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What is a thesis?

What is a dissertation, getting started, staying on track.

A thesis is a long-term project that you work on over the course of a semester or a year. Theses have a very wide variety of styles and content, so we encourage you to look at prior examples and work closely with faculty to develop yours. 

Before you begin, make sure that you are familiar with the dissertation genre—what it is for and what it looks like.

Generally speaking, a dissertation’s purpose is to prove that you have the expertise necessary to fulfill your doctoral-degree requirements by showing depth of knowledge and independent thinking.

The form of a dissertation may vary by discipline. Be sure to follow the specific guidelines of your department.

• PhD This site directs candidates to the GSAS website about dissertations , with links to checklists,  planning, formatting, acknowledgments, submission, and publishing options. There is also a link to guidelines for the prospectus . Consult with your committee chair about specific requirements and standards for your dissertation.
• DDES This document covers planning, patent filing, submission guidelines, publishing options, formatting guidelines, sample pages, citation guidelines, and a list of common errors to avoid. There is also a link to guidelines for the prospectus .
• Scholarly Pursuits (GSAS) This searchable booklet from Harvard GSAS is a comprehensive guide to writing dissertations, dissertation-fellowship applications, academic journal articles, and academic job documents.

Finding an original topic can be a daunting and overwhelming task. These key concepts can help you focus and save time.

Finding a topic for your dissertation should start with a research question that excites or at least interests you. A rigorous, engaging, and original dissertation will require continuous curiosity about your topic, about your own thoughts on the topic, and about what other scholars have said on your topic. Avoid getting boxed in by thinking you know what you want to say from the beginning; let your research and your writing evolve as you explore and fine-tune your focus through constant questioning and exploration.

Get a sense of the broader picture before you narrow your focus and attempt to frame an argument. Read, skim, and otherwise familiarize yourself with what other scholars have done in areas related to your proposed topic. Briefly explore topics tangentially related to yours to broaden your perspective and increase your chance of finding a unique angle to pursue.

Critical Reading

Critical reading is the opposite of passive reading. Instead of merely reading for information to absorb, critical reading also involves careful, sustained thinking about what you are reading. This process may include analyzing the author’s motives and assumptions, asking what might be left out of the discussion, considering what you agree with or disagree with in the author’s statements and why you agree or disagree, and exploring connections or contradictions between scholarly arguments. Here is a resource to help hone your critical-reading skills:

http://writing.umn.edu/sws/assets/pdf/quicktips/criticalread.pdf

Conversation

Your dissertation will incorporate some of the ideas of the other scholars whose work you researched. By reading critically and following your curiosity, you will develop your own ideas and claims, and these contributions are the core of your dissertation. However, your dissertation will also acknowledge the work of scholars who came before you, and you must accurately and fairly attribute this work and define your place within the larger discussion. Make sure that you know how to quote, summarize, paraphrase , integrate , and cite secondary sources to avoid plagiarism and to show the depth and breadth of your knowledge.

A thesis is a long-term, large project that involves both research and writing; it is easy to lose focus, motivation, and momentum. Here are suggestions for achieving the result you want in the time you have.

The dissertation is probably the largest project you have undertaken, and a lot of the work is self-directed. The project can feel daunting or even overwhelming unless you break it down into manageable pieces and create a timeline for completing each smaller task. Be realistic but also challenge yourself, and be forgiving of yourself if you miss a self-imposed deadline here and there.

Your program will also have specific deadlines for different requirements, including establishing a committee, submitting a prospectus, completing the dissertation, defending the dissertation, and submitting your work. Consult your department’s website for these dates and incorporate them into the timeline for your work.

Accountability

Sometimes self-imposed deadlines do not feel urgent unless there is accountability to someone beyond yourself. To increase your motivation to complete tasks on schedule, set dates with your committee chair to submit pre-determined pieces of a chapter. You can also arrange with a fellow doctoral student to check on each other’s progress. Research and writing can be lonely, so it is also nice to share that journey with someone and support each other through the process.

Common Pitfalls

The most common challenges for students writing a dissertation are writer’s block, information-overload, and the compulsion to keep researching forever.

There are many strategies for avoiding writer’s block, such as freewriting, outlining, taking a walk, starting in the middle, and creating an ideal work environment for your particular learning style. Pay attention to what helps you and try different things until you find what works.

Efficient researching techniques are essential to avoiding information-overload. Here are a couple of resources about strategies for finding sources and quickly obtaining essential information from them.

https://owl.purdue.edu/owl/subject_specific_writing/writing_in_literature/writing_in_literature_detailed_discussion/reading_criticism.html

https://students.dartmouth.edu/academic-skills/learning-resources/learning-strategies/reading-techniques

Finally, remember that there is always more to learn and your dissertation cannot incorporate everything. Follow your curiosity but also set limits on the scope of your work. It helps to create a folder entitled “future projects” for topics and sources that interest you but that do not fit neatly into the dissertation. Also remember that future scholars will build off of your work, so leave something for them to do.

Browsing through theses and dissertations of the past can help to get a sense of your options and gain inspiration but be careful to use current guidelines and refer to your committee instead of relying on these examples for form or formatting.

DASH Digital Access to Scholarship at Harvard.

HOLLIS Harvard Library’s catalog provides access to ProQuest Dissertations & Theses Global .

MIT Architecture has a list of their graduates’ dissertations and theses.

Rhode Island School of Design has a list of their graduates’ dissertations and theses.

University of South Florida has a list of their graduates’ dissertations and theses.

Harvard GSD has a list of projects, including theses and professors’ research.

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How to Write a Dissertation Proposal | A Step-by-Step Guide

Published on 14 February 2020 by Jack Caulfield . Revised on 11 November 2022.

A dissertation proposal describes the research you want to do: what it’s about, how you’ll conduct it, and why it’s worthwhile. You will probably have to write a proposal before starting your dissertation as an undergraduate or postgraduate student.

A dissertation proposal should generally include:

• An introduction to your topic and aims
• A literature review  of the current state of knowledge
• An outline of your proposed methodology
• A discussion of the possible implications of the research
• A bibliography  of relevant sources

Dissertation proposals vary a lot in terms of length and structure, so make sure to follow any guidelines given to you by your institution, and check with your supervisor when you’re unsure.

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Table of contents

Step 1: coming up with an idea, step 2: presenting your idea in the introduction, step 3: exploring related research in the literature review, step 4: describing your methodology, step 5: outlining the potential implications of your research, step 6: creating a reference list or bibliography.

Before writing your proposal, it’s important to come up with a strong idea for your dissertation.

Find an area of your field that interests you and do some preliminary reading in that area. What are the key concerns of other researchers? What do they suggest as areas for further research, and what strikes you personally as an interesting gap in the field?

Once you have an idea, consider how to narrow it down and the best way to frame it. Don’t be too ambitious or too vague – a dissertation topic needs to be specific enough to be feasible. Move from a broad field of interest to a specific niche:

• Russian literature 19th century Russian literature The novels of Tolstoy and Dostoevsky
• Social media Mental health effects of social media Influence of social media on young adults suffering from anxiety

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Like most academic texts, a dissertation proposal begins with an introduction . This is where you introduce the topic of your research, provide some background, and most importantly, present your aim , objectives and research question(s) .

Try to dive straight into your chosen topic: What’s at stake in your research? Why is it interesting? Don’t spend too long on generalisations or grand statements:

• Social media is the most important technological trend of the 21st century. It has changed the world and influences our lives every day.
• Psychologists generally agree that the ubiquity of social media in the lives of young adults today has a profound impact on their mental health. However, the exact nature of this impact needs further investigation.

Once your area of research is clear, you can present more background and context. What does the reader need to know to understand your proposed questions? What’s the current state of research on this topic, and what will your dissertation contribute to the field?

If you’re including a literature review, you don’t need to go into too much detail at this point, but give the reader a general sense of the debates that you’re intervening in.

This leads you into the most important part of the introduction: your aim, objectives and research question(s) . These should be clearly identifiable and stand out from the text – for example, you could present them using bullet points or bold font.

Make sure that your research questions are specific and workable – something you can reasonably answer within the scope of your dissertation. Avoid being too broad or having too many different questions. Remember that your goal in a dissertation proposal is to convince the reader that your research is valuable and feasible:

• Does social media harm mental health?
• What is the impact of daily social media use on 18– to 25–year–olds suffering from general anxiety disorder?

Now that your topic is clear, it’s time to explore existing research covering similar ideas. This is important because it shows you what is missing from other research in the field and ensures that you’re not asking a question someone else has already answered.

You’ve probably already done some preliminary reading, but now that your topic is more clearly defined, you need to thoroughly analyse and evaluate the most relevant sources in your literature review .

Here you should summarise the findings of other researchers and comment on gaps and problems in their studies. There may be a lot of research to cover, so make effective use of paraphrasing to write concisely:

• Smith and Prakash state that ‘our results indicate a 25% decrease in the incidence of mechanical failure after the new formula was applied’.
• Smith and Prakash’s formula reduced mechanical failures by 25%.

The point is to identify findings and theories that will influence your own research, but also to highlight gaps and limitations in previous research which your dissertation can address:

• Subsequent research has failed to replicate this result, however, suggesting a flaw in Smith and Prakash’s methods. It is likely that the failure resulted from…

Next, you’ll describe your proposed methodology : the specific things you hope to do, the structure of your research and the methods that you will use to gather and analyse data.

You should get quite specific in this section – you need to convince your supervisor that you’ve thought through your approach to the research and can realistically carry it out. This section will look quite different, and vary in length, depending on your field of study.

You may be engaged in more empirical research, focusing on data collection and discovering new information, or more theoretical research, attempting to develop a new conceptual model or add nuance to an existing one.

Dissertation research often involves both, but the content of your methodology section will vary according to how important each approach is to your dissertation.

Empirical research

Empirical research involves collecting new data and analysing it in order to answer your research questions. It can be quantitative (focused on numbers), qualitative (focused on words and meanings), or a combination of both.

With empirical research, it’s important to describe in detail how you plan to collect your data:

• Will you use surveys ? A lab experiment ? Interviews?
• What variables will you measure?
• How will you select a representative sample ?
• If other people will participate in your research, what measures will you take to ensure they are treated ethically?
• What tools (conceptual and physical) will you use, and why?

It’s appropriate to cite other research here. When you need to justify your choice of a particular research method or tool, for example, you can cite a text describing the advantages and appropriate usage of that method.

Don’t overdo this, though; you don’t need to reiterate the whole theoretical literature, just what’s relevant to the choices you have made.

Moreover, your research will necessarily involve analysing the data after you have collected it. Though you don’t know yet what the data will look like, it’s important to know what you’re looking for and indicate what methods (e.g. statistical tests , thematic analysis ) you will use.

Theoretical research

You can also do theoretical research that doesn’t involve original data collection. In this case, your methodology section will focus more on the theory you plan to work with in your dissertation: relevant conceptual models and the approach you intend to take.

For example, a literary analysis dissertation rarely involves collecting new data, but it’s still necessary to explain the theoretical approach that will be taken to the text(s) under discussion, as well as which parts of the text(s) you will focus on:

• This dissertation will utilise Foucault’s theory of panopticism to explore the theme of surveillance in Orwell’s 1984 and Kafka’s The Trial…

Here, you may refer to the same theorists you have already discussed in the literature review. In this case, the emphasis is placed on how you plan to use their contributions in your own research.

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You’ll usually conclude your dissertation proposal with a section discussing what you expect your research to achieve.

You obviously can’t be too sure: you don’t know yet what your results and conclusions will be. Instead, you should describe the projected implications and contribution to knowledge of your dissertation.

First, consider the potential implications of your research. Will you:

• Develop or test a theory?
• Provide new information to governments or businesses?
• Challenge a commonly held belief?
• Suggest an improvement to a specific process?

Describe the intended result of your research and the theoretical or practical impact it will have:

Finally, it’s sensible to conclude by briefly restating the contribution to knowledge you hope to make: the specific question(s) you hope to answer and the gap the answer(s) will fill in existing knowledge:

Like any academic text, it’s important that your dissertation proposal effectively references all the sources you have used. You need to include a properly formatted reference list or bibliography at the end of your proposal.

Different institutions recommend different styles of referencing – commonly used styles include Harvard , Vancouver , APA , or MHRA . If your department does not have specific requirements, choose a style and apply it consistently.

A reference list includes only the sources that you cited in your proposal. A bibliography is slightly different: it can include every source you consulted in preparing the proposal, even if you didn’t mention it in the text. In the case of a dissertation proposal, a bibliography may also list relevant sources that you haven’t yet read, but that you intend to use during the research itself.

Check with your supervisor what type of bibliography or reference list you should include.

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Caulfield, J. (2022, November 11). How to Write a Dissertation Proposal | A Step-by-Step Guide. Scribbr. Retrieved 3 June 2024, from https://www.scribbr.co.uk/thesis-dissertation/proposal/

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Dissertation Structure & Layout 101: How to structure your dissertation, thesis or research project.

By: Derek Jansen (MBA) Reviewed By: David Phair (PhD) | July 2019

So, you’ve got a decent understanding of what a dissertation is , you’ve chosen your topic and hopefully you’ve received approval for your research proposal . Awesome! Now its time to start the actual dissertation or thesis writing journey.

To craft a high-quality document, the very first thing you need to understand is dissertation structure . In this post, we’ll walk you through the generic dissertation structure and layout, step by step. We’ll start with the big picture, and then zoom into each chapter to briefly discuss the core contents. If you’re just starting out on your research journey, you should start with this post, which covers the big-picture process of how to write a dissertation or thesis .

*The Caveat *

In this post, we’ll be discussing a traditional dissertation/thesis structure and layout, which is generally used for social science research across universities, whether in the US, UK, Europe or Australia. However, some universities may have small variations on this structure (extra chapters, merged chapters, slightly different ordering, etc).

So, always check with your university if they have a prescribed structure or layout that they expect you to work with. If not, it’s safe to assume the structure we’ll discuss here is suitable. And even if they do have a prescribed structure, you’ll still get value from this post as we’ll explain the core contents of each section.  

Overview: S tructuring a dissertation or thesis

• Acknowledgements page
• Abstract (or executive summary)
• Table of contents , list of figures and tables
• Chapter 1: Introduction
• Chapter 2: Literature review
• Chapter 3: Methodology
• Chapter 4: Results
• Chapter 5: Discussion
• Chapter 6: Conclusion
• Reference list

As I mentioned, some universities will have slight variations on this structure. For example, they want an additional “personal reflection chapter”, or they might prefer the results and discussion chapter to be merged into one. Regardless, the overarching flow will always be the same, as this flow reflects the research process , which we discussed here – i.e.:

• The introduction chapter presents the core research question and aims .
• The literature review chapter assesses what the current research says about this question.
• The methodology, results and discussion chapters go about undertaking new research about this question.
• The conclusion chapter (attempts to) answer the core research question .

In other words, the dissertation structure and layout reflect the research process of asking a well-defined question(s), investigating, and then answering the question – see below.

To restate that – the structure and layout of a dissertation reflect the flow of the overall research process . This is essential to understand, as each chapter will make a lot more sense if you “get” this concept. If you’re not familiar with the research process, read this post before going further.

Right. Now that we’ve covered the big picture, let’s dive a little deeper into the details of each section and chapter. Oh and by the way, you can also grab our free dissertation/thesis template here to help speed things up.

The title page of your dissertation is the very first impression the marker will get of your work, so it pays to invest some time thinking about your title. But what makes for a good title? A strong title needs to be 3 things:

• Succinct (not overly lengthy or verbose)
• Specific (not vague or ambiguous)
• Representative of the research you’re undertaking (clearly linked to your research questions)

Typically, a good title includes mention of the following:

• The broader area of the research (i.e. the overarching topic)
• The specific focus of your research (i.e. your specific context)
• Indication of research design (e.g. quantitative , qualitative , or  mixed methods ).

For example:

A quantitative investigation [research design] into the antecedents of organisational trust [broader area] in the UK retail forex trading market [specific context/area of focus].

Again, some universities may have specific requirements regarding the format and structure of the title, so it’s worth double-checking expectations with your institution (if there’s no mention in the brief or study material).

Acknowledgements

This page provides you with an opportunity to say thank you to those who helped you along your research journey. Generally, it’s optional (and won’t count towards your marks), but it is academic best practice to include this.

So, who do you say thanks to? Well, there’s no prescribed requirements, but it’s common to mention the following people:

• Your dissertation supervisor or committee.
• Any professors, lecturers or academics that helped you understand the topic or methodologies.
• Any tutors, mentors or advisors.
• Your family and friends, especially spouse (for adult learners studying part-time).

There’s no need for lengthy rambling. Just state who you’re thankful to and for what (e.g. thank you to my supervisor, John Doe, for his endless patience and attentiveness) – be sincere. In terms of length, you should keep this to a page or less.

Abstract or executive summary

The dissertation abstract (or executive summary for some degrees) serves to provide the first-time reader (and marker or moderator) with a big-picture view of your research project. It should give them an understanding of the key insights and findings from the research, without them needing to read the rest of the report – in other words, it should be able to stand alone .

For it to stand alone, your abstract should cover the following key points (at a minimum):

• Your research questions and aims – what key question(s) did your research aim to answer?
• Your methodology – how did you go about investigating the topic and finding answers to your research question(s)?
• Your findings – following your own research, what did do you discover?
• Your conclusions – based on your findings, what conclusions did you draw? What answers did you find to your research question(s)?

So, in much the same way the dissertation structure mimics the research process, your abstract or executive summary should reflect the research process, from the initial stage of asking the original question to the final stage of answering that question.

In practical terms, it’s a good idea to write this section up last , once all your core chapters are complete. Otherwise, you’ll end up writing and rewriting this section multiple times (just wasting time). For a step by step guide on how to write a strong executive summary, check out this post .

Need a helping hand?

Table of contents

This section is straightforward. You’ll typically present your table of contents (TOC) first, followed by the two lists – figures and tables. I recommend that you use Microsoft Word’s automatic table of contents generator to generate your TOC. If you’re not familiar with this functionality, the video below explains it simply:

If you find that your table of contents is overly lengthy, consider removing one level of depth. Oftentimes, this can be done without detracting from the usefulness of the TOC.

Right, now that the “admin” sections are out of the way, its time to move on to your core chapters. These chapters are the heart of your dissertation and are where you’ll earn the marks. The first chapter is the introduction chapter – as you would expect, this is the time to introduce your research…

It’s important to understand that even though you’ve provided an overview of your research in your abstract, your introduction needs to be written as if the reader has not read that (remember, the abstract is essentially a standalone document). So, your introduction chapter needs to start from the very beginning, and should address the following questions:

• What will you be investigating (in plain-language, big picture-level)?
• Why is that worth investigating? How is it important to academia or business? How is it sufficiently original?
• What are your research aims and research question(s)? Note that the research questions can sometimes be presented at the end of the literature review (next chapter).
• What is the scope of your study? In other words, what will and won’t you cover ?
• How will you approach your research? In other words, what methodology will you adopt?
• How will you structure your dissertation? What are the core chapters and what will you do in each of them?

These are just the bare basic requirements for your intro chapter. Some universities will want additional bells and whistles in the intro chapter, so be sure to carefully read your brief or consult your research supervisor.

If done right, your introduction chapter will set a clear direction for the rest of your dissertation. Specifically, it will make it clear to the reader (and marker) exactly what you’ll be investigating, why that’s important, and how you’ll be going about the investigation. Conversely, if your introduction chapter leaves a first-time reader wondering what exactly you’ll be researching, you’ve still got some work to do.

Now that you’ve set a clear direction with your introduction chapter, the next step is the literature review . In this section, you will analyse the existing research (typically academic journal articles and high-quality industry publications), with a view to understanding the following questions:

• What does the literature currently say about the topic you’re investigating?
• Is the literature lacking or well established? Is it divided or in disagreement?
• How does your research fit into the bigger picture?
• How does your research contribute something original?
• How does the methodology of previous studies help you develop your own?

Depending on the nature of your study, you may also present a conceptual framework towards the end of your literature review, which you will then test in your actual research.

Again, some universities will want you to focus on some of these areas more than others, some will have additional or fewer requirements, and so on. Therefore, as always, its important to review your brief and/or discuss with your supervisor, so that you know exactly what’s expected of your literature review chapter.

Now that you’ve investigated the current state of knowledge in your literature review chapter and are familiar with the existing key theories, models and frameworks, its time to design your own research. Enter the methodology chapter – the most “science-ey” of the chapters…

In this chapter, you need to address two critical questions:

• Exactly HOW will you carry out your research (i.e. what is your intended research design)?
• Exactly WHY have you chosen to do things this way (i.e. how do you justify your design)?

Remember, the dissertation part of your degree is first and foremost about developing and demonstrating research skills . Therefore, the markers want to see that you know which methods to use, can clearly articulate why you’ve chosen then, and know how to deploy them effectively.

Importantly, this chapter requires detail – don’t hold back on the specifics. State exactly what you’ll be doing, with who, when, for how long, etc. Moreover, for every design choice you make, make sure you justify it.

In practice, you will likely end up coming back to this chapter once you’ve undertaken all your data collection and analysis, and revise it based on changes you made during the analysis phase. This is perfectly fine. Its natural for you to add an additional analysis technique, scrap an old one, etc based on where your data lead you. Of course, I’m talking about small changes here – not a fundamental switch from qualitative to quantitative, which will likely send your supervisor in a spin!

You’ve now collected your data and undertaken your analysis, whether qualitative, quantitative or mixed methods. In this chapter, you’ll present the raw results of your analysis . For example, in the case of a quant study, you’ll present the demographic data, descriptive statistics, inferential statistics , etc.

Typically, Chapter 4 is simply a presentation and description of the data, not a discussion of the meaning of the data. In other words, it’s descriptive, rather than analytical – the meaning is discussed in Chapter 5. However, some universities will want you to combine chapters 4 and 5, so that you both present and interpret the meaning of the data at the same time. Check with your institution what their preference is.

Now that you’ve presented the data analysis results, its time to interpret and analyse them. In other words, its time to discuss what they mean, especially in relation to your research question(s).

What you discuss here will depend largely on your chosen methodology. For example, if you’ve gone the quantitative route, you might discuss the relationships between variables . If you’ve gone the qualitative route, you might discuss key themes and the meanings thereof. It all depends on what your research design choices were.

Most importantly, you need to discuss your results in relation to your research questions and aims, as well as the existing literature. What do the results tell you about your research questions? Are they aligned with the existing research or at odds? If so, why might this be? Dig deep into your findings and explain what the findings suggest, in plain English.

The final chapter – you’ve made it! Now that you’ve discussed your interpretation of the results, its time to bring it back to the beginning with the conclusion chapter . In other words, its time to (attempt to) answer your original research question s (from way back in chapter 1). Clearly state what your conclusions are in terms of your research questions. This might feel a bit repetitive, as you would have touched on this in the previous chapter, but its important to bring the discussion full circle and explicitly state your answer(s) to the research question(s).

Next, you’ll typically discuss the implications of your findings . In other words, you’ve answered your research questions – but what does this mean for the real world (or even for academia)? What should now be done differently, given the new insight you’ve generated?

Lastly, you should discuss the limitations of your research, as well as what this means for future research in the area. No study is perfect, especially not a Masters-level. Discuss the shortcomings of your research. Perhaps your methodology was limited, perhaps your sample size was small or not representative, etc, etc. Don’t be afraid to critique your work – the markers want to see that you can identify the limitations of your work. This is a strength, not a weakness. Be brutal!

This marks the end of your core chapters – woohoo! From here on out, it’s pretty smooth sailing.

The reference list is straightforward. It should contain a list of all resources cited in your dissertation, in the required format, e.g. APA , Harvard, etc.

It’s essential that you use reference management software for your dissertation. Do NOT try handle your referencing manually – its far too error prone. On a reference list of multiple pages, you’re going to make mistake. To this end, I suggest considering either Mendeley or Zotero. Both are free and provide a very straightforward interface to ensure that your referencing is 100% on point. I’ve included a simple how-to video for the Mendeley software (my personal favourite) below:

Some universities may ask you to include a bibliography, as opposed to a reference list. These two things are not the same . A bibliography is similar to a reference list, except that it also includes resources which informed your thinking but were not directly cited in your dissertation. So, double-check your brief and make sure you use the right one.

The very last piece of the puzzle is the appendix or set of appendices. This is where you’ll include any supporting data and evidence. Importantly, supporting is the keyword here.

Your appendices should provide additional “nice to know”, depth-adding information, which is not critical to the core analysis. Appendices should not be used as a way to cut down word count (see this post which covers how to reduce word count ). In other words, don’t place content that is critical to the core analysis here, just to save word count. You will not earn marks on any content in the appendices, so don’t try to play the system!

Time to recap…

And there you have it – the traditional dissertation structure and layout, from A-Z. To recap, the core structure for a dissertation or thesis is (typically) as follows:

• Acknowledgments page

Most importantly, the core chapters should reflect the research process (asking, investigating and answering your research question). Moreover, the research question(s) should form the golden thread throughout your dissertation structure. Everything should revolve around the research questions, and as you’ve seen, they should form both the start point (i.e. introduction chapter) and the endpoint (i.e. conclusion chapter).

I hope this post has provided you with clarity about the traditional dissertation/thesis structure and layout. If you have any questions or comments, please leave a comment below, or feel free to get in touch with us. Also, be sure to check out the rest of the  Grad Coach Blog .

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36 Comments

many thanks i found it very useful

Glad to hear that, Arun. Good luck writing your dissertation.

Such clear practical logical advice. I very much needed to read this to keep me focused in stead of fretting.. Perfect now ready to start my research!

what about scientific fields like computer or engineering thesis what is the difference in the structure? thank you very much

Thanks so much this helped me a lot!

Very helpful and accessible. What I like most is how practical the advice is along with helpful tools/ links.

Thanks Ade!

Thank you so much sir.. It was really helpful..

You’re welcome!

Hi! How many words maximum should contain the abstract?

Thank you so much 😊 Find this at the right moment

You’re most welcome. Good luck with your dissertation.

best ever benefit i got on right time thank you

Many times Clarity and vision of destination of dissertation is what makes the difference between good ,average and great researchers the same way a great automobile driver is fast with clarity of address and Clear weather conditions .

I guess Great researcher = great ideas + knowledge + great and fast data collection and modeling + great writing + high clarity on all these

You have given immense clarity from start to end.

Morning. Where will I write the definitions of what I’m referring to in my report?

Thank you so much Derek, I was almost lost! Thanks a tonnnn! Have a great day!

Thanks ! so concise and valuable

This was very helpful. Clear and concise. I know exactly what to do now.

Thank you for allowing me to go through briefly. I hope to find time to continue.

Really useful to me. Thanks a thousand times

Very interesting! It will definitely set me and many more for success. highly recommended.

Thank you soo much sir, for the opportunity to express my skills

Usefull, thanks a lot. Really clear

Very nice and easy to understand. Thank you .

That was incredibly useful. Thanks Grad Coach Crew!

My stress level just dropped at least 15 points after watching this. Just starting my thesis for my grad program and I feel a lot more capable now! Thanks for such a clear and helpful video, Emma and the GradCoach team!

Do we need to mention the number of words the dissertation contains in the main document?

It depends on your university’s requirements, so it would be best to check with them 🙂

Such a helpful post to help me get started with structuring my masters dissertation, thank you!

Great video; I appreciate that helpful information

It is so necessary or avital course

This blog is very informative for my research. Thank you

Doctoral students are required to fill out the National Research Council’s Survey of Earned Doctorates

wow this is an amazing gain in my life

This is so good

How can i arrange my specific objectives in my dissertation?

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How to write a PhD thesis: a step-by-step guide

A draft isn’t a perfect, finished product; it is your opportunity to start getting words down on paper, writes Kelly Louise Preece

Kelly Louise Preece

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Congratulations; you’ve finished your research! Time to write your PhD thesis. This resource will take you through an eight-step plan for drafting your chapters and your thesis as a whole. 

Organise your material

Before you start, it’s important to get organised. Take a step back and look at the data you have, then reorganise your research. Which parts of it are central to your thesis and which bits need putting to one side? Label and organise everything using logical folders – make it easy for yourself! Academic and blogger Pat Thomson calls this  “Clean up to get clearer” . Thomson suggests these questions to ask yourself before you start writing:

• What data do you have? You might find it useful to write out a list of types of data (your supervisor will find this list useful too.) This list is also an audit document that can go in your thesis. Do you have any for the “cutting room floor”? Take a deep breath and put it in a separate non-thesis file. You can easily retrieve it if it turns out you need it.
• What do you have already written? What chunks of material have you written so far that could form the basis of pieces of the thesis text? They will most likely need to be revised but they are useful starting points. Do you have any holding text? That is material you already know has to be rewritten but contains information that will be the basis of a new piece of text.
• What have you read and what do you still need to read? Are there new texts that you need to consult now after your analysis? What readings can you now put to one side, knowing that they aren’t useful for this thesis – although they might be useful at another time?
• What goes with what? Can you create chunks or themes of materials that are going to form the basis of some chunks of your text, perhaps even chapters?

Once you have assessed and sorted what you have collected and generated you will be in much better shape to approach the big task of composing the dissertation. 

Decide on a key message

A key message is a summary of new information communicated in your thesis. You should have started to map this out already in the section on argument and contribution – an overarching argument with building blocks that you will flesh out in individual chapters.

You have already mapped your argument visually, now you need to begin writing it in prose. Following another of Pat Thomson’s exercises, write a “tiny text” thesis abstract. This doesn’t have to be elegant, or indeed the finished product, but it will help you articulate the argument you want your thesis to make. You create a tiny text using a five-paragraph structure:

• The first sentence addresses the broad context. This locates the study in a policy, practice or research field.
• The second sentence establishes a problem related to the broad context you have set out. It often starts with “But”, “Yet” or “However”.
• The third sentence says what specific research has been done. This often starts with “This research” or “I report…”
• The fourth sentence reports the results. Don’t try to be too tricky here, just start with something like: “This study shows,” or “Analysis of the data suggests that…”
• The fifth and final sentence addresses the “So What?” question and makes clear the claim to contribution.

Here’s an example that Thomson provides:

Secondary school arts are in trouble, as the fall in enrolments in arts subjects dramatically attests. However, there is patchy evidence about the benefits of studying arts subjects at school and this makes it hard to argue why the drop in arts enrolments matters. This thesis reports on research which attempts to provide some answers to this problem – a longitudinal study which followed two groups of senior secondary students, one group enrolled in arts subjects and the other not, for three years. The results of the study demonstrate the benefits of young people’s engagement in arts activities, both in and out of school, as well as the connections between the two. The study not only adds to what is known about the benefits of both formal and informal arts education but also provides robust evidence for policymakers and practitioners arguing for the benefits of the arts. You can  find out more about tiny texts and thesis abstracts on Thomson’s blog.

• Writing tips for higher education professionals
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• What is your academic writing temperament?

Write a plan

You might not be a planner when it comes to writing. You might prefer to sit, type and think through ideas as you go. That’s OK. Everybody works differently. But one of the benefits of planning your writing is that your plan can help you when you get stuck. It can help with writer’s block (more on this shortly!) but also maintain clarity of intention and purpose in your writing.

You can do this by creating a  thesis skeleton or storyboard , planning the order of your chapters, thinking of potential titles (which may change at a later stage), noting down what each chapter/section will cover and considering how many words you will dedicate to each chapter (make sure the total doesn’t exceed the maximum word limit allowed).

Use your plan to help prompt your writing when you get stuck and to develop clarity in your writing.

Some starting points include:

• This chapter will argue that…
• This section illustrates that…
• This paragraph provides evidence that…

Of course, we wish it werethat easy. But you need to approach your first draft as exactly that: a draft. It isn’t a perfect, finished product; it is your opportunity to start getting words down on paper. Start with whichever chapter you feel you want to write first; you don’t necessarily have to write the introduction first. Depending on your research, you may find it easier to begin with your empirical/data chapters.

Vitae advocates for the “three draft approach” to help with this and to stop you from focusing on finding exactly the right word or transition as part of your first draft.

This resource originally appeared on Researcher Development .

Kelly Louse Preece is head of educator development at the University of Exeter.

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Organizing Your Social Sciences Research Paper

• Academic Writing Style
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Academic writing refers to a style of expression that researchers use to define the intellectual boundaries of their disciplines and specific areas of expertise. Characteristics of academic writing include a formal tone, use of the third-person rather than first-person perspective (usually), a clear focus on the research problem under investigation, and precise word choice. Like specialist languages adopted in other professions, such as, law or medicine, academic writing is designed to convey agreed meaning about complex ideas or concepts within a community of scholarly experts and practitioners.

Academic Writing. Writing Center. Colorado Technical College; Hartley, James. Academic Writing and Publishing: A Practical Guide . New York: Routledge, 2008; Ezza, El-Sadig Y. and Touria Drid. T eaching Academic Writing as a Discipline-Specific Skill in Higher Education . Hershey, PA: IGI Global, 2020.

Importance of Good Academic Writing

The accepted form of academic writing in the social sciences can vary considerable depending on the methodological framework and the intended audience. However, most college-level research papers require careful attention to the following stylistic elements:

I.  The Big Picture Unlike creative or journalistic writing, the overall structure of academic writing is formal and logical. It must be cohesive and possess a logically organized flow of ideas; this means that the various parts are connected to form a unified whole. There should be narrative links between sentences and paragraphs so that the reader is able to follow your argument. The introduction should include a description of how the rest of the paper is organized and all sources are properly cited throughout the paper.

II.  Tone The overall tone refers to the attitude conveyed in a piece of writing. Throughout your paper, it is important that you present the arguments of others fairly and with an appropriate narrative tone. When presenting a position or argument that you disagree with, describe this argument accurately and without loaded or biased language. In academic writing, the author is expected to investigate the research problem from an authoritative point of view. You should, therefore, state the strengths of your arguments confidently, using language that is neutral, not confrontational or dismissive.

III.  Diction Diction refers to the choice of words you use. Awareness of the words you use is important because words that have almost the same denotation [dictionary definition] can have very different connotations [implied meanings]. This is particularly true in academic writing because words and terminology can evolve a nuanced meaning that describes a particular idea, concept, or phenomenon derived from the epistemological culture of that discipline [e.g., the concept of rational choice in political science]. Therefore, use concrete words [not general] that convey a specific meaning. If this cannot be done without confusing the reader, then you need to explain what you mean within the context of how that word or phrase is used within a discipline.

IV.  Language The investigation of research problems in the social sciences is often complex and multi- dimensional . Therefore, it is important that you use unambiguous language. Well-structured paragraphs and clear topic sentences enable a reader to follow your line of thinking without difficulty. Your language should be concise, formal, and express precisely what you want it to mean. Do not use vague expressions that are not specific or precise enough for the reader to derive exact meaning ["they," "we," "people," "the organization," etc.], abbreviations like 'i.e.'  ["in other words"], 'e.g.' ["for example"], or 'a.k.a.' ["also known as"], and the use of unspecific determinate words ["super," "very," "incredible," "huge," etc.].

V.  Punctuation Scholars rely on precise words and language to establish the narrative tone of their work and, therefore, punctuation marks are used very deliberately. For example, exclamation points are rarely used to express a heightened tone because it can come across as unsophisticated or over-excited. Dashes should be limited to the insertion of an explanatory comment in a sentence, while hyphens should be limited to connecting prefixes to words [e.g., multi-disciplinary] or when forming compound phrases [e.g., commander-in-chief]. Finally, understand that semi-colons represent a pause that is longer than a comma, but shorter than a period in a sentence. In general, there are four grammatical uses of semi-colons: when a second clause expands or explains the first clause; to describe a sequence of actions or different aspects of the same topic; placed before clauses which begin with "nevertheless", "therefore", "even so," and "for instance”; and, to mark off a series of phrases or clauses which contain commas. If you are not confident about when to use semi-colons [and most of the time, they are not required for proper punctuation], rewrite using shorter sentences or revise the paragraph.

VI.  Academic Conventions Among the most important rules and principles of academic engagement of a writing is citing sources in the body of your paper and providing a list of references as either footnotes or endnotes. The academic convention of citing sources facilitates processes of intellectual discovery, critical thinking, and applying a deliberate method of navigating through the scholarly landscape by tracking how cited works are propagated by scholars over time . Aside from citing sources, other academic conventions to follow include the appropriate use of headings and subheadings, properly spelling out acronyms when first used in the text, avoiding slang or colloquial language, avoiding emotive language or unsupported declarative statements, avoiding contractions [e.g., isn't], and using first person and second person pronouns only when necessary.

VII.  Evidence-Based Reasoning Assignments often ask you to express your own point of view about the research problem. However, what is valued in academic writing is that statements are based on evidence-based reasoning. This refers to possessing a clear understanding of the pertinent body of knowledge and academic debates that exist within, and often external to, your discipline concerning the topic. You need to support your arguments with evidence from scholarly [i.e., academic or peer-reviewed] sources. It should be an objective stance presented as a logical argument; the quality of the evidence you cite will determine the strength of your argument. The objective is to convince the reader of the validity of your thoughts through a well-documented, coherent, and logically structured piece of writing. This is particularly important when proposing solutions to problems or delineating recommended courses of action.

VIII.  Thesis-Driven Academic writing is “thesis-driven,” meaning that the starting point is a particular perspective, idea, or position applied to the chosen topic of investigation, such as, establishing, proving, or disproving solutions to the questions applied to investigating the research problem. Note that a problem statement without the research questions does not qualify as academic writing because simply identifying the research problem does not establish for the reader how you will contribute to solving the problem, what aspects you believe are most critical, or suggest a method for gathering information or data to better understand the problem.

IX.  Complexity and Higher-Order Thinking Academic writing addresses complex issues that require higher-order thinking skills applied to understanding the research problem [e.g., critical, reflective, logical, and creative thinking as opposed to, for example, descriptive or prescriptive thinking]. Higher-order thinking skills include cognitive processes that are used to comprehend, solve problems, and express concepts or that describe abstract ideas that cannot be easily acted out, pointed to, or shown with images. Think of your writing this way: One of the most important attributes of a good teacher is the ability to explain complexity in a way that is understandable and relatable to the topic being presented during class. This is also one of the main functions of academic writing--examining and explaining the significance of complex ideas as clearly as possible.  As a writer, you must adopt the role of a good teacher by summarizing complex information into a well-organized synthesis of ideas, concepts, and recommendations that contribute to a better understanding of the research problem.

Academic Writing. Writing Center. Colorado Technical College; Hartley, James. Academic Writing and Publishing: A Practical Guide . New York: Routledge, 2008; Murray, Rowena  and Sarah Moore. The Handbook of Academic Writing: A Fresh Approach . New York: Open University Press, 2006; Johnson, Roy. Improve Your Writing Skills . Manchester, UK: Clifton Press, 1995; Nygaard, Lynn P. Writing for Scholars: A Practical Guide to Making Sense and Being Heard . Second edition. Los Angeles, CA: Sage Publications, 2015; Silvia, Paul J. How to Write a Lot: A Practical Guide to Productive Academic Writing . Washington, DC: American Psychological Association, 2007; Style, Diction, Tone, and Voice. Writing Center, Wheaton College; Sword, Helen. Stylish Academic Writing . Cambridge, MA: Harvard University Press, 2012.

Strategies for...

Understanding Academic Writing and Its Jargon

The very definition of research jargon is language specific to a particular community of practitioner-researchers . Therefore, in modern university life, jargon represents the specific language and meaning assigned to words and phrases specific to a discipline or area of study. For example, the idea of being rational may hold the same general meaning in both political science and psychology, but its application to understanding and explaining phenomena within the research domain of a each discipline may have subtle differences based upon how scholars in that discipline apply the concept to the theories and practice of their work.

Given this, it is important that specialist terminology [i.e., jargon] must be used accurately and applied under the appropriate conditions . Subject-specific dictionaries are the best places to confirm the meaning of terms within the context of a specific discipline. These can be found by either searching in the USC Libraries catalog by entering the disciplinary and the word dictionary [e.g., sociology and dictionary] or using a database such as Credo Reference [a curated collection of subject encyclopedias, dictionaries, handbooks, guides from highly regarded publishers] . It is appropriate for you to use specialist language within your field of study, but you should avoid using such language when writing for non-academic or general audiences.

Problems with Opaque Writing

A common criticism of scholars is that they can utilize needlessly complex syntax or overly expansive vocabulary that is impenetrable or not well-defined. When writing, avoid problems associated with opaque writing by keeping in mind the following:

1.   Excessive use of specialized terminology . Yes, it is appropriate for you to use specialist language and a formal style of expression in academic writing, but it does not mean using "big words" just for the sake of doing so. Overuse of complex or obscure words or writing complicated sentence constructions gives readers the impression that your paper is more about style than substance; it leads the reader to question if you really know what you are talking about. Focus on creating clear, concise, and elegant prose that minimizes reliance on specialized terminology.

2.   Inappropriate use of specialized terminology . Because you are dealing with concepts, research, and data within your discipline, you need to use the technical language appropriate to that area of study. However, nothing will undermine the validity of your study quicker than the inappropriate application of a term or concept. Avoid using terms whose meaning you are unsure of--do not just guess or assume! Consult the meaning of terms in specialized, discipline-specific dictionaries by searching the USC Libraries catalog or the Credo Reference database [see above].

Additional Problems to Avoid

In addition to understanding the use of specialized language, there are other aspects of academic writing in the social sciences that you should be aware of. These problems include:

• Personal nouns . Excessive use of personal nouns [e.g., I, me, you, us] may lead the reader to believe the study was overly subjective. These words can be interpreted as being used only to avoid presenting empirical evidence about the research problem. Limit the use of personal nouns to descriptions of things you actually did [e.g., "I interviewed ten teachers about classroom management techniques..."]. Note that personal nouns are generally found in the discussion section of a paper because this is where you as the author/researcher interpret and describe your work.
• Directives . Avoid directives that demand the reader to "do this" or "do that." Directives should be framed as evidence-based recommendations or goals leading to specific outcomes. Note that an exception to this can be found in various forms of action research that involve evidence-based advocacy for social justice or transformative change. Within this area of the social sciences, authors may offer directives for action in a declarative tone of urgency.
• Informal, conversational tone using slang and idioms . Academic writing relies on excellent grammar and precise word structure. Your narrative should not include regional dialects or slang terms because they can be open to interpretation. Your writing should be direct and concise using standard English.
• Wordiness. Focus on being concise, straightforward, and developing a narrative that does not have confusing language . By doing so, you  help eliminate the possibility of the reader misinterpreting the design and purpose of your study.
• Vague expressions (e.g., "they," "we," "people," "the company," "that area," etc.). Being concise in your writing also includes avoiding vague references to persons, places, or things. While proofreading your paper, be sure to look for and edit any vague or imprecise statements that lack context or specificity.
• Numbered lists and bulleted items . The use of bulleted items or lists should be used only if the narrative dictates a need for clarity. For example, it is fine to state, "The four main problems with hedge funds are:" and then list them as 1, 2, 3, 4. However, in academic writing, this must then be followed by detailed explanation and analysis of each item. Given this, the question you should ask yourself while proofreading is: why begin with a list in the first place rather than just starting with systematic analysis of each item arranged in separate paragraphs? Also, be careful using numbers because they can imply a ranked order of priority or importance. If none exists, use bullets and avoid checkmarks or other symbols.
• Descriptive writing . Describing a research problem is an important means of contextualizing a study. In fact, some description or background information may be needed because you can not assume the reader knows the key aspects of the topic. However, the content of your paper should focus on methodology, the analysis and interpretation of findings, and their implications as they apply to the research problem rather than background information and descriptions of tangential issues.
• Personal experience. Drawing upon personal experience [e.g., traveling abroad; caring for someone with Alzheimer's disease] can be an effective way of introducing the research problem or engaging your readers in understanding its significance. Use personal experience only as an example, though, because academic writing relies on evidence-based research. To do otherwise is simply story-telling.

NOTE:   Rules concerning excellent grammar and precise word structure do not apply when quoting someone.  A quote should be inserted in the text of your paper exactly as it was stated. If the quote is especially vague or hard to understand, consider paraphrasing it or using a different quote to convey the same meaning. Consider inserting the term "sic" in brackets after the quoted text to indicate that the quotation has been transcribed exactly as found in the original source, but the source had grammar, spelling, or other errors. The adverb sic informs the reader that the errors are not yours.

Academic Writing. The Writing Lab and The OWL. Purdue University; Academic Writing Style. First-Year Seminar Handbook. Mercer University; Bem, Daryl J. Writing the Empirical Journal Article. Cornell University; College Writing. The Writing Center. University of North Carolina; Murray, Rowena  and Sarah Moore. The Handbook of Academic Writing: A Fresh Approach . New York: Open University Press, 2006; Johnson, Eileen S. “Action Research.” In Oxford Research Encyclopedia of Education . Edited by George W. Noblit and Joseph R. Neikirk. (New York: Oxford University Press, 2020); Oppenheimer, Daniel M. "Consequences of Erudite Vernacular Utilized Irrespective of Necessity: Problems with Using Long Words Needlessly." Applied Cognitive Psychology 20 (2006): 139-156; Ezza, El-Sadig Y. and Touria Drid. T eaching Academic Writing as a Discipline-Specific Skill in Higher Education . Hershey, PA: IGI Global, 2020; Pernawan, Ari. Common Flaws in Students' Research Proposals. English Education Department. Yogyakarta State University; Style. College Writing. The Writing Center. University of North Carolina; Invention: Five Qualities of Good Writing. The Reading/Writing Center. Hunter College; Sword, Helen. Stylish Academic Writing . Cambridge, MA: Harvard University Press, 2012; What Is an Academic Paper? Institute for Writing Rhetoric. Dartmouth College.

Structure and Writing Style

I. Improving Academic Writing

To improve your academic writing skills, you should focus your efforts on three key areas: 1.   Clear Writing . The act of thinking about precedes the process of writing about. Good writers spend sufficient time distilling information and reviewing major points from the literature they have reviewed before creating their work. Writing detailed outlines can help you clearly organize your thoughts. Effective academic writing begins with solid planning, so manage your time carefully. 2.  Excellent Grammar . Needless to say, English grammar can be difficult and complex; even the best scholars take many years before they have a command of the major points of good grammar. Take the time to learn the major and minor points of good grammar. Spend time practicing writing and seek detailed feedback from professors. Take advantage of the Writing Center on campus if you need help. Proper punctuation and good proofreading skills can significantly improve academic writing [see sub-tab for proofreading you paper ].

Refer to these three basic resources to help your grammar and writing skills:

• A good writing reference book, such as, Strunk and White’s book, The Elements of Style or the St. Martin's Handbook ;
• A college-level dictionary, such as, Merriam-Webster's Collegiate Dictionary ;
• The latest edition of Roget's Thesaurus in Dictionary Form .

3.  Consistent Stylistic Approach . Whether your professor expresses a preference to use MLA, APA or the Chicago Manual of Style or not, choose one style manual and stick to it. Each of these style manuals provide rules on how to write out numbers, references, citations, footnotes, and lists. Consistent adherence to a style of writing helps with the narrative flow of your paper and improves its readability. Note that some disciplines require a particular style [e.g., education uses APA] so as you write more papers within your major, your familiarity with it will improve.

II. Evaluating Quality of Writing

A useful approach for evaluating the quality of your academic writing is to consider the following issues from the perspective of the reader. While proofreading your final draft, critically assess the following elements in your writing.

• It is shaped around one clear research problem, and it explains what that problem is from the outset.
• Your paper tells the reader why the problem is important and why people should know about it.
• You have accurately and thoroughly informed the reader what has already been published about this problem or others related to it and noted important gaps in the research.
• You have provided evidence to support your argument that the reader finds convincing.
• The paper includes a description of how and why particular evidence was collected and analyzed, and why specific theoretical arguments or concepts were used.
• The paper is made up of paragraphs, each containing only one controlling idea.
• You indicate how each section of the paper addresses the research problem.
• You have considered counter-arguments or counter-examples where they are relevant.
• Arguments, evidence, and their significance have been presented in the conclusion.
• Limitations of your research have been explained as evidence of the potential need for further study.
• The narrative flows in a clear, accurate, and well-organized way.

Boscoloa, Pietro, Barbara Arféb, and Mara Quarisaa. “Improving the Quality of Students' Academic Writing: An Intervention Study.” Studies in Higher Education 32 (August 2007): 419-438; Academic Writing. The Writing Lab and The OWL. Purdue University; Academic Writing Style. First-Year Seminar Handbook. Mercer University; Bem, Daryl J. Writing the Empirical Journal Article. Cornell University; Candlin, Christopher. Academic Writing Step-By-Step: A Research-based Approach . Bristol, CT: Equinox Publishing Ltd., 2016; College Writing. The Writing Center. University of North Carolina; Style . College Writing. The Writing Center. University of North Carolina; Invention: Five Qualities of Good Writing. The Reading/Writing Center. Hunter College; Sword, Helen. Stylish Academic Writing . Cambridge, MA: Harvard University Press, 2012; What Is an Academic Paper? Institute for Writing Rhetoric. Dartmouth College.

Writing Tip

Considering the Passive Voice in Academic Writing

In the English language, we are able to construct sentences in the following way: 1.  "The policies of Congress caused the economic crisis." 2.  "The economic crisis was caused by the policies of Congress."

The decision about which sentence to use is governed by whether you want to focus on “Congress” and what they did, or on “the economic crisis” and what caused it. This choice in focus is achieved with the use of either the active or the passive voice. When you want your readers to focus on the "doer" of an action, you can make the "doer"' the subject of the sentence and use the active form of the verb. When you want readers to focus on the person, place, or thing affected by the action, or the action itself, you can make the effect or the action the subject of the sentence by using the passive form of the verb.

Often in academic writing, scholars don't want to focus on who is doing an action, but on who is receiving or experiencing the consequences of that action. The passive voice is useful in academic writing because it allows writers to highlight the most important participants or events within sentences by placing them at the beginning of the sentence.

Use the passive voice when:

• You want to focus on the person, place, or thing affected by the action, or the action itself;
• It is not important who or what did the action;
• You want to be impersonal or more formal.

Form the passive voice by:

• Turning the object of the active sentence into the subject of the passive sentence.
• Changing the verb to a passive form by adding the appropriate form of the verb "to be" and the past participle of the main verb.

NOTE: Consult with your professor about using the passive voice before submitting your research paper. Some strongly discourage its use!

Active and Passive Voice. The Writing Lab and The OWL. Purdue University; Diefenbach, Paul. Future of Digital Media Syllabus. Drexel University; Passive Voice. The Writing Center. University of North Carolina.  

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Writing a Paper: Thesis Statements

Basics of thesis statements.

The thesis statement is the brief articulation of your paper's central argument and purpose. You might hear it referred to as simply a "thesis." Every scholarly paper should have a thesis statement, and strong thesis statements are concise, specific, and arguable. Concise means the thesis is short: perhaps one or two sentences for a shorter paper. Specific means the thesis deals with a narrow and focused topic, appropriate to the paper's length. Arguable means that a scholar in your field could disagree (or perhaps already has!).

Strong thesis statements address specific intellectual questions, have clear positions, and use a structure that reflects the overall structure of the paper. Read on to learn more about constructing a strong thesis statement.

Being Specific

This thesis statement has no specific argument:

Needs Improvement: In this essay, I will examine two scholarly articles to find similarities and differences.

This statement is concise, but it is neither specific nor arguable—a reader might wonder, "Which scholarly articles? What is the topic of this paper? What field is the author writing in?" Additionally, the purpose of the paper—to "examine…to find similarities and differences" is not of a scholarly level. Identifying similarities and differences is a good first step, but strong academic argument goes further, analyzing what those similarities and differences might mean or imply.

Better: In this essay, I will argue that Bowler's (2003) autocratic management style, when coupled with Smith's (2007) theory of social cognition, can reduce the expenses associated with employee turnover.

The new revision here is still concise, as well as specific and arguable.  We can see that it is specific because the writer is mentioning (a) concrete ideas and (b) exact authors.  We can also gather the field (business) and the topic (management and employee turnover). The statement is arguable because the student goes beyond merely comparing; he or she draws conclusions from that comparison ("can reduce the expenses associated with employee turnover").

Making a Unique Argument

This thesis draft repeats the language of the writing prompt without making a unique argument:

Needs Improvement: The purpose of this essay is to monitor, assess, and evaluate an educational program for its strengths and weaknesses. Then, I will provide suggestions for improvement.

You can see here that the student has simply stated the paper's assignment, without articulating specifically how he or she will address it. The student can correct this error simply by phrasing the thesis statement as a specific answer to the assignment prompt.

Better: Through a series of student interviews, I found that Kennedy High School's antibullying program was ineffective. In order to address issues of conflict between students, I argue that Kennedy High School should embrace policies outlined by the California Department of Education (2010).

Words like "ineffective" and "argue" show here that the student has clearly thought through the assignment and analyzed the material; he or she is putting forth a specific and debatable position. The concrete information ("student interviews," "antibullying") further prepares the reader for the body of the paper and demonstrates how the student has addressed the assignment prompt without just restating that language.

Creating a Debate

This thesis statement includes only obvious fact or plot summary instead of argument:

Needs Improvement: Leadership is an important quality in nurse educators.

A good strategy to determine if your thesis statement is too broad (and therefore, not arguable) is to ask yourself, "Would a scholar in my field disagree with this point?" Here, we can see easily that no scholar is likely to argue that leadership is an unimportant quality in nurse educators.  The student needs to come up with a more arguable claim, and probably a narrower one; remember that a short paper needs a more focused topic than a dissertation.

Better: Roderick's (2009) theory of participatory leadership  is particularly appropriate to nurse educators working within the emergency medicine field, where students benefit most from collegial and kinesthetic learning.

Here, the student has identified a particular type of leadership ("participatory leadership"), narrowing the topic, and has made an arguable claim (this type of leadership is "appropriate" to a specific type of nurse educator). Conceivably, a scholar in the nursing field might disagree with this approach. The student's paper can now proceed, providing specific pieces of evidence to support the arguable central claim.

Choosing the Right Words

This thesis statement uses large or scholarly-sounding words that have no real substance:

Needs Improvement: Scholars should work to seize metacognitive outcomes by harnessing discipline-based networks to empower collaborative infrastructures.

There are many words in this sentence that may be buzzwords in the student's field or key terms taken from other texts, but together they do not communicate a clear, specific meaning. Sometimes students think scholarly writing means constructing complex sentences using special language, but actually it's usually a stronger choice to write clear, simple sentences. When in doubt, remember that your ideas should be complex, not your sentence structure.

Better: Ecologists should work to educate the U.S. public on conservation methods by making use of local and national green organizations to create a widespread communication plan.

Notice in the revision that the field is now clear (ecology), and the language has been made much more field-specific ("conservation methods," "green organizations"), so the reader is able to see concretely the ideas the student is communicating.

Leaving Room for Discussion

This thesis statement is not capable of development or advancement in the paper:

Needs Improvement: There are always alternatives to illegal drug use.

This sample thesis statement makes a claim, but it is not a claim that will sustain extended discussion. This claim is the type of claim that might be appropriate for the conclusion of a paper, but in the beginning of the paper, the student is left with nowhere to go. What further points can be made? If there are "always alternatives" to the problem the student is identifying, then why bother developing a paper around that claim? Ideally, a thesis statement should be complex enough to explore over the length of the entire paper.

Better: The most effective treatment plan for methamphetamine addiction may be a combination of pharmacological and cognitive therapy, as argued by Baker (2008), Smith (2009), and Xavier (2011).

In the revised thesis, you can see the student make a specific, debatable claim that has the potential to generate several pages' worth of discussion. When drafting a thesis statement, think about the questions your thesis statement will generate: What follow-up inquiries might a reader have? In the first example, there are almost no additional questions implied, but the revised example allows for a good deal more exploration.

Thesis Mad Libs

If you are having trouble getting started, try using the models below to generate a rough model of a thesis statement! These models are intended for drafting purposes only and should not appear in your final work.

• In this essay, I argue ____, using ______ to assert _____.
• While scholars have often argued ______, I argue______, because_______.
• Through an analysis of ______, I argue ______, which is important because_______.

Words to Avoid and to Embrace

When drafting your thesis statement, avoid words like explore, investigate, learn, compile, summarize , and explain to describe the main purpose of your paper. These words imply a paper that summarizes or "reports," rather than synthesizing and analyzing.

Instead of the terms above, try words like argue, critique, question , and interrogate . These more analytical words may help you begin strongly, by articulating a specific, critical, scholarly position.

Read Kayla's blog post for tips on taking a stand in a well-crafted thesis statement.

Related Resources

Didn't find what you need? Email us at [email protected] .

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• Open access
• Published: 27 May 2024

Associations between medical students’ stress, academic burnout and moral courage efficacy

• Galit Neufeld-Kroszynski   ORCID: orcid.org/0000-0001-9093-1308 1   na1 ,
• Keren Michael   ORCID: orcid.org/0000-0003-2662-6362 2   na1 &
• Orit Karnieli-Miller   ORCID: orcid.org/0000-0002-5790-0697 1  

BMC Psychology volume  12 , Article number:  296 ( 2024 ) Cite this article

220 Accesses

Metrics details

Medical students, especially during the clinical years, are often exposed to breaches of safety and professionalism. These contradict personal and professional values exposing them to moral distress and to the dilemma of whether and how to act. Acting requires moral courage, i.e., overcoming fear to maintain one’s core values and professional obligations. It includes speaking up and “doing the right thing” despite stressors and risks (e.g., humiliation). Acting morally courageously is difficult, and ways to enhance it are needed. Though moral courage efficacy, i.e., individuals’ belief in their capability to act morally, might play a significant role, there is little empirical research on the factors contributing to students’ moral courage efficacy. Therefore, this study examined the associations between perceived stress, academic burnout, and moral courage efficacy.

A cross-sectional study among 239 medical students who completed self-reported questionnaires measuring perceived stress, academic burnout (‘exhaustion,’ ‘cynicism,’ ‘reduced professional efficacy’), and moral courage efficacy (toward others’ actions and toward self-actions). Data analysis via Pearson’s correlations, regression-based PROCESS macro, and independent t -tests for group differences.

The burnout dimension of ‘reduced professional efficacy’ mediated the association between perceived stress and moral courage efficacy toward others’ actions. The burnout dimensions ‘exhaustion’ and ‘reduced professional efficacy’ mediated the association between perceived stress and moral courage efficacy toward self-actions.

Conclusions

The results emphasize the importance of promoting medical students’ well-being—in terms of stress and burnout—to enhance their moral courage efficacy. Medical education interventions should focus on improving medical students’ professional efficacy since it affects both their moral courage efficacy toward others and their self-actions. This can help create a safer and more appropriate medical culture.

Peer Review reports

Introduction

In medical school, and especially during clinical years, medical students (MS) are often exposed to physicians’ inappropriate behaviors and various breaches of professionalism or safety [ 1 , 2 , 3 ]. These can include lack of respect or sensitivity toward patients and other healthcare staff, deliberate lies and deceptions, breaching confidentiality, inadequate hand hygiene, or breach of a sterile field [ 4 , 5 ]. Furthermore, MS find themselves performing and/or participating in these inappropriate behaviors. For example, a study found that 80% of 3 rd– 4th year MS reported having done something they believed was unethical or having misled a patient [ 6 ]. Another study showed that 47.1–61.3% of females and 48.8–56.6% of male MS reported violating a patient’s dignity, participating in safety breaches, or examining/performing a procedure on a patient without valid consent, following a clinical teacher’s request, as a learning exercise [ 5 ]. These behaviors contradict professional values and MS’ own personal and moral values, exposing them to a dilemma in which they must choose if and how to act.

Taking action requires moral courage, i.e., taking an active stand or acting in the face of wrongdoing or moral injustice jeopardizing mental well-being [ 7 , 8 , 9 , 10 ]. Moral courage includes speaking up and “doing the right thing” despite risks, such as shame, retaliation, threat to reputation, or even loss of employment [ 8 ]. Moral courage is expressed in two main situations: when addressing others’ wrongdoing (e.g., identifying and disclosing a past/present medical error by colleagues/physicians); or when admitting one’s own wrongdoing (e.g., disclosing an error or lack of knowledge) [ 11 ].

Due to its “calling out” nature, acting on moral courage is difficult. A hierarchy and unsafe learning environment inhibits the ability for assertive expression of concern [ 12 , 13 , 14 ]. This leads to concerning findings indicating that only 38% of MS reported that they would approach someone performing an unsafe behavior [ 12 ], and about half claimed that they would report an error they had observed [ 15 ].

Various reasons were suggested to explain why MS, interns, residents, or nurses, hesitate to act in a morally courageous way, including difficulty questioning the decisions or actions of those with more authority [ 12 ], and fear of negative social consequences, such as being disgraced, excluded, attacked, punished, or poorly evaluated [ 13 ]. Other reasons were the wish to fit into the team [ 6 ] and being a young professional experiencing “lack of knowledge” or “unfamiliarity” with clinical subtleties [ 16 ].

Nevertheless, failing to act on moral courage might lead to negative consequences, including moral distress [ 17 ]. Moral distress is a psychological disequilibrium that occurs when knowing the ethically right course of action but not acting upon it [ 18 ]. Moral distress is a known phenomenon among MS [ 19 ], e.g., 90% of MS at a New York City medical school reported moral distress when carrying for older patients [ 20 ]. MS’ moral distress was associated with thoughts of dropping out of medical school, choosing a nonclinical specialty, and increased burnout [ 20 ].

These consequences of moral distress and challenges to acting in a morally courageous way require further exploration of MS’ moral courage in general and their moral courage efficacy specifically. Bandura coined the term self-efficacy, focused on one’s perception of how well s/he can execute the action required to deal successfully with future situations and to achieve desired outcomes [ 21 ]. Self-efficacy plays a significant role in human behavior since individuals are more likely to engage in activities they believe they can handle [ 21 ]. Therefore, self-efficacy regarding a particular skill is a major motivating factor in the acquisition, development, and application of that skill [ 22 ]. For example, individuals’ perception regarding their ability to deal positively with ethical issues [ 23 ], their beliefs that they can handle effectively what is required to achieve moral performance [ 24 ], and to practically act as moral agents [ 25 ], can become a key psychological determinant of moral motivation and action [ 26 ]. Due to self-efficacy’s importance there is a need to learn about moral courage efficacy, i.e., individuals’ belief in their ability to exhibit moral courage through sharing their concerns regarding others and their own wrongdoing. Moral courage efficacy was suggested as important to moral courage in the field of business [ 27 ], but not empirically explored in medicine. Thus, there is no known prevalence of moral courage efficacy toward others and toward one’s own wrongdoing in medicine in general and for MS in particular. Furthermore, the potential contributing factors to moral courage efficacy, such as stress and burnout, require further exploration.

The associations between stress, burnout, and moral courage efficacy

Stress occurs when people view environmental demands as exceeding their ability to cope with them [ 28 ]. MS experience high levels of stress during their studies [ 29 ], due to excessive workload, time management difficulties, work–life balance conflicts, health concerns, and financial worries [ 30 ]. Studies show that high levels of stress were associated with decreased empathy [ 31 ], increased academic burnout, academic dishonesty, poor academic performance [ 32 ], and thoughts about dropping out of medical school [ 33 ]. As stress may impact one’s perceived efficacy [ 34 ], this study examined whether stress can inhibit individuals’ moral courage efficacy to address others’ and their own wrongdoing.

An aspect related to a poor mental state that may mediate the association between stress and MS’ moral courage efficacy is burnout. Burnout includes emotional exhaustion, cynicism toward one’s occupation value, and doubting performance ability [ 35 ]. Burnout is usually work-related and is common in the helping professions [ 60 ]. For students, this concept relates to academic burnout [ 36 ], which includes exhaustion due to study demands, a cynical and detached attitude to studying, and low/reduced professional efficacy, i.e. feeling incompetent as learners [ 37 ].

Burnout has various negative implications for MS’ well-being and professional development. Burnout is associated with psychiatric disorders and thoughts of dropping out of medical school [ 33 ]. Furthermore, MS’ burnout is associated with increased involvement in unprofessional behavior, eroding professional development, diminishing qualities such as honesty, integrity, altruism, and self-regulation [ 38 ], reducing empathy [ 31 , 39 ] and unwillingness to provide care for the medically underserved [ 40 ]. Thus, burnout may also impact MS’ views on their responsibility and perceived ability to promote high-quality care and advocate for patients [ 41 ], possibly leading them to feel reluctant and incapable to act with moral courage [ 42 ]. Earlier studies exploring stress and its various outcomes, found that burnout, and specifically exhaustion, can become a crucial mediator for various harmful outcomes [ 43 ]. Although stress is impactful to creating discomfort, the decision and ability to intervene requires one’s own drive and power. When one is feeling stress, leading to burnout their depleted energy reserves and diminished sense of professional worth likely undermine their perceived power (due to exhaustion) or will (due to cynicism) to uphold professional ethical standards and intervene to advocate for patient care in challenging circumstances, such as the need to speak up in front of authority members. Furthermore, burnout may facilitate a cognitive distancing from professional values and responsibilities, allowing for moral disengagement and reducing the likelihood of morally courageous actions. This mediation role requires further exploration.

This study examined associations between perceived stress, academic burnout, and moral courage efficacy. In addition to the mere associations among the variables, it will be examined whether there is a mediation effect (perceived stress → academic burnout → moral courage efficacy) to gain more insight into possible mechanisms of the development of moral courage efficacy and of protective factors. Understanding these mechanisms has educational benefit for guiding interventions to enhance MS’ moral courage efficacy.

H1: Perceived stress and academic burnout dimensions will be negatively associated with moral courage efficacy dimensions.

H2: Perceived stress will be positively associated with academic burnout dimensions.

H3: Academic burnout dimensions will mediate the association between perceived stress and moral courage efficacy dimensions.

Materials and methods

Sample and procedure.

A quantitative cross-sectional study among 239 MS. Most participants were female (60%), aged 29 or less (90%), and unmarried (75%). About two thirds (64.3%) were at the pre-clinical stage of medical school and about a third (35.7%) at the clinical stage. In December 2019, the research team approached MS through email and social media to participate in the study and complete an online questionnaire. This was a part of a national study focused on MS’ burnout [ 44 ]. The 239 participants were recruited by a convenience sampling. Data were collected online through Qualtrics platform, via anonymous self-reported questionnaires. The University Ethics Committee approved the study, and all participants signed an informed consent form.

Moral courage efficacy —This 8-item instrument, developed for this study, is based on the literature on moral courage, professionalism, and speaking-up, including qualitative and quantitative studies [ 7 , 13 , 45 , 46 , 47 ], and discussions with MS and medical educators. The main developing team included a Ph.D. medical educator expert in communication in healthcare and professionalism; an M.D. psychiatrist expert in decision making, professionalism, and philosophy; a Ph.D. graduate who analyzed MS’ narratives focused on moral dilemmas and moral courage during professionalism breaches; and a Ph.D. candidate focused on assertiveness in medicine [ 14 ]. This allowed the identification of different types of situations MS face that may require moral courage.

As guided by instructions for measuring self-efficacy, which encourage using specific statements that relate to the specific situation and skill required [ 48 ], the instrument measures MS’ perception of their own ability, i.e., self-efficacy, to act based on their moral beliefs when exposed to safety and professionalism breaches or challenges. Due to our qualitative findings indicating that students change their interpretation of the problematic event based on their decision to act in a morally courageous way and that some are exposed to specific professionalism violations while others are not when designing the questionnaire, we decided to make the cases not explicit to specific types of professionalism breaches – e.g., not focused on talking above a patient’s head [ 1 ], but rather general the type of behavior e.g., “behaves immorally”. This decreases the personal interpretation if one behavior is acceptable by this individual; and also decreases the possibility of not answering the question if the individual student has never seen that specific behavior. Furthermore, to avoid “gray areas” in moral issues, we wrote the statements in a manner where there is no doubt whether there is a moral problem (“problematic situation”) [ 47 ], and thus the focus was only on one’s feeling of being capable of speaking up about their concern, i.e., act in a moral courage efficacy (see Table  1 ).

The instrument’s initial development consisted of 14 items addressing various populations, including senior MDs. The 14-item tool included questions regarding the willingness to recommend a second opinion or to convey one’s medical mistake to patients and their families. These actions are less relevant to MS. Thus, we extracted the questionnaire to a parsimonious instrument of 8 items.

The 8 items were divided into two dimensions: others and the self. This division is supported by the literature on moral courage that distinguishes between courage regarding others- vs. self-behavior. Hence, the questionnaire was designed to assess one’s perceived ability to act/speak up in these two dimensions: (a) situations of moral courage efficacy relating to others’ behavior (e.g., “ capable of telling a senior physician if I have detected a mistake s/he might have made ”); (b) situations of moral courage efficacy relating to self (e.g., “ capable of disclosing my mistakes to a senior physician ”). This two-dimension division is important and was absent in former measurements of moral courage. It was also replicated in another study we conducted among MS [ 49 ]. Furthermore, factor analysis with Oblimin rotation supported this two-factor structure (Table  1 ). All items had a high factor loading on the relevant factor (it should be mentioned that item 4 was loaded 0.59 on the relevant factor and 0.32 on the non-relevant factor).

All items are rated on a 5-point Likert scale (0 = to a small extent; 4 = to a very great extent) and are calculated by averaging the answers on the dimension, with higher scores representing higher moral courage efficacy. Internal reliability was α = 0.80 for the “others” dimension and α = 0.84 for the “self” dimension.

Perceived stress —This single-item questionnaire (“How would you rate the level of stress you’ve been experiencing in the last few days?” ) evaluates MS’ perceived stress currently in their life on an 11-point Likert scale (0 = no stress; 10 = extreme stress), with higher scores representing higher perceived stress. It is based on a similar question evaluating MS’ perceived emotional stress [ 29 ]. Even though a multi-item measure might be more stable, previous studies indicated that using a single item is a practical, reliable alternative, with high construct validity in the context of felt/perceived stress, self-esteem, health status, etc [ 43 , 50 , 51 ].

Academic burnout —This 15-item instrument is a translated version [ 44 ] of the MBI-SS (MBI–Student Survey) [ 37 ], a common instrument used to measure burnout in the academic context, e.g. MS [ 52 , 53 ]. It measures students’ feelings of burnout regarding their studies on three dimensions: (a) ‘exhaustion’ (5 items; e.g., “ Studying or attending a class is a real strain for me ”), (b) ‘cynicism’ (4 items; e.g., “ I doubt the significance of my studies ”), (c) lack of personal academic efficacy (‘reduced professional efficacy’) (6 items; “ I feel [un]stimulated when I achieve my study goals ”). Each item is rated on a 7-point Likert scale (0 = never; 6 = always) and is calculated by summing the answers on the dimension (after re-coding all professional efficacy items), with higher scores representing more frequent feelings of burnout. Internal reliability was α = 0.80 for ‘exhaustion’, α = 0.80 for ‘cynicism’, and α = 0.84 for ‘reduced professional efficacy’.

Statistical analyses

IBM-SPSS (version 25) was used to analyze the data. Pearson’s correlations examined all possible bivariate associations between the study variables. PROCESS macro examined the mediation effects (via model#4). The significance of the mediation effects was examined by calculating 5,000 samples to estimate the 95% percentile bootstrap confidence intervals (CIs) of indirect effects of the predictor on the outcome through the mediator [ 54 ]. T -tests for independent samples examined differences between the study variables in the pre-clinic and clinic stages. The defined significance level was set generally to 5% ( p  < 0.05).

This study focused on understanding moral courage efficacy, i.e., MS’ perceived ability to speak up and act while exposed to others’ and their own wrongdoing. The sample’s frequencies demonstrate that only 10% of the MS reported that their moral courage efficacy toward the others was “very high to high,” and 54% reported this toward the self. Mean scores demonstrate that regarding the others, MS showed relatively low/moderate levels of moral courage and higher levels regarding the self. As for the variables tested to be associated with moral courage efficacy, MS showed relatively high perceived stress and low-to-moderate academic burnout (see Table  2 for the variables’ psychometric characteristics).

Table  2 also shows the correlations among the study variables. According to Cohen’s (1988) [ 55 ] interpretation of the strength in bivariate associations (Pearson correlation), the effect size is low when r value varies around 0.1, medium when it is around 0.3, and large when it is more than 0.5. Hence, regarding the associations between the two dimensions of moral courage efficacy: we found a moderate positive correlation between the efficacy toward others and the efficacy toward the self. Regarding the associations among the three academic burnout dimensions: we found a strong positive correlation between ‘exhaustion’ and ‘cynicism,’ a weak positive correlation between ‘exhaustion’ and ‘reduced professional efficacy,’ and a moderate positive correlation between ‘cynicism,’ and ‘reduced professional efficacy.’

As for the associations concerning H1, Table  2 indicates that one academic burnout dimension, i.e., ‘reduced professional efficacy,’ had a weak negative correlation with moral courage efficacy toward the others, thus high burnout was associated with lower perceived moral courage efficacy toward others. Additionally, perceived stress and all three burnout dimensions had weak negative correlations with moral courage efficacy toward the self—partially supporting H1.

As for the associations concerning H2, Table  2 indicates that perceived stress had a strong positive correlation with ‘exhaustion,’ a moderate positive correlation with ‘cynicism,’ and a weak positive correlation with ‘reduced professional efficacy’—supporting H2.

Based on these correlations, we conducted regression-based models to examine the unique and complex relationships among the study variable, including their various dimensions, while focusing on the examination of whether academic burnout mediates the association between perceived stress and moral courage efficacy (see Tables  3 and 4 ; and Figs.  1 and 2 ).

A model presenting the association between perceived stress and moral courage efficacy toward others, mediated by academic burnout. Note full arrows contain significant β coefficient values (fractured arrows mean nonsignificance

Focusing on moral courage efficacy toward others

Table  3  and Fig.  1 indicate that perceived stress was positively associated with all three academic burnout dimensions: ‘exhaustion’ (path a 1 ), ‘cynicism’ (path a 2 ), and ‘reduced professional efficacy’ (path a 3 ). These paths support H2. In turn, ‘reduced professional efficacy’ was negatively associated with moral courage efficacy toward the others (path b 3 ), supporting H1. The CIs of the indirect effect (paths a 3 b 3 ) did not contain zero; therefore, perceived stress had a significant indirect effect on moral courage efficacy toward the others, through the burnout dimension ‘reduced professional efficacy.’ This path supports H3.

A model presenting the association between perceived stress and moral courage efficacy towards self, mediated by academic burnout. Note full arrows contain significant β coefficient values (fractured arrows mean non-significance

Focusing on moral courage efficacy toward the self

Table  4  and Fig.  2 also indicate that perceived stress was positively associated with all three academic burnout dimensions: ‘exhaustion’ (path a 4 ), ‘cynicism’ (path a 5 ), and ‘reduced professional efficacy’ (path a 6 ). These paths support H2. In turn, ‘exhaustion’ and ‘reduced professional efficacy’ were negatively associated with moral courage efficacy toward the self (paths b 4 , b 6 respectively). These paths support H1 The CIs of the indirect effects (paths a 4 b 4 , a 6 b 6 ) did not contain zero; therefore, perceived stress had a significant indirect effect on moral courage efficacy toward the self, through the burnout dimensions ‘exhaustion’ and ‘reduced professional efficacy.’ These paths support H3. It should be noted that in this analysis, the initially significant association between perceived stress and moral courage efficacy toward the self (path c 2, representing H1) became insignificant in the existence of academic burnout dimensions (path c’ 2 ). These results demonstrate complete mediation and also support H3.

In addition to examining the complex relationships between stress, academic burnout, and moral courage efficacy among MS, we tested the differences between MS in the pre-clinical and clinical school stages in all study variables. The results indicate non-significant differences in moral courage efficacy. However, medical-school-stage differences were found in stress [t(197.4)=-4.36, p  < 0.001] and in one academic burnout dimension [t(233)=-2.40, p  < 0.01]. In that way, MS at the clinical stage reported higher levels of perceived stress ( M  = 7.32; SD  = 2.17) and exhaustion ( M  = 19.67; SD  = 6.58) than MS in the pre-clinical stage ( M  = 5.94; SD  = 2.59 and M  = 17.48; SD  = 6.78, respectively).

This study examined the associations between perceived stress, academic burnout, and moral courage efficacy to understand MS’ perceived ability to speak up and act while exposed to others’ and their own wrongdoing. The findings show that one dimension of burnout, that of ‘reduced professional efficacy,’ mediated the associations between perceived stress and moral courage efficacy toward both others and self. ‘Exhaustion’ mediated the association between perceived stress and moral courage efficacy only toward the self.

Before discussing the meanings of the associations, this study was an opportunity to explore moral courage efficacy occurrence. The findings indicated fairly low/moderate mean scores of perceived ability to speak up and act while confronted with others’ wrongdoing and moderate/high scores of perceived ability while confronted with one’s own wrongdoing. This implies that students do not feel capable enough to share their concerns regarding others’ possible errors and feel more able, but still not enough, to share their own flaws and needs for guidance. These findings require attention, from both patient safety and learning perspectives.

Regarding patient safety, feeling unable to act while confronted with others or self- wrongdoing means that some errors may occur and not be addressed. This is in line with former findings that showed that less than 50% of MS would actually approach someone performing an unsafe behavior [ 12 ], or report an error they had observed [ 15 ]. These numbers are likely to improve in postgraduates as studies showed that between 64 and 79% of interns and residents reported they would likely speak up to an attending when exposed to a safety threat [ 56 , 57 ].

Regarding learning, our MS’ scores must improve for various reasons. First, moderate scores may indicate a psychologically unsafe learning environment, which prevents or discourages sharing uncertainties, especially about others’ behavior, and creates difficulty for students to share their own concerns, limitations, mistakes, and hesitations when feeling incapable or unqualified for a task [ 58 ]. Second, limited sharing of errors may be problematic because by not disclosing their error, students miss the chance to learn from it; [ 59 ] they lose the opportunity for reflective guidance to explore what worked well, what did not, and how to improve [ 59 , 60 ]. Third, if they do not discuss others’ errors or their own, they may deny themselves the necessary support to learn the all-important skills of how to deal with the emotional turmoil and challenges of errors, and how to share the error with a patient or family member [ 61 ]. Furthermore, if MS feel incapable of sharing their concern about a senior’s possible mistake, they miss other learning opportunities—e.g., the senior’s reasoning and clinical judgment may show that a mistake was not made. In this case, the student would miss being shown why they were wrong and what they did do well. Thus, identifying what can enhance moral courage efficacy and practice is needed. The fact that there are no significant differences between pre-clinical and clinical years students in their perceived ability to apply moral courage, may indicate that there is a cultural barrier in perceiving the idea of sharing weakness or of revealing others’ mistakes as unacceptable. Thus, the socialization, in the medical school environment, both in pre-clinical and clinical years, perhaps lacks the encouragement to speak up and provision of safe space.

This study examined the associations between perceived stress, academic burnout, and moral courage efficacy among MS. The findings indicate that, like earlier studies, stress is not directly connected to speaking up [ 62 ] or moral courage. It rather contributes to it indirectly, through the impact of burnout. Beyond the well-established role of stress in explaining burnout [ 63 , 64 ], we identified a negative consequence of burnout—hindering moral courage efficacy. This may help explain the path in which previous studies found burnout to impair MS’ quality of life, how it leads to dropout, and to more medical errors [ 65 ]. When individuals experience the burnout dimension of ‘reduced professional efficacy,’ they may feel less confident and fit, leading them to feel more disempowered to take the risk (required in courage) and share their concerns and hesitations about others’ mistakes and their own challenges. This fits earlier studies indicating that being a young professional experiencing “lack of knowledge” or “unfamiliarity” with clinical subtleties is a barrier to moral courage [ 11 ]. This may have various negative implications, of limited moral courage efficacy, as seen here, as well as paying less attention and not fully addressing their learning needs, leading to a vicious cycle of “feeding” the misfit feeling, potentially increasing their moral distress. Furthermore, those who feel they know less and, therefore, need more support to fill the gap in knowledge and skills, are less inclined to ask for help.

Beside the negative associations between ‘reduced professional efficacy’ and both dimensions of moral courage efficacy (toward others and the self), another dimension of academic burnout—‘exhaustion’—was negatively associated with moral courage efficacy toward the self. This is worrying because when learners are exhausted, their attention is reduced and they are at greater risk of error, as proven in an earlier study [ 65 ]. The current study adds to this information another worry, showing that MS are less willing to share their hesitations about themselves or the mistakes they already made, thus perhaps not preventing the error or fixing it. MS might create an unspoken contract with senior physicians about not exposing each other’s mistakes, with various possible negative implications. Some MS’ tendency to defend physicians’ mistakes was identified elsewhere [ 66 ].

The findings concerning medical-school-stage differences demonstrated that MS in the clinical stage had higher perceived stress and exhaustion levels than MS in the pre-clinical stage. These results support previous studies indicating stress, academic burnout, and more challenging characteristics among more senior students, including a decline in ideals, altruistic attitudes, and empathy during medical school studies; or more exhaustion, cynicism, and higher levels of detached emotions and depression through the years of medical school [ 67 , 68 , 69 ]. These higher levels of stress and exhaustion, can be explained by the senior students’ exposure to the rounds in the hospitals, which requires ongoing learning, more pressure, and a sense of overload in their academic life.

Limitations and future studies

Despite the importance of the findings, the study has several limitations. First, the participants were from one university, and recruited via convenience sampling, including only MS who voluntarily completed the questionnaires, undermining generalizability. To address this limitation, future research should aim to include a more diverse and representative sample of medical students from multiple universities and geographical regions. This would enhance the external validity and applicability of the findings across different educational and cultural contexts. Second, future studies are recommended to follow up on medical students’ stress, academic burnout, and moral courage efficacy over time. Exploring the development of professional efficacy and the barriers to exposing one’s and others’ weaknesses and flaws within the medical environment can help improve the medical culture into a safer space. Third, an intriguing avenue for future research is the exploration of the construct of ‘moral courage efficacy’ within different cohorts of healthcare students throughout their undergraduate and postgraduate years to learn about their moral courage efficacy development as well as and to verify the association between the findings from this newly developed scale and actual moral courage behavior. Additionally, experimental designs, such as interventions to reduce stress and burnout among medical students, could be employed to observe the impact on moral courage efficacy.

Conclusions and implications

This study is a first step in understanding moral courage efficacy and what contributes to it. The study emphasizes the importance of promoting MS’ well-being—in terms of stress and burnout—to enhance their moral courage efficacy. The findings show that the ‘reduced professional efficacy’ mediated the association between perceived stress and moral courage efficacy, toward both the others and self. This has potential implications for safety, learning, and well-being. To encourage MS to develop moral courage efficacy that will potentially increase their morally courageous behavior, we must find ways to reduce their stress and burnout levels. As the learning and work environments are a major cause of burnout [ 38 ], it would be helpful to focus on creating safe spaces where they can share others- and self-related concerns [ 70 ]. The first step is a learning environment promoting students’ overall health and well-being [ 71 ]. Useful additions are processes that support MS while dealing with education- and training-related stresses, improving their academic-professional efficacy, and constructively helping them handle challenging situations through empathic feedback [ 70 ]. This can lead them to a stronger belief in their ability to share safety and professionalism issues, thus enhancing their learning and patient care.

Data availability

No datasets were generated or analysed during the current study.

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Acknowledgements

The authors wish to thank Dr. Lior Rozental in helping in recruiting students to the study. This study was done as part of Orit Karnieli-Miller’s Endowed chair of the Dr. Sol Amsterdam, Dr. David P. Schumann in Medical Education, Tel Aviv University. This study is written in the blessed memory of Oshrit Bar-El, devoted to enhancing Moral Courage.

The manuscript was partially supported by a grant by the by the Israel Science Foundation (grant no. 1599/21).

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Galit Neufeld-Kroszynski and Keren Michael contributed equally to this work.

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Department of Medical Education, Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, 69778, Israel

Galit Neufeld-Kroszynski & Orit Karnieli-Miller

Department of Human Services, Max Stern Yezreel Valley College, Yezreel Valley, Israel

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GNK: conception and design, interpretation of data, drafting and revision of the manuscript, and final approval of the version to be published; KM: analysis and interpretation of data, drafting and revision of the manuscript, and final approval of the version to be published; OKM: conception and design, interpretation of data, drafting and revision of the manuscript, and final approval of the version to be published.

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Correspondence to Orit Karnieli-Miller .

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This study was conducted in accordance with the principles outlined in the Declaration of Helsinki and received ethical approval by the Ethics Committee of Tel-Aviv University on 31/10/2019. Informed written consent was obtained from all participants before their participation in this study.

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Study findings were presented at the Academy for Professionalism in Healthcare Conference, June 2nd, 2022, virtual; and the 7th International Conference on Public Health, August 8th, 2021, virtual.

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Neufeld-Kroszynski, G., Michael, K. & Karnieli-Miller, O. Associations between medical students’ stress, academic burnout and moral courage efficacy. BMC Psychol 12 , 296 (2024). https://doi.org/10.1186/s40359-024-01787-6

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DOI : https://doi.org/10.1186/s40359-024-01787-6

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