to experience the highest test anxiety [ 29 ].

Test anxiety has a significant negative correlation with academic performance measures and grade point average (GPA) [ 27 , 28 , 29 ]. Green et al. (2016) found that test anxiety was moderately negatively correlated with USMLE score ( r = − 0.24, p  = 0.00); high test anxiety was associated with low USMLE scores in the control group, further suggesting that anxiety can adversely affect performance. The findings that a test-taking strategy course reduced anxiety without improving test scores highlight the complex nature of anxiety’s impact on performance.

Nazir et al. (2021) found that excellent female medical students reported significantly lower test anxiety than those with low academic grades, with an odds ratio of 1.47, indicating that students with higher test anxiety are more likely to have lower academic grades. Kim’s (2016) research shows moderate correlations between test anxiety and negative achievement emotions such as anxiety and boredom, but interestingly, this anxiety does not significantly affect practical exam scores (OSCE) or GPAs. However, one study found that examination stress enhanced academic performance with a large effect size (W = 0.78), with stress levels at 47.4% among their sample, suggesting that a certain stress level before exams may be beneficial [ 30 ].

Three papers explored shame’s effect on medical students’ academic achievement [ 24 , 31 , 32 ]. Hayat et al. (2018) reported that academic feelings, like shame, significantly depend on the academic year. shame was found to have a slight negative and significant correlation with the academic achievement of learners ( r =-0.15). One study found that some medical students felt shame during simulations-based education examinations because they had made incorrect decisions, which decreased their self-esteem and motivation to learn. However, others who felt shame were motivated to study harder to avoid repeating the same mistakes [ 23 ].

Hautz (2017) study examined how shame affects medical students’ learning using a randomised controlled trial where researchers divided the students into two groups: one group performed a breast examination on mannequins and the other group on actual patients. The results showed that students who performed the clinical examination on actual patients experienced significantly higher levels of shame but performed better in examinations than in the mannequin group. In the final assessments on standardised patients, both groups performed equally well. Therefore, shame decreased with more clinical practice, but shame did not have significant statistics related to learning or performance. Similarly, Burr and Dallaghan (2019) reported that the shame level of medical students was (40%) but had no association with academic performance.

Academic performance, emotions and medical students

Three articles discussed medical students’ emotions and academic performance [ 23 , 24 , 32 ]. Burr and Dallaghan (2019) examine the relationship between academic success and emotions in medical students, such as pride, hope, worry, and shame. It emphasises the links between academic accomplishment and professional efficacy, as well as hope, pride, worry, and shame. Professional efficacy was the most significant factor linked to academic performance, explaining 31.3% of the variance. The importance of emotions on understanding, processing of data, recall of memories, and cognitive burden is emphasised throughout the research. To improve academic achievement, efforts should be made to increase student self-efficacy.

Hayat et al. (2018) found that positive emotions and intrinsic motivation are highly connected with academic achievement, although emotions fluctuate between educational levels but not between genders. The correlations between negative emotions and academic achievement, ranging from − 0.15 to -0.24 for different emotions, suggest small but statistically significant adverse effects.

Behren et al.‘s (2019) mixed-method study found that students felt various emotions during the simulation, focusing on positive emotions and moderate anxiety. However, no significant relationships were found between positive emotions and the student’s performance during the simulation [ 23 ].

This review aims to investigate the role of emotions in the academic performance of undergraduate medical students. Meta-analysis cannot be used because of the heterogeneity of the data collection tools and different research designs [ 33 ]. Therefore, narrative synthesis was adopted in this paper. The studies are grouped into four categories as follows: (1) The effect of depression and anxiety on academic performance, (2) Test anxiety and academic achievement, (3) Shame and academic performance, and (4) Academic performance, emotions and medical students. The control-value theory [ 20 ], will be used to interpret the findings.

The effect of depression and anxiety on academic performance

According to the retrieved research, depression and anxiety can have both a negative and a positive impact on the academic performance of medical students. Severe anxiety may impair memory function, decrease concentration, lead to a state of hypervigilance, interfere with judgment and cognitive function, and further affect academic performance [ 4 ]. Most of the good-quality retrieved articles found that anxiety and depression were associated with low academic performance [ 16 , 24 , 25 , 26 ]. Moreira (2018) and Mihailescu (2016) found that higher depression levels were associated with more failed courses and a lower GPA. However, they did not find any association between anxiety level and academic performance.

By contrast, some studies have suggested that experiencing some level of anxiety reinforces students’ motivation to improve their academic performance [ 16 , 34 ]. Zalihic et al. (2017) conducted a study to investigate anxiety sensitivity about academic success and noticed a positive relationship between anxiety level and high academic scores; they justified this because when medical students feel anxious, they tend to prepare and study more, and they desire to achieve better scores and fulfil social expectations. Similarly, another study found anxiety has a negative impact on academic performance when excessive and a positive effect when manageable, in which case it encourages medical students and motivates them to achieve higher scores [ 35 ].

In the broader literature, the impact of anxiety on academic performance has contradictory research findings. While some studies suggest that having some level of anxiety can boost students’ motivation to improve their academic performance, other research has shown that anxiety has a negative impact on their academic success [ 36 , 37 ]. In the cultural context, education and anxiety attitudes differ widely across cultures. High academic pressure and societal expectations might worsen anxiety in many East Asian societies. Education is highly valued in these societies, frequently leading to significant academic stress. This pressure encompasses attaining high academic marks and outperformance in competitive examinations. The academic demands exerted on students can result in heightened levels of anxiety. The apprehension of not meeting expectations can lead to considerable psychological distress and anxiety, which can appear in their physical and mental health and academic achievement [ 38 , 39 ].

Test anxiety and academic achievement

The majority of the studies reviewed confirm that test anxiety negatively affects academic performance [ 27 , 28 , 29 ]. Several studies have found a significant correlation between test anxiety and academic achievement, indicating that higher levels of test anxiety are associated with lower exam scores and lower academic performance [ 40 , 41 ]. For example, Green et al. (2016) RCT study found that test anxiety has a moderately significant negative correlation with the USMLE score. They found that medical students who took the test-taking strategy course had lower levels of test anxiety than the control group, and their test anxiety scores after the exam had improved from the baseline. Although their test anxiety improved after taking the course, there was no significant difference in the exam scores between students who had and had not taken the course. Therefore, the intervention they used was not effective. According to the control-value theory, this intervention can be improved if they design an emotionally effective learning environment, have a straightforward instructional design, foster self-regulation of negative emotions, and teach students emotion-oriented regulation [ 22 ].

Additionally, according to this theory, students who perceive exams as difficult are more likely to experience test anxiety because test anxiety results from a student’s negative appraisal of the task and outcome values, leading to a reduction in their performance. This aligns with Kim’s (2016) study, which found that students who believed that the OSCE was a problematic exam experienced test anxiety more than other students [ 9 , 22 , 42 ].

In the wider literature, a meta-analysis review by von der Embse (2018) found a medium significant negative correlation ( r =-0.24) between test anxiety and test performance in undergraduate educational settings [ 43 ] . Also, they found a small significant negative correlation ( r =-0.17) between test anxiety and GPA. This indicates that higher levels of test anxiety are associated with lower test performance. Moreover, Song et al. (2021) experimental study examined the effects of test anxiety on working memory capacity and found that test anxiety negatively correlated with academic performance [ 44 ]. Therefore, the evidence from Song’s study suggests a small but significant effect of anxiety on working memory capacity. However, another cross-sectional study revealed that test anxiety in medical students had no significant effect on exam performance [ 45 ]. The complexities of this relationship necessitate additional investigation. Since the retrieved articles are from different countries, it is critical to recognise the possible impact of cultural differences on the impact of test anxiety. Cultural factors such as different educational systems, assessment tools and societal expectations may lead to variances in test anxiety experience and expression across diverse communities [ 46 , 47 ]. Culture has a substantial impact on how test anxiety is expressed and evaluated. Research suggests that the degree and manifestations of test anxiety differ among different cultural settings, emphasising the importance of using culturally validated methods to evaluate test anxiety accurately. A study conducted by Lowe (2019) with Canadian and U.S. college students demonstrated cultural variations in the factors contributing to test anxiety. Canadian students exhibited elevated levels of physiological hyperarousal, but U.S. students had more pronounced cognitive interference. These variations indicate that the cultural environment has an influence on how students perceive and respond to test anxiety, resulting in differing effects on their academic performance in different cultures. Furthermore, scholars highlight the significance of carrying out meticulous instruments to assess test anxiety, which are comparable among diverse cultural cohorts. This technique guarantees that the explanations of test scores are reliable and can be compared across different populations. Hence, it is imperative to comprehend and tackle cultural disparities in order to create efficient interventions and assistance for students who encounter test anxiety in diverse cultural environments. Therefore, there is a need for further studies to examine the level of test anxiety and cultural context.

Shame and academic performance

The review examined three studies that discuss the impact of feelings of shame on academic performance [ 23 , 24 , 48 ]. Generally, shame is considered a negative emotion which involves self-reflection and self-evaluation, and it leads to rumination and self-condemnation [ 49 ]. Intimate examinations conducted by medical students can induce feelings of shame, affecting their ability to communicate with patients and their clinical decisions. Shame can increase the avoidance of intimate physical examinations and also encourage clinical practice [ 23 , 24 , 48 ].

One study found that some medical students felt shame during simulations-based education examinations because they had made incorrect decisions, which decreased their self-esteem and motivation to learn. However, others who felt shame were motivated to study harder to avoid repeating the same mistakes [ 23 ]. Shame decreased with more clinical practice, but shame did not affect their learning or performance [ 48 ]. The literature on how shame affects medical students’ learning is inconclusive [ 31 ].

In the broader literature, shame is considered maladaptive, leading to dysfunctional behaviour, encouraging withdrawal and avoidance of events and inhibiting social interaction. However, few studies have been conducted on shame in the medical field. Therefore, more research is needed to investigate the role of shame in medical students’ academic performance [ 49 ]. In the literature, there are several solutions that can be used to tackle the problem of shame in medical education; it is necessary to establish nurturing learning settings that encourage students to openly discuss their problems and mistakes without the worry of facing severe criticism. This can be accomplished by encouraging medical students to participate in reflective practice, facilitating the processing of their emotions, and enabling them to derive valuable insights from their experiences, all while avoiding excessive self-blame [ 50 ]. Offering robust mentorship and support mechanisms can assist students in effectively managing the difficulties associated with intimate examinations. Teaching staff have the ability to demonstrate proper behaviours and provide valuable feedback and effective mentoring [ 51 ]. Training and workshops that specifically target communication skills and the handling of sensitive situations can effectively equip students to handle intimate tests, hence decreasing the chances of them avoiding such examinations due to feelings of shame [ 52 ].

The literature review focused on three studies that examined the relationship between emotions and the academic achievements of medical students [ 23 , 24 , 32 ].

Behren et al. (2019) mixed-method study on the achievement emotions of medical students during simulations found that placing students in challenging clinical cases that they can handle raises positive emotions. Students perceived these challenges as a positive drive for learning and mild anxiety was considered beneficial. However, the study also found non-significant correlations between emotions and performance during the simulation, indicating a complex relationship between emotions and academic performance. The results revealed that feelings of frustration were perceived to reduce students’ interest and motivation for studying, hampered their decision-making process, and negatively affected their self-esteem, which is consistent with the academic achievement emotions literature where negative emotions are associated with poor intrinsic motivation and reduced the ability to learn [ 3 ].

The study also emphasises that mild anxiety can have positive effects, corroborated by Gregor (2005), which posits that moderate degrees of anxiety can improve performance. The author suggests that an ideal state of arousal (which may be experienced as anxiety) enhances performance. Mild anxiety is commonly seen as a type of psychological stimulation that readies the body for upcoming challenges, frequently referred to as a “fight or flight” response. Within the realm of academic performance, this state of heightened arousal can enhance concentration and optimise cognitive functions such as memory, problem-solving skills, and overall performance. However, once the ideal point is surpassed, any additional increase in arousal can result in a decline in performance [ 53 ]. This is additionally supported by Cassady and Johnson (2002), who discovered that a specific level of anxiety can motivate students to engage in more comprehensive preparation, hence enhancing their performance.

The reviewed research reveals a positive correlation between positive emotions and academic performance and a negative correlation between negative emotions and academic performance. These findings align with the control–value theory [ 8 , 22 ], which suggests that positive emotions facilitate learning through mediating factors, including cognitive learning strategies such as strategic thinking, critical thinking and problem-solving and metacognitive learning strategies such as monitoring, regulating, and planning students’ intrinsic and extrinsic motivation. Additionally, several studies found that extrinsic motivation from the educational environment and the application of cognitive and emotional strategies improve students’ ability to learn and, consequently, their academic performance [ 23 , 24 , 32 ]. By contrast, negative emotions negatively affect academic performance. This is because negative emotions reduce students’ motivation, concentration, and ability to process information [ 23 , 24 , 32 ].

Limitations of the study

This review aims to thoroughly investigate the relationship between emotions and academic performance in undergraduate medical students, but it has inherent limitations. Overall, the methodological quality of the retrieved studies is primarily good and fair. Poor-quality research was excluded from the synthesis. The good-quality papers demonstrated strengths in sampling techniques, data analysis, collection and reporting. However, most of the retrieved articles used cross-section studies, and the drawback of this is a need for a more causal relationship, which is a limitation in the design of cross-sectional studies. Furthermore, given the reliance on self-reported data, there were concerns about potential recall bias. These methodological difficulties were noted in most of the examined research. When contemplating the implications for practice and future study, the impact of these limitations on the validity of the data should be acknowledged.

The limitation of the review process and the inclusion criteria restricted the study to articles published from January 2013 to December 2023, potentially overlooking relevant research conducted beyond this timeframe. Additionally, the exclusive focus on undergraduate medical students may constrain the applicability of findings to other health fields or educational levels.

Moreover, excluding articles in non-English language and those not published in peer-reviewed journals introduces potential language and publication biases. Reliance on electronic databases and specific keywords may inadvertently omit studies using different terms or indexing. While the search strategy is meticulous, it might not cover every relevant study due to indexing and database coverage variations. However, the two assessors’ involvement in study screening, selection, data extraction, and quality assessment improved the robustness of the review and ensured that it included all the relevant research.

In conclusion, these limitations highlight the need for careful interpretation of the study’s findings and stress the importance of future research addressing these constraints to offer a more comprehensive understanding of the nuanced relationship between emotions and academic performance in undergraduate medical education.

Conclusion and future research

The review exposes the widespread prevalence of depression, anxiety and test anxiety within the medical student population. The impact on academic performance is intricate, showcasing evidence of adverse and favourable relationships. Addressing the mental health challenges of medical students necessitates tailored interventions for enhancing mental well-being in medical education. Furthermore, it is crucial to create practical strategies considering the complex elements of overcoming test anxiety. Future research should prioritise the advancement of anxiety reduction strategies to enhance academic performance, focusing on the control-value theory’s emphasis on creating an emotionally supportive learning environment. Additionally, Test anxiety is very common among medical students, but the literature has not conclusively determined its actual effect on academic performance. Therefore, there is a clear need for a study that examines the relationship between test anxiety and academic performance. Moreover, the retrieved literature did not provide effective solutions for managing test anxiety. This gap highlights the need for practical solutions informed by Pekrun’s Control-Value Theory. Ideally, a longitudinal study measuring test anxiety and exam scores over time would be the most appropriate approach. it is also necessary to explore cultural differences to develop more effective solutions and support systems tailored to specific cultural contexts.

The impact of shame on academic performance in medical students was inconclusive. Shame is a negative emotion that has an intricate influence on learning outcomes. The inadequacy of current literature emphasises the imperative for additional research to unravel the nuanced role of shame in the academic journeys of medical students.

Overall, emotions play a crucial role in shaping students’ academic performance, and research has attempted to find solutions to improve medical students’ learning experiences; thus, it is recommended that medical schools revise their curricula and consider using simulation-based learning in their instructional designs to enhance learning and improve students’ emotions. Also, studies have suggested using academic coaching to help students achieve their goals, change their learning styles, and apply self-testing and simple rehearsal of the material. Moreover, the study recommended to improve medical students’ critical thinking and autonomy and changing teaching styles to support students better.

Data availability

all included articles are mentioned in the manuscript, The quality assessment of included articles are located in the supplementary materials file no. 1.

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Alshareef, N., Fletcher, I. & Giga, S. The role of emotions in academic performance of undergraduate medical students: a narrative review. BMC Med Educ 24 , 907 (2024). https://doi.org/10.1186/s12909-024-05894-1

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