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Yale Medicine Thesis Digital Library

Starting with the Yale School of Medicine (YSM) graduating class of 2002, the Cushing/Whitney Medical Library and YSM Office of Student Research have collaborated on the Yale Medicine Thesis Digital Library (YMTDL) project, publishing the digitized full text of medical student theses on the web as a valuable byproduct of Yale student research efforts. The digital thesis deposit has been a graduation requirement since 2006. Starting in 2012, alumni of the Yale School of Medicine were invited to participate in the YMTDL project by granting scanning and hosting permission to the Cushing/Whitney Medical Library, which digitized the Library’s print copy of their thesis or dissertation. A grant from the Arcadia Fund in 2017 provided the means for digitizing over 1,000 additional theses. IF YOU ARE A MEMBER OF THE YALE COMMUNITY AND NEED ACCESS TO A THESIS RESTRICTED TO THE YALE NETWORK, PLEASE MAKE SURE YOUR VPN (VIRTUAL PRIVATE NETWORK) IS ON.

Theses/Dissertations from 2024 2024

Refractory Neurogenic Cough Management: The Non-Inferiority Of Soluble Steroids To Particulate Suspensions For Superior Laryngeal Nerve Blocks , Hisham Abdou

Percutaneous Management Of Pelvic Fluid Collections: A 10-Year Series , Chidumebi Alim

Behavioral Outcomes In Patients With Metopic Craniosynostosis: Relationship With Radiographic Severity , Mariana Almeida

Ventilator Weaning Parameters Revisited: A Traditional Analysis And A Test Of Artificial Intelligence To Predict Successful Extubation , John James Andrews

Developing Precision Genome Editors: Peptide Nucleic Acids Modulate Crispr Cas9 To Treat Autosomal Dominant Disease , Jem Atillasoy

Radiology Education For U.s. Medical Students In 2024: A State-Of-The-Art Analysis , Ryan Bahar

Out-Of-Pocket Spending On Medications For Diabetes In The United States , Baylee Bakkila

Imaging Markers Of Microstructural Development In Neonatal Brains And The Impact Of Postnatal Pathologies , Pratheek Sai Bobba

A Needs Assessment For Rural Health Education In United States Medical Schools , Kailey Carlson

Racial Disparities In Behavioral Crisis Care: Investigating Restraint Patterns In Emergency Departments , Erika Chang-Sing

Social Determinants Of Health & Barriers To Care In Diabetic Retinopathy Patients Lost To Follow-Up , Thomas Chang

Association Between Fine Particulate Matter And Eczema: A Cross-Sectional Study Of The All Of Us Research Program And The Center For Air, Climate, And Energy Solutions , Gloria Chen

Predictors Of Adverse Outcomes Following Surgical Intervention For Cervical Spondylotic Myelopathy , Samuel Craft

Genetic Contributions To Thoracic Aortic Disease , Ellelan Arega Degife

Actigraphy And Symptom Changes With A Social Rhythm Intervention In Young Persons With Mood Disorders , Gabriela De Queiroz Campos

Incidence Of Pathologic Nodal Disease In Clinically Node Negative, Microinvasive/t1a Breast Cancers , Pranammya Dey

Spinal Infections: Pathophysiology, Diagnosis, Prevention, And Management , Meera Madhav Dhodapkar

Childen's Reentry To School After Psychiatric Hospitalization: A Qualitative Study , Madeline Digiovanni

Bringing Large Language Models To Ophthalmology: Domain-Specific Ontologies And Evidence Attribution , Aidan Gilson

Surgical Personalities: A Cultural History Of Early 20th Century American Plastic Surgery , Joshua Zev Glahn

Implications Of Acute Brain Injury Following Transcatheter Aortic Valve Replacement , Daniel Grubman

Latent Health Status Trajectory Modelling In Patients With Symptomatic Peripheral Artery Disease , Scott Grubman

The Human Claustrum Tracks Slow Waves During Sleep , Brett Gu

Patient Perceptions Of Machine Learning-Enabled Digital Mental Health , Clara Zhang Guo

Variables Affecting The 90-Day Overall Reimbursement Of Four Common Orthopaedic Procedures , Scott Joseph Halperin

The Evolving Landscape Of Academic Plastic Surgery: Understanding And Shaping Future Directions In Diversity, Equity, And Inclusion , Sacha C. Hauc

Association Of Vigorous Physical Activity With Psychiatric Disorders And Participation In Treatment , John L. Havlik

Long-Term Natural History Of Ush2a-Retinopathy , Michael Heyang

Clinical Decision Support For Emergency Department-Initiated Buprenorphine For Opioid Use Disorder , Wesley Holland

Applying Deep Learning To Derive Noninvasive Imaging Biomarkers For High-Risk Phenotypes Of Prostate Cancer , Sajid Hossain

The Hardships Of Healthcare Among People With Lived Experiences Of Homelessness In New Haven, Ct , Brandon James Hudik

Outcomes Of Peripheral Vascular Interventions In Patients Treated With Factor Xa Inhibitors , Joshua Joseph Huttler

Janus Kinase Inhibition In Granuloma Annulare: Two Single-Arm, Open-Label Clinical Trials , Erica Hwang

Medicaid Coverage For Undocumented Children In Connecticut: A Political History , Chinye Ijeli

Population Attributable Fraction Of Reproductive Factors In Triple Negative Breast Cancer By Race , Rachel Jaber Chehayeb

Evaluation Of Gastroesophageal Reflux And Hiatal Hernia As Risk Factors For Lobectomy Complications , Michael Kaminski

Health-Related Social Needs Before And After Critical Illness Among Medicare Beneficiaries , Tamar A. Kaminski

Effects Of Thoracic Endovascular Aortic Repair On Cardiac Function At Rest , Nabeel Kassam

Conditioned Hallucinations By Illness Stage In Individuals With First Episode Schizophrenia, Chronic Schizophrenia, And Clinical High Risk For Psychosis , Adam King

The Choroid Plexus Links Innate Immunity To Dysregulation Of Csf Homeostasis In Diverse Forms Of Hydrocephalus , Emre Kiziltug

Health Status Changes After Stenting For Stroke Prevention In Carotid Artery Stenosis , Jonathan Kluger

Rare And Undiagnosed Liver Diseases: New Insights From Genomic And Single Cell Transcriptomic Analyses , Chigoziri Konkwo

“Teen Health” Empowers Informed Contraception Decision-Making In Adolescents And Young Adults , Christina Lepore

Barriers To Mental Health Care In Us Military Veterans , Connor Lewis

Barriers To Methadone For Hiv Prevention Among People Who Inject Drugs In Kazakhstan , Amanda Rachel Liberman

Unheard Voices: The Burden Of Ischemia With No Obstructive Coronary Artery Disease In Women , Marah Maayah

Partial And Total Tonsillectomy For Pediatric Sleep-Disordered Breathing: The Role Of The Cas-15 , Jacob Garn Mabey

Association Between Insurance, Access To Care, And Outcomes For Patients With Uveal Melanoma In The United States , Victoria Anne Marks

Urinary Vegf And Cell-Free Dna As Non-Invasive Biomarkers For Diabetic Retinopathy Screening , Mitchelle Matesva

Pain Management In Facial Trauma: A Narrative Review , Hunter Mccurdy

Meningioma Relational Database Curation Using A Pacs-Integrated Tool For Collection Of Clinical And Imaging Features , Ryan Mclean

Colonoscopy Withdrawal Time And Dysplasia Detection In Patients With Inflammatory Bowel Disease , Chandler Julianne Mcmillan

Cerebral Arachnoid Cysts Are Radiographic Harbingers Of Epigenetics Defects In Neurodevelopment , Kedous Mekbib

Regulation And Payment Of New Medical Technologies , Osman Waseem Moneer

Permanent Pacemaker Implantation After Tricuspid Valve Repair Surgery , Alyssa Morrison

Non-Invasive Epidermal Proteome-Based Subclassification Of Psoriasis And Eczema And Identification Of Treatment Relevant Biomarkers , Michael Murphy

Ballistic And Explosive Orthopaedic Trauma Epidemiology And Outcomes In A Global Population , Jamieson M. O'marr

Dermatologic Infectious Complications And Mimickers In Cancer Patients On Oncologic Therapy , Jolanta Pach

Distressed Community Index In Patients Undergoing Carotid Endarterectomy In Medicare-Linked Vqi Registry , Carmen Pajarillo

Preoperative Psychosocial Risk Burden Among Patients Undergoing Major Thoracic And Abdominal Surgery , Emily Park

Volumetric Assessment Of Imaging Response In The Pnoc Pediatric Glioma Clinical Trials , Divya Ramakrishnan

Racial And Sex Disparities In Adult Reconstructive Airway Surgery Outcomes: An Acs Nsqip Analysis , Tagan Rohrbaugh

A School-Based Study Of The Prevalence Of Rheumatic Heart Disease In Bali, Indonesia , Alysha Rose

Outcomes Following Hypofractionated Radiotherapy For Patients With Thoracic Tumors In Predominantly Central Locations , Alexander Sasse

Healthcare Expenditure On Atrial Fibrillation In The United States: The Medical Expenditure Panel Survey 2016-2021 , Claudia See

A Cost-Effectiveness Analysis Of Oropharyngeal Cancer Post-Treatment Surveillance Practices , Rema Shah

Machine Learning And Risk Prediction Tools In Neurosurgery: A Rapid Review , Josiah Sherman

Maternal And Donor Human Milk Support Robust Intestinal Epithelial Growth And Differentiation In A Fetal Intestinal Organoid Model , Lauren Smith

Constructing A Fetal Human Liver Atlas: Insights Into Liver Development , Zihan Su

Somatic Mutations In Aging, Paroxysmal Nocturnal Hemoglobinuria, And Myeloid Neoplasms , Tho Tran

Illness Perception And The Impact Of A Definitive Diagnosis On Women With Ischemia And No Obstructive Coronary Artery Disease: A Qualitative Study , Leslie Yingzhijie Tseng

Advances In Keratin 17 As A Cancer Biomarker: A Systematic Review , Robert Tseng

Regionalization Strategy To Optimize Inpatient Bed Utilization And Reduce Emergency Department Crowding , Ragini Luthra Vaidya

Survival Outcomes In T3 Laryngeal Cancer Based On Staging Features At Diagnosis , Vickie Jiaying Wang

Analysis Of Revertant Mosaicism And Cellular Competition In Ichthyosis With Confetti , Diana Yanez

A Hero's Journey: Experiences Using A Therapeutic Comicbook In A Children’s Psychiatric Inpatient Unit , Idil Yazgan

Prevalence Of Metabolic Comorbidities And Viral Infections In Monoclonal Gammopathy , Mansen Yu

Automated Detection Of Recurrent Gastrointestinal Bleeding Using Large Language Models , Neil Zheng

Vascular Risk Factor Treatment And Control For Stroke Prevention , Tianna Zhou

Theses/Dissertations from 2023 2023

Radiomics: A Methodological Guide And Its Applications To Acute Ischemic Stroke , Emily Avery

Characterization Of Cutaneous Immune-Related Adverse Events Due To Immune Checkpoint Inhibitors , Annika Belzer

An Investigation Of Novel Point Of Care 1-Tesla Mri Of Infants’ Brains In The Neonatal Icu , Elisa Rachel Berson

Understanding Perceptions Of New-Onset Type 1 Diabetes Education In A Pediatric Tertiary Care Center , Gabriel BetancurVelez

Effectiveness Of Acitretin For Skin Cancer Prevention In Immunosuppressed And Non-Immunosuppressed Patients , Shaman Bhullar

Adherence To Tumor Board Recommendations In Patients With Hepatocellular Carcinoma , Yueming Cao

Clinical Trials Related To The Spine & Shoulder/elbow: Rates, Predictors, & Reasons For Termination , Dennis Louis Caruana

Improving Delivery Of Immunomodulator Mpla With Biodegradable Nanoparticles , Jungsoo Chang

Sex Differences In Patients With Deep Vein Thrombosis , Shin Mei Chan

Incorporating Genomic Analysis In The Clinical Practice Of Hepatology , David Hun Chung

Emergency Medicine Resident Perceptions Of A Medical Wilderness Adventure Race (medwar) , Lake Crawford

Surgical Outcomes Following Posterior Spinal Fusion For Adolescent Idiopathic Scoliosis , Wyatt Benajmin David

Representing Cells As Sentences Enables Natural Language Processing For Single Cell Transcriptomics , Rahul M. Dhodapkar

Life Vs. Liberty And The Pursuit Of Happiness: Short-Term Involuntary Commitment Laws In All 50 US States , Sofia Dibich

Healthcare Disparities In Preoperative Risk Management For Total Joint Arthroplasty , Chloe Connolly Dlott

Toll-Like Receptors 2/4 Directly Co-Stimulate Arginase-1 Induction Critical For Macrophage-Mediated Renal Tubule Regeneration , Natnael Beyene Doilicho

Associations Of Atopic Dermatitis With Neuropsychiatric Comorbidities , Ryan Fan

International Academic Partnerships In Orthopaedic Surgery , Michael Jesse Flores

Young Adults With Adhd And Their Involvement In Online Communities: A Qualitative Study , Callie Marie Ginapp

Becoming A Doctor, Becoming A Monster: Medical Socialization And Desensitization In Nazi Germany And 21st Century USA , SimoneElise Stern Hasselmo

Comparative Efficacy Of Pharmacological Interventions For Borderline Personality Disorder: A Network Meta-Analysis , Olivia Dixon Herrington

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Edinburgh Medical School is one of two schools at the College of Medicine and Veterinary Medicine at the University of Edinburgh. The Edinburgh Medical School integrates research and teaching across our three Deaneries: Biomedical Sciences, Clinical Sciences and Molecular,Genetic and Population Health Sciences.

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Circadian biology of the systemic inflammatory response during critical illness caused by acute pancreatitis , integrated computational-experimental approach to identify and optimise drug therapy for metabolic dysfunction-associated steatotic liver disease , aetiology of neurodevelopmental disorders: contribution of immunological and genetic risk factors , investigating the role of pabpc5 in mouse physiology , community use of digital auscultation to improve diagnosis of childhood pneumonia in sylhet, bangladesh , investigating mechanisms of demyelination , preterm birth and the early-life respiratory microbiota: implications for host epigenetics and respiratory health , single-synapse resolution molecular mapping reveals both widespread and highly targeted experience-dependent synaptic plasticity in the mammalian brain , impact of primary renal epithelial senescence induction in the murine kidney , anatomic, histologic and histomorphometric analysis of the acetabular labrum and its enthesis , investigating disease progression of cutaneous squamous cell carcinoma , identification of methylation qtls in breast cancer characterises the influence of germline snp variation on the abnormal tumour methylome , investigating the sex-specific role of perivascular adipose tissue (pvat) on vascular function in obesity , integrated analysis of patient gene expression data for precision medicine applications in breast and pancreatic cancer , investigating chromosome cohesion loss in mammalian oocytes , quality palliative care in humanitarian crises in low- and middle-income country context , understanding and stratifying brain health through blood-based omics data , role of the nuclear basket in regulating the senescence-associated secretory phenotype , identifying mistranslating mrnas in mouse models of autism , development of attachment in infants born preterm .

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UKnowledge > College of Medicine > Medical Sciences > Theses & Dissertations

Theses and Dissertations--Medical Sciences

Theses/dissertations from 2024 2024.

Modulating the mTOR Pathway Using Inducible Retrogradely Transported AAVs as a Novel Approach to Improve Motor Recovery in Spinal Cord Injury , Christopher Bosse-Joseph

Theses/Dissertations from 2023 2023

Examining a Blood Biomarker Approach to Blood-Brain Barrier Disruption , Samantha Ford

Theses/Dissertations from 2022 2022

Establishment and Verification of a SARS CoV2 Antibody Detection Assay Comparing Venous and Mitra Samples , Stephen C. Mayer

Mammalian Target of Rapamycin Cell Signaling Pathway in Phosphatase and Tensin Homolog Induced Kinase 1 Knockout Rat Model of Familial Parkinson's Disease , Martha Helena Mortell

Classification and Effect of Correctors on Sitosterolemia-Associated Mutants in ABCG8 , Brittney Poole

Membrane Palmitoylated Protein Magu-3 Regulates the C. elegans Locomotor Circuit via Modulation of Cholinergic Activity , Henry Richburg

TREM2: Gene Expression and Role in Alzheimer’s Disease , Henry Snider

APOE Genotype and Sex Modulate Ketogenic Diet Enhancements to Metabolism and Gut Microbiome in Young Mice , Andrew T. Yackzan

Investigating The Effects of In-vivo Therapeutics Hypoxia Treatment Paradigms In Neurite Outgrowth Patterns , Jae Hyun Yoo

Theses/Dissertations from 2021 2021

ACL Injury, a Time Course Study of Transcriptional Changes , Thomas Carter

S. gordonii -PRODUCED HYDROGEN PEROXIDE MODULATES miR-663A AND CCL20 EXPRESSION IN ORAL EPITHELIAL CELLS , Marshall Houston Maynard

THE ROLE OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN LEUKEMIA TRAFFICKING , Shaw Powell

Theses/Dissertations from 2020 2020

ETHANOL INDUCED NEUROTOXICITY THROUGH DYSREGULATION OF AMPK IN A FETAL ALCOHOL SYNDROME MODEL , Jessica Gebhardt

Involvement of the Sigma-1 Receptor in Methamphetamine-Mediated Changes to Astrocyte Structure and Function , Richik Neogi

MEASURING THE EFFECTS OF LOBINALINE-N-BIOXIDE (419) ON ALCOHOL CONSUMPTION, NICOTINE LOCOMOTOR SENSITIZATION, AND CONDITIONED PLACE PREFERENCE IN MICE AND RATS , Cocanut M. Suhail

Theses/Dissertations from 2019 2019

The Stimulation of Dendritic Cells by Cationic Lipids , John Peyton Bush

RAPID NO• MEASURES IN RAT NUCLEUS ACCUMBENS AND FRONTAL CORTEX FOLLOWING NASAL ADMINISTRATION OF NITROGLYCERIN , Victoria A. Scott

Theses/Dissertations from 2018 2018

MYOSIN-XVA IS KEY MOLECULE IN ESTABLISHING THE ARCHITECTURE OF MECHANOSENSORY STEREOCILIA BUNDLES OF THE INNER EAR HAIR CELLS , Shadan Hadi

Theses/Dissertations from 2017 2017

THE EFFECTS OF EXERCISE PRECONDITIONING ON FOCAL ISCHEMIC STROKE , Gillian Grohs

Theses/Dissertations from 2016 2016

CEREBROVASCULAR RISK FACTORS, ARTERIOLAR SCLEROSIS, AND COGNITIVE DECLINE IN THE KENTUCKY APPALACHIAN “STROKE-BELT” , Omar M. Al-Janabi

VARIANCE OF THE AMYLOID BETA PEPTIDE AS A METRIC FOR THE DIAGNOSIS OF ALZHEIMER'S DISEASE , Christina Beckett

EVALUATING THE USE OF SECOND LIFE TM FOR VIRTUAL TEAM-BASED LEARNING IN AN ONLINE UNDERGRADUATE ANATOMY COURSE , Christena Gazave

Theses/Dissertations from 2014 2014

Listeria Monocytogenes can Utilize both M Cell Transcytosis and InlA-Mediated Uptake to Cross the Epithelial Barrier of the Intestine during an Oral Infection Model of Listeriosis , Hilary Denney

MODULATION OF VACCINE-INDUCED RESPONSES BY ANTHELMINTIC TREATMENT IN PONIES , Emily Rubinson

Immobilizing Mutation in an Unconventional Myosin15a Affects not only the Structure of Mechanosensory Stereocilia in the Inner Ear Hair Cells but also their Ionic Conductances , Diana Syam

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How To Write A Dissertation Or Thesis

8 straightforward steps to craft an a-grade dissertation.

By: Derek Jansen (MBA) Expert Reviewed By: Dr Eunice Rautenbach | June 2020

Writing a dissertation or thesis is not a simple task. It takes time, energy and a lot of will power to get you across the finish line. It’s not easy – but it doesn’t necessarily need to be a painful process. If you understand the big-picture process of how to write a dissertation or thesis, your research journey will be a lot smoother.  

In this post, I’m going to outline the big-picture process of how to write a high-quality dissertation or thesis, without losing your mind along the way. If you’re just starting your research, this post is perfect for you. Alternatively, if you’ve already submitted your proposal, this article which covers how to structure a dissertation might be more helpful.

How To Write A Dissertation: 8 Steps

• Clearly understand what a dissertation (or thesis) is
• Find a unique and valuable research topic
• Craft a convincing research proposal
• Write up a strong introduction chapter
• Review the existing literature and compile a literature review
• Design a rigorous research strategy and undertake your own research
• Present the findings of your research
• Draw a conclusion and discuss the implications

Step 1: Understand exactly what a dissertation is

This probably sounds like a no-brainer, but all too often, students come to us for help with their research and the underlying issue is that they don’t fully understand what a dissertation (or thesis) actually is.

So, what is a dissertation?

At its simplest, a dissertation or thesis is a formal piece of research , reflecting the standard research process . But what is the standard research process, you ask? The research process involves 4 key steps:

• Ask a very specific, well-articulated question (s) (your research topic)
• See what other researchers have said about it (if they’ve already answered it)
• If they haven’t answered it adequately, undertake your own data collection and analysis in a scientifically rigorous fashion
• Answer your original question(s), based on your analysis findings

In short, the research process is simply about asking and answering questions in a systematic fashion . This probably sounds pretty obvious, but people often think they’ve done “research”, when in fact what they have done is:

• Started with a vague, poorly articulated question
• Not taken the time to see what research has already been done regarding the question
• Collected data and opinions that support their gut and undertaken a flimsy analysis
• Drawn a shaky conclusion, based on that analysis

If you want to see the perfect example of this in action, look out for the next Facebook post where someone claims they’ve done “research”… All too often, people consider reading a few blog posts to constitute research. Its no surprise then that what they end up with is an opinion piece, not research. Okay, okay – I’ll climb off my soapbox now.

The key takeaway here is that a dissertation (or thesis) is a formal piece of research, reflecting the research process. It’s not an opinion piece , nor a place to push your agenda or try to convince someone of your position. Writing a good dissertation involves asking a question and taking a systematic, rigorous approach to answering it.

If you understand this and are comfortable leaving your opinions or preconceived ideas at the door, you’re already off to a good start!

Step 2: Find a unique, valuable research topic

As we saw, the first step of the research process is to ask a specific, well-articulated question. In other words, you need to find a research topic that asks a specific question or set of questions (these are called research questions ). Sounds easy enough, right? All you’ve got to do is identify a question or two and you’ve got a winning research topic. Well, not quite…

A good dissertation or thesis topic has a few important attributes. Specifically, a solid research topic should be:

Let’s take a closer look at these:

Attribute #1: Clear

Your research topic needs to be crystal clear about what you’re planning to research, what you want to know, and within what context. There shouldn’t be any ambiguity or vagueness about what you’ll research.

Here’s an example of a clearly articulated research topic:

An analysis of consumer-based factors influencing organisational trust in British low-cost online equity brokerage firms.

As you can see in the example, its crystal clear what will be analysed (factors impacting organisational trust), amongst who (consumers) and in what context (British low-cost equity brokerage firms, based online).

Need a helping hand?

Attribute #2:   Unique

Your research should be asking a question(s) that hasn’t been asked before, or that hasn’t been asked in a specific context (for example, in a specific country or industry).

For example, sticking organisational trust topic above, it’s quite likely that organisational trust factors in the UK have been investigated before, but the context (online low-cost equity brokerages) could make this research unique. Therefore, the context makes this research original.

One caveat when using context as the basis for originality – you need to have a good reason to suspect that your findings in this context might be different from the existing research – otherwise, there’s no reason to warrant researching it.

Attribute #3: Important

Simply asking a unique or original question is not enough – the question needs to create value. In other words, successfully answering your research questions should provide some value to the field of research or the industry. You can’t research something just to satisfy your curiosity. It needs to make some form of contribution either to research or industry.

For example, researching the factors influencing consumer trust would create value by enabling businesses to tailor their operations and marketing to leverage factors that promote trust. In other words, it would have a clear benefit to industry.

So, how do you go about finding a unique and valuable research topic? We explain that in detail in this video post – How To Find A Research Topic . Yeah, we’ve got you covered 😊

Step 3: Write a convincing research proposal

Once you’ve pinned down a high-quality research topic, the next step is to convince your university to let you research it. No matter how awesome you think your topic is, it still needs to get the rubber stamp before you can move forward with your research. The research proposal is the tool you’ll use for this job.

So, what’s in a research proposal?

The main “job” of a research proposal is to convince your university, advisor or committee that your research topic is worthy of approval. But convince them of what? Well, this varies from university to university, but generally, they want to see that:

• You have a clearly articulated, unique and important topic (this might sound familiar…)
• You’ve done some initial reading of the existing literature relevant to your topic (i.e. a literature review)
• You have a provisional plan in terms of how you will collect data and analyse it (i.e. a methodology)

At the proposal stage, it’s (generally) not expected that you’ve extensively reviewed the existing literature , but you will need to show that you’ve done enough reading to identify a clear gap for original (unique) research. Similarly, they generally don’t expect that you have a rock-solid research methodology mapped out, but you should have an idea of whether you’ll be undertaking qualitative or quantitative analysis , and how you’ll collect your data (we’ll discuss this in more detail later).

Long story short – don’t stress about having every detail of your research meticulously thought out at the proposal stage – this will develop as you progress through your research. However, you do need to show that you’ve “done your homework” and that your research is worthy of approval .

So, how do you go about crafting a high-quality, convincing proposal? We cover that in detail in this video post – How To Write A Top-Class Research Proposal . We’ve also got a video walkthrough of two proposal examples here .

Step 4: Craft a strong introduction chapter

Once your proposal’s been approved, its time to get writing your actual dissertation or thesis! The good news is that if you put the time into crafting a high-quality proposal, you’ve already got a head start on your first three chapters – introduction, literature review and methodology – as you can use your proposal as the basis for these.

Handy sidenote – our free dissertation & thesis template is a great way to speed up your dissertation writing journey.

What’s the introduction chapter all about?

The purpose of the introduction chapter is to set the scene for your research (dare I say, to introduce it…) so that the reader understands what you’ll be researching and why it’s important. In other words, it covers the same ground as the research proposal in that it justifies your research topic.

What goes into the introduction chapter?

This can vary slightly between universities and degrees, but generally, the introduction chapter will include the following:

• A brief background to the study, explaining the overall area of research
• A problem statement , explaining what the problem is with the current state of research (in other words, where the knowledge gap exists)
• Your research questions – in other words, the specific questions your study will seek to answer (based on the knowledge gap)
• The significance of your study – in other words, why it’s important and how its findings will be useful in the world

As you can see, this all about explaining the “what” and the “why” of your research (as opposed to the “how”). So, your introduction chapter is basically the salesman of your study, “selling” your research to the first-time reader and (hopefully) getting them interested to read more.

How do I write the introduction chapter, you ask? We cover that in detail in this post .

Step 5: Undertake an in-depth literature review

As I mentioned earlier, you’ll need to do some initial review of the literature in Steps 2 and 3 to find your research gap and craft a convincing research proposal – but that’s just scratching the surface. Once you reach the literature review stage of your dissertation or thesis, you need to dig a lot deeper into the existing research and write up a comprehensive literature review chapter.

What’s the literature review all about?

There are two main stages in the literature review process:

Literature Review Step 1: Reading up

The first stage is for you to deep dive into the existing literature (journal articles, textbook chapters, industry reports, etc) to gain an in-depth understanding of the current state of research regarding your topic. While you don’t need to read every single article, you do need to ensure that you cover all literature that is related to your core research questions, and create a comprehensive catalogue of that literature , which you’ll use in the next step.

Reading and digesting all the relevant literature is a time consuming and intellectually demanding process. Many students underestimate just how much work goes into this step, so make sure that you allocate a good amount of time for this when planning out your research. Thankfully, there are ways to fast track the process – be sure to check out this article covering how to read journal articles quickly .

Literature Review Step 2: Writing up

Once you’ve worked through the literature and digested it all, you’ll need to write up your literature review chapter. Many students make the mistake of thinking that the literature review chapter is simply a summary of what other researchers have said. While this is partly true, a literature review is much more than just a summary. To pull off a good literature review chapter, you’ll need to achieve at least 3 things:

• You need to synthesise the existing research , not just summarise it. In other words, you need to show how different pieces of theory fit together, what’s agreed on by researchers, what’s not.
• You need to highlight a research gap that your research is going to fill. In other words, you’ve got to outline the problem so that your research topic can provide a solution.
• You need to use the existing research to inform your methodology and approach to your own research design. For example, you might use questions or Likert scales from previous studies in your your own survey design .

As you can see, a good literature review is more than just a summary of the published research. It’s the foundation on which your own research is built, so it deserves a lot of love and attention. Take the time to craft a comprehensive literature review with a suitable structure .

But, how do I actually write the literature review chapter, you ask? We cover that in detail in this video post .

Step 6: Carry out your own research

Once you’ve completed your literature review and have a sound understanding of the existing research, its time to develop your own research (finally!). You’ll design this research specifically so that you can find the answers to your unique research question.

There are two steps here – designing your research strategy and executing on it:

1 – Design your research strategy

The first step is to design your research strategy and craft a methodology chapter . I won’t get into the technicalities of the methodology chapter here, but in simple terms, this chapter is about explaining the “how” of your research. If you recall, the introduction and literature review chapters discussed the “what” and the “why”, so it makes sense that the next point to cover is the “how” –that’s what the methodology chapter is all about.

In this section, you’ll need to make firm decisions about your research design. This includes things like:

• Your research philosophy (e.g. positivism or interpretivism )
• Your overall methodology (e.g. qualitative , quantitative or mixed methods)
• Your data collection strategy (e.g. interviews , focus groups, surveys)
• Your data analysis strategy (e.g. content analysis , correlation analysis, regression)

If these words have got your head spinning, don’t worry! We’ll explain these in plain language in other posts. It’s not essential that you understand the intricacies of research design (yet!). The key takeaway here is that you’ll need to make decisions about how you’ll design your own research, and you’ll need to describe (and justify) your decisions in your methodology chapter.

2 – Execute: Collect and analyse your data

Once you’ve worked out your research design, you’ll put it into action and start collecting your data. This might mean undertaking interviews, hosting an online survey or any other data collection method. Data collection can take quite a bit of time (especially if you host in-person interviews), so be sure to factor sufficient time into your project plan for this. Oftentimes, things don’t go 100% to plan (for example, you don’t get as many survey responses as you hoped for), so bake a little extra time into your budget here.

Once you’ve collected your data, you’ll need to do some data preparation before you can sink your teeth into the analysis. For example:

• If you carry out interviews or focus groups, you’ll need to transcribe your audio data to text (i.e. a Word document).
• If you collect quantitative survey data, you’ll need to clean up your data and get it into the right format for whichever analysis software you use (for example, SPSS, R or STATA).

Once you’ve completed your data prep, you’ll undertake your analysis, using the techniques that you described in your methodology. Depending on what you find in your analysis, you might also do some additional forms of analysis that you hadn’t planned for. For example, you might see something in the data that raises new questions or that requires clarification with further analysis.

The type(s) of analysis that you’ll use depend entirely on the nature of your research and your research questions. For example:

• If your research if exploratory in nature, you’ll often use qualitative analysis techniques .
• If your research is confirmatory in nature, you’ll often use quantitative analysis techniques
• If your research involves a mix of both, you might use a mixed methods approach

Again, if these words have got your head spinning, don’t worry! We’ll explain these concepts and techniques in other posts. The key takeaway is simply that there’s no “one size fits all” for research design and methodology – it all depends on your topic, your research questions and your data. So, don’t be surprised if your study colleagues take a completely different approach to yours.

Step 7: Present your findings

Once you’ve completed your analysis, it’s time to present your findings (finally!). In a dissertation or thesis, you’ll typically present your findings in two chapters – the results chapter and the discussion chapter .

What’s the difference between the results chapter and the discussion chapter?

While these two chapters are similar, the results chapter generally just presents the processed data neatly and clearly without interpretation, while the discussion chapter explains the story the data are telling  – in other words, it provides your interpretation of the results.

For example, if you were researching the factors that influence consumer trust, you might have used a quantitative approach to identify the relationship between potential factors (e.g. perceived integrity and competence of the organisation) and consumer trust. In this case:

• Your results chapter would just present the results of the statistical tests. For example, correlation results or differences between groups. In other words, the processed numbers.
• Your discussion chapter would explain what the numbers mean in relation to your research question(s). For example, Factor 1 has a weak relationship with consumer trust, while Factor 2 has a strong relationship.

Depending on the university and degree, these two chapters (results and discussion) are sometimes merged into one , so be sure to check with your institution what their preference is. Regardless of the chapter structure, this section is about presenting the findings of your research in a clear, easy to understand fashion.

Importantly, your discussion here needs to link back to your research questions (which you outlined in the introduction or literature review chapter). In other words, it needs to answer the key questions you asked (or at least attempt to answer them).

For example, if we look at the sample research topic:

In this case, the discussion section would clearly outline which factors seem to have a noteworthy influence on organisational trust. By doing so, they are answering the overarching question and fulfilling the purpose of the research .

For more information about the results chapter , check out this post for qualitative studies and this post for quantitative studies .

Step 8: The Final Step Draw a conclusion and discuss the implications

Last but not least, you’ll need to wrap up your research with the conclusion chapter . In this chapter, you’ll bring your research full circle by highlighting the key findings of your study and explaining what the implications of these findings are.

What exactly are key findings? The key findings are those findings which directly relate to your original research questions and overall research objectives (which you discussed in your introduction chapter). The implications, on the other hand, explain what your findings mean for industry, or for research in your area.

Sticking with the consumer trust topic example, the conclusion might look something like this:

Key findings

This study set out to identify which factors influence consumer-based trust in British low-cost online equity brokerage firms. The results suggest that the following factors have a large impact on consumer trust:

While the following factors have a very limited impact on consumer trust:

Notably, within the 25-30 age groups, Factors E had a noticeably larger impact, which may be explained by…

Implications

The findings having noteworthy implications for British low-cost online equity brokers. Specifically:

The large impact of Factors X and Y implies that brokers need to consider….

The limited impact of Factor E implies that brokers need to…

As you can see, the conclusion chapter is basically explaining the “what” (what your study found) and the “so what?” (what the findings mean for the industry or research). This brings the study full circle and closes off the document.

Let’s recap – how to write a dissertation or thesis

You’re still with me? Impressive! I know that this post was a long one, but hopefully you’ve learnt a thing or two about how to write a dissertation or thesis, and are now better equipped to start your own research.

To recap, the 8 steps to writing a quality dissertation (or thesis) are as follows:

• Understand what a dissertation (or thesis) is – a research project that follows the research process.
• Find a unique (original) and important research topic
• Craft a convincing dissertation or thesis research proposal
• Write a clear, compelling introduction chapter
• Undertake a thorough review of the existing research and write up a literature review
• Undertake your own research
• Present and interpret your findings

Once you’ve wrapped up the core chapters, all that’s typically left is the abstract , reference list and appendices. As always, be sure to check with your university if they have any additional requirements in terms of structure or content.  

Psst... there’s more!

This post was based on one of our popular Research Bootcamps . If you're working on a research project, you'll definitely want to check this out ...

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20 Comments

thankfull >>>this is very useful

Thank you, it was really helpful

unquestionably, this amazing simplified way of teaching. Really , I couldn’t find in the literature words that fully explicit my great thanks to you. However, I could only say thanks a-lot.

Great to hear that – thanks for the feedback. Good luck writing your dissertation/thesis.

This is the most comprehensive explanation of how to write a dissertation. Many thanks for sharing it free of charge.

Very rich presentation. Thank you

Thanks Derek Jansen|GRADCOACH, I find it very useful guide to arrange my activities and proceed to research!

Thank you so much for such a marvelous teaching .I am so convinced that am going to write a comprehensive and a distinct masters dissertation

It is an amazing comprehensive explanation

This was straightforward. Thank you!

I can say that your explanations are simple and enlightening – understanding what you have done here is easy for me. Could you write more about the different types of research methods specific to the three methodologies: quan, qual and MM. I look forward to interacting with this website more in the future.

Thanks for the feedback and suggestions 🙂

Hello, your write ups is quite educative. However, l have challenges in going about my research questions which is below; *Building the enablers of organisational growth through effective governance and purposeful leadership.*

Very educating.

Just listening to the name of the dissertation makes the student nervous. As writing a top-quality dissertation is a difficult task as it is a lengthy topic, requires a lot of research and understanding and is usually around 10,000 to 15000 words. Sometimes due to studies, unbalanced workload or lack of research and writing skill students look for dissertation submission from professional writers.

Thank you 💕😊 very much. I was confused but your comprehensive explanation has cleared my doubts of ever presenting a good thesis. Thank you.

thank you so much, that was so useful

Hi. Where is the excel spread sheet ark?

could you please help me look at your thesis paper to enable me to do the portion that has to do with the specification

my topic is “the impact of domestic revenue mobilization.

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• Bodleian Libraries
• Oxford LibGuides
• Biomedical Sciences
• Theses and Dissertations

Biomedical Sciences: Theses and Dissertations

• Journals and Conference Proceedings
• Writing for Publication
• Keeping up to date

Introduction

Theses and dissertations are documents that present an author's research findings, which are submitted to the University in support of their academic degree. They are very useful to consult when carrying out your own research because they:

• provide a springboard to scope existing literature
• provide inspiration for the finished product
• show you the evolution of an author's ideas over time
• provide relevant and up-to-date research (for recent theses and dissertations)

On this page you will find guidance on how to search for and access theses and dissertations in the Bodleian Libraries and beyond.

Definitions

Terms you may encounter in your research.

Thesis: In the UK, a thesis is normally a document that presents an author's research findings as part of a doctoral or research programme.

Dissertation: In the UK, a dissertation is normally a document that presents an author's research findings as part of an undergraduate or master's programme.

DPhil: An abbreviation for Doctor of Philosophy, which is an advanced research qualification. You may also see it referred to as PhD.

ORA: The Oxford University Research Archive , an institutional repository for the University of Oxford's research output including digital theses.

Theses and dissertations

• Reading theses and dissertations in the Bodleian Libraries

The Bodleian Libraries collection holds DPhil, MLitt and MPhil theses deposited at the University of Oxford, which you can consult. You may also be interested to read theses and dissertations beyond the University of Oxford, some of which can be read online, or you can request an inter-library loan.

Help with theses and dissertations

To find out more about how to find and access theses and dissertations in the Bodleian Libraries and beyond, we recommend the following:

• Bodleian Libraries theses and dissertations Links to information on accessing the Bodleian Libraries collections of Oxford, UK, US and other international theses.
• Oxford University Research Archive guide
• Help & guidance for digital theses Information on copyright, how to deposit your thesis in ORA and other important matters
• Guide to copyright The Bodleian Libraries' Quick guide to copyright and digital sources.

Plagiarism checking tools

Read the University academic good practice page.

Seek your Supervisor or Tutor's guidance. In addition, your Supervisor or Tutor may decide to submit your work to Turnitin, accessible to teaching staff only. Visit the Turnitin website for product information.

Consult books - suggested reading:

• Neville, C. (2016). The complete guide to referencing and avoiding plagiarism (3rd ed.).  Maidenhead: Open University Press. Title available in e-book and print format - shelfmark PN171.F56 NEV 2016 in the Radcliffe Science Library 
• Pears, R. & Shields, G.J. (2019). Cite them right: the essential referencing guide (11th ed.) Basingstoke: Palgrave Macmillan. Title available in e-book format

Depositing your thesis

It is mandatory for students completing a research degree at the University of Oxford (registered to a programme of study on or after 1st October 2007) to deposit an electronic copy of their theses with the Oxford University Research Archive (ORA) in order to meet the requirements of their award. To find out more, visit the Oxford University Research Archive guide.

Quick access to research & writing guides

• Research integrity and ethics The University of Oxford regards research integrity as a core value and has a longstanding commitment to ensuring that it is embedded in its research culture and activity
• Academic good practice Advice on academic good practice including avoiding plagiarism, managing your time, reading, note taking, referencing and revision.
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Patrias K, author; Wendling D, editor. Citing Medicine: The NLM Style Guide for Authors, Editors, and Publishers [Internet]. 2nd edition. Bethesda (MD): National Library of Medicine (US); 2007-.

Citing Medicine: The NLM Style Guide for Authors, Editors, and Publishers [Internet]. 2nd edition.

Chapter 5 dissertations and theses.

Created: October 10, 2007 ; Last Update: August 11, 2015 .

A. Entire Dissertations and Theses

• Sample Citation and Introduction
• Citation Rules with Examples

B. Parts of Dissertations and Theses

• A. Sample Citation and Introduction to Citing Entire Dissertations and Theses

The general format for a reference to entire dissertation, including punctuation:

The general format for a reference to entire master's thesis, including punctuation:

• Examples of Citations to Entire Dissertations and Theses

Dissertations and theses are rigorous reports of original research written in support of academic degrees above the baccalaureate level. Although some countries use the term "thesis" to refer to material written for a doctorate, the term in this chapter is reserved for work at the master's level, while "dissertation" is used for the doctorate.

Citations to dissertations and theses are similar to the standard book, with the following important points:

• With rare exceptions, dissertations have only one author. Most master's theses also have a single author, but occasionally will have two.
• The place of publication for a thesis or dissertation is the city where the university or other institution granting the degree is located. Many dissertations, particularly those of US universities, do not state the place of publication. When this occurs, obtain the city name from another source and place it in square brackets.
• The publisher is the university or other institution granting the degree.

The chief source for information about a dissertation or thesis is its title page. The back of the title page, called the verso page, and the cover are additional sources of authoritative information not found on the title page.

Continue to Citation Rules with Examples for Entire Dissertations and Theses .

Continue to Examples of Citations to Entire Dissertations and Theses .

• Citation Rules with Examples for Entire Dissertations and Theses

Components/elements are listed in the order they should appear in a reference. An R after the component name means that it is required in the citation; an O after the name means it is optional.

Author (R) | Title (R) | Content Type (O) | Type of Medium (R) | Place of Publication (R) | Publisher (R) | Date of Publication (R) | Pagination (O) | Physical Description (O) | Language (R) | Notes (O)

Author for a Dissertation or Thesis (required)

General rules for author.

• List names in the order they appear in the text
• Enter surname (family or last name) first for each author
• Capitalize surnames and enter spaces within surnames as they appear in the document cited on the assumption that the author approved the form used. For example: Van Der Horn or van der Horn; De Wolf or de Wolf or DeWolf.
• Convert given (first) names and middle names to initials for a maximum of two initials following each surname
• Separate author names from each other by a comma and a space
• End author information with a period

Specific Rules for Author

• Surnames with hyphens and other punctuation in them
• Other surname rules
• Given names containing punctuation, a prefix, a preposition, or particle
• Degrees, titles, and honors following a personal name
• Designations of rank in a family, such as Jr and III
• Names in non-roman alphabets (Cyrillic, Greek, Arabic, Hebrew, Korean) or character-based languages (Chinese, Japanese)
• Options for author names

Surnames with hyphens and other punctuation in them.

Other surname rules.

Given names containing punctuation, a prefix, a preposition, or particle.

Degrees, titles, and honors following a personal name.

Designations of rank in a family, such as Jr and III.

Names in non-roman alphabets (Cyrillic, Greek, Arabic, Hebrew, Korean) or character-based languages (Chinese, Japanese).

Options for author names.

Examples for Author

1. standard dissertation, 2. standard master's thesis, 3. dissertation or thesis with optional full name(s) for author, 4. dissertation or thesis with more than one author (rare), 5. dissertation or thesis with authors showing designations of rank within the family, title for a dissertation or thesis (required), general rules for title.

• Enter the title of a dissertation or thesis as it appears in the original document and in the original language
• Capitalize only the first word of a title, proper nouns, proper adjectives, acronyms, and initialisms
• Use a colon followed by a space to separate a title from a subtitle, unless another form of punctuation (such as a question mark, period, or an exclamation point) is already present
• Follow non-English titles with a translation whenever possible; place the translation in square brackets
• End a title with a period unless a question mark or exclamation point already ends it or a Content Type or Type of Medium follows it, then end with a space

Specific Rules for Title

• Titles not in English
• Titles containing a Greek letter, chemical formula, or another special character

Titles not in English.

Titles containing a Greek letter, chemical formula, or another special character.

Examples for Title

6. dissertation or thesis with titles ending in punctuation other than a period, 7. dissertation or thesis with titles containing a chemical formula, greek letter, or other special characters, 8. dissertation or thesis with non-english titles, 9. dissertation or thesis with non-english titles, with translation, content type for a dissertation or thesis (optional), general rules for content type.

• Place [dissertation] or [master's thesis] after the title to alert the user that the reference is not to a standard book
• Follow the bracketed type with a period unless the dissertation or thesis is in a non-print medium (see Type of Medium below)

Specific Rules for Content Type

• Titles ending in punctuation other than a period
• Non-English titles with translation

Titles ending in punctuation other than a period.

Non-English titles with translation.

Examples for Content Type

10. dissertation or thesis in a microform, type of medium for a dissertation or thesis (required), general rules for type of medium.

• Indicate the specific type of medium (microfiche, ultrafiche, microfilm, microcard, etc.) following the title and the content type when a dissertation or thesis is published in a microform
• Place the name of the medium inside the square brackets for the content type, preceded by the word "on". For example: [dissertation on microfiche].
• End with a period following the closing bracket
• Add information about the medium according to the instructions under Physical Description below
• See Chapter 15 for dissertations or theses in audiovisual formats; Chapter18 and Chapter 22 for those in electronic formats

Specific Rules for Type of Medium

Examples for type of medium, place of publication for a dissertation or thesis (required), general rules for place of publication.

• Place is defined as the city where the university or other institution granting the degree is located
• Follow US and Canadian cities with the two-letter abbreviation for the state or province (see Appendix E ) to avoid confusion when citing lesser known cities or when cities in different locations have the same name, such as Palm Springs (CA) and Palm Springs (FL)
• Follow cities in other countries with the name of the country, either written out or as the two-letter ISO country code (see Appendix D ), when citing lesser known cities or when cities in different locations have the same name, such as London (ON) and London (England)
• Use the anglicized form for a non-US city, such as Vienna for Wien
• End place information with a colon

Specific Rules for Place of Publication

• Non-US cities
• No place of publication can be found

Non-US cities.

No place of publication can be found.

Examples for Place of Publication

11. dissertation or thesis with place of publication not found on title page, publisher for a dissertation or thesis (required), general rules for publisher.

• The publisher is the university or other institution granting the degree
• Record the name of the institution as it appears in the publication, using whatever capitalization and punctuation is found there
• Abbreviate well-known words in institutional names, such as Univ. for University, if desired
• When a division or other subsidiary part of an institution appears in the publication, enter the main institutional name first. For example: University of Illinois at Chicago, Health Sciences Center.
• End publisher information with a semicolon

Specific Rules for Publisher

• Abbreviations in publisher names
• Non-English names of institutions
• Government agencies and other national and international bodies as publisher

Abbreviations in publisher names.

Non-English names of institutions.

Government agencies and other national and international bodies as publisher.

Examples for Publisher

12. dissertation or thesis publisher with subsidiary part included, 13. dissertation or thesis issued by a governmental body, 14. dissertation or thesis issued by other than a university, date of publication for a dissertation or thesis (required), general rules for date of publication.

• Always give the year of publication, i.e., the year the degree was granted
• Convert roman numerals to arabic numbers. For example: MM to 2000.
• Include the month of publication, if desired, after the year, such as 2004 May
• Use English names for months and abbreviate them to the first three letters, such as Jan
• End date information with a period

Specific Rules for Date of Publication

• Non-English names for months
• Seasons instead of months
• Options for date of publication

Non-English names for months.

Seasons instead of months.

Options for date of publication.

Examples for Date of Publication

15. dissertation or thesis date with month included, 16. dissertation or thesis date with season, pagination for a dissertation or thesis (optional), general rules for pagination.

• Provide the total number of pages on which the text of the dissertation or thesis appears
• Do not count pages for such items as introductory material, appendixes, and indexes unless they are included in the pagination of the text
• Follow the page total with a space and the letter p
• For dissertations or theses published in more than one physical volume, cite the total number of volumes instead of the number of pages, such as 2 vol
• End pagination information with a period

Specific Rules for Pagination

• No numbers appear on the pages

No numbers appear on the pages.

Examples for Pagination

17. dissertation or thesis submitted in more than one volume, physical description for a dissertation or thesis (optional), general rules for physical description.

• Give information on the physical characteristics if a dissertation or thesis is published in a microform (microfilm, microfiche, microcard, etc.), such as 3 microfiche: black & white, 2 x 4 in.

Specific Rules for Physical Description

• Language for describing physical characteristics

Language for describing physical characteristics.

Examples for Physical Description

Language for a dissertation or thesis (required), general rules for language.

• Give the language of publication if other than English
• Capitalize the language name
• Follow the language name with a period

Examples for Language

Notes for a dissertation or thesis (optional), general rules for notes.

• Notes is a collective term for any type of useful information given after the citation itself
• Complete sentences are not required

Specific Rules for Notes

Dissertations or theses accompanied by a videocassette, CD-ROM, DVD, etc.

• Other types of material to include in notes

Other types of material to include in notes.

Examples for Notes

18. dissertation or thesis with availability statement included, 19. dissertation or thesis with location of a library or other holding institution where the dissertation/thesis may be found, 20. dissertation or thesis with note on specific type of degree, 21. dissertation or thesis with sponsorship or support note included, 22. dissertation or thesis accompanied by a cd-rom, dvd, or other medium, 23. dissertation or thesis with supplemental material on the internet.

Jones DL. The role of physical activity on the need for revision total knee arthroplasty in individuals with osteoarthritis of the knee [dissertation]. [Pittsburgh (PA)]: University of Pittsburgh; 2001. 436 p.

Liu-Ambrose TY. Studies of fall risk and bone morphology in older women with low bone mass [dissertation]. [Vancouver (BC)]: University of British Columbia; 2004. 290 p.

Zhao C. Development of nanoelectrospray and application to protein research and drug discovery [dissertation]. Buffalo (NY): State University of New York at Buffalo; 2005. 276 p.

Roguskie JM. The role of Pseudomonas aeruginosa 1244 pilin glycan in virulence [master's thesis]. [Pittsburgh (PA)]: Duquesne University; 2005. 111 p.

Weisbaum LD. Human sexuality of children and adolescents: a comprehensive training guide for social work professionals [master's thesis]. Long Beach (CA): California State University, Long Beach; 2005. 101 p.

Baldwin, Karen Brandt. An exploratory method of data retrieval from the electronic medical record for the evaluation of quality in healthcare [dissertation]. Chicago: University of Illinois at Chicago, Health Sciences Center; 2004. 116 p.

Kolotylo C, MacDonald JM. Exploration of the relationships among personal and illness-related factors, migraine headache pain, the chronic pain experience, coping, depressive symptomatology, disability, and quality of life in women with migraine headache [dissertation]. [Milwaukee (WI)]: University of Wisconsin - Milwaukee; 1999. 295 p.

Korir J, Karr-Kidwell PJ. The relationship between self esteem and effective educational leadership: a literary review, recommendations, and interviews [master's thesis]. [Denton (TX)]: Texas Woman's University; 2000 May. 98 p.

Daugherty RH 3rd. Social work education and public assistance workers in Kentucky 1936-2001 [dissertation]. Louisville (KY): University of Louisville; 2004. 203 p.

Boyer CL. Do rural Medicare patients have different post-acute service patterns than their non-rural counterparts? [dissertation]. [Cleveland (OH)]: Case Western Reserve University; 2004. 131 p.

Martin EJ. 1,1-dichloroethylene -induced mitochondrial aberrations precede apoptotic and necrotic cell death in murine liver and lung [dissertation]. Kingston (ON): Queen's University; 2004. 149 p.

Greek letters may be written out if special fonts are not available

Goel R. Characterization of α-thrombin -induced rapid phase of PI 3-kinase [dissertation]. St. Louis (MO): Saint Louis University; 2004. 141 p.

Goel R. Characterization of alpha-thrombin -induced rapid phase of PI 3-kinase [dissertation]. St. Louis (MO): Saint Louis University; 2004. 141 p.

Superscripts/subscripts may be enclosed within parentheses if fonts are not available

Uddemarri S. Aging affects stretch-induced p70 S6k and 4E-BP1 phosphorylation in fast- and slow-twitch muscle [master's thesis]. [Huntington (WV)]: Marshall University; 2005. 151 p.

Uddemarri S. Aging affects stretch-induced p70(S6k) and 4E-BP1 phosphorylation in fast- and slow-twitch muscle [master's thesis]. [Huntington (WV)]: Marshall University; 2005. 151 p.

Montes Alvarez MJ. Parametros predictivos de complicaciones macroangiopaticos en la diabetes mellitus tipo 2 que precisa insulinoterapia [dissertation]. Cadiz (Spain): Universidad de Cadiz; 2005. 180 p. Spanish.

Cisse A. Connaissances et comportements sexuels des jeunes de 15-29 ans sur les M.T.S. et le SIDA a Bamako [master's thesis]. [Quebec (QC)]: Laval University; 1993. 69 p. French.

Montes Alvarez MJ. Parametros predictivos de complicaciones macroangiopaticos en la diabetes mellitus tipo 2 que precisa insulinoterapia [Predictive parameters for macroangiopathy complications in Type 2 diabetes which requires insulin] [dissertation]. Cadiz (Spain): Universidad de Cadiz; 2005. 180 p. Spanish.

Cisse A. Connaissances et comportements sexuels des jeunes de 15-29 ans sur les M.T.S. et le SIDA a Bamako [Sexual knowledge and behavior of young people 15-29 years of age concerning sexually transmitted diseases (STDs) and AIDS in Bamako] [master's thesis]. [Quebec (QC)]: Laval University; 1993. 69 p. French.

Craft LL. Exercise and clinical depression: examining psychological mechanisms [dissertation on microfiche]. [East Lansing (MI)]: Michigan State University; 2002. 116 p. 2 microfiche: black & white, negative, 4 x 6 in.

Peppas D. Der Anatom Eduard Jacobshagen (1886-1967) [The anatomist Eduard Jacobshagen (1886-1967)] [dissertation on microfiche]. [Marburg (Germany)]: Marburg University; 2001. 133 p. 2 microfiche: black & white, negative, 4 x 6 in. German.

Brill S. Hygieia: health and medicine in Plato's Republic [dissertation on microfilm]. [College Park (PA)]: Pennsylvania State University; 2004. 311 p. 1 reel: black & white, negative, 35 mm.

Johnston PG. A survey of nursing school libraries in the city of Philadelphia [master's thesis on microcard]. Philadelphia: Drexel Institute of Technology; 1955. 55 p. 3 microcards: 3 x 5 in.

Campbell E. Childbearing and choice: views of young Chinese professional women [dissertation]. [Claremont (CA)]: Claremont Graduate University; 1996. 147 p.

Metry KJ. NAT polymorphism in breast cancer risk [master's thesis]. Louisville (KY): University of Louisville, Department of Pharmacology and Toxicology; 2004. 71 p.

Miller LE, Sperry BM. Central American women's experience of prenatal care [master's thesis]. [Boston (MA)]: Massachusetts General Hospital, Institute of Health Professions; 1992. 66 p.

Schauppner CE. Some ramifications of compensation limitations in personal services contracts for direct health care providers [master's thesis]. Monterey (CA): Naval Postgraduate School (US); 1990. 74 p.

Kazerouni NN. Family history of breast cancer as a determinant of the risk of developing endometrial and ovarian cancers: a nationwide cohort study [dissertation]. [Bethesda (MD)]: Uniformed Services University of the Health Sciences (US), Department of Preventive Medicine and Biometrics; 2002.

Kan H. Does the Medicare principal inpatient diagnostic cost group model adequately adjust for selection bias? [dissertation]. Santa Monica (CA): RAND Graduate School; 2002. 101 p.

Lemov RM. The laboratory imagination: experiments in human and social engineering. [Berkeley (CA)]: University of California, Berkeley; 2000 Spring. 2 vol.

Hanson CA. Embodying erudition: English art, medicine, & antiquarianism in the age of empiricism [dissertation]. [Chicago]: University of Chicago, Department of Art History; 2003. 2 vol.

Boyer CL. Do rural Medicare patients have different post-acute service patterns than their non-rural counterparts? [dissertation]. [Cleveland (OH)]: Case Western Reserve University; 2004. 131 p. Available from: UMI, Ann Arbor, MI; AAT 3145345.

Overlock JA. The relationship between balance and fundamental motor skills in children five to nine years of age [master's thesis]. [Corvallis (OR)]: Oregon State University; 2004. 111 p. Available from: Kinesiology Publications, University of Oregon, Eugene, OR; PSY 2317.

Akerstrom B. Adults with autism and mental retardation: a life-span perspective [dissertation]. Uppsala (Sweden): S. Academiae Upsaliensis; 2001. 156 p. Located at: National Library of Medicine, Bethesda, MD; W1 AC955 v.20 2001.

Ari AB. Eye injuries on the battlefields of Iraq and Afghanistan: public health implications [master's thesis]. Anchorage (AK): University of Alaska; 2005. 48 p. Master of Public Health.

Verhovsek EL. Examining stages in curriculum change: implementation of Complementary and Alternative Medicine (CAM) [dissertation]. [Morgantown (WV)]: West Virginia University; 2003. 197 p. Doctor of Education.

Kanika K. Labor market implications of employer provided health insurance [dissertation]. Evanston (IL): Northwestern University; 1997. 204 p. Sponsored by the Agency for Health Care Policy and Research.

Tuitele BA. The current practices in injury prevention and safety helmet use in an Air Force medical center [master's thesis]. [Bethesda (MD)]: Uniformed Services University of the Health Sciences; 2000. 59 p. Supported by the Uniformed Services University of the Health Sciences, Protocol No. T061AK-01.

Lukasik-Sedmak DM. How to develop an interactive MRI brain cross-sectional anatomy CD-ROM and Web-based educational materials to meet the needs of medical imaging specialists working in magnetic resonance imaging [dissertation]. [Milwaukee (WI)]: Cardinal Stritch University; 2002. 113 p. Accompanied by: 1 CD-ROM.

Morgan JC. VISIO/KINESIS: a mixed media installation and performance [master's thesis]. Dominguez Hills (CA): California State University, Dominguez Hills; 2001. 47 p. Accompanied by: 1 videocassette.

Wyatt TH. Pilot testing Okay with Asthma (TM) : a digital story for psychosocial asthma management [dissertation]. [Charlottesville (VA)]: University of Virginia; 2003. 109 p. Web site for the program available at: http://okay-with-asthma.org/ .

• B. Sample Citation and Introduction to Citing Parts of Dissertations and Theses

The general format for a reference to a part of a dissertation, including punctuation:

The general format for a reference to a part of a master's thesis, including punctuation:

• Examples of Citations to Parts of Dissertations and Theses

Rather than citing a dissertation or thesis as a whole, separately identified portions of them may be cited. Chapters, sections, tables, charts, graphs, photographs, appendixes, and the like are considered parts of dissertations/theses when they are written or compiled by the authors of the dissertation or thesis. In general, most modern texts have standardized to three types of parts: figures, tables, and appendixes. However, many other names may be found for parts.

Because a reference should start with the individual or organization with responsibility for the intellectual content of the publication, begin a reference to a part of a dissertation or thesis with the citation to the dissertation or thesis itself, then follow it with the information about the part. See Chapter 2C Parts of Books for further details on citing parts.

Medical texts frequently contain charts, figures, and other illustrative material that has been reproduced with permission from other sources. Do not cite these as parts using the instructions presented here. Consult the original publication and cite the particular item from there.

Continue to Citation Rules with Examples for Parts of Dissertations and Theses .

Continue to Examples of Citations to Parts of Dissertations and Theses .

• Citation Rules with Examples for Parts of Dissertations and Theses

Dissertation or Thesis (R) | Name and Number/Letter (R) | Title (R) | Location (Pagination) (R)

Dissertation or Thesis (required)

• Cite the dissertation or thesis according to Chapter 5A Entire Dissertations or Theses

Name and Number/Letter of the Part for a Dissertation or Thesis (required)

General rules for name and number/letter.

• Enter the name of the part, such as Chapter, Table, Figure, or Appendix
• Do not abbreviate names. For example, convert Fig. to Figure.
• Follow the name with any accompanying number or letter, such as Chapter 12, Table 2, Figure 3.1, or Appendix A
• Use arabic numbers only. For example: convert VI or Six to 6.
• End name and number/letter information with a comma and a space

Specific Rules for Name and Number/Letter

• Non-English names for parts
• No letter or number follows the name
• No name appears

Non-English names for parts.

No letter or number follows the name.

No name appears.

Examples for Name and Number/Letter

1. chapter in a dissertation or thesis, 2. table in a dissertation or thesis, 3. figure in a dissertation or thesis, 4. appendix in a dissertation or thesis, 5. other part of a dissertation or thesis, 6. other part of a dissertation or thesis, without name and number/letter, 7. part of a dissertation or thesis in a language other than english, title of the part for a dissertation or thesis (required).

• Enter the title of the part as it appears in the dissertation or thesis
• End title information with a semicolon and a space
• Non-English titles for parts
• Titles containing a Greek letter, chemical formula, or other special character
• No title appears

Non-English titles for parts.

Titles containing a Greek letter, chemical formula, or other special character.

No title appears.

Location (Pagination) of the Part for a Dissertation or Thesis (required)

General rules for location (pagination).

• Begin location with "p." followed by a space
• Enter the page number or numbers on which the part appears. Examples: p. 438 and p. 663-4.
• Do not repeat page numbers unless they are followed by a letter. For example: 126-127 becomes p. 126-7, but p. 126A-127A is correct.
• Include a letter (often S for Supplement or A for Appendix) when it precedes the page number. For example: p. S10-8.
• End page information with a period

Specific Rules for Location (Pagination)

• Roman numerals for page numbers
• Part paginated separately
• No page numbers appear on the pages of the part

Roman numerals for page numbers.

Part paginated separately.

No page numbers appear on the pages of the part.

Examples for Location (Pagination)

Lemov RM. The laboratory imagination: experiments in human and social engineering [dissertation]. [Berkeley (CA)]: University of California, Berkeley; 2000 Spring. Chapter 2, Running the maze: animal and human experiments; p. 67-130.

Christensen PM. Infant nutrition and child health on Tarawa, Kiribati: a nutritional anthropological approach [master's thesis]. Sydney (Australia): University of New South Wales, Centre for South Pacific Studies; 1995. Chapter 3.1, Breastfeeding practices on Tarawa; p. 46-53.

Hayenga ES. Dieting through the decades: a comparative study of weight reduction in America as depicted in popular literature and books from 1940 to the late 1980's [dissertation]. [Minneapolis (MN)]: University of Minnesota; 1988. Chapter 3C, Science and health; p. 257-70.

Cornwell D. A cost benefit of telemedicine: an assessment of aero-medical evacuation patients throughout the Pacific Basin [master's thesis]. [Waco (TX)]: Baylor University, US Army-Baylor University Graduate Program; 1995. Table 4, Total air-evacs vs total potential telemedicine patients; p. 45.

Munoz JA. What is the quality of care in a developing country? Measuring physician practice and health outcomes [dissertation]. Santa Monica (CA): Rand Graduate School; 2002. Table 4.8, Mean objective measures of health for healthcare facility users; p. 4-33.

Bicks C. Lurking in the gossip's bowl: genealogy, gynecology, and the politics of midwifery in Shakespeare's England [dissertation]. [Stanford (CA)]: Stanford University, Department of English; 1997 Jun. Figure 9, Syringe for emergency in utero baptism; p.194.

Roberts PR. Snakes and ladders: the pursuit of a safety culture in New Zealand public hospitals [master's thesis]. [Wellington (New Zealand)]: Victoria University of Wellington, Institute of Policy Studies and Health Services Research Centre; 2002. Figure 2.1, Schema showing relationship of paradigms to human performance and links to and through culture; p. 13.

Deutsch B. Lifestyle and contaminants in Greenland 1994-1996: evaluation of the AMAP, Human Health Subprogram [master's thesis]. Aarhus (Denmark): University of Aarhus; 1999. Figure 2, Histograms of birth weight and gestational age; p. 20.

Grant MM. Under the microscope: "race," gender, and medical laboratory science in Canada [dissertation]. [Toronto (ON)]: University of Toronto, Ontario Institute for Studies in Education; 2004. Appendix, Survey on the career patterns and professional experiences of Canadian medical laboratory technologists; p. 285-92.

Kneale C. Health claims: an exploration of the current debate in Australia [master's thesis]. Sydney (Australia): University of Sydney, Nutrition Research Foundation; 1996 Oct. Appendix 4, Health claims questionnaire; p. 49.

Munoz JA. What is the quality of care in a developing country? Measuring physician practice and health outcomes [dissertation]. Santa Monica (CA): Rand Graduate School; 2002. Appendix 1, Background on problems of less developed countries; p. A1-8.

Powers JC. Herman Boerhaave and the pedagogical reform of eighteenth-century chemistry [dissertation]. [Bloomington (IN)]: Indiana University, Department of History and Philosophy of Science; 2001 May. Epilogue, Boerhaave's legacy; p. 296-301.

Mackowski MP. Human factors: aerospace medicine and the origins of manned space flight in the United States [dissertation]. [Tempe (AZ)]: Arizona State University; 2002 May. Part 2, Space medicine; p. 188-377.

Kairo JG. A review of the ecology and restoration of mangroves systems [dissertation]. Brussels (Belgium): Vrije University; 2001. Ecology and restoration of mangrove systems in Kenya; p. 2-15.

Kneale C. Health claims: an exploration of the current debate in Australia [master's thesis]. Sydney (Australia): University of Sydney, Nutrition Research Foundation; 1996 Oct. Summary recommendations; p. 44.

Stewart EP. Who shall decide when doctors disagree? Hoaxes and American men of science in the nineteenth century [dissertation]. Washington: American University, Faculty of the College of Arts and Sciences; 2003. "Doctor" Dionysius Lardner; p. 132-48.

Mackowski MP. Human factors: aerospace medicine and the origins of manned space flight in the United States [dissertation]. [Tempe (AZ)]: Arizona State University; 2002 May. [Map], Germany 1946: showing Allied zones of occupation; p. 188.

Tamayo Lorenzo PA. Descentralizacion y financiacion de la asistencia sanitaria publica en Espana: un estudio desde la perspectiva de la equidad [dissertation]. Madrid: Universidad Nacional de Educacion a Distancia; 1999. Tabla 5.11, Resumen de los resultados de los estudios evaluados, en terminos de necesidad para cada comunidad autonoma; p. 238. Spanish.

with translation

Tamayo Lorenzo PA. Descentralizacion y financiacion de la asistencia sanitaria publica en Espana: un estudio desde la perspectiva de la equidad [Decentralization and financing of public health assistance in Spain: a study from the perspective of equality] [dissertation]. Madrid: Universidad Nacional de Educacion a Distancia; 1999. Tabla 5.11, Resumen de los resultados de los estudios evaluados, en terminos de necesidad para cada comunidad autonoma [Table 5.11, Summary of the results of the evaluated studies, in terms of need for each independent community]; p. 238. Spanish.

• Cite this Page Patrias K, author; Wendling D, editor. Citing Medicine: The NLM Style Guide for Authors, Editors, and Publishers [Internet]. 2nd edition. Bethesda (MD): National Library of Medicine (US); 2007-. Chapter 5, Dissertations and Theses. 2007 Oct 10 [Updated 2015 Aug 11].
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Digital Commons @ USF > USF Health > College of Nursing > Theses and Dissertations

Nursing Theses and Dissertations

Theses/dissertations from 2023 2023.

Psychological Distress, Resilience, and the Impact on Quality of Life in Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy , Lauren Schwab

Theses/Dissertations from 2022 2022

Medication-Assisted Treatment Versus 12-Step Group Therapy: A Comparative Analysis of Adherence and Abstinence In Patients With Opioid Use Disorder , Derrick C. Glymph

Theses/Dissertations from 2021 2021

Quality of Life of Older Adults with Complicated Grief Receiving Accelerated Resolution Therapy: A Mixed Methods Study , Tina M. Mason

Theses/Dissertations from 2020 2020

In Post-Extubated Patients What are the Preferred Methods of Communication During Their Experience of Endotracheal Intubation with Mechanical Ventilation , Lanette Dumas

The Effect of Hope on the Relationship between Personal and Disease Characteristics and Anxiety and Depression in Adolescents and Young Adults with Cancer , Sharon B. McNeil

Predictors of Nonadherence to Radiation Therapy Schedules Among Head and Neck Cancer Patients , Jennifer Lynn Miller

Theses/Dissertations from 2019 2019

Perceived Discrimination and Cardiovascular Outcomes in Blacks: A Secondary Data Analysis of the Heart SCORE Study , Marilyn Aluoch

Exploration of Gratitude in Cardiovascular Health: Mediators, Medication Adherence and Psychometrics , Lakeshia A. Cousin

Theses/Dissertations from 2018 2018

Fatigue-related Symptom Clusters and their Relationship with Depression, and Functional Status in Older Adults Hospice Patients with Cancer. , Suzan Fouad Abduljawad

Genetic Moderation of Pain and Fatigue Symptoms Resulting from the Mindfulness-Based Stress Reduction for Breast Cancer Program , Carissa Bea Alinat

The Moderating Effect of Religion on Death Distress and Quality of Life between Christian Cancer patients in the United States with Muslim cancer patients in Saudi Arabia , Doaa Almostadi

Prevention of Post Intensive Care Syndrome-Family with Sensation Awareness Focused Training Intervention: A Randomized Controlled Trial Pilot Study , Paula L. Cairns

Assessing Abstinence in Infants Greater Than 28 Days Old , Genieveve J. Cline

The Relationship Between Sleep Quality and Motor Function in Hospitalized Older Adult Survivors of Critical Illness , Maya N. Elías

The Role of Migration-Related Stress in Depression Among Haitian Immigrants in Florida: A Mixed Method Sequential Explanatory Approach , Dany Amanda C. Fanfan

The Effect of Depression, Inflammation and Sleep Quality on Risk for Cardiovascular Disease , Catherine L. O'Neil

Adapting SafeMedicate (Medication Dosage Calculation Skills software) For Use In Brazil , Samia Valeria Ozorio Dutra

Theses/Dissertations from 2017 2017

The Relationship Between Total Neuropathy Score-reduced, Neuropathy Symptoms and Function. , Ashraf Abulhaija

Validation of the Electronic Kids Dietary Index (E-KINDEX) Screening Tool for Early Identification of Risk for Overweight/Obesity (OW/OB) in a Pediatric Population: Associations with Quality of Life Perceptions , Patricia A. Hall

Theses/Dissertations from 2016 2016

The Effectiveness of an Intervention Designed to Improve Chlorhexidine (CHG) Bathing Technique in Adults Hospitalized in Medical Surgical Units , Janette Echemendia Denny

Levels of Distress Among Women Veterans Attending a Women’s Health Specialty Clinic in the VA Healthcare System , Debbie T. Devine

Examination of the Use of Accelerated Resolution Therapy (ART) in the Treatment of Symptoms of PTSD and Sleep Dysfunction in Veterans and Civilians , Marian Jevone Hardwick

Investigating the Mutual Effects of Depression and Spiritual Well-being on Quality of Life in Hospice Patients with Cancer and Family Caregivers Using the Actor-Partner Interdependence Model , Li-Ting Huang

The Change in Nutritional Status in Traumatic Brain Injury Patients: A Retrospective Descriptive A Retrospective Descriptive Study , Dina A. Masha'al

Exploring the Relationship Between Severity of Illness and Human Milk Volume in Very Low Birth Weight and Extremely Low Birth Weight Infants Over Six Weeks , Shannon Leigh Morse

Cardiovascular Disease Risk Scores and Novel Risk Factors in Relation to Race and Gender , Johanna Wilson

Theses/Dissertations from 2015 2015

A Comparative Evaluation of the Learner Centered Grading Debriefing Method in Nursing Education , Marisa J. Belote

Sleep, Depressive Symptoms and Cognition in Older Adults and Caregivers of Persons with Dementia , Glenna Shemida Brewster

The Relationship between Hearing Status and Cognitive Performance and the Influence of Depressive Symptoms in the Older Adult , Julie A. Daugherty

Basal Salivary Oxytocin and Skin to Skin Contact among Lactating Mothers of Premature Infants , Jessica Marie Gordon

The Relationship Between Nurses' Emotional Intelligence and Patient Outcomes , Mary Kutash

Sexual Functioning and Body Image in Younger Breast Cancer Survivors , Carly Lynn Paterson

Cognitive Load of Registered Nurses During Medication Administration , Sarah Faith Perron

A Comparison of Quality of Life between Intense and Non-Intense Treatment for Patients with Acute Myeloid Leukemia and High-Risk Myelodysplastic Syndrome , Sara Marie Tinsley

Theses/Dissertations from 2014 2014

Acculturation, Self-Efficacy and Breastfeeding Behavior in a Sample of Hispanic Women , Ivonne F. Hernandez

Knowledge and Acceptance of HPV and the HPV Vaccine in Young Men and Their Intention to be Vaccinated , Brenda Renee Jasper

The Relationships Between Sleep Disturbances, Depression, Inflammatory Markers, and Sexual Trauma in Female Veterans , Ellen Marcolongo

Examination of Possible Protective Effect of Rhesus D Positive Blood Factor on Toxoplasma-related Depressive Symptoms in Pregnancy , Lisa Lynn Parnell

Knowledge, Attitudes, and Practice of Primary Care Nurse Practitioners Regarding Skin Cancer Assessmnets: Validity and Reliability of a New Instrument , Debra Michelle Shelby

Theses/Dissertations from 2013 2013

Knowledge and Practice of Reproductive Health among Mothers and their Impact on Fetal Birth Outcomes: A Case of Eritrea , Winta Negusse Araya

Race/Ethnicity, Subjective and Objective Sleep Quality, Physical and Psychological Symptoms in Breast Cancer Survivors , Pinky H. Budhrani

Factors Predicting Pap Smear Adherence in HIV-infected Women: Using the Health Belief Model , Crystal L. Chapman Lambert

The Relationship Between Socioeconomic Status and Body Mass Index on Vitamin D Levels in African American Women with and without Diabetes Living in Areas with Abundant Sunshine , Shani Vann Davis

Predictors of Quality of Life in Patients with Cutaneous T cell Lymphoma , Darcie Marie Deaver

Relationship between dysphoric moods, risk-taking behaviors, and Toxoplasma gondii antibody titers in female veterans , Allyson Radford Duffy

Prenatal Stress, Depression, and Herpes Viral Titers , Pao-Chu Hsu

Factors Associated with Fear of Breast Cancer Recurrence Among Survivors , Jean Marie Lucas

Sickle Cell Disease: The Role of Self-Care Management , Nadine Matthie

Factors Influencing Vaccination Decisions in African American Mothers of Preschool Age Children , Chauntel Mckenzie Mcnair

The Strong Black Woman, Depression, and Emotional Eating , Michelle Renee Offutt

Development of an Investigator-designed Questionnaire Concerning Childbirth Delivery Options based on the Theory of Planned Behavior , Chun-Yi Tai

Theses/Dissertations from 2012 2012

The Mediating Effect of Distress Caused by Constipation on Predictors of Quality of Life of Hospice Patients with Cancer. , Abdel Alkhalouf

Testing a Model of Bacterial Vaginosis among Black Women , Jessica Brumley

The Effect of Tight Glycemic Control on Surgical Site Infection Rates in Patients Undergoing Open Heart Surgery , Sierra Gower

Development of a Tool for Pressure Ulcer Risk Assessment and Preventive Interventions in Ancillary Services Patients , Monica Shutts Messer

Hospice Nurses- Attitudes and Knowledge about Pain Management , Amie Jacqueline Miller

Theses/Dissertations from 2011 2011

Literacy and Hazard Communication Comprehension of Employees Presenting to an Occupational Health Clinic , Christine Bouchard

A Meta-Analysis of Cultural Competence Education in Professional Nurses and Nursing Students , Ruth Wilmer Gallagher

Relationship Between Cancer-Related Fatigue and Depression: A Pilot Study , Gloria Michelle Guess

A Comparison of Oncology and Non-Oncology Nurses in Their Knowledge of Cancer Pain Management , Nicole Houle

Evaluating Knowledge and Attitudes of Graduate Nursing Students Regarding Pain , Eric Bartholomew Jackson

Bone Marrow Transplant Nurses' Attitudes about Caring for Patients Who are Near the End of Life: A Quality Improvement Project , Leslie Lauersdorf

Translation and Adaptation of the Center for Epidemiologic Studies-Depression (CES-D) Scale Into Tigrigna Language for Tigrigna Speaking Eritrean Immigrants in the United States , Mulubrhan Fisseha Mogos

Nurse Manager Emotional Intelligence as a Predictor to Registered Nurse Job Satisfaction and RN Perceptions of the Practice Environment and the Relationship to Patient, Nursing and Hospital Outcomes , Jacqueline Cecilia Munro

The Relationship of Mid-Pregnancy Levels of Cytokines, Stress, and Depression with Gestational Age at Delivery , Melissa Molinari Shelton

Prophylactic, Risk-Reducing Surgery in Unaffected BRCA-Positive Women: Quality Of Life, Sexual Functioning and Psychological Well-Being , Sharon Tollin

Theses/Dissertations from 2010 2010

The Relationship Between FAM5C SNP (rs10920501) Variability, Metabolic Syndrome, and Inflammation, in Women with Coronary Heart Disease , Jennifer L. Cline

Women’s Perceptions of Postpartum Stress: A Narrative Analysis , Nancy Gilbert Crist

Lived Experience: Near-Fatal Adolescent Suicide Attempt , Phyllis Ann Dougherty

Exploring the Relationships among Work-Related Stress, Quality of Life, Job Satisfaction, and Anticipated Turnover on Nursing Units with Clinical Nurse Leaders , Mary Kohler

A Comparative Study of Knowledge of Pain Management in Certified and Non-Certified Oncology Nurses , Sherrie A. LaLande

Evaluating Knowledge and Attitudes of Undergraduate Nursing Students Regarding Pain Management , Jessica Latchman

Evaluation of Oncology Nurses' Knowledge, Practice Behaviors, and Confidence Specific to Chemotherapy Induced Peripheral Neuropathy , Rebecca Denise McAllister

Moderating the Effectiveness of Messages to Promote Physical Activity in Type 2 Diabetes , Rachel E. Myers

Factors Affecting the Process of Clinical Decision-Making in Pediatric Pain Management by Emergency Department Nurses , Teresa A. Russo

The Correlation Between Neuropathy Limitations and Depression in Chemotherapy Patients , Melissa Thebeau

Theses/Dissertations from 2009 2009

Fatigue Symptom Distress and Its Relationship with Quality Of Life in Adult Stem Cell Transplant Survivors , Suzan Fouad Abduljawad R.N., B.S.N.

Nursing Advocacy and the Accuracy of Intravenous to Oral Opioid Conversion at Discharge in the Cancer Patient , Maria L. Gallo R.N., O.C.N.

Transitional Care for Adolescents with HIV: Characteristics and Current Practices of the Adolescent Trials Network Systems of Care , Patricia Gilliam

The Effect of Ethical Ideology and Professional Values on Registered Nurses’ Intentions to Act Accountably , Susan R. Hartranft

Falls in Bone Marrow Transplant Patients: A Retrospective Study , Lura Henderson R.N., B.S.N.

Predictors of cancer caregiver depression symptomatology , Henry R. Rivera

Psychosocial outcomes of weight stigma among college students , Sabrina Joann Robinson

The Experience of Fatigue and Quality of Life in Patients with Advanced Lung Cancer , Andrea Shaffer

The Relationship Between Uncertainty in Illness and Anxiety in Patients With Cancer , Naima Vera

Shifting Paradigms: The Development of Nursing Identity in Foreign-Educated Physicians Retrained as Nurses Practicing in the United States , Liwliwa Reyes Villagomeza

Theses/Dissertations from 2008 2008

Prostate Cancer Screening Intention Among African American Men: An Instrument Development Study , Susan Anita Baker

The Geriatric Cancer Experience in End of Life: Model Adaptation and Testing , Harleah G. Buck

Communication Systems and HIV/AIDS Sexual Decision Making in Older Adolescent and Young Adult Females , Rasheeta D. Chandler MS, ARNP, FNP-BC

Relationship of Anger Trait and Anger Expression to C-Reactive Protein in Post-Menopausal Women , Rosalyn Gross

Identifying Patients with Cancer at Risk of Experiencing a Fall While Hospitalized , Joann M. Heaton

Modulation of Monocyte-Derived Dendritic Cell Maturation and Function by Cigarette Smoke Condensate in a Bronchial Epithelial Cell Co-Culture Model , Alison J. Montpetit

Cancer Patients with Pain: Examination of the Role of the Spouse/Partner Relationship In Mediating Quality of Life Outcomes for the Couple , Mary Ann Morgan

Development of an Ecological Model to Predict Risk for Acquisition of Clostridium difficile -Associated Diarrhea During Acute Care Hospitalization , Susan Elaine Steele

Development and Psychometric Evaluation of the Chemotherapy Induced Peripheral Neuropathy Assessment Tool , Cindy S. Tofthagen

Health Decision Behaviors: Appropriateness of Dietary Choice , Daryle Hermelin Wane

Theses/Dissertations from 2007 2007

The Relationship Between Sleep-Wake Disturbance and Pain in Cancer Patients Admitted to Hospice Home Care , Marjorie Acierno

Wheelchair Positioning and Pulmonary Function in Children with Cerebral Palsy , Lee Barks

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Dissertation examples

Listed below are some of the best examples of research projects and dissertations from undergraduate and taught postgraduate students at the University of Leeds We have not been able to gather examples from all schools. The module requirements for research projects may have changed since these examples were written. Refer to your module guidelines to make sure that you address all of the current assessment criteria. Some of the examples below are only available to access on campus.

• Undergraduate examples
• Taught Masters examples

• Open access
• Published: 03 June 2024

Evaluating competency-based medical education: a systematized review of current practices

• Nouf Sulaiman Alharbi 1 , 2 , 3  

BMC Medical Education volume  24 , Article number:  612 ( 2024 ) Cite this article

183 Accesses

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Metrics details

Few published articles provide a comprehensive overview of the available evidence on the topic of evaluating competency-based medical education (CBME) curricula. The purpose of this review is therefore to synthesize the available evidence on the evaluation practices for competency-based curricula employed in schools and programs for undergraduate and postgraduate health professionals.

This systematized review was conducted following the systematic reviews approach with minor modifications to synthesize the findings of published studies that examined the evaluation of CBME undergraduate and postgraduate programs for health professionals.

Thirty-eight articles met the inclusion criteria and reported evaluation practices in CBME curricula from various countries and regions worldwide, such as Canada, China, Turkey, and West Africa. 57% of the evaluated programs were at the postgraduate level, and 71% were in the field of medicine. The results revealed variation in reporting evaluation practices, with numerous studies failing to clarify evaluations’ objectives, approaches, tools, and standards as well as how evaluations were reported and communicated. It was noted that questionnaires were the primary tool employed for evaluating programs, often combined with interviews or focus groups. Furthermore, the utilized evaluation standards considered the well-known competencies framework, specialized association guidelines, and accreditation criteria.

This review calls attention to the importance of ensuring that reports of evaluation experiences include certain essential elements of evaluation to better inform theory and practice.

Peer Review reports

Medical education worldwide is embracing the move toward outcome-based education (OBME) [ 1 , 2 ]. One of the most popular outcome-based approaches being widely adopted by medical schools worldwide is competency-based medical education (CBME) [ 3 ]. CBME considers competencies as the ultimate outcomes that should guide curriculum development at all steps or stages—that is, implementation, assessment, and evaluation [ 3 , 4 , 5 ]. To embrace CBME and prepare medical students for practice, medical educators usually utilize an organized national or international competency framework that describes the abilities that physicians must possess to meet the needs of patients and society. There are numerous global competency frameworks that reflect the characteristics of a competent doctor, for example, CanMEDS, Scottish Doctor, Medical School Projects, ACGME Outcome Project, the Netherlands National Framework, and Saudi Meds [ 1 , 6 , 7 , 8 ].

With the worldwide implementation of CBME and availability of different competency frameworks, educators are expected to evaluate various modifications made to existing medical curricula [ 9 , 10 ]. Such evaluation is intended to explore whether the program is operating as planned and its outcomes are achieved as intended in comparison to predetermined standards as well as to ensure improvement [ 11 , 12 , 13 ]. Furthermore, program evaluation revolves around two main concepts, that is, merit and worth [ 12 , 14 ]. In 1981, Guba and Lincoln explained that the merits of a program are intrinsic, implicit, and independent and do not refer to a specific context or application, while evaluating a program’s worth entails judging the value of any aspect of it in reference to a certain context or precise application [ 12 , 14 ].

To enable educators to determine the merits and worth of an educational program or curriculum, evaluation experts have proposed several models [ 14 , 15 ]. Evaluation models are guiding frameworks that demonstrate what appropriate evaluation looks like and detail how it should be designed and implemented [ 16 ]. Although almost all evaluation models focus on exploring whether a program attains its objectives, they vary in numerous aspects, including their evaluation philosophy, approaches, and the specific areas that they encompass [ 17 ].

It is essential that educators choose a suitable evaluation model when they implement CBME, as the right model will enable them to pinpoint [ 15 , 18 , 19 ]. In other words, a program helps identify areas of success, challenges, and opportunities for improvement in CBME implementation, leading to a deeper comprehension of CBME strategies and their effectiveness. Moreover, implementing CBME demands significant efforts and a wide range of financial, human, time, and infrastructure resources [ 20 ]. Thus, ensuring that these efforts and resources are well utilized to enhance educational and healthcare outcomes is crucial. In addition, evaluation provides valuable evidence for accreditation, quality assurance, policies, and guidelines. Otherwise put, it supports informed decision-making on many levels [ 21 ]. On another front, sharing evaluation results and being transparent about evaluation processes can enhance public trust in available programs, colleges, and universities [ 19 ]. However, deciding which evaluation model to adopt can be challenging [ 9 ].

Not only can it be difficult to select an appropriate model to evaluate a CBME program, but CBME evaluation itself has numerous challenges, particularly given the lack of a common definition or standardized description of what constitutes a CBME program [ 9 , 22 , 23 ]. The complexity of CBME further tangles evaluation efforts, given the multilayered nature of CBME’s activities and outcomes and the need to engage a wide variety of stakeholders [ 11 ]. Moreover, the scarcity and variable quality of reporting in studies focusing on the evaluation of CBME curricula exacerbate these challenges [ 24 ]. Furthermore, few published articles provide a comprehensive overview of available evidence on the topic.

This review is therefore designed to synthesize the findings of published studies that have reported CBME evaluation practices in undergraduate and postgraduate medical schools and programs. Its objective is to explore which CBME program evaluation practices have been reported in the literature by inspecting which evaluation objectives, models, tools, and standards were described in the included studies. In addition, the review inspects the results of evaluations and how they were shared. Thus, the review will serve in supporting educators to make evidence-based decisions when designing a CBME program. In addition, it will provide a useful resource for educators to embrace what was done right, learn from what was done wrong, improve many current evaluation practices, and compare different CBME interventions across various contexts.

Following a preliminary search within relevant journals for publications addressing evaluation practices utilized to assess competency-based curricula in medical education, the researcher used the PEO (participant, educational aspect, and outcomes) model to set and formulate the search question [ 24 ] as follows: participants : healthcare professionals and healthcare profession students; educational aspect : CBME curricula; outcome : program evaluation practices.

Next, the researcher created a clear plan for the review protocol. This review is classified as a systematized review rather than a systematic review [ 25 ]. While it does not meet the criteria for a systematic review because it relies on a single researcher and does not evaluate the quality of the studies included, it adheres to most of the steps outlined in the “Systematic Reviews in Medical Education: A Practical Approach: AMEE guide 94” [ 26 ]. Moreover, the researcher met with a medical educator with a strong background in CBME, an expert in review methods, and a librarian who is an expert in available databases and provided guidance and support for navigating such databases. Feedback was obtained from all three and used to finalize the review protocol. The protocol was followed to ensure that the research progressed in a consistent and systematized manner.

For this review, full-text articles published in peer-reviewed journals in English from 1 January 2000 to 31 December 2022 were searched within the following electronic data bases: PubMed, ERIC, Education Source, and CINHAL. The following terms were utilized to conduct the search: (Competency Based Medical Education OR Outcome Based Medical Education) AND (Evaluation OR assessment) AND (Undergraduate OR Postgraduate) AND (Implementing OR Performance OR Framework OR Program* OR Project OR Curriculum OR Outcome) (Additional file 1 ).

The researcher included articles that were published in English and reported evaluation practices for CBME or OBME curricula whether for undergraduate or postgraduate healthcare professionals. The researcher did not consider research reviews, commentaries, perspective articles, conference proceedings, and graduate theses in this review. In addition, articles that addressed students’ assessments rather than program evaluation were not included. Furthermore, articles that focused on teaching a particular skill (e.g., communication skills) or specific educational strategies (e.g., the effectiveness of Problem Based Learning) were excluded from this review.

To facilitate the screening of articles and ensure the process was properly documented, an online review software that streamlines the production of reviews (Covidence) was utilized, and all the lists of articles retrieved from the specified databases were uploaded to the tool website (available at www.covidence.org ). The tool set the screening to start with the titles and abstracts then to proceed to full texts. During these stages, the reasons for excluding an article were precisely noted. Moreover, the PRISMA diagram (available at http://www.prisma-statement.org/ ) was produced by Covidence to illustrate the process of screening and including articles in this review.

After the decision was made to include an article, a data extraction tool created for the purpose of this review was used (Additional file 2 ). Since the term “program evaluation practices” is general and does not clearly define the method or focus of the analysis involved in critiquing evaluation efforts, the analysis of available evaluation practices in this review was based on the Embedded Evaluation Model (EEM) provided by Giancola (2020) for educators to consider when embedding evaluations into educational program designs and development [ 27 ]. The EEM outlines several steps. In the first step, “Define,” educators are expected to build an understanding of the evaluated program, including its logic and context. In the second step, “Plan,” educators must establish the evaluation-specific objectives and questions and select the model or approach along with the methods or tools that will be utilized to achieve those objectives. The next step, “Implement and Analyze,” requires educators to determine how the data will be collected, analyzed, and managed. In the fourth step, “Interpret the Results,” educators are expected to derive insights from the results in terms of how the evaluation can help with resolving issues and improving the program as well as how the results should be communicated and employed. Finally, in the “Inform and Refine” step, educators should focus on applying the results to realize improvements to the program and promote accountability [ 27 ].

In addition to supporting the aim of the current review, the theoretical insights from Giancola (2020) help to ensure alignment with best practices in curriculum evaluation. Thus, for each article, the extraction tool collected the following information: the author, the publication year, the country and name of the institution that implemented the CBME curriculum, the aim and method of the article, the type of curriculum based on the health profession specialty (e.g., medicine, nursing), the level of the curriculum (postgraduate or undergraduate), the evaluation objective, the approach/model or tool, the evaluation standard, the evaluation results, and the sharing of the evaluation results. The extracted information points are essential to contextualize the evaluation and allow educators to make sense of it and adapt or adjust it to their own situations. Understanding the context of an evaluation is important considering the wide variety of available educational environments, the diversity of evaluators, and the differences in goals, modes, and benchmarks for evaluation, all of which influence how an evaluation is framed and conducted [ 27 ].

The author, publication year , and name and country of the institution that implemented the CBME curriculum provide identifiers for the original article and enable educators to seek further information about a study. The aim and method of the article were highlighted because they clarify the general context in which the evaluation was conducted. For example, this information can help educators understand whether an evaluation was carried out as a single action in response to a certain problem or was a phase or part of a larger project. The type of curriculum based on the health profession specialty (e.g., medicine, nursing) along with the level of the curriculum (postgraduate or undergraduate) have specific implications related to the nature of each specialty and the level of the competencies associated with the advancement of the program. All of the previously mentioned information is vital for educators to define and understand the program they are aiming to evaluate, which is the first step in the EEM. The evaluation objective , approach/model or tool , evaluation standard , evaluation results , and sharing of the evaluation results help to answer the research question of the current review by dissecting various aspects of the evaluation activities. In addition, the reporting of these aspects provides valuable insight into evaluation directives, plans, and execution. For educators, the evaluation objective usually clarifies the focus of the evaluation (e.g., how the program was implemented, the action done to execute education or outcomes of the program, and its effectiveness). The approach/model or tool of an evaluation is a core element of the design and implementation of the evaluation, as it determines the theoretical guidelines that underlie the evaluation and the practical steps for its execution. Based on the evaluation standard, which refers to the target used to compare the evidence or results of the evaluation, educators can judge the relevance of the evaluation to their own practices or activities. This information aligns with steps two and three of the EEM. The evaluation results are the results of the evaluation, which form the cornerstone for emerging solutions or future improvements. Finally, sharing the evaluation results , or communicating the evaluation, is a key part of handling the results and working toward their application. This information is aligned with steps four and five of the EEM.

Search results

Searching the identified databases revealed a total of 640 articles, and 183 total duplicates were removed. A total of 457 articles was considered for screening (371 PubMed, 13 ERIC, 23 Education Source, 50 CINHAL) (Fig.  1 ). Of those articles, 87 were retrieved for full-text screening. Ultimately, 38 studies met the inclusion criteria and were considered eligible to be included in the current review.

Flowchart illustrating the process of including articles in the review

Findings of the included studies

The 38 studies that met the inclusion criteria were published between 2010 and 2021, and the majority (15%; n  = 6) were published in 2019. The studies represented the following countries: Canada (37%, n  = 14) [ 10 , 11 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ], USA (27.5%, n  = 11) [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ], Australia (5%, n  = 2) [ 51 , 52 ], China (5%, n  = 2) [ 53 , 54 ], Dutch Caribbean islands (2.5%, n  = 1) [ 55 ], Germany (2.5%, n  = 1) [ 56 ], Guatemala (2.5%, n  = 1) [ 57 ], Korea (2.5%, n  = 1) [ 58 ], the Netherlands (2.5%, n  = 1) [ 59 ], New Zealand (2.5%, n  = 1) [ 60 ], The Republic of Haiti (2.5%, n  = 1) [ 61 ], Turkey (2.5%, n  = 1) [ 62 ], and the region of West Africa (2.5%, n  = 1) [ 63 ].

According to the evidence synthesized from the included studies, most of the evaluation practices were reported in competency-based curricula that targeted the level of postgraduate professionals (57%, n  = 22) and were medical in nature (71%, n  = 27) (Fig.  2 ).

Curricula specialties in included articles

The findings showed that 37% ( n  = 14) of the articles did not report the precise objective of evaluating the curriculum. Moreover, 84% ( n  = 32) did not report the evaluation approach or model used to assess the described curricula. The approaches or models reported include Pawson’s model of realist program evaluation [ 37 ], theory-based evaluation approaches [ 10 ], Stufflebeam’s context, inputs, processes, and products (CIPP) model [ 62 ], the concerns-based adoption model, sensemaking and outcome harvesting [ 33 ]the CIPP model [ 48 ], and quality improvement (QI) for program and process improvement [ 50 ]. On the other hand, a wide variety of evaluation tools was reported including observations (3%, n  = 1) [ 28 ] surveys or questionnaires (58%, n  = 22) [ 10 , 28 , 29 , 31 , 34 , 35 , 36 , 38 , 39 , 41 , 42 , 45 , 49 , 50 , 51 , 52 , 53 , 55 , 56 , 58 , 59 , 63 ] interviews (16%, n  = 6) [ 10 , 28 , 37 , 41 , 47 , 62 ], focus groups (13%, n  = 5) [ 35 , 37 , 41 , 50 , 59 ], historical document review or analysis (8%, n  = 3) [ 10 , 29 , 33 ], educational activity assessment or analysis of the activity by separate reviewers (5%, n  = 2) [ 55 , 61 ], stakeholder discussions or reports about their inputs (5%, n  = 2) [ 43 , 44 ], curriculum mapping (3%, n  = 1) [ 32 ], feedback from external reviews from accrediting bodies (3%, n  = 1) [ 32 ], the Dundee Ready Education Environment Measure (DREEM) (3%, n  = 1) [ 56 ], and students’ or participants’ assessments (5%, n  = 2) [ 38 , 46 ].

Of the studies, 37% ( n  = 14) utilized multi methods [ 10 , 28 , 29 , 30 , 32 , 34 , 35 , 37 , 38 , 41 , 48 , 52 , 56 , 59 ]. Furthermore, 7.8% ( n  = 3) of the studies reported the nature of the tool, for example, quantitative or qualitative, without specifying the exact tool utilized [ 57 , 60 ]. Moreover, 63% ( n  = 24) of the studies included in this review did not report the evaluation standards applied while assessing the competency-based curricula addressed. Yet, those studies that reported their standards were stated in various ways as follows: some publications referred to the standards of specific specialized associations or societies, such as the American Academy of Family Physicians and College of Family Physicians Canada [ 61 ], Royal Australian and New Zealand College of Psychiatrists [ 60 ], and The American Association of Occupational Health Nurses [ 45 ]. Other publications utilized known competency frameworks as their standards, such as CanMED [ 36 , 37 , 59 ], or the competencies of the American Board of Surgery [ 43 ] Association of Canadian Faculties of Dentistry [ 31 ], Royal College of Ophthalmologists [ 52 ], The Florida Consortium for Geriatric Medical Education [ 50 ], or the Dutch Advisory Board for Postgraduate Curriculum Development for Medical Specialists [ 59 ]. Furthermore, many of the publications referred to accreditation standards, such as the Accreditation Standards of the Australian Medical Council [ 51 ], Competencies of Accreditation Council for Graduate Medical Education [ 43 ], Accreditation Body in the Competency-based Curriculum [ 32 ], and the Commission on Dental Accreditation of Canada [ 31 ]. All the publications included in the review reported the results of their evaluations.

Finally, the results revealed that almost half (52.6%, n  = 20) of the authors of the articles mentioned that they were publishing their experience with the intent of sharing lessons learned, yet they did not refer to any other means of sharing the results of their evaluations. In contrast, the other half did not mention any measures taken to communicate and share the evaluation results. Additional file 3 includes the characteristics and details of the data extracted from the studies included addressing evaluation practices in healthcare professionals’ education.

Evaluating a curriculum appropriately is important to ensure that the program is operating as intended [ 13 ]. The present study aimed to review the available literature on the evaluation practices of competency-based undergraduate and postgraduate health professionals’ schools and programs. This review inspected which evaluation objectives, models, tools, and standards were described as well as the results of evaluations and how the results were shared. The synthesized evidence indicates that most of the programs reporting evaluation practices were postgraduate-level medical programs. This focus on CMBE among postgraduate programs can be related to the fact that competency-based education is organized around the most critical competencies useful for health professionals after graduation. Thus, they are better judged at practice [ 64 , 65 , 66 ]. Moreover, although competency-based curricula were introduced to many health professions over 60 years ago, such as pharmacology and chiropractic therapy, within the medical field they have only evolved in the last decade [ 67 ].

Furthermore, the data revealed that there is a discrepancy in how evaluation practices were reported in the literature in terms of evaluation objectives, approaches/models, tools, standards, documenting of results, and communication plans. Each area will be further discussed in the following paragraphs considering the ten-task approach and embedded evaluation model [ 27 , 68 ]. Both guide evaluation as an important step in curriculum development in medical education, detail the evaluation process, and outline many important considerations from design to execution [ 27 , 68 ].

Evaluation is a crucial part of curriculum development, and it can serve many purposes, such as ensuring attaining educational objectives, identifying areas of improvement, improving decision-making, and assuring quality [ 13 , 27 ]. Consequently, when addressing evaluation, it is important for educators to start by explaining the logic of the curriculum by asking, for example, what the program’s outcomes are and whether it is designed for postgraduates or undergraduates [ 27 ]. Moreover, educators must be precise in setting evaluation objectives, which entails answering certain questions: who will use the evaluation data; how will the data be used at both the individual and program level; will the evaluation be summative or formative; and what evaluation questions must be answered [ 27 , 68 , 69 ] However, many of the studies included in this review did not clearly explain the context of the curricula or report the objectives of their evaluation endeavors; rather, they settled for clarifying the objectives of the study or of the publication itself. One reason for this is that evaluation and educational research have many similarities [ 13 ] Nevertheless, the distinction between the two should be clarified, as doing so will enable other medical educators to better understand and benefit from the evaluation experience shared. Moreover, since CBME outcomes are complicated and should be considered on many levels, evaluation plans should include a focus, level, and timeline. The focus of an evaluation can be educational, with outcomes relevant to learners, or clinical, with health outcomes relevant to patients. The level of an evaluation can be micro, meso, or macro, targeting an individual, a program, or a system, respectively. The timeline of an evaluation can investigate outcomes during the program, after the program (i.e., how well learners have put what they learned in a CBME program into practice), and in the long term (i.e., how well learners are doing as practicing physicians) [ 70 ].

Once the evaluation objectives are clearly identified and prioritized, it is logical to start considering the evaluation approach or model that is most appropriate to attain these objectives considering the available resources. In other words, evaluation design should be outlined [ 27 , 68 ]. The choice of an evaluation approach or model affects the accuracy of assessing certain tasks carried out by or to specific subjects in a particular setting [ 68 , 71 , 72 , 73 , 74 , 75 ] This accuracy is referred to as an evaluation’s internal validity. Yet, the external validity of an evaluation entails that the evaluation results are generalizable to other subjects and other settings [ 68 ]. Each model has its own strengths and weaknesses, which require careful examination when planning an evaluation [ 14 , 73 , 74 , 75 ]. Explaining and justifying why a particular evaluation approach was chosen for a specific curriculum can enrich the lessons learned from the evaluation and aid other educators. Furthermore, some of the available models were more utilized within various educational contexts than others [ 17 ] that calls for a continuous documentation of the evaluation approaches or models used to inform theory and practice. Considering the importance of reporting the approaches and models used, it is unfortunate that most of the publications did not indicate the approach/model they used for evaluation, which limits educators’ abilities to utilize the plans and build on their evidence.

Another critical task in the evaluation process is deciding on the measurement tool or instrument to be used. The tool choice will determine what data will be gathered and how they will be collected and analyzed [ 27 , 68 ]. Thus, the choice should consider the evaluation objective as well as the uses, strengths, and limitations of each tool. The evidence in this review indicates that questionnaires or surveys were the most utilized tools in evaluating competency-based curricula. This result can be attributed to the advantages of this method (for example, it is a convenient and economical tool that is easy to administer and analyze and can be utilized with many individuals) [ 27 , 68 ]. Nevertheless, it is important to highlight that questionnaires and surveys usually target attitudes and perceptions, which usually entails only a surface-level evaluation, according to the Kirkpatrick model [ 76 ]. The results also showed that in around 50% of the mixed-methods evaluations, the questionnaires were combined with another tool, such as interviews or focus groups. Understandably, utilizing an additional tool aims to deepen the level of the evaluation focus to include learning, behaviors, or results [ 76 ].

The evaluation evidence must be compared with a standard or target for educators to judge the program and make decisions [ 12 ]. Standards can be implicit or explicit, but they usually provide an understanding of what is ideal [ 12 ]. Worryingly, the results of this review revealed that many of the included studies did not clarify the standards they used to judge different CBME curricula. However, the studies that reported their standards used accreditation criteria or broad competencies frameworks, such as CanMeds, which consider the guides of specialized associations, such as family physicians or nursing. Although deciding what standard to use can be challenging to those designing and evaluating programs, evaluating without an understanding of the level of quality desired can lead to many complications and a waste of resources.

Communicating and reporting evaluation results are crucial to attaining the evaluation objectives [ 27 , 68 , 75 ]. Moreover, effective communication strategies have many important functions, such as providing decision makers with the necessary data to make an informed decision. Informing other stakeholders about the results is also important to achieve their support in implementing program changes and nourish a culture of quality [ 77 , 78 ]. Around half of the authors of studies included in this review indicated that they were publishing to share their own evaluation experiences, while the other half did not. Regardless, none of the studies shared or indicated how their results were reported and communicated, which is an important part of the evaluation cycle that should not be overlooked when sharing evaluation lessons within the scientific community. Reporting the results also ensures quality transformation by closing the evaluation cycle and encourages future engagement in evaluation among different stakeholders [ 78 , 79 , 80 ]. Moreover, the results of the evaluation should be shared publicly to contribute to increasing public trust in educational programs and their outcomes [ 19 , 69 ].

In summary, this review of evaluation practices within competency-based curricula for undergraduate and postgraduate health professional programs provides valuable insight into the current landscape. The results of the review show that most evaluation practices published pertain to postgraduate medical programs. In addition, by examining the objectives, models, tools, standards, and communication of evaluation results, this study exposes a discrepancy between the reported evaluation practices and identified evaluation elements. This discrepancy extends to the data that are reported, which makes it even more difficult to synthesize a holistic picture and definitively fulfill the aim of the review. Moreover, the issue of missing information poses serious challenges for educators who try to leverage existing knowledge to inform their curriculum development and improvement efforts, and it highlights the need for a more systematic and transparent approach to evaluation within CBME.

This review illustrates the importance of agreeing on the main evaluation elements to be reported when publishing a CBME evaluation. Establishing a shared understanding of these fundamental elements will give educators a framework for enhancing the practical utility of evaluation methodologies. In addition, educators and practitioners can ensure that the evaluation process yields more insightful outcomes and is better tailored to meet the needs of the educational context.

Data availability

The datasets used during the current study are available from the corresponding author on reasonable request.

Abbreviations

Outcome-Based Medical Education

Competency-Based Medical Education

Embedded Evaluation Model

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Acknowledgements

The author would like to acknowledge the support that Prof. Ahmad Alrumayyan and Dr. Emad Masuadi gave this research by reviewing its protocol and providing general feedback. In addition, the author would like to acknowledge Dr. Noof Albaz for the discussions about educational program evaluation, which contributed to improving the final version of this manuscript. Thanks, are also due to Mr. Mohammad Alsawadi for reviewing the utilized search terminologies and participating in the selection of appropriate databases and searching them to obtain the needed lists of articles.

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Alharbi, N.S. Evaluating competency-based medical education: a systematized review of current practices. BMC Med Educ 24 , 612 (2024). https://doi.org/10.1186/s12909-024-05609-6

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Received : 13 November 2023

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DOI : https://doi.org/10.1186/s12909-024-05609-6

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