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Communication Studies *: The Literature Review

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A literature review surveys scholarly articles, books and other sources relevant to a particular issue, area of research, or theory, and by so doing, providing a description, summary, and critical evaluation of these works. Literature reviews are designed to provide an overview of sources you have explored while researching a particular topic and to demonstrate to your readers how your research fits into the larger field of study.

All contect is from a Literature Review please refer to the sub-tab under The Literature Review created by Dr. Robert Larabee.

Importance of a Good Literature Review

A literature review may consist of simple a summary of key sources, but it usually has an organizational pattern and combines both summary and synthesis, often within specific conceptual categories . A summary is a recap of the important information of the source, but a synthesis is a re-organization, or a reshuffling, of that information in a way that informs how you are planning to investigate a research problem. The analytical features of a literature review might:

• give a new interpretation of old material or combine new with old interpretations,
• trace the intellectual progression of the field, including major debates,
• depending on the situation, evaluate the sources and advise the reader on the most pertinent or relevant, or
• usually in the conclusion of a literature review, identify where gaps exist in how a problem has been researched to date.

The purpose of a literature review is to:

• Place each work in the context of its contribution to the understanding of the research problem being studied,
• Describe the relationship of each work to the others under consideration,
• Identify new ways to interpret, and shed light on any gaps in previous research,
• Resolve conflicts amongst seemingly contradictory previous studies,
• Identify areas of prior scholarship to prevent duplication of effort,
• Point the way in fulfilling a need for additional research, and
• Locate your own research within the context of existing literature.

All contect is from The Literature Review created by Dr. Robert Larabee.

Types of Literature Reviews

As Kennedy (2007) notes*, it is important to think of knowledge in a given field as consisting of three layers. First, there are the primary studies that researchers conduct and publish. Second are the reviews of those studies that summarize and offer new interpretations built from and often extending beyond the original studies. Third, there are the perceptions, conclusions, opinion, and interpretations that are shared informally that become part of the lore of field. In composing a literature review, it is important to note that it is often this third layer of knowledge that is cited as "true" even though it often has only a loose relationship to the primary studies and secondary literature reviews.

Given this, while literature reviews are designed to provide an overview and synthesis of pertinent sources you have explored, there are several approaches to how they can be done, depending upon the type of analysis underpinning your study. Listed below are definitions of types of literature reviews:

Argumentative Review      This form examines literature selectively in order to support or refute an argument, deeply imbedded assumption, or philosophical problem already established in the literature. The purpose is to develop a body of literature that establishes a contrarian viewpoint. Given the value-laden nature of some social science research [e.g., educational reform; immigration control], argumentative approaches to analyzing the literature can be a legitimate and important form of discourse. However, note that they can also introduce problems of bias when they are used to to make summary claims of the sort found in systematic reviews.

Integrative Review      Considered a form of research that reviews, critiques, and synthesizes representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated. The body of literature includes all studies that address related or identical hypotheses. A well-done integrative review meets the same standards as primary research in regard to clarity, rigor, and replication.

Historical Review      Few things rest in isolation from historical precedent. Historical reviews are focused on examining research throughout a period of time, often starting with the first time an issue, concept, theory, phenomena emerged in the literature, then tracing its evolution within the scholarship of a discipline. The purpose is to place research in a historical context to show familiarity with state-of-the-art developments and to identify the likely directions for future research.

Methodological Review      A review does not always focus on what someone said [content], but how they said it [method of analysis]. This approach provides a framework of understanding at different levels (i.e. those of theory, substantive fields, research approaches and data collection and analysis techniques), enables researchers to draw on a wide variety of knowledge ranging from the conceptual level to practical documents for use in fieldwork in the areas of ontological and epistemological consideration, quantitative and qualitative integration, sampling, interviewing, data collection and data analysis, and helps highlight many ethical issues which we should be aware of and consider as we go through our study.

Systematic Review      This form consists of an overview of existing evidence pertinent to a clearly formulated research question, which uses pre-specified and standardized methods to identify and critically appraise relevant research, and to collect, report, and analyse data from the studies that are included in the review. Typically it focuses on a very specific empirical question, often posed in a cause-and-effect form, such as "To what extent does A contribute to B?"

Theoretical Review      The purpose of this form is to concretely examine the corpus of theory that has accumulated in regard to an issue, concept, theory, phenomena. The theoretical literature review help establish what theories already exist, the relationships between them, to what degree the existing theories have been investigated, and to develop new hypotheses to be tested. Often this form is used to help establish a lack of appropriate theories or reveal that current theories are inadequate for explaining new or emerging research problems. The unit of analysis can focus on a theoretical concept or a whole theory or framework.

* Kennedy, Mary M. "Defining a Literature." Educational Researcher 36 (April 2007): 139-147.

Structure and Writing Style

I.  Thinking About Your Literature Review

The structure of a literature review should include the following :

• An overview of the subject, issue or theory under consideration, along with the objectives of the literature review,
• Division of works under review into themes or categories (e.g. works that support of a particular position, those against, and those offering alternative approaches entirely),
• An explanation of how each work is similar to and how it varies from the others,
• Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research

The critical evaluation of each work should consider :

• Provenance -- what are the author's credentials? Are the author's arguments supported by evidence (e.g. primary historical material, case studies, narratives, statistics, recent scientific findings)?
• Objectivity -- is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point?
• Persuasiveness -- which of the author's theses are most/least convincing?
• Value -- are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject?

II.  The Development of the Literature Review

Four stages : 1.  Problem formulation -- which topic or field is being examined and what are its component issues? 2.  Literature search -- finding materials relevant to the subject being explored. 3.  Data evaluation -- determining which literature makes a significant contribution to the understanding of the topic. 4.  Analysis and interpretation -- discussing the findings and conclusions of pertinent literature.

Consider the following issues before writing the literature review: Clarify If your assignment is not very specific about what form your literature review should take, seek clarification from your professor by asking these questions: 1.  Roughly how many sources should I include? 2.  What types of sources should I review (books, journal articles, websites)? 3.  Should I summarize, synthesize, or critique your sources by discussing a common theme or issue? 4.  Should I evaluate the sources? 5.  Should I provide subheadings and other background information, such as definitions and/or a history? Find Models Use the exercise of reviewing the literature to examine how authors in your discipline or area of interest have composed their literature reviews. Read them to get a sense of the types of themes you might want to look for in your own research or ways to organize your final review. The bibliography or reference section of sources you've already read are also excellent entry points into your own research. Narrow the Topic The narrower your topic, the easier it will be to limit the number of sources you need to read in order to obtain a good survey of relevant resources. Your professor will probably not expect you to read everything that's available about the topic, but you'll make your job easier if you first limit scope of the research problem. A good strategy is to begin by searching the HOMER catalog for books about the topic and review their contents for chapters that focus on more specific issues. You can also review the subject indexes of books to find references to specific issues that can serve as the focus of your research. For example, a book surveying the history of the Israeli-Palestinian conflict may include a chapter on the role Egypt has played in mediating the conflict. Consider Whether Your Sources are Current Some disciplines require that you use information that is as current as possible. This is very common in the sciences where research conducted only two years ago could be obsolete. However, when writing a review in the social sciences, a survey of the history of the literature may be what is needed because what is important is how perspectives have changed over the years or within a certain time period. Try sorting through some other current bibliographies or literature reviews in the field to get a sense of what your discipline expects. You can also use this method to consider what is consider by scholars to be a "hot topic" and what is not.

III.  Ways to Organize Your Literature Review

Chronological of Events If your review follows the chronological method, you could write about the materials according to when they were published. This approach should only be followed if a clear path of research building on previous research can be identified and that these trends follow a clear chronological order of development. For example, a literature review that focuses on continuing research about the emergence of German economic power after the fall of the Soviet Union. By Publication Order your sources by publication chronology, then, only if the order demonstrates a more important trend. For instance, you could order a review of literature on environmental studies of brown fields if the progression of revealed a change in the soil collection practices of the researchers who wrote and/or conducted the studies. Thematic (“conceptual categories”) Thematic reviews of literature are organized around a topic or issue, rather than the progression of time. However, progression of time may still be an important factor in a thematic review. For example, a review of the Internet’s impact on American presidential politics could focus on the development of online political satire. While the study focuses on one topic, the Internet’s impact on American presidential politics, it will still be organized chronologically reflecting technological developments in media. The only difference here between a "chronological" and a "thematic" approach is what is emphasized the most: the role of the Internet in presidential politics. Note however that more authentic thematic reviews tend to break away from chronological order. A review organized in this manner would shift between time periods within each section according to the point made. Methodological A methodological approach focuses on the methods utilized by the researcher. For the Interbnet in American presidential politics project, one methodological approach would be to look at cultural differences between the portrayal of American presidents on American, British, and French websites. Or the review might focus on the fundraising impact of the Internet on a particular political party. A methodological scope will influence either the types of documents in the review or the way in which these documents are discussed.

Other Sections of Your Literature Review Once you've decided on the organizational method for your literature review, the sections you need to include in the paper should be easy to figure out because they arise from your organizational strategy. In other words, a chronological review would have subsections for each vital time period; a thematic review would have subtopics based upon factors that relate to the theme or issue. However, sometimes you may need to add additional sections that are necessary for your study, but do not fit in the organizational strategy of the body. What other sections you include in the body is up to you but include only what is necessary for the reader to locate your study within the larger scholarship framework.

Here are examples of other sections you may need to include depending on the type of review you write:

• Current Situation : information necessary to understand the topic or focus of the literature review.
• History : the chronological progression of the field, the literature, or an idea that is necessary to understand the literature review, if the body of the literature review is not already a chronology.
• Selection Methods : the criteria you used to select (and perhaps exclude) sources in your literature review. For instance, you might explain that your review includes only peer-reviewed articles and journals.
• Standards : the way in which you present your information.
• Questions for Further Research : What questions about the field has the review sparked? How will you further your research as a result of the review?

IV.  Writing Your Literature Review

Once you've settled on how to organize your literature review, you're ready to write each section. When writing your review, keep in mind these issues.

Use Evidence A literature review in this sense is just like any other academic research paper. Your interpretation of the available sources must be backed up with evidence to show that what you are saying is valid. Be Selective Select only the most important points in each source to highlight in the review. The type of information you choose to mention should relate directly to the research problem, whether it is thematic, methodological, or chronological. Use Quotes Sparingly Some short quotes are okay if you want to emphasize a point, or if what the author said just cannot be rewritten in your own words. Sometimes you may need to quote certain terms that were coined by the author, not common knowledge, or taken directly from the study. Do not use extensive quotes as a substitute your own summary and interpretation of the literature. Summarize and Synthesize Remember to summarize and synthesize your sources within each paragraph as well as throughout the review. Recapitulate important features of a research study, but then synthesize it by rephrasing the study's significance and relating it to their own work. Keep Your Own Voice While the literature review presents others' ideas, your voice (the writer's) should remain front and center. For example, weave references to other sources into what you are writing but maintain your own voice by starting and ending the paragraph with your own ideas and wording. Use Caution When Paraphrasing When paraphrasing a source that is not your own, be sure to represent the author's information or opinions accurately and in your own words. Even when paraphrasing an author’s work, you still must provide a citation to that work.

V.  Common Mistakes to Avoid

The most common mistakes made in reviewing social science research literature are that the researcher:

• does not clearly relate the findings of the literature review to the research problem;
• does not take sufficient time to define and identify the most relevent sources to use in the literature review related to the research problem;
• relies exclusively on secondary analytical sources rather than including primary research studies or data;
• uncritically accepts another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis;
• does not describe the search procedures that were used in the literature review;
• reports isolated statistical results rather than sythesizing them in chi-squared or meta-analytic methods; and,
• only includes research that validates assumptions and does not consider contrary findings and alternative interpretations found in the literature.

Writing Tip

Break Out of Your Disciplinary Box!

Thinking interdisciplinarily about a research problem can be a rewarding exercise in applying new ideas, theories, or concepts to an old problem. For example, what might cultural anthropologists say about the continuing conflict in the Middle East? In what ways might geographers view the need for better distribution of social service agencies in large cities than how social workers might study the issue? You don’t want to substitute a thorough review of core research literature in your discipline for studies conducted in other fields of study. However, particularly in the social sciences, thinking about research problems from multiple vectors is a key strategy for finding new solutions. Consult with a librarian about identifying research databases in other disciplines; almost every discipline has at least one comprehensive database devoted to indexing its research literature.

Another Writing Tip

Don't Just Review for Content!

While conducting a review of the literature, maximize the time you devote to this part of writing a research paper by thinking broadly about what you should be looking for and evaluating. Review not just what scholars are saying, but how are they saying it. How are they structuring their ideas? What methods have they used to study the problem? What sources have they cited to support of their conclusions? How have they used non-textual elements [e.g., charts, graphs, figures, etc.] to illustrate key points?

Yet Another Writing Tip

When Do I Know I Can Stop Looking and Move On?

Here are several strategies you can utilize to assess whether you've adequately reviewed the research literature:

• Look for repeating patterns in the research findings . If the same thing is being said, just by different people, then this likely demonstrates that the research problem has hit a dead end. At this point consider: Does your study extend current research?  Does it forge as new path? Or, does is merely add more of the same thing being said?
• Look at the sources authors cite to in their work . If you begin to see the same researchers cited again and again, then this is often an indication that no new ideas have been introduced to the research question.
• Search the World of Knowledge Citation database and Google Scholar to identify who has subsequently cited leading scholars already identified in your literature review. This is called citation tracking and there are a number of sources that can help you identify who has cited whom, particularly scholars from outside of your discipline.
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What is a literature review?

What are Literature Reviews?

Literature reviews examine scholarly literature surrounding a subject-area, topic, or historical event. Literature reviews typically synthesize popular academic arguments, spanning multiple viewpoints. They often explore common trends, themes, and arguments, examining how perceptions of an event have changed over time. However, literature reviews are more than historiographies. Literature reviews should evaluate sources, determining common argumentative flaws. They should also identify knowledge-gaps in the field. You should not make a new argument in your literature review. However, you should evaluate the legitimacy of current sources and arguments. 

An example literature review, from the University of West Florida, is attached below:

How Should I Write My Literature Review? 

• Literature reviews on your subject likely already exist. Before writing your literature review, you should examine pre-existing ones. This process will quickly familiarize you with prominent themes, arguments, and sources in your field.
• Once you are familiar with influential arguments and sources, you should begin organizing your literature review. Literature reviews are organized by ideas, not sources. You should align your sources to popular arguments, evaluating the similarities and differences between these arguments. Ideally, you should examine how the scholarly conversation has changed over time. What aspects of the conversation have become more important? What arguments have fallen out of favor? Why has this happened? 
• The introduction should briefly introduce common themes, and foreshadow your organizational strategy.
• The "body" of your literature review should analyze sources and arguments.
• Finally, the conclusion should identify gaps in the scholarly conversation, and summarize your findings. Where is further research needed?
• Like a research paper, your literature review should include a bibliography. 

For more information on literature reviews, including more tips on writing them, visit the link below:

Literature Review: Conducting & Writing  by the  University of West Florida Library

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Literature Reviews

A good literature review finds relevant academic literature and places it in a context that supports future research.  In other words, what background does the audience need to know in order to understand the innovation that you are presenting in your thesis or article?

Reed, L. (1998). Performing a Literature Review. 1 998 Frontiers in Engineering Conference . IEEE: Tempe, AZ.  Available online .

Tips for a Successful Literature Review

• Historical articles sometimes needed
• Use EI Engineering Village or other abstract database for historical literature
• Keywords - use to focus search on your topic
• Subject Descriptors - match your keywords to these to maximize efficient searching
• Download citations to citation management software to track where you have been

Purdue AllSearch

Start at http://www.lib.purdue.edu . Click Search All.  (Link opens a new window.)

• Google type search interface with facets to narrow search. 
• Provides extensive, broad searching across disciplines.
• Includes everything owned by Purdue plus many things we do not.
• Serendipitous searching.
• A good first place to start.
• The place to find  books.
• The place to find  print editions of magazine  articles. 

How to Use Databases

• Provides in-depth, efficient , subject specific searching.
• Includes academic, scholarly journals , some of which Purdue does not subscribe to.
• Results are highly targeted to discipline.
• A good place to continue a search after you have figured out useful keywords.
• A good place to go when you want a quick , accurate search.
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Systematic Literature Review on Communication in Construction Project Management: Issues Among Project Participants

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An Integrative Literature Review of Project Management in Technical and Professional Communication

Benjamin Lauren and Joanna Schreiber

Purpose : This article presents the results of an integrative literature review on project management in technical and professional communication. The goal of the article is to demonstrate how project management has been discussed and studied by the field. By analyzing the field’s approach to project management, the article sets groundwork for research, pedagogies, and best practices that prepare technical and professional communicators to shape effective project management practices.

Method : To achieve this goal, we assembled a sample of 326 sources across academic and practitioner publishing venues from the years 2005–2016. To comprise the sample, we used targeted keyword searches to identify published work that addressed project management in technical and professional communication.

Results : Project management in technical and professional communication is often presented as an adjacent practice to other concepts or practices, such as leadership or documentation management. Additionally, project management is described or discussed primarily in terms of skills and relationships established through concepts such as teaming, collaboration, professional communication, communication theory, and education.

Conclusion : The limited characterization of project management in the existing research creates the opportunity for technical and professional communicators (TPCs) to explicitly acknowledge the complexity of project management from a rhetorical perspective. The outcome of this rhetorical approach would position TPCs to develop and shape ethical and audience-focused PM practices through their communication expertise.

Keywords : project management, integrative literature review, rhetoric, technical and professional communication

Practitioner’s Takeaway:

• Project management links TPC tools and processes with organizational and team contexts.
• Project management skills are essential for developing and sustaining TPC careers, especially since teams are more often sharing in project management activities.
• Project management processes are often discussed as a skillset for TPCs to acquire rather than as a practice to be refined for different organizations, teams, and individuals.
• More methods in project management should emphasize the importance of effectively communicating with people to do complex knowledge work, an area of opportunity for TPCs.
• Acknowledging the complexity of PM as a field helps TPCs define the value of their work.

Technical and professional communication (TPC) has discussed project management (PM) for some time (Carliner, 2004; Carliner et al., 2014; Giammona, 2004; Lanier, 2009), and recent shifts in organizational structure, approaches to product development, process management, global economics, and team practices (see Hart & Conklin, 2006; Dubinsky, 2015; Spinuzzi, 2015) suggest it remains essential to the TPC skillset. Yet, published work on PM in TPC focuses almost entirely on practice—evaluating tools and describing processes and methods. This focus on practice has positioned PM as a skill to be acquired or developed (Dicks, 2010; 2013) rather than as a kind of knowledge used to shape how people work within and across organizations. Also, by positioning PM as just a needed skillset, TPC may be missing opportunities to critically evaluate emerging forms of PM, particularly how it informs the ways in which we work and what we produce. For a field and profession that takes great pains to explain writing as complex knowledge work (Allen,1990; Johnson, 1997; Miller, 1989; Winsor, 1999), the lack of critical engagement with PM seems almost out of character. Or, as Dicks (2013) put it, “For an area that is as critically important to technical communication as project management, it is surprising that there are not more articles in the literature dedicated to the subject” (pp. 311–312).

Given these observations on TPC work in PM, we believe the timing is appropriate for an integrative literature review of published work that brings together conversations about PM in our field. To be clear, an integrative literature review does not aim to integrate everything published about a topic in a given discipline; instead, it works to assemble “representative literature on a topic in an integrated way such that new frameworks and perspectives on the topic are generated” (Torraco, 2005, p. 356). In this article, we offer an integrative literature review of PM in TPC that draws from publications offered in both academic and practitioner venues.

But why is the time right for an integrative literature review on PM in TPC beyond what we’ve noted already? Many people who work in TPC note the field is undergoing disciplinary transformation, expanding the role and scope of our work. We briefly summarize some of these transformations in the following points:

• How technical and professional communicators (TPCs) are participating on project teams is and has been evolving. For example, Spinuzzi (2015) recently described how some teams share PM activities. On these teams, PM is not the job of a single person but an activity practiced and coordinated across a team, so TPCs must be prepared to participate in project management.
• TPCs have an important leadership role to play in the facilitation of cross-functional project work (Dubinsky, 2015; Hart & Conklin, 2006; Marchwinski & Mandziuk, 2002). Healthy communication workflows are intrinsic to effective teamwork, and TPC has important value in conversations about effective communications management (Amidon & Blythe, 2008; Suchan, 2006).
• Emerging development methodologies like Agile, Lean, Six Sigma, and so on (Hackos, 2016; Schreiber, 2017) have had an important influence on TPC practice. Understanding how these methodologies contribute to our work is key to establishing the value of TPC in leadership roles, particularly as information developers are given “autonomy to manage many day-to-day tasks” (Agile Development, para 6).
• Content management and strategy has changed who can participate in the development of content (McCarthy et al., 2011) and how technical and professional communicators organize work practices (Hart-Davidson et al., 2008). Additionally, tools and processes related to content management further shapes TPC field knowledge, organizational position, and role on teams.

These transformations, while certainly not exhaustive of every shift the field is experiencing, demonstrate the pervasiveness of PM in TPC. We believe these shifts also suggest it is a good moment to assemble and examine how TPC practitioners and academics are approaching PM so that we can critically reflect on how, as a field, TPC is contributing to the development of emerging PM practices and theories. Therefore, this integrative literature review seeks to 1) document emerging areas for PM research in TPC and 2) present a critique of existing work with the goal of identifying gaps and opportunities for future research and identification of best practices.

To provide some background, we begin the article with a brief history of PM scholarship in TPC. We continue by describing our methods for assembling the scholarship into a conversation. Next, we explain the results of our review, which demonstrates that PM is often discussed in relationship to other activities, such as leadership practices or teams and teaming. After reporting our results, we discuss implications of the findings and offer a critique of the scope of published work on PM. Finally, after discussing the limitations of our research design and results, we conclude the article with several suggestions for future study.

Brief history of PM

While documenting every event or factor that influenced the evolution of PM and PM in TPC is beyond the scope of this article, this section briefly gives key moments to show PM has historically developed in sometimes parallel and overlapping ways with TPC.

PM as a workplace practice emerged from efficiency management structures and efforts to organize work which took hold in the early 1900s (Miller, 1998). Additionally, PM grew out of engineering and science, specifically through advancements in knowledge and resulting complexities which surfaced due to product development and research (Longo, 2000). Advances in information communication technologies and flattened organizational structures required inventing methods to scale operations (Yates, 1989), so PM can also be traced across a trajectory of organizational development. Research has also traced TPC practices as foundational to the development and implementation of early scientific management work (Killingsworth & Jones, 1989), and it is these early efficiency practices which also marked the beginning of PM as part of organizational management structures.

World War II was an important touchpoint for both TPC and PM as scientific and technological products grew increasingly complex and dangerous, requiring documentation and interdisciplinary teams (see Morris, 2011). Later, in the 1960s, many of the PM processes and tools that were developed in the military became more widely adopted (for example, Program Evaluation Review Technique, or PERT), and were intimately tied to managing and improving team processes. By 1969, the Project Management Institute (PMI) was formed to act as a hub for professionals and helped standardize PM as a practice and discipline. Later, in the 1980s, white collar managers in the United States adopted Lean principles as a way to increase profits by doing more with less (Saval, 2014). At this time, interest in process improvement remained an important concern of management professionals and was dramatized in the popular business novel The Goal by Goldratt and Cox (2014). In product-focused environments, technical and professional communicators often developed end user documentation. Later, the first official Project Management Body of Knowledge (PMBOK) was released in 1996, which created opportunities for professional training and certification in PM.

In the 2000s, PM approaches became more closely aligned with software development methodologies, like Agile development. In 2001, The Agile Manifesto was published. At this time, commercial software development changed how projects were managed as teams moved from developing physical products for manufacturing to developing software. As well, documentation began to move from print to screen. Effective processes of developing and publishing documentation was captured by a range of texts, including Hackos’ (2007) Information Development (which is widely regarded as a foundational text for defining PM in the context of TPC). While more recent scholarship on coordinating work (see Pigg, 2014) certainly informs PM practices, Hackos’ (2007) work was the most recent substantial contribution to PM in TPC.

As this brief history shows, PM and TPC are increasingly connected and even merge at some points. Despite shared history, TPC often treats PM as an important practice to acquire or wrestles with best methods for teaching others how to do it. Although many have argued that TPCs would make for excellent project managers and facilitators of work (see Hart & Conklin, 2006; Potts, 2014), we also believe that our field has an important role to play in shaping PM as a social practice.

As our introduction and brief history of PM shows, PM has been discussed as an important skill, particularly as TPC work and roles transformed. However, we ask a central question: What has TPC as a field more recently offered about PM knowledge? To answer this question, we used Toracco’s (2005) work to shape our analysis of published work, using elements of grounded theory (Charmez, 2006) to organize and locate emerging themes as we read each article in our sample. We captured articles broadly with a range of keywords and refined our sample with focused readings to determine which articles addressed PM. To further guide our analysis of PM in TPC, we asked three research questions:

• How is PM described as a practice ?
• What communication theory is studied in the context of PM?
• What PM methods are being discussed?

Integrative literature reviews help to generate new knowledge about a topic studied because mature topics have more room for critique, whereas the goal for emerging areas is to simply capture the conversation. Torraco (2005) explained, “Most integrative literature reviews are intended to address two general kinds of topics–mature topics or new, emerging topics” (p. 357). Additionally, Torraco suggested mature topics and emerging topics have different goals in mind. Our research is specifically designed to study a relatively mature phenomenon (because we have accounts of PM in TPC) that has recently undergone shifts in disciplinary practice.

To start, we identified major publication venues and platforms in TPC. Since we were specifically interested in emerging accounts of PM in TPC, we identified the date range January 2005 to September 2016. To capture academic conversations, we focused on journals whose mission was technical communication, professional communication, or both. We identified journals central to technical and professional communication and those that directly overlap. To capture practitioner conversations, we included User Experience Magazine , TC World , and Intercom . Additionally, since both academics and practitioners publish proceedings papers, we searched two popular conferences: the International Professional Communication Conference (ProComm) and the Special Interest Group on the Design of Communication (SIGDOC). We also searched using Google, Google Scholar, and Amazon.com to identify major textbooks and edited collections. We defined edited collection broadly and included two special issues from International Journal of Sociotechnology and Knowledge Development because they were edited by TPC scholar Guiseppe Getto and focused on user experience PM. To make sure we identified appropriate texts as we assembled the sample, we engaged in an ongoing dialogue about project scope as we searched. We included articles from the following journals/proceedings in our final sample:

• Technical Communication
• Journal of Business and Technical Communication
• Transactions on Professional Communication
• Technical Communication Quarterly
• Business Communication Quarterly
• Special Interest Group on the Design of Communication (SIGDOC) Proceedings
• Journal of Technical Writing and Communication
• International Professional Communication Conference (ProCommO Proceedings

Next, we searched abstracts, keyword lists, and/or metadata (if the database included such information) of articles in each publication for our time period. In order to broadly capture PM in TPC, we used the keywords “project management,” “management,” “project,” “teams,” “collaboration,” “Agile,” “Lean,” and “leadership.” We also included slight variations of these terms, such as “project manager,” “teamwork,” or “project leader.” To isolate project management and to make our sample manageable, we did not explicitly include phrases or terms that included “management,” such as “knowledge management,” “content management,” “information management,” “documentation management,” “crisis management,” “impression management,” or “boundary management” (some of which have already received their own integrative literature reviews; see Andersen & Batova, 2015). Since the goal of this project was to focus on PM specifically, we only selected articles for our sample that directly tied themselves to PM in a substantive way. From our initial searching, we assembled 326 potential sources after removing book reviews and other similar texts. To further narrow our sample, we evaluated each source to determine its relevance to PM, finding that 128 texts of our initial sample substantively discussed PM. Also, throughout the writing and revising process, we continued to review our sample through additional searching as previously described to make sure coverage was appropriate.

Iterative Coding Method

To evaluate our sample, we developed starter codes and piloted them on a small portion of the work to norm our approach. We drew from grounded theory (Charmaz, 2006) to develop an iterative and systematic process for refining our codes and analyzing our sample, giving “priority to showing patterns and connections rather than linear reasoning” (p. 126). For instance, in testing our original codes, we discovered that methods and tools were often interchangeably used, and that, to capture how PM was defined, we needed to code more broadly to capture both direct definitions of PM and definitions of PM that were focused on solving particular problems. This approach helped us focus on relationships and linkages between PM and several areas of interest to TPC, and our coding scheme was useful in discovering other broad TPC knowledges and practices. Table 1 demonstrates how we revised our starter codes. As well with our sample, we regularly reviewed our codes throughout the coding process.

After reading through the sample, we assembled the findings by emergent themes produced by each reading. We moved summaries of the texts into a document and developed themes through an iterative process of analysis and reanalysis (Charmez, 2006). Once initial themes were created, we continued to reevaluate relationships between the themes to collapse our summaries into more specific categories, using our research questions as broad organizational categories for the themes. For example, we found a small number of articles about technology as they related to PM (as opposed to technology used to facilitate PM) and space as relates to PM; we combined these articles into a theme about environmental factors that influence PM. Our findings are more fully detailed in the next section of the article.

We organized our results according to 1) a quantitative breakdown of the sample; 2) emerging themes; and, 3) how the results addressed our research questions.

Sample Breakdown

Examining the breakdown of our sample reveals some useful insight. Figure 1 demonstrates the overall breakdown of genres included in the sample. The largest category of our sample was trade magazines ( Intercom , TC World , and User Experience Magazine ). The second largest was journal articles, followed by textbooks, academic monographs, special issues, and classroom/instructional texts. Lastly, proceedings papers ( SIGDOC ) made up the smallest amount of our sample. Often, the published cases focused a great deal on describing practice or offering advice, echoing the sentiments of Dicks (2013) that much of the published work on PM in TPC over the last ten years has been largely descriptive and/or prescriptive.

Additionally, PM was rarely the primary topic in our sample, though many texts established links between PM and other workplace activities and experiences. Once again drawing from Charmez (2006), we identified this quality as “relationships.” As a point of order, we organized the results by aligning them with the corresponding research question. We also would like to note, due to space constraints, we did not discuss each article from the sample in detail.

Below, Figure 2 demonstrates the breakdown of our sample by academic publishing venue. The largest sample was from Technical Communication (TC) , followed closely by both Technical Communication Quarterly (TCQ) and Transactions on Professional Communication (TPC). The topic of articles published in these venues varied, but there was considerable interest in describing and teaching current PM practice to students. Coincidentally, the sample size was similar across the Journal of Business and Technical Communication (JBTC), the Journal of Technical Writing and Communication (JTWC), and Business Communication Quarterly (BCQ). As with the other journals, the topic range of articles in JBTC, JTWC, and BCQ varied. The abbreviations used here are the same in Figure 2.

Figure 3 illustrates the trade magazines included in the final sample. We discovered that trade magazines appeared to have most interest in demonstrating the practice of PM in different organizational circumstances. As the majority of our sample (by just 7%), the articles published in trade magazines were instructive and useful for professionals interested in developing individual careers. Additionally, it appeared there was a similar focus on PM across both TPC World and Intercom . User Experience Magazine , or UX Magazine , discussed PM in the context of user experience, which overlaps with TPC. During our reading, we noted some redundancy across the topics and experiences detailed in trade articles.

Table 1. Revised code categories after pilot

Emerging Themes

Because few articles in our sample focused only on PM in TPC, the emerging themes we discovered describe relationships between related concepts and practices and PM. While we believe there is much to be gained from the results of our literature review, we wish to highlight two overarching themes:

• PM is often presented as an adjacent practice to other concepts or practices (for example, leadership or documentation management), instead of grounding these practices together theoretically (for example, providing a framework for related concepts like collaboration, leadership, interpersonal communication, and user experience) and contextually (for example, foregrounding relationships between several related workplace practices and structures like information management and management philosophies).
• PM is described or discussed primarily in terms of skills (for example, as a necessary skill or as something requiring particular skills) and relationships (for example, how it relates to teams, collaboration, professional communication, communication theory, and education).

PM’s relationship to leadership and management

Our findings show PM was often positioned in conversations related to leadership and management, and that these terms were often conflated. For example, in a study by Flammia, Cleary, and Slattery (2010), “team leaders” were responsible for PM activities on distributed teams of students. In their study, students from the University of Central Florida and the University of Limerick were paired on a Web development project with team leaders who are described as “those individuals who took the initiative to establish communication and to keep teammates on task” (p. 94). Additionally, “team leaders” tended to take responsibility for activities typically assigned to project managers. Walton (2013) examined how trust and credibility influenced development projects, defining the PMs as “project leaders, who envisioned the project from the beginning and spearheaded the early, exploratory research efforts” (p. 90). While reflecting on experiences managing projects with globally distributed teams, Aschwanden (2013) also addressed leadership in terms of shared approaches to managing projects and gives examples of how roles are negotiated by teams. He noted that one way to create familiarity with each other is to create opportunities to for teams to meet face-to-face.

Several authors argue that TPCs are well positioned for leadership roles. For instance, Sturz (2012) discussed the outcome of when TPCs are also information and knowledge-managers, suggesting they are participating in management activities. In integrating these activities,

Does the technical writer then bear the responsibility for everything in the organization? No, but management of information, knowledge, and communication and certainly even other areas of process management, insofar as they entail dealing with information, should be in the focus of technical writers not just within the documentation department, but also across the company. (Sturz, 2012, n.p.)

The call for leadership is echoed by practitioners and academics alike. For example, Potts (2014) argued TPCs should be in leadership positions on teams. Similarly, Gosset (2012) made an argument suggesting that TPCs have the skills to manage projects “across industries” (n.p).

When discussing leadership and PM, scholarship has also focused on describing roles and responsibilities. The role of leader and the role of project manager may or may not be fulfilled by the same person (Tebeaux & Dragga, 2015; Wolfe, 2010). Wolfe (2010) argued that the PM should not be confused with the leader or boss: “Instead of viewing the project manager as some kind of supervisor, think of the project manager as someone who plays a specific role on the team by keeping the project on course” (p. 13). Tebeaux and Dragga (2015) described collaborative projects as having a leader, but the leader may or may not actually be the PM. Further illustrating this dynamic, Vang (2016) explained, “Writers serve not just as resources on project teams but also as leaders within those teams. The lead or sole writer on a project is often responsible for planning and managing relevant tasks within that project” (p. 21). The overlap between managing, leading, and writing often seemed part of how unique workplaces would position writers to manage and lead their own project work.

As with the concept of leadership, management and PM could also be conflated concepts. Nevertheless, PM is also described as a skill appreciated by upper management. Studies of TPC managers conducted in the last decade have cited PM as a desirable skill for TPCs (Amidon & Blythe, 2008; Rainey, Turner, & Dayton, 2005). Baehr (2015) cited PM as a skill TPCs find important and as a role TPCs take on as they move through an organization. As well, Kimball (2015) explained PM as something useful to learn as part of TPC education. Management was also discussed as a changing structure that affects the need for PM. Dicks (2010) argued that changes in management structures and fads are as important for TPCs to pay attention to as well as changes in technology. Flattening team and organization structures require TPCs to be better able to explain value and to work autonomously—thus the need for PM skills. Because communication skills are so central to the success of TPCs, Lewis (2012) argued projects and working with PMs are opportunities to illustrate TPC value.

Finally, it is worth noting some emerging interest in PM, leadership, and gaming. The terms of management, leadership, and PM appeared conflated in this scholarship as well. Two examples, in particular, seemed relevant because of the emphasis on managing communities of people. Robinson (2016) studied World of Warcraft ad-hoc teams in virtual worlds to understand which leadership traits were most valuable, concluding: “Managers of virtual teams might also reconsider the ways in which they assign or talk about leadership; allowing teams to utilize emergent leadership might yield better performance” (p. 188). Meanwhile, McDaniel and Fanfarelli (2015) explored the concept of micro-project management in game design. Their interest was specifically focused on how user experience principles can be used to help manage game development.

PM’s relationship to teams and teaming

PM was sometimes discussed in scholarship that focused on managing globally distributed teams. It was also referenced in scholarship that addressed collaboration as an activity and in other work focused on forming team dynamics.

The global marketplace has influenced many workplaces that TPCs encounter, particularly as they work on the development of products and services. As a result, TPC scholarship has been interested in globally distributed and virtual teams for quite a while now. Weimann et al. (2013) report on an extensive case study that took place over two years and focused on 15 different virtual project teams. In their research, they found the importance of building and maintaining trust to ensure there is adequate infrastructure in place to access useful and appropriate information communication technologies and to make sure people benefited from their participation on the team (p. 348). The emphasis on infrastructure, communication, and participation on the team directly concerned PM. Others also argued the importance of building infrastructure for global teams so that they can function effectively (Marghitu & van der Zalm, 2007), the importance of people and ingroup relationships (Burian, 2013; Fox, 2015; Plotnick, Hiltz, & Privman, 2016), effective approaches to communicating in international environments (Wellings, 2009), and the importance of knowledge management for globally distributed teams, especially to guide the use of technology to support communication and information (Ramamurthy, 2009).

Another relationship presented itself in published work that focused on time management, teamwork, collaboration, and team dynamics. For example, Lanier (2009) defined PM skills as those based on collaboration, interpersonal communication, and multitasking. Mogull (2014) reported on a class project where students appeared to define some PM skills as “professional skills” like “teamwork” and “time management” (p. 354). Randazzo (2012) also explained a classroom project where students described PM as related to personal organization, but, over the course of the project, they also learned to define PM as having an “element of stamina” (p. 386). We can surmise Mogull’s (2014) and Randazzo’s (2012) findings build on Conklin’s (2007) work that argued PM skills are increasingly important for TPCs as they worked on cross-functional teams and also locate similar arguments offered by the Technical Communication Body of Knowledge (see the entry on Agile, in particular). Spinuzzi’s (2015) work also emphasized the importance of having a PM skillset, describing workplace conditions that are networked and made up of contingent teams that share in project management activities.

Additionally, published work has discussed social norms, communication patterns, and communities of practice (Bartell & Brown, 2009; Fisher & Bennion, 2006; Vitas, 2013) and managing team conflict (Rose & Tenenberg, 2015), areas that directly influence how PM is practiced. Other authors discussed managing relationships between silos once a project has been developed (Kumar & Salzer, 2011) and different methods of collaborating on teams (Wolfe, 2010). Lloyd and Simpson (2005) illustrate a case study that explains the role of a PM as managing strands of “activity” (activities constituted prototype development, computer science research, clinical research, and blueprint development). Each of these areas may inform PM practice considerably, even though a feature of the research is it is context-specific.

PM’s relationship to specific kinds of workplace projects

We found intersections with documentation management, user experience, localization, and terminology management in the literature.

Hackos’ (2007) work provided a foundation for thinking about managing documentation projects, especially the influence of Agile on creating documentation. Additional accounts by both scholars and practitioners offer advice and resources for new documentation managers (Huettner, 2006), although some cover Scrum as a documentation management technique (Friedl & Worth, 2011), authoring platforms and their influence on managing documentation projects (Sabane, 2012), and the importance of planning for the unexpected in documentation projects (Brüggemann & Rehberg, 2014). Mara and Jorgenson (2015) discuss heuristics for managing UX projects. Additionally, Hart-Davidson (2015) discusses the role of UX as essential to the shift of “learning organizations,” which has implications for PM through activities like process improvement.

There also appears to be an interest in the role of PM in healthcare contexts. For example, Willerton (2008) illustrated a case about how online content about health is developed. He described project management as a cognitive process essential to the work of the team he studied for the case, noting the importance of timelines and managing individual information development activities. Similarly, Tomlin (2008) examined how the role of medical writers had changed given the availability of online regulations from the federal Food and Drug Administration (FDA). In essence, the article suggested that the position of writers had become more central to development processes. The article concluded by arguing future curriculum should prepare medical writers to develop project documentation and take the lead on PM when applicable.

We also noted a relationship between PM and managing localization and translation projects, including managing terminology. The scholarship in this area appeared to originate in practitioner work. Several articles addressed managing localization and translation projects. Although not explicitly discussing PM as an isolated practice, Zerfaß and Schildhauer (2009) explained the importance of frameworks for information on localization projects, especially around four areas: “the project as a process; communications; tools and technologies used before, during and after translation/localization; and quality assurance” (para. 7). Others have written about running in-house translation departments (Salisbury, 2010), establishing essential tasks for teams to successfully navigate localization projects (Brown-Hoekstra, 2011), discussing the overlap of documentation and translation processes (Brown-Hoekstra, 2010), and, somewhat relatedly, creating healthy translation/localization departments and organizations (Yeng, 2013). Finally, Schmitz (2013) discusses the role TPCs sometimes take on when managing terminology to facilitate knowledge-transfer.

There was also some work that pointed to PM as organizational practice. For instance, Holdaway, Rauch, and Flink (2009) described how information designers can adapt to PM at all levels of organizations, specifically to deliver “excellence” or quality documentation as companies inevitably change management approach and style. Lastly, Condone (2008) explained that traditional forms of PM need to be augmented to manage multimedia projects effectively. The article assembled a list of best practices for managing unpredictable multimedia projects, such as “Know your project,” “Know your team,” and “Know your organizational structure under which you and your team fall” (n.p.). Mochal (2014) described project rescue as a particular project type that often gets overlooked but still needs to be approached systematically like other projects.

PM, teaching, and training

Many of the articles and books in the sample were intended for instructional purposes. We also found several articles about pedagogical approaches related to PM, particularly as they relate to on-the-job reference materials and service learning.

We identified instructional texts that focused on publication management for TPC managers. For example, Schwarzman’s (2011) book is specifically written for technical publication managers. Hackos’ Information Management (2007) provides guidance for documentation and information management projects, and remains a foundational text in this area. Kampf (2012) contributed a chapter in a text on engineering project management that focuses on teaching students to write effective project documentation. Though it is not specific to TPC, the PMBOK offers certification through the Project Management Institute and forwards concepts, such as the project lifecycle, that are meant to be a guide for PMs in most organizational contexts.

Additional texts focused on PM as important for collaboration and teams or using PM methods as pedagogical tools. Campbell (2007) argued the classroom was the place to develop team dynamics and learn to manage team projects. Kampf (2006) advocated for a rhetorical approach to teaching PM to prepare students to work on project teams. Ding and Ding (2008) argue that pedagogy must focus on developing socially responsible, critical reflective practice in teamwork, suggesting that PM methods can be incorporated to help manage these team projects. Lam (2015) builds on Ding and Ding (2008) and Wolfe (2010) by suggesting student teams develop communication charters as a way to help them avoid social loafing during group projects. As well, Smith (2012) devoted much of his PM textbook to teamwork and argued for “a set of heuristics for participating in and managing multidisciplinary teams” (p. 177). Kampf and Longo (2009) described a case study of students working to manage projects in global contexts, discovering that knowledge management and communication can productively influence project documentation. There was also a focus on learning from real-life case studies (Pflugfelder, 2016) as important for effectively teaching PM skills.

Other pedagogical approaches focused on teaching PM in the context of user experience (UX), an area that overlaps with TPC and has a rich history in the work of scholars like Pat Sullivan, Robert Johnson, and Jan Spyridakis. For example, Getto (2015) developed a set of heuristics for teaching PM in UX. Lund (2011) also offered a focus on managing UX teams, covering topics such as hiring people and evangelizing the team’s work. Among other areas of interest, the book advances discussions related to workspaces, explaining, “one of the things I have learned is that the physical environment you create can go a long way in shaping a team identity and climate” (p. 105). It is impossible to summarize all of the important ideas Lund forwards, but much of the advice blurs the line between management and PM (Lund recommends establishing communication plans for teams, which is traditionally a PM activity).

Ethics and rhetoric are noted as related to PM in multiple pedagogical articles. In these texts, rhetoric should be understood as audience-focused strategies for effectively and ethically communicating. For example, Hamilton (2009) offered a discussion on the ethics of managers motivating teams, noting several de-motivators in the process: “not listening,” “being inflexible,” “imposing arbitrary schedules,” “taking away power,” “withholding information,” “disrespecting people,” “not leading,” “personnel craziness,” and “market realities” (pp. 59-60). Textbooks (such as Rude and Eaton, 2011) build on the concepts in rhetoric that are widely taught in TPC college courses, such as audience and purpose. Rude and Eaton (2011) specifically lean on rhetoric to introduce PM as an important TPC skill in later chapters of their book.

PM methods have also been utilized as pedagogical tools. Rebecca Pope-Ruark’s (2014, 2015) work focuses on using Agile methods to teach professional writing and learn more complex rhetorical concepts. In these texts, rhetoric is used to help teach TPCs how to be more effective communicators. Agile has also been used to teach other skills, such as managing internships (Vakaloudis and Anagnostopoulos, 2015). Another example is offered by Beale (2016), who advocates teaching Agile methods using board games.

Research Question 1: How Is PM Described as a Practice?

How PM is described as a practice is addressed in two ways. The first and most prevalent way is to describe PM in terms of the skills and tasks required in the activity or PM as a needed skill in the workplace or as part of a necessary TPC skillset. The second is to describe how external or physical forces (documentation, technology, workplace design) appeared to influence or define PM practice in TPC.

PM in terms of skills or tasks

PM is described in the literature in terms of required soft skills for PM activity (Lanier, 2009; Michaels, 2005), organizational skills (Kimball & Hawkins, 2007; Lannon, 2008; Markel, 2015; Wolfe, 2010), and as a skill needed by TPCs (Carliner, 2012). Soft skills cited are collaboration, interpersonal communication, flexibility, multitasking, and communication skills (Green & DiGiammarino, 2014; Lanier, 2009; Michaels, 2005; O’Connor, 2006). Markel (2015) described PM as breaking down a project into “manageable chunks” and Lannon (2008) described PM as organizational strategies for keeping projects on track (goal setting, timetables, and setting meetings). Wolfe (2010) highlighted the PM’s role in task analysis and meeting minutes. Hackos (2007) specifically discussed implementing a new CMS and explained the PM’s role as keeping projects and tasks moving while other larger projects are being implemented.

Our sample also indicated it is important for PM practice to utilize the roles of peers effectively and to understand the value of their roles and associated knowledge. Lebson (2012) explained, “The project management triangle has three constraints: time, cost, and scope. It is important for the project manager and those on the project to understand how usability relates to these three constraints” (p. 13). Ames and Riley (2013) argued that it is very important that PMs and information architects understand the strengths the other brings to the table, because the success of the projects is reliant on these two roles utilizing each other’s skills effectively. Similarly, Berggreen and Kampf (2015) explored how technical documentation for projects can be developed through social and interpersonal interactions.

Interestingly, Green and DiGiammarino (2014) argue that the interpersonal skills necessary for PMs (the ability to negotiate and resolve conflict) are separate from the skills required for TPC work. This aligns with Herman’s (2013) contention that TPCs are in great positions to be PMs, but they need more than communication skills to successfully budget and scope projects as well as identify risks: “Project management is about leadership, team building, motivation, communication, negotiation, conflict management, political and cultural awareness, trust building, coaching, and decision making” (p. 7). One way to approach these skills is through modeling. Dyer (2012) argued that information architects (IA) benefit from modeling: “Models help IAs capture the benefit of a scientific process while leaving room for the art that happens when you innovate on the user’s behalf” (p. 19). Hackos (2012) also advocated the importance of mutual understanding between IAs and PMs as well as those roles’ understanding of writers’ work and value. Finally, Harris (2014) argued for developing skill maps in the workplace; he identified leadership and project management as two categories of skills/capabilities, with PM at their intersection. The skillset of the PM in this configuration seemed to focus on facilitation.

Discussions about the skills or tasks of PM also extended from producing documentation to highlighting rhetorical practices. PM has been described exclusively in terms of documentation or managing documents (see Rude & Eaton, 2011). As noted several times in the literature, PM has also been cited as a needed skill for TPCs, but some argue it is still not getting enough attention. For example, Henning and Bemer (2016) argued the Occupational Outlook Handbook entry for technical writing should be updated to include several skills, including PM. Importantly, PM skills have been explicitly tied to rhetoric. Berggreen and Kampf (2016) explored relationships between technical communication and stage-gate project management processes, concluding, “Project Management, and particularly the Stage Gate processes involved in project conception represent an area that is suited to the same types of rhetorical analysis used in designing communication” (n.p.). While the concept of rhetoric seemed most often aligned with work published in academic venues, it is still notable that rhetoric was the communication theory most often paired with PM.

PM and workplace contexts

Published work also discussed the environmental or physical factors affecting project management, such as TPC documentation (Walton et al., 2016), technology (Carliner, Qayyum, & Sanchez-Lozano, 2014; Dicks, 2010), and the design of the workplace (Lauren, 2015). Rather than focus on projects involving developing documentation, Walton et al. (2016) went a step further to highlight documentation as defining projects. Dicks (2010) argued that changes in technology alongside changes in management and organizational practices (for example, flattening structures) changed the way TPCs do their work—content oriented, single-sourcing—and thus influence PM practices and make them more important for TPCs. Carliner (2012) also argued that TPC work is influenced by business models, and the technologies used to facilitate PM are also an important factor. As such, TPCs need to understand how work can be tracked by PM systems, because these systems can be used to define value and productivity (Carliner, Qayyum, & Sanchez-Lozano, 2014).

Research Question 2: What Communication Theory Is Studied in the Context of PM?

Our findings indicate that PM is most often discussed through rhetorical frameworks used to evaluate and shape project communication. For example, Brizee (2008) writes about stasis theory, a rhetorical strategy, to help address the changing dynamics between subject matter experts and technical communicators in the workplace and the changing nature of collaboration practices. He argued, “We need to emphasize for our students and for our work teams the importance and value of using rhetoric for productive ends” (Brizee, 2008, p. 376). Others have discussed the importance of a strategic framework for managing change. For example, Bialek (2008) noted the importance of a communication plan for managing corporate culture change. She explained, “According to Marks and Mirvis, the following aspects are necessary to manage the merger syndrome: Insight, Information, Involvement and Inspiration. Communication is an essential part of all of those” (n.p.). Such communication frameworks seem an essential part of PM practice. Suchan (2006) also offered a change management plan that focused on designing effective communication by emphasizing the importance of dialogue.

In addition to rhetorical theory, intercultural communication has been discussed in the context of PM. For example, Ray, Reilly, and Tirrell (2015) argued the importance of intercultural communication in managing a distributed international grant project. Their work demonstrates the challenges of communicating and collaborating across distributed teams. Additionally, Happ (2014) discussed the importance of adjusting management and communication strategies when collaborating with people from different cultural backgrounds. To do so, she grounds her discussion in Chinese contexts and draws from existing cultural identity heuristics to guide the ideas. Corroborating this approach, Voss and Flammia (2007) advocated for a rhetorical approach to intercultural communication for teamwork, arguing, “Effective teamwork across multi-national business units adds an important new tool to the technical communicator’s skill set—intercultural sensitivity and rhetorical awareness (both verbal and nonverbal)” (p. 77). Certainly, the emphasis on ethical intercultural communication extends to the PMs leading these teams.

Research Question 3: What PM Methods Are Being Discussed?

In comparison to communication theories, implementation strategies were discussed less often in the sample. Of the existing strategies, Agile was discussed most frequently. This is not surprising. As Dicks (2013) stated: “Practitioners now refer to any method that seeks to abandon the waterfall method and use more streamlines processes as ‘agile,’ whether they happen to align with the ‘official’ agile methods espoused by the Agile Alliance or not” (p. 135). Though Agile or SCRUM (an Agile tool) are discussed as examples of preferred PM methods in the literature (Baca, 2014), some have argued that they require some getting used to (Sigman, 2007). Others have discussed Agile environments as opportunities for TPCs to expand their roles (Austin, 2014) or become embedded in teams (Smith & Gale, 2014). Collins (2014) recommended aligning existing documentation approaches with Agile methodologies. Moving beyond aligning existing approaches, Baker (2014) advocated for creating Agile TPC processes because it aligned with user content needs, explaining that Agile “requires us to create content as small, highly cohesive units that are loosely coupled. Happily, that is exactly the sort of content that works best for the new ways people seek and use content” (p. 27). Agile has also been promoted as a preferred method for conducting TPC practices relating to editing (Rude & Eaton, 2011).

As workflows shift and production cycles shorten, PM methods have moved away from the traditional step-by-step waterfall approach and toward more flexible, iterative strategies. Kimball and Hawkins (2008) offer iterative and mixed methods in addition to waterfall. Arguing that the traditional waterfall method can be “inefficient,” Dicks (2010, 2013) covered user-centered design (UCD), Agile, iterative, extreme programming PM methods. He also discussed SCRUM as a separate PM method from Agile. Both the Technical Communication Body of Knowledge (TC-BOK) and the PMBOK discuss Agile as influencing PM. The TC-BOK specifically addressed Agile as it influences the work of TPCs.

Across the publication venues we reviewed, PM was generally positioned as a significant and important practice to TPC that requires training and education. Our literature review also showed that many of the accounts of PM in TPC seek to describe it as a prescriptive skillset that must be learned rather than as a workplace practice that requires critical attention and reflection. While we can point to examples in TPC that approach PM in organizations from a critical mindset (Hart-Davidson, 2015), as well as teaching cases that emphasize reflection through practice (Randazzo, 2016), this work seemed to be an exception. While we do not want to dismiss the importance of work that describes PM skills, we also believe that a better balance could be struck that asks deeper questions about how TPC can add to conversations about PM as a practice in meaningful ways. Below we make suggestions for several potential areas that research and practice might address:

Study and Practice of Implementation Methods

We see a strong opportunity for understanding how implementation methods like Agile, Scrum, and Lean influence the ways in which teams communicate and work with each other to manage projects and connect with customers. How do these methods shape what TPCs produce? How do they shape teams? Many teams trying out emerging implementation strategies are flatter in terms of hierarchy, and so, it follows that the communication strategies, practices, and philosophies being used may be responding to, rather than shaping, these new ways of working. Future research in this area might also examine how issues of power function on these flatter teams and how these circumstances influence the ways in which projects are managed and by whom.

We also think it would be useful to further investigate how inclusive implementation strategies are in practice. In TPC there are applications of implementation methods used to support teaching and learning (Pope-Ruark, 2012), but we might also stop to ask if these strategies are actually inclusive and equitable in practice. And, as we adapt TPC work to implementation methods like Agile (as described in the TC-BOK), we might ask if these methods of managing people and projects are producing ethical outcomes. Could TPCs be involved with making implementation strategies more ethical and inclusive? How do we support and instruct TPCs to anticipate rather than react to and adopt changing PM practices?

Conflation of Terminology

A second area we believe would be useful is a deeper analysis and understanding of the conflation of terminology we discovered. That is, PM, leadership, and management were often used interchangeably. We do not want to suggest that blurring terms is essentially an unproductive approach, but these ideas do presently serve very different functions in a variety of organizations. Research that aims at this issue might begin by asking about the roles of leadership, management, and PM—what distinguishes these ideas from each other and where are they purposefully being blurred for practical reasons? How do the terms being used to describe PM influence how people do the job? We think empirical research and reflective practice in this area, as well as a historical perspective in this area, would be productive.

Content Strategy and PM

One surprising finding was that little scholarship on Content Strategy (CS) directly addressed PM in our sample. In recent years, CS has appeared to replace discussions of publication management in TPC work. As Andersen and Batova (2016) explained, “Component content management—an interdisciplinary area of practice that focuses on creating and managing information as small components rather than documents—has brought significant changes to professional and technical communication work since 2008” (p. 2). The move away from developing documents toward managing content can be understood as embracing a model for TPC that focuses on integration. Andersen (2014) explained the shift as “integration of organizational and user generated content, disciplines and departments, expertise and roles, and business processes and tools” (p. 10). Such integration requires skills in PM, “but, as is too often the case, most technical communicators have not been trained to think like managers, business analysts, or content engineers” (p. 13).

In our view, CS is an important area of study that has already garnered a great deal of attention across academic and industry publication venues, but our research suggests its relationship to PM requires further analysis and understanding. For example, we might ask questions like, Is CS a kind of PM? What is the value of explicitly acknowledging the relationship between CS and PM? Have these two areas matured as separate but related practices? If so, how do they work or fit together? It seems there are implications from such questions that could affect the teaching, practice, and research of both PM and CS.

Teaching and Learning PM

Since TPC is very interested in educating students with a PM skillset, we believe further understanding of what comprises that skillset in today’s fast-paced, global workplaces, economies, and networks would be useful. Our literature review pointed out accounts of PM, for example, in health care, game development, and in cross-functional development teams. So, how do the variety of contexts where PM is practiced in TPC influence classroom curriculum, training materials, and, relatedly, the TC-BOK? Future instructional cases could look to assemble rhetorical frameworks for thinking about PM as more than planning, scoping, budgeting, and time-keeping. While we concede PM is made up of technical activities at times, it is also a social activity that requires audience-focused communication skills. Future instructional work might more specifically examine how we can prepare PMs to respond to the dynamics of their organizations, teams, and individuals.

Limitations

As with any study, our literature review has important limitations. The first limitation is the scope of the project. We did not include publications such as blogs, podcasts, or slide decks in our review. For the purposes of this research, we decided to focus on texts that had been published about or with inferred relationships to PM by venues that are widely recognized by the field. Although we do believe an expanded version of our literature review might consider such publication outlets, that was not the stated purpose of our article. As well, we chose not to pursue questions only about information communication technologies (ICTs) and their relationship to PM. Although there is some discussion of ICTs in areas of the review, the research produced on the role ICTs in PM we found useful as embedded into each section of our findings rather than as a separate section. It is possible, in hindsight, that a clearer relationship between CS and PM might have been established had we focused more on these relationships.

Other recent integrative literature reviews (see Andersen & Batova, 2015) explicitly studied the relationship between practitioner publication and scholarly publication approaches to their topic. We included both types of publications, but making direct comparisons was also not a stated goal of our research. Rather, we aimed to bring academic and practitioner publications into conversation without identifying the background of the text’s authors. As a result, we recognize additional practitioner publications and blogs as well as relevant scholarship from other fields (for example, management studies, sociology, and engineering) would enrich our findings, but we also argue these publications were beyond the scope of this particular project. Another literature review on PM might work to more deliberately assemble data from publication venues listed in the TC-BOK or from outlets such as Nielsen Norman Group or A List Apart.

Finally, while we worked to be exhaustive in this research, our scope created several other research design limitations. For example, at times by containing the scope of the project, we were forced to discover workarounds for the methods used by different databases to catalog publications (for example, the differences in the way one outlet uses keywords and metadata in comparison to another). We addressed these issues in dialogue with each other and responded to such issues as they surfaced—always in the spirit of assembling the most complete sample we could, given our study parameters. This approach led to us making judgment calls regarding published work we knew existed but could not include, because it was not published in one of the journals we identified or not within the years we specifically outlined for our sample. For example, Rebecca Pope-Ruark’s (2012) article “We Scrum Every Day: Using Scrum Project Management Framework for Group Projects” was published in College Teaching . To respond to such issues, we worked to include some sources in the introduction, literature review, and discussion sections to make sure they surfaced in our conversation in a meaningful way.

Conclusion: Toward a Rhetorical Approach to Developing PM Best Practices

Our integrative literature review shows that the literature from both academic and practitioner outlets discusses PM as primarily an adjacent practice to teamwork and collaboration or as requiring skills like leadership. At the same time, the literature demonstrated how often TPC published work collapses important areas like management and PM, even though these areas are rapidly changing alongside organizational structures and working practices. Thinking of PM not as simply relating to all of these things but actually situating them is important moving forward for TPC to develop flexible and sustainable best practices.

We believe a productive way to critically engage the complexity of PM is to rhetorically situate practices contextually (Andersen, 2014; Porter, 2010; Salvo, 2004). While TPC seems to be approaching the teaching of PM rhetorically, we also need to explicitly theorize the practices of PM rhetorically in the organizations where we work. By rhetorically situating, we mean that rhetoric theory offers TPCs the tools to critically analyze and align relationships among tools, processes, and stakeholders at individual, project, and organizational levels. We believe the outcome of this approach would necessarily position TPCs to develop and shape ethical and audience-focused PM practices through our communication expertise. It also positions TPCs to explain the complexity of PM and the importance of rhetorical communication as central to effective work processes. This change in how we approach PM has clear implications for how we approach instruction and preparation, workplace studies, and best practices of managing people, texts, and projects. Furthermore, grounding PM with a rhetorical approach to communicating also helps TPCs think through the strengths and weaknesses of existing models in productive ways. PM has a direct influence on the frequency and type of communication practices; team dynamics; leadership philosophies; distributed workflows; collaboration activities; and organizational structures, cultures, and philosophies. A rhetorical approach can help make relationships between these activities and agents visible, and demonstrate how associated coordinative communicative dynamics influence the work of project teams. Indeed, this is a natural role for us as TPCs, because advocating for the people around us has always been a foundational mindset of our field.

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About the Authors

Benjamin Lauren is an Assistant Professor in the Department of Writing, Rhetoric, and American Cultures at Michigan State University, where he teaches in professional writing, experience architecture, and rhetoric and writing. He is also an Assistant Director of the graduate program in Rhetoric and Writing. His work has been published in Technical Communication , Computers and Composition , the Journal of Technical Writing and Communication , Intercom , User Experience Magazine, and Transactions on Professional Communication . He is available at [email protected] .

Joanna Schreiber is an Assistant Professor of Professional and Technical Communication at Georgia Southern University, where she is coordinator of technical and professional writing courses. She currently serves as Treasurer for the Council for Programs in Technical and Scientific Communication (CPTSC) and as Book Review Editor for Programmatic Perspectives . Her research focuses on the ways in which communication practices inform and are informed by efficiency management practices, and her work has been published in Technical Communication and Technical Communication Quarterly. She is available at [email protected] .

Manuscript received 8 December 2016, revised 15 July 2017; accepted 16 September 2017.

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Scope, content and quality of clinical pharmacy practice guidelines: a systematic review

• Review Article
• Open access
• Published: 22 November 2023
• Volume 46 , pages 56–69, ( 2024 )

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• Vibhu Paudyal   ORCID: orcid.org/0000-0002-4173-6490 1 ,
• Betul Okuyan   ORCID: orcid.org/0000-0002-4023-2565 2 ,
• Martin Charles Henman 3 ,
• Derek Stewart   ORCID: orcid.org/0000-0001-7360-8592 4 ,
• Daniela Fialová 5 , 6 ,
• Ankie Hazen 7 ,
• Monika Lutters 8 ,
• Anna Oleárová 9 ,
• Anita E. Weidmann 10 ,
• Francesca Wirth 11 ,
• Cathal A. Cadogan 12 &
• Zachariah Nazar   ORCID: orcid.org/0000-0003-4104-4221 4  

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Guidelines for pharmacy practitioners regarding various clinical pharmacy activities have been published in a number of countries. There is a need to review the guidelines and identify the scope of activities covered as a prelude to developing internationally acceptable common guidelines.

To review the scope of clinical pharmacy guidelines and assess the extent to which these guidelines conform to quality standards as per the AGREE II instrument.

Medline, Embase, Guideline Central, International Pharmaceutical Abstracts, Google Scholar and Google (for grey literature) were searched for the period 2010 to January 2023. Guidelines which focused on any health care setting and any clinical pharmacy activity were included. Data were extracted and quality assessed independently by two reviewers using the English version of the AGREE II instrument.

Thirty-eight guidelines were included, mostly originating from Australia (n = 10), Ireland (n = 8), UK (n = 7) and USA (n = 5). Areas covered included medication reconciliation, medicines optimisation, medication management and transition of care. As per the AGREE II assessment, the highest score was obtained for the scope and purpose domain and the lowest score for rigour of development, mainly due to non-consideration of literature/evidence to inform guideline development.

Clinical pharmacy guidelines development processes need to focus on all quality domains and should take a systematic approach to guideline development. Guidelines need to further emphasise person-centred care and clinical communication. There is a scope to harmonise the guidelines internationally considering the diverse practices, standards and legislations across different geographies.

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Impact statements

A range of clinical pharmacy practice guidelines have been published with a greater focus on medication review and optimisation and less on areas including communication skills and person-centred care.

Clinical pharmacy guidelines need to focus more on all quality domains such as the use of evidence in guideline development.

There is a need to develop international best practice guidelines which could be adapted in different countries in the context of national policies and practices, given the resources identified in this study were restricted in scope to a specific country or setting.

Introduction

The European Society of Clinical Pharmacy (ESCP) published a position paper in 2022 defining the scope of clinical pharmacy [ 1 ]. The paper describes clinical pharmacy as the ‘activities and services focused on optimisation of medicines use through practice and research to achieve person-centred and public health goals’ [ 1 ]. The extended definition identifies activities covered by clinical pharmacy including services to support roles around selection, administration, and monitoring of medicines by healthcare professionals, patients, and the public [ 1 ]. These activities include clinical pharmacy services such as medication counselling, communication, medication review, reconciliation, and optimisation of pharmacotherapy, as well as advanced services, such as pharmacist prescribing [ 2 , 3 ].

The scope of clinical pharmacy practice may vary across countries and settings guided by established policies and norms. Indeed, a recently published study has indicated that this variation is also reflected in pharmacy education and training offered within European countries [ 4 ]. The recent COVID-19 pandemic illustrated such diversity of regulations and roles with reference to pharmacist involvement in COVID-19 vaccinations, with pharmacists’ roles ranging from traditional compounding and preparation of vaccines to vaccine administration and counselling [ 5 ]. Countries such as the UK have introduced pharmacist prescribing models which allow pharmacists to prescribe prescription medicines within their areas of competence [ 6 ]. Pharmacist involvement in medicines optimisation within general practice (family physician) clinics in the UK National Health Service [ 7 ] and the Netherlands [ 8 ] are other examples of step change when discussing emerging new clinical pharmacy roles. Medicines optimisation emphasises on pharmacists working as part of the multidisciplinary team to engage with patients to review, prescribe and deprescribe medicines, provide lifestyle and non-medical interventions, improve adherence to and cost-effectiveness of pharmacotherapy and non-pharmacological strategies, and reduce medicines wastage [ 9 ]. Such roles have also been described within other countries in Europe and beyond, such as in the USA, Canada, and Australia [ 10 , 11 , 12 , 13 ].

Despite these variations in practices, many of the activities such as counselling, communication, medication review and reconciliation are common to a wide range of clinical pharmacy services. It is essential that these activities are informed by standards and evidence-based guidelines to support pharmacists and the wider clinical pharmacy team in delivering the best outcomes for patients and the health system. By definition, guidelines refer to ‘systematically developed statements to assist practitioner decisions about appropriate health care for specific clinical circumstances’ [ 14 ]. They help to improve and standardise quality of care and should ideally be developed based on current evidence and through involvement of wider healthcare team, patients and carers [ 15 ]. Whilst clinical pharmacy organisations and professional societies in different countries are known to develop and disseminate practice guidelines, there is lack of a ‘go to’ resource for societies, practitioners, and researchers in identifying all the relevant guidelines that relate to the specific areas or range of activities relevant to various clinical pharmacy services. There is a need to review scope and purpose of the published guidelines as well as assessment of quality criteria such as rigour, evidence-base and applicability of the published guidelines.

This study aimed to review the scope of clinical pharmacy guidelines and assess the extent to which these guidelines conform to quality standards as per the AGREE II [ 16 ] instrument.

This systematic review was conducted according to the Cochrane guideline [ 17 ]. A protocol was drafted and agreed amongst the research team prior to undertaking the full review (electronic supplementary material 1).

Eligibility criteria and study selection

Guidelines focusing on procedural activities relating to the provision of clinical pharmacy services in any health care setting were included. Guidelines published or approved by pharmacy professional societies, pharmacy regulatory organisations and best practice recommendations via special interest groups and consensus research methodology were included without any language restriction. Non-English publications were reviewed by members of the research team proficient in the language of publication. Where this was not possible, Google Translate was used for translation into English. Terminologies including ‘guideline’, ‘guidance’ or ‘practice recommendations’ as used in the document titles were included. Clinical pharmacy guidelines that focused on specific clinical area(s), such as diabetes, hypertension, or a specific patient population, such as older adults, were excluded.

Information sources and search strategy

Medline, Embase, Guideline Central, International Pharmaceutical Abstracts and Google Scholar were searched from 2010 to January 2023. Guidelines published prior to 2010 were not considered to be representing current practices and hence excluded. Keywords and medical subject headings, where available, were searched using Boolean operators (AND, OR) to optimise the search strategy (electronic supplementary material 2). Webpages of professional societies and regulatory bodies were also searched (electronic supplementary material 3). In addition, a web-based search was undertaken using the Google advanced search functions, whereby the first 200 relevant hits were screened for eligibility.

Selection process

The study team worked in pairs independently for title and abstract screening. The full-texts of the included articles were then screened independently by two reviewers (VP and BO). Any discrepancy or disagreements were initially resolved through discussion in pairs, and if unresolved, within the extended team. All eligible articles were transferred to EndNote 7 software for duplicates to be removed.

Data collection process

A data extraction tool was developed using Microsoft Excel software and piloted using a sample of the included articles. The included articles were distributed amongst the reviewers (all had expertise in clinical pharmacy) who worked in pairs independently to undertake the data extraction. Data on guideline characteristics were extracted including the title, date of publication, country of published guideline, organisation approving and/or releasing the guideline and aim of the guideline. Data on the scope of the guidelines were extracted focusing on specific procedural activities covered, targeted patient populations, practice settings, health care professionals, as well as professional standards stipulated and educational and training needs of pharmacy staff. Furthermore, the study authors developed a list of items intended to assess the comprehensiveness of the guidelines and where relevant, the extent to which they supported the delivery of person-centred care, considering equity, patient safety and interprofessional collaboration. The data extraction tool was piloted and agreed between the team prior to its use.

Quality assessment

Quality assessment of the guidelines was undertaken by independent reviewers working in pairs using the English version of the AGREE II instrument [ 16 ] after a pilot exercise within the research team. Any discrepancies were resolved through team discussions. The AGREE II instrument consists of 23 items grouped into six domains: scope and purpose; stakeholder involvement; rigour of development; clarity and presentation; applicability; and editorial independence. For each domain the allocated scores were divided by the maximum possible score to calculate the proportionate scores. A narrative synthesis of the extracted data was undertaken.

General characteristics of eligible guidelines

Thirty-eight guidelines were included (Fig.  1 presents the PRISMA flow diagram), published between 2010 and 2022 [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. Guidelines originated from Australia (n = 10), Ireland (n = 8), UK (n = 7), USA (n = 5), Netherlands (n = 3), and one from Czech Republic, Republic of Serbia, Bulgaria, Estonia, and South Africa. The majority were developed by the Society of Hospital Pharmacists of Australia (n = 9), Pharmaceutical Society of Ireland (n = 8), National Institute of Health and Care Excellence (NICE) (n = 3), and the Royal Dutch Pharmacists Association (KNMP) (n = 3). The general characteristics of the eligible guidelines are presented in Table 1 .

PRISMA flowchart. *First 200 titles based on relevance

The included guidelines covered a wide range of clinical pharmacy services, activities or procedures, some of which were specific to a clinical setting (e.g. primary care workplaces including community pharmacy), whereas others were applicable to a range of clinical settings. The included guidelines provided limited details on resources required for implementation of the guidelines. Two exceptions were guidelines published by the Pharmaceutical Society of Ireland, namely guidance on the provision of testing services in community pharmacies [ 35 ], and guidance on the provision of vaccination services in the community pharmacy setting [ 37 ]. Both guidelines provided details of facilities and equipment, the need for public communication, and resources to support quality delivery of services.

To underpin recommendations, the majority of guidelines (n = 34) made reference to either nationally published professional standards, such as those published by the national pharmacy professional body, such as the UK General Pharmaceutical Council [ 21 ] and the Society of Hospital Pharmacists of Australia [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ], or professional standards published by national institutes or organisations concerned with optimising the delivery of health care, such as NICE [ 50 , 52 , 53 ].

Extent to which guidelines supported delivery of person-centred care

Most guidelines (n = 25) encouraged patient involvement in decision-making, and included specific guidance on effective patient communication (n = 23). However, exceptions included six guidelines published between 2012 and 2013 [ 24 , 28 , 29 , 30 , 39 , 44 ]; and guidelines issued in countries where clinical pharmacy services were described to be in early development phases [ 18 , 39 , 41 , 42 ]. Most of the guidelines (n = 22) stated the importance of involving patients´ family and carers during the process of clinical pharmacy service provision [ 19 , 21 , 22 , 24 , 25 , 26 , 27 , 30 , 32 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 43 , 44 , 50 , 52 , 53 , 54 ].

In terms of ensuring equity and inclusivity in services delivery, five of the guidelines articulated the need to provide culturally sensitive information to patients [ 21 , 43 , 50 , 52 , 55 ], and seven included consideration for people with physical, sensory or learning disabilities [ 21 , 35 , 37 , 43 , 45 , 50 , 52 ]. The majority of these guidelines were published after 2016, and by bodies in the UK [ 21 , 50 , 52 ], Ireland [ 35 , 37 ] and the Netherlands [ 43 , 45 ].

An assessment of eligible guidelines for person-centeredness is presented in Table 2 .

AGREE II scores

Among the domains of the AGREE II instrument, the highest score was for Domain 1: Scope and purpose, and the lowest for Domain 3: Rigour of development. Table 3 presents the AGREE II scores for each domain and the cumulative totals for each of the included guidelines; and scores obtained for each domain of the AGREE II instrument are displayed in Fig.  2 .

Scores obtained from each domain of AGREE II tool. Domain 1: scope and purpose; Domain 2: stakeholder involvement; Domain 3: rigour of development; Domain 4: clarity of presentation; Domain 5: applicability; Domain 6: editorial independence

A total of ten of the included guidelines scored 100% for Domain 1 [ 21 , 31 , 37 , 40 , 47 , 48 , 49 , 50 , 52 , 53 ]; other guidelines which did not score 100% were either lacking details relating to the intended target population, such as age, co-morbidities or excluded populations; or the overall objective of the guideline was poorly defined. Four guidelines (one developed by Pharmaceutical Society of Australia [ 48 ], and three developed by NICE [ 50 , 52 , 53 ]) scored 100% for Domain 2: Stakeholder involvement . Many of the guidelines scored poorly in this domain; most frequently there were insufficient details to ascertain who the stakeholders involved in the development process were and how their views were considered in the development of the guideline (Table 3 ). For Domain 3 : Rigour of development , no guidelines scored 100%. Guidelines lacked details pertaining to the search strategy employed to collate the cited evidence; strengths and limitations of the included evidence; methods for formulating the recommendations; and processes adopted for external review and update the guideline. Clarity of presentation (Domain 4): Seven guidelines scored 100% [ 23 , 31 , 43 , 46 , 47 , 48 , 49 ], indicating that key recommendations were easy to identify and interpret from the guidelines. For Domain 5: Applicability , no guidelines scored 100%. The guidelines failed to comprehensively describe the barriers and facilitators to application, including the resource implications; and did not provide adequate details regarding monitoring criteria to measure application of the guideline recommendations. For Editorial independence (Domain 6), no guidelines scored 100%, either due to the absence of an explicit statement to describe contributing stakeholders’ conflicts of interest (if any) or failure to report the funding body’s influence on the content of the guideline (where relevant).

Overall, 9 out of 38 guidelines were recommended without modification for use in practice based on the AGREE-II instrument [ 31 , 37 , 38 , 46 , 47 , 48 , 49 , 52 , 53 ].

Key findings

The majority of guidelines represented a limited number of countries including Australia, Ireland, UK and USA, and described specific clinical pharmacy services or activities. While greater focus was on aspects such as medication review and medication reconciliation, there was little attention paid to education, training and competency development, which are central to the acquisition of these skills, for development of new services and to encourage advanced practice. Most of the guidelines promoted multidisciplinary working which underlines the pharmacy profession’s approach to improving the use of medicines through collaboration with other healthcare professionals.

Interpretation

The content and focus of most of the guidelines related to services such as medication review, medicines reconciliation and medication management including provision of dispensing services and clinical checking. Most of the official bodies approving and releasing the guidelines were professional regulators, professional society bodies, Health Technology Assessment bodies and independent healthcare bodies. Only a small number of guidelines focused on person-centred care and clinical communication. There is scope to develop international guidelines that can assist best practices in the delivery of person-centred care and clinical communications considering the relevance of these activities to the range of clinical pharmacy services and potential for application across diverse settings and countries.

Equity and patient-centred care are important aspects of healthcare, particularly at a time when migration and displacement of population groups has created multi-ethnic societies all around the world, and ageing populations are leading to an increasing proportion of citizens dependent upon health and social care services. The results identified that while 20 of the 38 guidelines endorsed the involvement of family and carers, only a few emphasised on providing culturally sensitive information (n = 4) or consideration of people with physical, sensory, or learning disabilities (n = 6). Allied to this, only a minority (n = 6) addressed applicability which assesses implementation and monitoring. This finding strongly suggests that a stronger vision and urgency is needed to support practice implementation of published guidelines.

Using the AGREE II tool, the quality of the guidelines was found to be low to moderate. Across the guidelines, scope and clarity aspects of the guidelines were rated higher than rigour of development, stakeholder involvement and applicability. For example, only a few demonstrated a systematic, evidence-based approach to their recommendations which is surprising given that most were produced by regulators or professional representative bodies. The extent of stakeholder involvement in the development process were unclear in most guidelines. Similarly, the low scores for the rigour of development and editorial independence domains were notable. Although just over half (n = 20) of the guidelines were published between 5 to 10 years ago, all but one of the others were less than 5 years old. Over this period the adoption of systematic and evidence-based methods of guideline development have been accepted as best practice and the AGREE II instrument has been extensively used since 2009 [ 56 ].

The role of the pharmacist and the place of clinical pharmacy services remain contested facets of healthcare in many countries [ 5 , 57 ], and without rigorous, evidence-based guidelines, clinical pharmacy development is likely to continue to struggle to gain more widespread recognition. To remedy this, guideline development bodies, including professional societies that develop clinical practice guidelines should focus efforts on the quality aspects of guideline development and resources to support implementation. Utilisation of skilled professionals and strengthening the clinical pharmacy support staff team is key to promote safe and effective use of medications and provide person-centred care [ 58 ]. At the same time, guidelines should also be able to carefully consider practical challenges for practitioners and administrators and how to implement recommendations in a resource-constrained environment. Quality guidelines should be better utilised in various languages and in versions adjusted to the local situation and needs in different countries.

Strengths and limitations

This is the first systematic review published on scope and quality of clinical pharmacy guidelines. It encompassed guidelines published in different countries and used the validated AGREE II instrument to assess the quality of the included guidelines. The study reviewers used a previously defined approach for quality assessment of guidelines, reviewed texts independently and thoroughly, discussed their approach, and resolved any difficulties encountered during the process in these discussions. However, inter-rator agreement was not assessed using statistical approaches and some divergence in approach may have remained.

Limitations of the AGREE II instrument have been previously discussed in the literature. The six domains in the AGREE II instrument are independent of each other and the tool does not allow calculation of a single global score based on domain scores [ 59 ]. It is also worth noting that from the perspective of guideline development bodies, some of the expectations laid out by the AGREE II criteria require extensive resources to implement compared to others. For example, satisfying the appraisal criteria around ‘rigour of development’ (domain 3) requires guideline development bodies to undertake a rigorous systematic review of existing literature prior to formulating the guidelines, whereas, satisfying domain criteria around ‘clarity of presentation’ and ‘editorial independence’ could be argued to be relatively less resource intensive.

Future research

Reviewing guidelines specific to a clinical condition, technology or patient population was not within the scope of this study. Future research should evaluate published guidelines in specific areas of practice regarding their scope, strengths, limitations and applicability. Pharmacists’ roles are increasing internationally with emphasis on delivery of cognitive services and independent prescribing [ 6 , 60 , 61 , 62 ]. There is an opportunity for international professional practice societies and health systems to make a positive impact on patient care globally by developing common practice guidelines focusing on core pharmacy practice activities. Such guidelines could be adapted further by different nations and geographies for the recommendations to be implemented in local/national contexts.

Clinical pharmacy guidelines included in this review represent a limited number of countries, settings and services. There is a scope to co-develop and disseminate internationally applicable guidelines in promoting person-centred care and clinical communication given their relevance to a range of clinical pharmacy services, settings, and countries. International best practice guidelines for various clinical pharmacy activities may provide a basis for the development of country-specific guidelines and clinical pharmacy services in different countries and healthcare systems including low and middle income countries. Quality of most guidelines as assessed by the AGREE II instrument was found to be low to moderate. Developers of future clinical pharmacy guidelines need to focus more on all quality domains and should adopt a systematic approach to guideline development to generate evidence supporting establishment of modern clinical pharmacy services in different countries, helping to improve healthcare quality.

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Acknowledgements

Authors represent various working committees of European Society of Clinical Pharmacy (ESCP). We thank ESCP for providing forum to generate ideas and the network required to retrieve the guidelines. Research works of DF were supported also by institutional research program Cooperation, Faculty of Pharmacy, Charles University.

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Paudyal, V., Okuyan, B., Henman, M.C. et al. Scope, content and quality of clinical pharmacy practice guidelines: a systematic review. Int J Clin Pharm 46 , 56–69 (2024). https://doi.org/10.1007/s11096-023-01658-x

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Received : 18 August 2023

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DOI : https://doi.org/10.1007/s11096-023-01658-x

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