This article provides a brief introduction to critical steps needed for conducting a high-quality State-of-the-Art (SotA) literature review, one that will add to our understanding of the phenomenon under study. This introduction complements another article in this issue, which discusses the purposes, underlying foundations, strengths, and weakness of SotA reviews in more detail.1 

The fundamental purpose of SotA literature reviews is to create a 3-part argument about the state of knowledge for a specific phenomenon: This is where we are now. This is how we got here. This is where we could go next (Table 1). Below is a 6-stage process for conducting a SotA literature review.2  To support this process, questions for guiding each of the 6 stages are provided in Table 2.

Table 1

Example of a Medical Education State-of-the-Art (SotA) Literature Review

Example of a Medical Education State-of-the-Art (SotA) Literature Review
Example of a Medical Education State-of-the-Art (SotA) Literature Review
Table 2

Six-Stage Approach to Conducting a State-of-the-Art Review With Guiding Questions

Six-Stage Approach to Conducting a State-of-the-Art Review With Guiding Questions
Six-Stage Approach to Conducting a State-of-the-Art Review With Guiding Questions

It is important to identify individuals who will be a part of the research team. While a SotA review can be conducted by a single author, most SotA reviews harness the perspectives of an interdisciplinary team to generate rich interpretations of the literature. The team should also include a medical librarian to help with developing the search strategy.

In Stage 1, the research team determines the initial research question that incorporates the phenomenon to be addressed in the SotA literature review. It is important to clearly define the field of knowledge and/or practice that will be targeted.

Stage 2 determines the time frame that will define “state-of-the-art” for the research question defined in Stage 1. In Stage 2, the research team should engage in a broad overview of the literature to develop an understanding of the phenomenon's historical development (ie, seminal articles). This process will shape the research team's focus vis-à-vis the pivotal moments in history when the thinking about the phenomenon changed and the time frame for contemporary thinking (ie, the date marking the beginning of this is where we are now thinking). At the end of Stage 2, the research team should be able to justify why a specific year (ie, turning point in history) is chosen to mark the beginning of state-of-the-art thinking around the phenomenon.

Based on the developments from Stages 1 and 2, the research team will revise and finalize the research question(s) to determine what needs to be included in the search strategy and analyses. The revised research question(s) and justification for the timeline must be reported in the article.

Next, a search strategy is developed, enabling the research team to construct the corpus of literature to be included in the SotA review. This involves determining which database(s) to search and when to set the start date for the review. Since the review needs to describe this is how we got here, it must include literature that predates the this is where we are now time frame determined in Stage 2. Stage 4 is an iterative process of testing and revising the search strategy to capture pertinent literature required to meet the purpose of the SotA review. It is important to note that the search goal is not to review all pertinent literature in the SotA review; instead, the goal is to include relevant literature to describe a historical evolution in the field's thinking about a topic. The final search strategy must be included in the manuscript. If possible, a librarian should be consulted when developing the search strategy. A software program such as Covidence may be useful to help organize and share all articles with the research team.

Analysis of the included literature is an inductive process where the research team reads and reflects on the articles and constructs an interpretation of the historical development of how the specific phenomenon is understood in the field. The research team should begin by reading each included article to become familiar with this literature and be able to identify similarities among the articles, ways of thinking that have shaped current understandings, assumptions underpinning changes in understandings over time, and gaps and assumptions in the current knowledge.

Next, the research team can generate the premises that fit the purpose of a SotA review (ie, creating an understanding of the topic, constructing a history of knowledge development that gave rise to this modern thinking, and developing suggestions for future research). In this stage, the research team should highlight specific articles that either support or contradict its premises.

The final step in Stage 5 is to verify the thoroughness and strength of the research team's interpretations. This can be done by selecting different articles and examining if they are congruent with the team's interpretations. The research team may also seek out additional literature that offers alternative interpretations to convey that their summary successfully refutes conflicting interpretations. The goal of this verification work is not to engage in a triangulation process for objectivity or for external confirmation; instead, this process is to help the research team ensure that they have successfully explained their interpretations in a way that supports or refutes the interpretations offered by others.

The SotA manuscript should offer insights into the subjectivity of the research team by describing members who comprise the team, applications of their expertise, and how these informed their interpretations of the data. This reflexivity description will help readers understand the perspectives that informed the interpretation offered by the research team.

1. 
Barry
ES,
Merkebu
J,
Varpio
L.
Understanding state-of-the-art literature reviews
.
J Grad Med Educ
.
2022
;
14
(6)
:
659
-
662
.
2. 
Barry
ES,
Merkebu
J,
Varpio
L.
State-of-the-art literature review methodology: a six-step approach for knowledge synthesis [published online ahead of print September 5, 2022]
.
Perspect Med Educ. doi:10.1007/s40037-022-00725-9

Author notes

Disclaimer: The opinions and assertions contained herein are those of the authors and are not to be construed as reflecting the views of the Uniformed Services University of the Health Sciences or the US Department of Defense.