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Banner that represents writing. Picture showing laptop, notepad and a pen, mobile phone, and a cup of coffee. Title says: Professional Writing in the Health Disciplines. Author Sandra Collins.

January 2020

Professional Writing in the Health Disciplines is a resource for graduate students to enhance their competency in professional writing. Effective graduate writing has two different components:

The content that follows is a substantive revision of Collins (2016), Professional Writing in the Health Disciplines: A Guide for Graduate Students; however, this revised resource focuses exclusively on the first component, writing style. It does not address editorial format. The Publication Manual of the American Psychological Association (APA) contains some information on writing style; however, it is predominantly an editorial style manual. Please access the current APA manual to align your grammar, writing style, citations and references, tables and figures, and the overall format of your paper with professional editorial standards. In addition to the APA manual, you may find the following resources helpful:

I have used the editorial style of the 7th edition of the APA manual. However, the layout of this resource does not lend itself easily to full APA format. Web standards for accessibility also required some stylistic changes (e.g., bolded URLs to make them more visible, multimedia content in multiple formats).

  1. Embracing Professional Writing
  2. 1.1 Appreciating Graduate Writing Expectations
    1.2 Envisioning the Writing Process
    1.3 Developing Your Voice

  3. Exhibiting Academic Integrity and Intellectual Honesty
  4. 2.1 Embracing Intellectual Honesty
    2.2 Plagiarizing the Work of Others
    2.3 Plagiarizing Your Own Work
    2.4 Misusing Secondary Sources
    2.5 Discerning When and How to Cite Others
    2.6 Facing the Consequences of Intellectual Dishonesty

  5. Establishing a Scholarly Foundation
  6. 3.1 Discerning Appropriate Information Sources
    3.2 Enhancing Information Literacy
    3.3 Selecting Information Sources
    3.4 Padding Your Reference List

  7. Developing a Writing Plan: Critical Deconstruction
  8. 4.1 Selecting a Topic and Objective
    4.2 Understanding Literature Reviews
    4.3 Deconstructing the Professional Literature
    4.4 Generating and Organizing Your Ideas
    4.5 Reading, Thinking, and Writing Critically

  9. Drafting Your Paper: Critical Reconstruction
  10. 5.1 Understanding Reconstruction
    5.2 Structuring Your Literature Review
    5.3 Developing a Thesis or Problem Statement
    5.4 Creating a Conceptual Framework
    5.5 Building Your Argument
    5.6 Synthesizing and Integrating the Professional Literature

  11. Revising, Editing, and Final Review
  12. 6.1 Revising Your Paper
    6.2 Editing Your Paper: APA Format
    6.3 Capitalizing on Peer Reviewing, Copy Editing, and Proofreading

As you begin your graduate professional training, you will find a great deal of emphasis placed on learning to communicate effectively. Your verbal and nonverbal communication skills are foundational tools for building solid working relationships with your clients/patients, your colleagues, and your professional community. Many students enter graduate studies believing that they are proficient in these skills through their undergraduate courses or through their life and work experiences. However, this assumes that your learning environments have purposefully modelled effective communication skills. It is possible that you have developed writing habits that you now want to improve. The intent of this resource is to build on your earlier learning by focusing on areas for improvement and fine-tuning your strengths.


There is a qualitative difference in professional writing expectations for students in graduate programs compared to writing expectations in undergraduate programs. As a graduate student, you will be expected to develop your own voice and to engage in more in-depth critical thinking and analysis. You may have gone through your entire undergraduate program without having to take a personal stand or learning to articulate your opinion. You may have cited sources for your papers, but you may not have engaged in systematic critical reflection on the credibility of your sources, the context of their ideas and their relationship to other perspectives, or the themes that emerged through synthesis and analysis across sources. Through this professional writing resource, you will move from reading and thinking about a topic with a critical perspective to choosing a particular position, building effective arguments, drawing on appropriate literature to support those arguments, and pulling together relevant implications and conclusions.

Written communication is one of the primary means of assessing how well students have attained the competencies targeted in any graduate program. Your success will depend, in part, on how well you can present your point of view and how effectively you communicate your ideas in written form, whether in course assignments, postings to online discussion forums, email correspondence, or in culminating experiences in your program (i.e., comprehensive exam, project, course-based exist, thesis). These are all opportunities to demonstrate your preparedness to participate effectively in the professional community where you will be expected to apply your writing skills to client or patient record-keeping, interprofessional communication, report writing, policy development, and so on.

In addition to discipline-specific competencies, graduates of all masters programs from Canadian universities are expected to be able to demonstrate certain foundational transdisciplinary competencies. These transdisciplinary competencies come from a number of sources: notably, the Council of Ministers of Education, Canada (2007), Canadian Degree Qualifications Framework. The Faculty of Health Disciplines (FHD) has integrated many of these into their Transdisciplinary Program Outcomes for all graduate students. The subset below summarizes the learning outcomes from this resource.

Knowledge acquisition. Evaluate critically and integrate knowledge from a range of scholarly sources and disciplines.

Knowledge application. Analyze critically, synthesize, and competently apply knowledge to academic and professional tasks and roles.

Knowledge transfer. Communicate and share knowledge effectively, professionally, honestly, and with integrity.

Professional capacity & autonomy. Assume responsibility for your own learning, and engage in reflective practice to support continued competency development.

This resource will provide you with practical strategies and tools, as well as exercises and activities, for increasing the effectiveness of your writing. I encourage you to make optimal use of the resources provided. Gaining proficiency in these skills early on will facilitate successful completion of your graduate program and optimize your communication efficacy throughout your career.


For many graduate students, especially those who have not attended university in a number of years, the thought of writing a 20-page research paper is quite overwhelming. Like most tasks, however, once the process is broken down into a series of smaller steps, the end product becomes more realistic and attainable.

There are several phases in writing a graduate paper, which I have adapted from Fowler et al. (2005) and Neilsen (2019). Even though I will address them sequentially, most people do not follow a strict linear process; instead, they loop back and forth between the following phases.

  1. Planning. In the first phase, establish a general direction for your research and writing, gather appropriate resources, and organize the ideas from these sources in a meaningful way.
  2. Drafting. Through critical reading, and analysis of, the professional literature, take a position on the topic, identify the key points you want to make, organize these within the structure of your paper, and then craft your introduction and conclusion.
  3. Revising. Once you have a draft of your paper, it is time to review and revise the content of the paper. In this phase, you are examining your own critical thinking process and reading the paper with a view to ensuring that you have effectively communicated your ideas.
  4. Editing. Although editing occurs throughout the entire writing process, you should also plan a deliberate editorial style review of your paper. This includes aligning grammar, writing style, citations and references, tables and figures, and the overall format of your paper with the standards outlined in the current APA manual.

The purpose of this resource is to provide you with principles and practices to support you at each stage of the writing process.


At the graduate level, you are expected to do more than simply gather information from various sources and reorganize it to meet the assignment criteria. You must review the literature with an evaluative lens, and engage in critical thinking and reflection so that you are able to take a position on a topic or an issue. Your position is expressed as a thesis statement, which then becomes the guide for the rest of your writing process. In Section 5, I will explore the process of developing a thesis statement and supporting that thesis with a set of key arguments. At this point, I want to emphasize the difference between descriptive reporting on the perspectives of others and developing your own voice. The active engagement of voice is expressed in the following FHD Program Outcome:

Knowledge creation. Participate in the creation of health-related knowledge through original and creative thinking and writing.

You bring unique experiences, ideas, and perspectives to your graduate program. However, in other contexts, you may have received the message that your own voice is less important than the voices in the published literature or the views of your course instructors or my voice. All of these other voices are really the background against which you can develop your own professional voice. Having said this, it is important to note we expect you to shape your professional voice with careful attention to the values, ethics, guidelines, and practices of the professions you aspire to join. Developing your voice is critical for meeting the following FHD Program Outcomes:

Responsibility & accountability. Exercise initiative, and demonstrate both personal responsibility and accountability.

Intellectual independence. Demonstrate the intellectual independence required for ongoing professional development.

One of the purposes of this introduction to professional writing is to provide you with the tools to integrate new knowledge, critically reflect upon it, and then clearly articulate your views. This recursive, interactive, and reflective process is how new meanings are generated. As you work through this resource, you will gain confidence in your ability to synthesize ideas from others, critically analyze those ideas, and use them to support, challenge, and build your own professional opinions and perspectives.


Writing in the First Person

Many graduate students believe that they should never write in first person (i.e., use I-statements). However, it is important to understand when it is appropriate to speak in the first person as part of developing your professional voice. One of the main criteria for effective writing is to eliminate ambiguity. Use personal pronouns when you are referring to your viewpoint, to your actions, or to activities you were involved in as part of a study or as the author of the paper. Claiming your voice in this way enhances the clarity and precision of your writing. For example, you might write “I analyzed all articles published in the Canadian Journal of Nursing Research between 2015 and 2020 to identify emergent themes,” or “Based on this analysis, I reached the following conclusions,” or "My purpose in this paper is to examine critically the application of solution-focused therapy to work with at-risk youth." In each case, speaking in the first person makes your voice and intentions clear to the reader.

There is a misconception that speaking in the third person enhances credibility. Instead, it may actually introduce ambiguity, and ambiguity reduces credibility. Consider the examples in Table 1.3.1. In the first column, the reader is left wondering who conducted the analysis and who came to these conclusions. If you want the reader to give you credit for your actions and ideas, you must claim your voice.

Table 1.3.1

First Versus Third Person Voice

Third Person Voice

First Person Voice

An analysis of Journal for Nurse Practitioners between 2014 and 2019 identified emergent themes. I conducted an analysis of the Journal for Nurse Practitioners between 2014 and 2019 and identified emergent themes.
Based on this analysis, the following conclusions were reached. I reached the following conclusions based on this analysis.
One might assume from this analysis that nurse practitioners . . . From my analysis, I concluded that nurse practitioners . . .

It is important, however, not to clutter your paper with the extraneous use of phrases such as "I believe," "in my opinion," or "it occurred to me." Consider this sentence: “I can see a relationship between stress and well-being. An increase in stress, in my opinion, can put people at risk of both physical and emotional health problems.” The use of an insertion, such as “in my opinion,” can suggest a lack of confidence in your writing, can imply that yours is an unsubstantiated opinion, and can reflect a failure to acknowledge the sources of your ideas (see Section 2 on Intellectual Honestly). In this case, it is far more clear and concise to write in the third person as follows: “There is a relationship between stress and well-being (citations). An increase in stress can put people at risk of both physical and emotional health problems (citations).”


Using Active Versus Passive Voice

Your writing will also improve if you use the active rather than the passive voice wherever possible. Statements in active voice typically begin with the subject of the sentence; whereas, statements in passive voice typically start with the object. In Table 1.3.2, I provide examples of passive voice versus active voice. You introduce further ambiguity and potentially obscure meaning when you use the passive voice.

Table 1.3.2

Active Versus Passive Voice

Passive Person Voice

Active Person Voice

Based on this analysis, the following conclusions were reached. I reached the following conclusions based on this analysis.
It is believed by students that writing style is less important than content. Students believe that writing style is less important than content.
The focus group activity was completed by all group members. All group members completed the focus group activity.

One of the main reasons that writers slip into using passive voice is the mistaken belief that it is inappropriate to speak from the first person. In an attempt to speak from the third person, the passive voice is often drawn upon. Did you catch the passive voice in the previous sentence? The fact that there is no clear subject in the sentence is often a signal that the passive voice has been used. I will illustrate first person, active voice: I find it more natural to use active voice when I write from the first person.

A word of caution. Speaking from the first person and using the active voice does not mean expressing your views without reference to the body of knowledge in the health disciplines, your professional codes of ethics, or the context within which you write. Rather, you are positioning yourself as an active contributing member to this professional dialogue. Keep the focus on your subject, and use “I” statements when you need to indicate that you are speaking of your own experience, ideas, or actions.

Exercise 1.3.1

Complete Exercise 1.3.1 to practice using the first person and the active voice. Then check your responses against the Exercise 1.3.1 Feedback.


Modelling Cultural Sensitivity and Eliminating Bias

Nondominant and marginalized populations in Canada and the United States have been widely underrepresented in health research, policy development, and practice. Hook and Watkins (2015), Paré and Sutherland (2016), and Scheel et al. (2018) posit that the theories and practice models in psychology, for example, have functioned to maintain the status quo. Systemic oppression on the basis of gender, gender identity, ethnicity, sexual orientation, age, ability, religion, language, or other cultural identity factors remains widespread (Collins, 2018b). Even though members of nondominant groups are more likely to experience mental and physical health problems (Singh & Moss, 2016), the professions have a long way to go to prevent cultural oppression and to mediate its effects.

One effort toward reducing bias in theory and practice is reflected in the APA editorial guidelines, which guide against biased language. In both your spoken and written communication, the words you select and the context in which you place them can reveal both intentional and unintentional biases. Healthcare practitioners each have their own assumptions, beliefs, values, and worldviews that influence how they relate to other people as well as to diverse ideas. Reducing bias involves bringing those attitudes into awareness and actively acknowledging and addressing stereotypes, prejudices, or other misperceptions (Ratts et al., 2015, 2016).

In both verbal and written communication, it is important to pay attention to the tone you set through the words you choose. You may believe that you are being persuasive, but your use of language can quickly alienate your reader. You can provide support for your point of view by carefully selecting an appropriate tone. The tone you choose should consider your audience, the ethical and professional guidelines of the health disciplines, and the purpose of your writing project.

Exercise 1.3.2

Take some time to review carefully the content of your current APA manual for guidelines related to bias-free language, sensitivity to labels, and tone. Choose a paper you have written in the past or a current writing project, and evaluate critically the degree to which your writing meets these standards.

One of the skills you must develop in your academic writing is to balance your own voice with the voices of others in the field. Intellectual honesty essentially means giving credit where credit is due for the ideas you present in your writing. I am addressing this near the beginning of this resource, because it is such an important concept, and the consequences for not attending to the principles of academic integrity can be serious.


At its core, intellectual honesty requires students, academics, and researchers to be transparent about the sources of their ideas and to acknowledge the contributions of others in their writing. This basic principle forms a foundation for acquiring and developing knowledge. Because knowledge is typically cumulative, further advances are predicated on the contributions of others. Within systems of scholarship, such contributions are critically evaluated before being used as a foundation for further inquiry. Intellectual honesty is essential to ensure that intellectual contributions are transparent and open to critique. Throughout your coursework you will be expected always to cite your sources and to describe clearly the means by which you obtained the information you share, so that others can follow your research practices and thought processes.

There is a large body of knowledge in the health disciplines that continues to evolve as writers integrate, debate, and build upon the ideas, models, theories, and research outcomes generated by others. However, that foundational knowledge becomes unstable and unreliable if there is no way to trace the origins and evolution of these conceptual threads, because the ideas have not been accurately and consistently attributed to their sources. To claim the contributions and ideas of another author as your own is plagiarism. As a writer, you not only compromise your own academic integrity by failing to attribute accurately ideas to their sources, but also you break the threads that allow those who read your work to critique and evaluate it, and to build a solid foundation of knowledge in the health disciplines.

Intellectual honesty is one of the core values of the FHD, and it is a concept we expect each of you to understand fully as you enter into graduate studies. Students enrolled in programs and courses within the FHD are considered to be responsible scholars; they are, therefore, expected to adhere rigorously to the principles of intellectual integrity. These expectations are reflected in the following FHD program outcome:

Intellectual honesty & scholarly integrity. Demonstrate intellectual honesty and scholarly integrity; in particular, attribute ideas to their information sources accurately.

Acting with intellectual integrity begins with recognizing the expected standards of honesty. The remaining subsections describe policies and practices related to intellectual indebtedness and plagiarism. You may also find it useful to read the Athabasca University [AU] Student Academic Misconduct Policy for a better understanding of the kinds of activities that constitute breaches of academic honesty.


Plagiarism is a form of intellectual dishonesty in which another person's work (e.g., ideas, wording, arguments) is wrongfully presented as one's own. All direct quotations from the original source (i.e., an exact copy of three or more words) and indirect quotations (i.e., paraphrased ideas) must be acknowledged and attributed to the correct source. Failure to do so constitutes plagiarism, and as with any form of academic misconduct, you may be penalized for your lack of intellectual honesty (see the AU policy).

Exercise 2.2.1

The brief Adventures of Ruby video (below), created by the Centre for Nursing and Health Studies at AU, explains the basics of plagiarism and its relationship to APA formatting in an entertaining way. This video was created based on an earlier version of APA. As you watch the video, make note of what you would do to help Ruby bring her paper in line with current APA format. For those with visual or audio challenges, please review the Word version of the video transcript.

Did you identify everything Ruby needs to complete the final edit of her paper?

To create a strong paper that evidences scholarly integrity, you will synthesize the work of a number of individuals, express their ideas in your own words, and credit them accurately. When you present your own ideas or opinions, you will provide evidence to substantiate your position by drawing on the professional literature. Graduate students are considered to be responsible scholars and are, therefore, expected to adhere rigorously to the principles of intellectual integrity. Deliberate deceit in reporting information, ideas, and research is clearly unacceptable; however, there can be other, less obvious, forms of intellectual dishonesty for which you can be held accountable. Each of the common pitfalls (below) are considered forms of plagiarism, even if you engage in them unintentionally.


Failure to Cite the Sources of Ideas

One of the most common pitfalls into which students fall, in terms of scholarly integrity, is not providing citations for the sources of their ideas. The bottom line is transparency. You must make it crystal clear to the reader whose idea you are presenting. For each of the key points and subpoints in your paper, you must provide the proper citation for the sources of your information. When you draw information from someone else, please be very careful to (a) present the ideas in your own words, and (b) cite the source accurately. If you make a statement that most people would consider common knowledge, you do not need a citation (e.g., "Canada and the United States share a common border"). However, other types of substantive statements in your paper must be supported with sources taken from the professional literature.

The following examples demonstrate writing using insufficient citations, which is a form of plagiarism.

  1. You make the following statements and provide no citation for them: "The therapeutic relationship has emerged as one of the most important factors in effective counselling," or "There is little evidence that vaccination alone can account for all of the variance in health outcomes." This information is not something that you would know without drawing on the work of others, so you must provide an appropriate citation.

  2. You copy a phrase, sentence, or larger portion from a source, and you fail to include both quotation marks and the proper citation. For example, you might write, “Nurse practitioners should attend to the principles of assessment and triage for specific presenting concerns.” The portion underlined is word-for-word from one of your sources. Including that phrase without using quotation marks and citing the source is considered plagiarism even though you did not copy the whole sentence.

  3. You draw an idea from someone and fail to cite the source of that idea, even if you have carefully paraphrased the idea (i.e., you have used your own words, but not your own idea). For example, you summarize the work of Jerry (2019), or you write down in your own words what you learned from both Jerry (2019) and Nuttgens (2018), but you do not cite them. Even though you have used your own words, these are not your ideas; therefore, not citing them constitutes plagiarism.

  4. You provide an incorrect source for a direct quotation (i.e., word-for-word excerpt) or a paraphrase. You make the following statement, and you cite Jerry (2019), when it was actually Nuttgens (2018) who made the statement: "There is little evidence that counselling theory alone can account for all of the variance in success rates" (Jerry, 2019). This may happen, because of the use of secondary sources, or because you have not kept careful track of the sources of your information. Regardless of the cause, this too is considered plagiarism.

If you are providing your own opinion or pulling out the themes from various sources you have already described, then be sure to indicate clearly that this is what you are doing: "Based on the analysis provided above, I have identified three themes that reflect current trends in the literature." In this case, you don't need to include all of your sources again, but you must ensure that this is your own synthesis and that the sources are documented in the section you are summarizing.

In the audio file below, I position plagiarism in the context of professional ethics, in terms of development of your own voice and respect for the voices of others.

Please review the Word version if you have challenges accessing the audio clip.


Failure to Properly Paraphrase Information

Unless there is something unique or particularly powerful about the wording used by another writer, you should use your own words in your paper, citing the source of the idea. Using your own words means building your arguments within each paragraph by drawing on ideas, concepts, and themes from the work of others, rather than stringing together statements they have made.

The following examples would be considered plagiarism:

  1. You repeat a simple statement, such as "The crux of education is collaborative learning," without putting it in quotation marks or substantially rewording it. Simply restating it as "Learning collaboratively is the crux of graduate education" is not a paraphrase and would be considered plagiarism. A proper paraphrase might be "What is really important is that the learning experience is bi-directional."

  2. You create a list in your paper that pulls key points from a source without putting each point in your own words. For example, you state: "Collins (2020) identifies three potential pitfalls that evidence plagiarism: failure to cite sources of ideas, failure to properly paraphrase information, and copying an entire paper." Even though this statement is not one continuous quotation from Collins (i.e., it has been drawn from the headings on this page), it is not a paraphrase. You would need to say something like "Collins (2020) warns graduate students to pay careful attention to the need to appropriately credit all sources, the importance of using one's own words, as well as to the more blatant dishonesty of submitting a paper they did not write."

To ensure you understand these principles, please listen to the audio file on proper paraphrasing.

Please review the Word version if you have challenges accessing the audio clip.


Copying an Entire Paper (or Portions Thereof)

You are always expected to complete your own work, unless assignments have been set up specifically for group work. This does not mean that you cannot solicit feedback from an instructor to incorporate into your assignment, have a colleague proofread your work before you submit it, or consult with peers on ideas and expectations. It simply means that your work is your work. Consider the following examples of plagiarism:

Instructors have many tools available to them to detect this type of intellectual dishonesty, including plagiarism detection software.

Exercise 2.2.2

To assess your understanding of the principles of intellectual integrity related to accurate crediting of sources of information, complete Exercise 2.2.2. Then check your responses against the Exercise 2.2.2 Feedback.


In addition to diligently tracking and making transparent the information you draw on from other people, you must be careful to avoid self-plagiarism in your professional writing. Typically self-plagiarism occurs when a student submits a previous assignment, in whole or in part, in lieu of creating a new piece of writing.

However, there is considerable benefit to building upon your learning across courses. So, I have provided some guidelines in this section for ethically integrating previous research and writing, particularly into the culminating experiences of your graduate program (thesis, project, final paper).

Resubmitting Previous Coursework

Submitting previous course work in another course or in another assignment may seem like an obvious “Don't do it!” from an intellectual honesty perspective, but it can be a bit more complicated to discern what this means in practical terms.

You might not want to reinvent the wheel completely every time you write a paper, particularly if you have an emergent area of professional interest. For example, if you are curious about the social determinants of health, or more specifically, you want to specialize in the area of domestic violence, you would be wise to start gathering information on this topic from the very beginning of your program. I suggest you resist focusing every single assignment on the same topic, because it will limit your learning. However, you may pick certain assignments throughout the program to use as a way of building your knowledge and expertise in the area. If you do this in a strategic way, you will have a foundation to build upon for writing your thesis, project, or final paper at the end of your program.

The problem is that you cannot take the same paragraphs and simply plug them into different assignments, or tweak them only slightly for different courses. Submitting work that you completed in one course, in whole or in part, for another course assignment is considered cheating, even if you credit yourself to avoid charges of plagiarism. This includes

  1. taking an assignment from another course (even if that course was taken in another program) and editing it to resubmit for your current course;
  2. lifting sections from one assignment and including them in another assignment; and
  3. resubmitting a previously graded assignment from the same course, if you repeat that course for some reason.

Each assignment is designed to build specific competencies, and you are expected to submit a new piece of academic work for each one. It is your responsibility to ensure that the content was created specifically for the particular assignment, and in the course you are taking currently. You can certainly draw on the same sources and ideas, but you must create a new and original document. To avoid self-plagiarism and maintain the academic integrity of your work, you can use one or more of the following strategies:

The last two suggestions should be approached with considerable caution. In most cases, there will not be content in your course assignments that cannot be reworked substantively and built upon as you move through your program.

A couple of exceptions to this self-plagiarism regulation follow:

Building Toward Culminating Experiences

Most graduate programs culminate in a final project, thesis, or other course-based exit process in which students are expected to demonstrate what they have learned about the theories and practices within the field of health disciplines as well as their competencies in professional writing and ethical scholarship.

Although you are expected to avoid self-plagiarism in course assignments, it is efficient and strategic to build toward your culminating experience throughout your program. Certain course assignments are tailored to build your knowledge and critique of the current literature in areas that you might want to write about as part of your thesis, project, or final paper. So how do you put these two things together? On the one hand, you cannot copy from previous assignments, and on the other hand, you have been working on a particular topic area across a number of courses with a view to integrating your developing knowledge into your exit document.

Faculty who do research and writing as part of their ongoing professional work face a similar dilemma. Many choose a particular area of research and theoretical interest and continue to develop their thinking and writing in that area for many years. However, they are bound by these same ethical principles. They cannot simply rearrange one journal article to create another. The guidelines for almost all journals explicitly require submission of an original piece of work. This does not mean that the topic must be new to the author; it means that they have not made the same argument or presented the same data in another publication. Instead they have presented new ideas and, if applicable, have substantively rewritten or explicitly cited content drawn from previous work to support their thesis in the new article.

The art of not plagiarizing yourself is an essential skill for you to develop as part of your professional development. What this means in practical terms is that you cannot take one of your previous course assignments and submit it as a culminating experience; nor can you simply merge sections from various assignments. In Section 4.4 Generating and Organizing Your Ideas, I provide a process to help you keep track of the original sources from which you have drawn your ideas. This process also provides a means for you to create "rough notes" documents on particular topics that you build upon across various courses. You can draw from these documents in your culminating work without citing yourself as long as you have not copied sections of these documents directly into other course assignments.

Because you are encouraged to build toward your exit process throughout your program, you may be permitted to repurpose a percentage of the content of your within-program writing in your thesis, project, or final paper. In GCAP, for example, we permit you to repurpose 50% of the content of earlier assignments for the course-based exit paper and to integrate your thesis proposal, including the literature review, into your final thesis. However, if you do not have rough notes of your research, then you will need to incorporate some of the principles in the section above (Resubmitting Course Assignments) to ensure you maintain standards of scholarly integrity as you draw on your previous work.

The bottom line is that the culminating activity in your graduate program must represent a new and original piece of work. You are being assessed on your ability to integrate your learning and to demonstrate your ability to create a professional product that meets standards for scholarly integrity and professional writing within the health disciplines.


An original source is the author(s) who first makes a statement, introduces a concept, reports on research, or presents a new idea. Sometimes this original source is cited within the text of an article or book you read. This makes that article or book you read a secondary source for the statement, concept, research, or idea. A secondary source provides a second-hand account of information from the primary source. So, for example, Mules (2020) described a study conducted by Nuttgens (2017). Mules is a secondary source of information; Nuttgens is the original source. Using Mules as your source, rather than reading and citing Nuttgens, is like relying on hearsay in court, and it is a breach of academic integrity. You cannot state for sure what Nuttgens said unless you actually read their work. Otherwise, you are taking Mules’ word for what Nuttgens had to say. You may later discover that Mules did not correctly represent Nuttgens’ views. You have then become responsible for passing on that misrepresentation. In addition, you put yourself at risk of plagiarism and other breaches of scholarly integrity that may have occurred in the secondary source you read.

Consider, for example, the following statements by Mules (2020): "There is growing support for taking a more metalevel approach to the teaching of counselling theories (Nuttgens, 2017). However, some graduate courses maintain a traditional approach to teaching theories." The following examples demonstrate intellectual dishonesty, because you are failing to give proper respect and credit to the information sources you are using in your paper:

  1. You cite Mules (2020) for ideas he presents, when Mules was actually citing Nuttgens (2017); this gives Mules credit for the work of Nuttgens. For example, it is inappropriate to write in your paper: "The current trend in counselling theories courses is to organize the course according to broader philosophical principles (Mules, 2009)." You must actually read the work of Nuttgens (2017) and credit Nuttgens, not Mules, for this idea.

  2. You cite Mules as a secondary source when the article by Nuttgens is in the university library; this is inappropriate, because you chose not to access the readily available primary source of the information. For example, you write in your paper "According to Nuttgens, the current trend in counselling theories courses is to organize the course according to broader philosophical principles (as cited in Mules, 2020)." In this case, you are giving Nuttgens credit (in APA style), but you are still taking Mules' word for what Nuttgens had to say even though you could have accessed Nuttgens directly. You must actually read the work of Nuttgens and credit them, not Mules, for this idea.

Unless the article by Nuttgens (2017) is difficult to access (i.e., not available through the library or an Internet search), you are expected to read the original source before you make reference to it in your paper. If it is difficult to access, then your first course of action is to find an alternative source for this information. Only in rare instances, where the material is a classic piece of writing that is no longer accessible, may you draw on the secondary source.

Many textbooks are primarily secondary sources. For example, the person(s) who wrote your text on nursing or counselling theory may not have developed the theories themselves; instead, they drew on other sources to pull together a succinct overview of each model. Much of the content of the text is, therefore, a secondary source, and you must find works by the original theorist, wherever possible, if you want to reference key aspects of a particular theory. Exceptions exist, of course, such as textbooks wherein the author of the text presents their own research, conceptual, or theoretical work. It is also important to watch out for edited books, in which individual chapters are written by different authors. In this case, you must attribute the ideas to the chapter author, not the book editor.

Please watch this short animated video on secondary sources for more details.

Please review the video transcript if you have visual or auditory challenges with the video.


The key to avoiding plagiarism is being very clear about which content requires a citation and understanding how to properly paraphrase information. In the following subsections, I will provide some helpful principles and practices.


Discerning When to Cite Others

It is often a challenge for students to figure out how much citing of other works to do in a paper. Here are some general guidelines:

Exercise 2.5.1

To enhance your understanding of what constitutes common knowledge and when other sources are necessary, check out the following resources.


Paraphrasing Effectively

The main way to avoid plagiarizing the work of others is to learn to paraphrase effectively. Be sure that you use this skill from the moment you begin to take notes about what others have written. Consider the following suggestions to support writing in your own words.

Unless there is something unique or particularly powerful about the wording used by a source, you should use your own words in your paper, and cite the source of the idea. You are expected to build your own argument in your own words, drawing on ideas, concepts, and themes from the work of others. I provide more details and suggestions about how to synthesize and integrate the literature in Section 5.6.

Recalling the discussion of developing your own voice (Section 1.3), if you are providing your own opinion or pulling out the themes from various sources you have already described, be sure to indicate clearly that this is what you are doing: “Based on the analysis provided above, I have identified three themes that reflect current trends in the literature.” In this case, you do not need to include all of your sources again, but you must be sure that this is your own synthesis and that the sources are documented in the section you are summarizing. The bottom line is transparency: Ask yourself "Will the reader be able, easily, to identify the source of the ideas?"

Exercise 2.5.2

To assess your understanding of the principles of intellectual integrity related to accurate crediting of sources of information, complete Exercise 2.5.2. Then check your responses against the Exercise 2.5.2 Feedback.


Few students deliberately attempt to present the work of another as their own or purposefully engage in other forms of intellectual dishonesty. Those who do will likely tell you that it is not worth the embarrassment or the academic consequences. There is a zero tolerance policy in most universities for plagiarism and other forms of academic misconduct, and the academic consequences, and potential career implications, are very serious. You may want to review the AU Student Academic Misconduct Policy to be clear about the potential consequences of plagiarism and other academic offences. You will be held accountable to the principles outlined in this policy, as well as other guidelines provided specifically through the FHD. Please raise any questions you have with a course instructor or your faculty mentor.

In my opinion, effective writing has as much to do with attitude as it does with skill. You are well on your way to becoming a professional writer if you approach your writing with (a) appreciation for the intellectual work of others, (b) respect for your subject matter and audience, (c) belief in your own ability to make a contribution to the intellectual community, and (d) willingness to learn new strategies to improve your communication skills.

The foundation for scholarly work and practices of intellectual honesty is your grounding in the scholarly literature of the discipline. This involves selecting appropriate sources of information, as well using those sources ethically in your own work. If you fail to use academic sources for your paper, your paper will not be considered graduate level writing, and it will be graded accordingly. The intent of this section is to support your development of information literacy skills, so that you can effectively discern appropriate sources of information as a foundation for your writing.


Establishing a strong scholarly foundation for your work is the logical partner to intellectual honesty. You may be completely transparent about the sources of information you used in your paper; however, if you have not chosen appropriate sources, then you have significantly weakened any position you take in the paper as well as the quality of your professional writing. In this subsection, I will focus in on the following FHD program outcomes:

Breadth & depth of knowledge. Analyze critically and systematically the breadth and depth of knowledge in the health-related academic discipline or professional practice area, including emerging trends.

Scholarly foundation. Select appropriate information sources, citing the required number, and evaluate critically the quality of current research and scholarship.


Establishing a Scientific and Scholarly Foundation

The conceptual and operational bases of the health disciplines are grounded in a shared body of scientific knowledge, which has evolved through research, clinical observation, and generation of theory. Healthcare professionals are accountable to, and reliant upon, this common body of knowledge. Graduate students build upon this knowledge base in course assignments, theses, projects, and other learning activities. It is important to ask yourself whether the sources you are relying upon in your writing are considered scholarly academic resources by others within your profession.

There are various bodies of knowledge that inform each of our perspectives, values, and decision-making processes. For example, people of various cultural and faith groups rely on a shared set of assumptions about human nature as well as values and beliefs about personal and interpersonal ways of being in the world. This body of knowledge is highly valued in the formation of their opinions. However, as healthcare practitioners, overreliance on your own cultural or spiritual ways of knowing for decision-making about client/patient well-being could result in inappropriate and unethical positions or choices, particularly if you superimpose your worldview rather than carefully attending to the worldview of the patient or client (Collins, 2018b). The body of professional knowledge in nursing, health studies, counselling, and psychology forms the common ground upon which healthcare professionals must build relationships with their clients/patients, understand client/patient perspectives and needs, and make informed decisions about client/patient health. It is also our responsibility to ensure that we apply healthcare knowledge in culturally responsive and socially just ways, as reflected in the following FHD program outcomes.

Complexity of knowledge. Acknowledge the complexity of knowledge and the potential of other worldviews, interpretations, ways of knowing, and disciplines to contribute to knowledge.

Cognitive complexity. Be tolerant of ambiguity, and cultivate cognitive complexity to enable you to see beyond your own values, worldview, and sociocultural contexts.


Integrating Sufficient Sources

Some graduate programs specify the minimum number of scholarly sources that you must integrate into a particular writing assignment. See the example from the Master of Counselling in Figure 3.1.1 below. In other cases, you will need to use your own judgment to ensure you sufficiently ground your paper in the professional literature.

Figure 3.1.1

GCAP Scholarly Foundation in Writing Expectations

Unless different instructions are provided in the assignment description, all GCAP course papers are expected meet the following minimum standards:

  • The reference list must include recent scholarly (typically peer-reviewed) sources such as academic journals, books, monographs, and other appropriate sources. GCAP defines recent as within the last ten years, with emphasis on the most current sources.

    • A shorter paper (i.e., 10–12 pages*) must include at least 10 recent peer-reviewed sources.
    • A longer paper (i.e., 15–20 pages) must include at least 15 recent peer-reviewed sources.
    • *Note: Page lengths refer to the assignment criteria, not the length of paper you choose to submit!

  • Students are encouraged to draw on the course materials and required/supplementary readings in assignments, although these sources do not count toward the minimum research requirements outlined above.

  • Citations of foundational or important critical works may reference sources older than ten years.

  • No citations from secondary sources should be used unless the original work is not available from the AU library.

    • Such exceptional secondary sources should be kept to a maximum of one or two citations.

    Students who do not meet the minimum standards for grounding their arguments within the academic literature of the discipline will receive an automatic grade deduction.

    If you are writing on a topic with little current literature, you must consult, in advance, with the course instructor for approval to rely on older peer-reviewed sources in your paper.

One of the typical features of quality healthcare literature is that it is peer-reviewed. This means that other professionals with relevant expertise have provided feedback on the content and judged its quality as sufficiently rigorous and scholarly to warrant publication. Many books are not peer-reviewed. However, most academic journals are peer-reviewed. The Canadian Journal of Counselling and Psychotherapy (n.d.), guidelines state:

The purpose of submitting manuscripts for blind review is threefold: to benefit from the reviewer's expertise in a particular field of study or practice, to gain the reviewer's critical assessment, and finally, to provide concrete feedback to the authors. The intent of the review process is not only to assist the editors in making decisions about manuscripts for publication, but also to educate authors as to how to improve or strengthen their professional writing" (Peer Review Process section, para. 1).

In this age of digital publishing, with its ease of self-publishing, there are also many resources that are not peer-reviewed. This does not necessarily mean they are not good quality, scholarly sources. It means simply that you must apply your own critical lens in evaluating their appropriateness for integration into your graduate papers. This webpage, for example, has not undergone a formal peer review; however, it is based on several decade’s worth of interaction with graduate students, instructors, faculty, editors, and available writing resources and guidelines.


Information literacy is the ability to identify, evaluate the appropriateness of, and effectively make use of, information for a particular purpose. The Association of College and Research Libraries (2016) defined information literacy as follows: “Information literacy is the set of integrated abilities encompassing the reflective discovery of information, the understanding of how information is produced and valued, and the use of information in creating new knowledge and participating ethically in communities of learning” (p. 8).

Operating with scholarly integrity requires you to select appropriate sources from which to draw information and then to identify accurately and communicate the information or argument from your source. If you argue, for example, that the sky is falling in a scholarly paper, you may be accurately reflecting the assertion of Chicken Little (from Robert Chamber’s folk story reprinted in Fowle [1956]); however, you would be hard-pressed to convince your instructor that Chicken Little is a reliable and credible source. How then do you go about selecting sources of information that are considered sufficiently scholarly? Consider the diagram in Figure 3.2.1 below; it synthesizes some important considerations for selecting information sources. The sources I drew on to create Figure 3.2.1. are integrated into Exercise 3.2.1 (below).

Figure 3.2.1

The Process of Professional Writing

In the centre of the figure are questions related to information literacy: Who? What? Why? When, and Where. Each question is responded to in the text boxes on the outside of the figure. In response to Who?, there are three key points for consideration: (a) authorship (e.g., credentials, contact information); (b) credibility (e.g., trustworthiness, expertise, organizational affiliation, peer-reviewed, expert-reviewed); and (c) recognition (e.g., cited or recommended by credible source, linked from reputable websites, search engine or database, reader comments, ratings). In response to What?, there are three points: (a) accuracy (e.g., sources provided, verifiable, discernable opinion vs. factual data); (b) bias (lack of transparency, inflammatory language, misleading); and (c) scope (e.g., extensiveness, comprehensiveness, breadth of audience, diverse points of view). The question Why? has three points: (a) purpose (e.g., information, training, public health vs. product sales, political gain); (b) relevance (e.g., useful to writing project, supports or refutes your arguments); and (c) generalizability (e.g., audience, data sources, context). Finally, When and Where? questions have a combined response of four key points: (a) currency (e.g., up-to-date, most recent version, publication vs. creation date); (b) publisher (e.g., credibility, affiliation,  political or financial interests, webmaster contact); (c) location (e.g., academic or professional vs. business or commercial); and (d) website accessibility (e.g., functional, searchable, easy to navigate, site map, index).

An audio file is provided below for students who are visually challenged.

Exercise 3.2.1

You may want to explore some of the sources below to enhance your understanding of information literacy and to establish your own criteria for choosing appropriate sources.

In the next subsection, I will review the main categories of information sources to provide guidance on applying the best principles of information literacy to these sources.


Library Sources

The most obvious starting place for finding scholarly information is the AU library. You are strongly advised to draw most of your sources from the library. The library journal collections have been carefully screened and selected for quality and relevance. The librarians have created a number of resources to help you optimize your use of the library. Check out the Quick Links on the main page of the Athabasca University Library.

In graduate papers, a heavy emphasis is placed on peer-reviewed and current scholarly sources. You must also be discerning when it comes to books and other monographs. If you are unsure about a source, apply the principles in Section 3.2 Enhancing Information Literacy. The library may contain self-help books, for example, which likely will not meet the criteria for inclusion as scholarly sources in your academic papers within the health disciplines.


Web Sources

At times, it may be appropriate to include carefully selected information from the web in your assignments. There are some great sources of information on the Internet, and there are some very biased and nonscholarly sources. Your responsibility, as a scholar, is to distinguish between the two. In particular, you may want to attend to the following relatively reliable information sources:

There are many other independent webpages designed by individuals or groups with a range in credibility as scholarly sources. You must be careful to apply a critical lens to evaluate both the content and the source of the information. Unless you find a peer-reviewed article online or your assignment specifically permits the use of Internet sources that have not been peer-reviewed, these sources should be in addition to the minimum requirements for a scholarly foundation of your paper (See Figure 3.1.1 in Section 3.1 Discerning Appropriate Information Sources). The Society of College, National, and University Libraries (SCONUL) provides a very useful competency summary for moving from identifying digital sources through to integrating those resources into your paper: 7 Pillars of Information Literacy through a Digital Literacy ‘Lens.’


Open Educational Resources

In recent years, there has also been an evolving body of knowledge that is shared publicly through open educational resources (OERs). These are materials that are freely available on the Internet and have been specifically designated for sharing, adapting, and repurposing by others. These resources are often grounded in a social justice approach to knowledge that asserts the rights of all people and peoples to have access to credible knowledge and high-quality learning opportunities. However, you must be diligent in critically analyzing these sources for use in professional writing projects. They must meet all of the information literacy criteria for scholarly resources. Wikipedia is a good example of an OER that would fail to meet information literacy criteria for academic or professional writing, because there is no way to trace and validate the sources of any specific content it contains. On the other hand, the OpenLearn Project (available through the UK Open University) offers materials that would meet most of these scholarly standards.

Along with written materials, you can access open source images, videos, and other digital materials. It is important to review carefully the copyright certificates for these materials to ensure you use and credit them appropriately. Many OERs have a Creative Commons (CC) copyright license, which allows others to adapt, choose, rework and evolve portions, or the whole of particular materials for new purposes. Some restrictions may apply depending on the type of CC license. For example, this writing resource has a CC license that requires others to acknowledge my authorship, to license their work in a similar way, and to agree not to use the content for commercial purposes. The intent of this type of copyright is to support collaborative knowledge sharing and development. If you are looking for an image to include in a course assignment, you are best off searching for OERs; otherwise, you may be required to get permission from the copyright holder to reproduce the image. A common scholarly integrity infraction, for example, is the inclusion of commercial comics in PowerPoint presentations. Rarely have presenters obtained permission from the copyright owner.

Exercise 3.3.1

Check out the following examples of sources of OERs. Search for an OER on a topic of interest to professional practice in the health disciplines.

The bottom line in selecting sources for academic papers, presentations, or other scholarly works is that you must apply a critical lens to the choices you make. If you write a brilliant paper based on unscholarly or biased sources, your paper will have little academic value, which translates into a low grade. Your choice of sources forms the foundation for all that follows: your argument and your grade!


Sources to Use with Caution

There are a few sources of information that you should use with caution in your graduate papers.


Many graduate assignments outline the number and type of academic sources that you are required to use. In addition, you are expected to use each source in a substantive way, which means that you draw ideas that make a significant contribution to the arguments in your paper from each source you list in your references.

The following activities are considered cheating and constitute a breach of scholarly integrity:

  1. You pad your reference list by adding references that you did not actually use to write the paper. You must have read every article in your reference list. As well, each source in your reference list must correspond to a citation within the body of your paper.

  2. You add a citation from which you have not drawn substantive content. For example, you have used Jerry (2019) and Nuttgens (2018) for the key points in a paragraph. However, you need one more source to meet the standards for creating a sufficiently scholarly foundation in your writing, so you find an article on a similar topic that adds nothing new; you skim the article, and add it to your citation list (Jerry, 2019; Nuttgens, 2018; Padding, 2020).

Each source you use should clearly contribute something unique to your paper. When you engage in the above activities to pad your reference list, your paper is no different than it was before you added these new citations and references. Instead, if you find yourself short a couple of sources by the time you get to the end of your paper, ask yourself the following questions:

In other words, think critically about your paper; think critically about the sources that you are using; and integrate them in a way that is meaningful and makes a substantive contribution to the flow of argument in both your paper and your field of interest.

Planning your paper involves selecting a topic, carefully reviewing the assignment criteria to determine the objective of the paper, and delving into the professional literature to start gathering and organizing your research material in a meaningful way. In this section, I introduce principles and practices to enhance the strength and congruence of your writing plan by deconstructing (i.e., pulling apart) both the assignment expectations and the current professional literature. Some students make the mistake of thinking that these processes are sufficient for professional writing. However, they are simply the background research for your paper! In the Section 5, you will learn how to draw on this background research to infuse your own voice into your professional writing.


Choosing Your Topic

In most cases when you are writing a graduate paper, the place to start is with the description provided for the particular assignment. It is possible to write an amazing paper, but not address the topic or objective targeted in the assignment or to place too much emphasis on one element at the expense of others. As a starting point for examining this issue, please read the excerpts from two assignment descriptions in Figure 4.1.1 below.

Figure 4.1.1

Sample Assignment Descriptions

Assignment 1

The objective of this assignment is to give you an opportunity to analyze critically, and to deconstruct, the major tenets of psychotherapy models by engaging in a process of case conceptualization. Drawing on one of the case scenarios provided, shape your analysis through the following questions:

  1. What is your working hypothesis about the problem? Provide a brief analysis of the problem from the perspective of your chosen model. Draw on the model's concepts for understanding the nature of humans, the nature of healthy (or well-adjusted) functioning, and the causes of problems (i.e., not functioning in a healthy manner).
  2. What is your working hypothesis about how change is likely to occur? Based on your chosen model, elaborate on the nature of change. You may want to take into account which variables or factors are targeted, which processes are involved, whether change occurs within, or outside of, the counselling session, and the model’s perspectives on the role(s) of client and counsellor.
  3. What intervention might you choose? Identify a potential intervention based on your chosen model. Describe what you would do to be helpful to the client, what you would invite the client to do, what resources you would draw on, the context of your activities, and so on.
  4. What outcomes do you anticipate? How would you describe a successful outcome for the client based on your chosen model. Be specific and creative in imagining a preferred future for this client.

Assignment 2

We live in a society in which there is differential privilege, inequitable access to health resources and services, and lack of full participation in community, organizational, and social systems, based on both visible and invisible cultural identity factors and group affiliations. The objective of this assignment is to (a) identify the types of messages that abound in popular media that either challenge or perpetuate oppression of members of nondominant populations, and (b) articulate a reasoned, supported, and convincing argument in support of equity, cultural sensitivity, and social justice in health service provision. Your task is to write an article that could be published in a popular magazine or newspaper.

  1. Choose a topic or issue related to culture or social justice (impacting one or more nondominant populations). Then, scan the popular media to see what ideas are currently being discussed, or which diverse positions are being argued. You can do this through news reports, magazine articles, websites providing commentaries, or other appropriate sources. Try to use online sources so your peers can easily access your sources.
  2. Analyze critically the various messages you encounter. Once you are satisfied that you understand the arguments being made, write a brief paragraph (4–6 lines) in which you synthesize the essence of the debate, challenge, or controversy that has captured your attention. Select 2–3 articles to reference, and provide links to them.
  3. Decide on a position you want to take on the topic or issue. Draw from the values, principles, or competencies outlined in the course. Articulate a clear thesis statement that will form the foundation for your own article. This can be a rebuttal to one or more of the original articles, or it can further extend their positions.
  4. Develop the key points in your argument. Base your points on your thesis statement, and integrate and synthesize the professional literature to support your position. Come up with a catchy title for your article to encourage others to read it. Be creative about the message you want to send.

There is a lot of important information provided in these assignment outlines that will help you begin your writing process. In both cases, you must start by selecting a topic (i.e., the psychotherapy model or the topic/issue related to culture and social justice). Figure 4.1.2 provides a few tips for selecting a topic.

Figure 4.1.2

Tips for Selecting a Topic

  • Flexibility. Your topic may evolve as you delve into the professional literature. Do not lock yourself in too tightly at the outset.
  • Breadth. It is better to cast a wide net to ensure you have sufficient research to allow you to understand the topic as fully as possible before narrowing your focus. It will not be acceptable to say, “No one has written in this area!”
  • Relevance. Your topic should be grounded in the existing literature within the field of health disciplines. You may be very interested in the effects of owning pets on climate change; however, you may have difficulty creating a thesis and argument that position this topic within health disciplines' research and practice.
  • Cultural responsivity. Many topics in the health disciplines require attention to culture and social justice. Consider the risks of applying ethnocentric lenses, engaging in cultural appropriation or exploitation, or excluding diverse voices in your choice of topics; take appropriate steps to avoid these risks.

Adapted from “Literature review and focusing the research” in Research and evaluation in education and psychology by D. M. Mertens, 2015, p. 93–96.


Clarifying Your Objective

Before you can begin writing about a particular topic, you must understand clearly the objective of the assignment. The objective might be to describe a particular phenomenon, to argue a specific point of view, to reflect critically on personal values, to increase self-awareness, or to persuade the reader to adopt a particular position. Understanding the objective of your writing is a key step in planning your paper.

A well-worded assignment description uses language that is consistent with the objective of the assignment. Many course designers draw on Bloom's (1956) taxonomy of learning objectives as a means of providing guidance to students about the academic objective(s) of the assignment (i.e., the purpose or aim of the learning activity and assessment process). Bloom identified three domains of learning that assignments can target: cognitive, affective, and skills.

Each domain is broken down into specific types of learning goals and descriptors that are used to assess whether those goals have been reached. I have adapted Bloom’s (1956) descriptors in Table 4.1.1.

Table 4.1.1

Bloom's (1956) Taxonomy of Education Objectives

Cognitive Domain

Level of Learning


  • observe and recall information
  • know major ideas
  • describe the subject matter accurately
  • understand content and grasp meaning
  • interpret, compare, and contrast facts
  • provide examples
  • use information, methods, concepts, theories in new situations
  • solve problems using acquired skills or knowledge
  • identify patterns and draw connections
  • recognize hidden meanings or implications
  • use old ideas to create new ones or generalize them to new situations
  • integrate knowledge from several areas
  • predict, draw conclusions
  • compare and discriminate between ideas or models
  • assess value of theories and concepts
  • make choices based on reasoned argument
  • recognize subjectivity and potential biases

Affective Domain

Level of Learning


  • demonstrate self-awareness, sensitivity towards others, personal responsibility
  • identify areas for personal change
  • adopt a self-reflective attitude toward personal and professional activities
  • exhibit values and attitudes appropriate to the context and professional role
  • seek personal and professional development

Skills Domain

Level of Learning


Simulated demonstration
  • demonstrate purpose, structure, and application of skill, procedure, or strategy
  • implement skill, procedure, or strategy in practice contexts according to prescribed step-by-step criteria
  • attend to the intrapersonal, interpersonal, and contextual factors in choice of skill, procedure, or strategy
  • generalize use of skill, procedure, or strategy to applied contexts
Responsive implementation
  • demonstrate skill, procedure, or strategy fluently, flexibly, and creatively
  • introduce new combinations of skills
  • adapt and integrate components of procedures and strategies to address emergent needs

Exercise 4.1.1

Review the two sample assignments in Figure 4.1.1 (above), and identify words that suggest the levels of learning targeted in the assignment.

For most graduate papers, you will be required to go beyond knowledge and comprehension to analyze and apply what you have learned (see Figure 4.1.1, Assignment 1 above), to engage in evaluation, and to integrate and synthesize the relevant literature (see Figure 4.1.1, Assignment 2 above). If the level of learning is unclear from the assignment description, assume you are to aim for the highest levels of learning. Both of the assignments in Figure 4.1.1 focus predominantly on the cognitive domain. In other assignments you may be expected to demonstrate a commitment to the values of the profession (affective domain) or to engage in applied practice activities (skills domain) in a way that is responsive to patient/client needs and contexts. Some course assignments may be more open-ended, offering you a chance to design your own writing plans to meet particular learning objectives.

Applying the levels of learning to your analysis of the assignment gives you clues about how to establish an appropriate objective for your paper. Table 4.1.2 illustrates both a congruence and a mismatch between levels of learning and the objective identified for an assignment. In each case, the topic is models of patient/client care.

Table 4.1.2

Congruence between level of learning and writing objective

Level of learning

Congruent Objective

Mismatched Objective

Analysis The objective of this paper is to analyze critically the similarities and differences between an individualist and an ecological approach to patient/client care. The objective of this paper is to describe two different approaches to health care: individualistic and ecological.
Synthesis and evaluation The objective of this paper is to build a solid case for an ecological approach to patient/client care based on current theory and clinical research. The objective of this paper is to identify and create a list of the best practices for patient/client care.
Commitment The objective of this paper is to reflect on and position my values and beliefs about how best to care for each unique individual patient/client I encounter. The objective of this paper is to explore what I believe about patient/client services and to identify my personal values.

Exercise 4.1.2

Recall an assignment you have recently written, or choose one from a current course. Complete Exercise 4.1.2 to practice crafting objectives that reflect cognitive levels of learning. There are no right answers to this exercise, because many different objectives could emerge from a single topic.

What is important is that you identify an objective that reflects the levels of learning targeted by the assignment, before you start conducting research into the topic area. Depending on your knowledge of the topic area, you may begin with a relatively simple objective and elaborate it over time as you increase your knowledge base. Your objective can be incorporated directly into the introduction of your paper.


One specific type of professional writing you will encounter in your graduate program is a literature review. The term literature review is used in many different ways. It is important to clarify what this term means in various contexts, so that you can discern the type of literature review that is appropriate for various academic and professional writing activities.

In many course assignments, you will critically analyze the professional literature with a view to synthesizing and integrating it in support of the specific objective of the assignment (e.g., application of theory to practice, analysis of a case study, critical analysis of approach or model). In other cases, the core objective of the assignment, or a substantive portion of it, will be to conduct a literature review (i.e., an in-depth analysis of a particular topic, theory, concept, methodology, argument) based on the professional literature.

Exercise 4.2.1

Compare and contrast the diverse types of literature reviews described in the following resources. Different labels are sometimes applied, so pay close attention to the purpose and content of the various types of reviews.

In Figure 4.2.1, I summarize the various types of literature reviews based on the objective (purpose) and common applications of each type. As you are conducting your own research in your topic area, try to classify literature reviews you encounter according to these two criteria.

Figure 4.2.1

Types of Literature Reviews

Type of Review Objective Common Applications
Traditional review, Narrative review Critique existing literature to generate a narrative synthesis of themes related to a particular topic, sometimes pointing to new research possibilities
  • Paper
  • Research proposal
  • Chapter in thesis
  • Journal article
Theoretical review Analyze critically theoretical models or concepts with a view to identifying places where existing theory fails to address new problems or contexts
  • Paper
  • Research proposal
  • Chapter in thesis
  • Journal article
Conceptual review Highlight what is known about a particular concept and potentially point to new understandings or applications
  • Paper
  • Research proposal
  • Chapter in thesis
  • Journal article
Historical review

State-of-the-Art review
Track the evolution of a theme, concept, model, or phenomenon over time,
or review only the most current literature
  • Paper
  • Research proposal
  • Chapter in thesis
  • Journal article
Methodological review Critique the methods and techniques used in conducting research rather than research outcomes
  • Paper
  • Research proposal
  • Chapter in thesis
  • Journal article
Argumentative review Synthesize and integrate the literature to further support or to counter-argue an existing thesis and argument in the professional literature
  • Paper
  • Research proposal
  • Journal article
Critical review Analyze critically the literature, critically evaluating diverse perspectives, to support conceptual innovation or theory generation
  • Thesis research study
  • Journal article
Systematic review Analyze systematically, comprehensively, and rigorously the quality and quantity of existing research through predefined parameters to answer specific questions
  • Thesis research study
  • Journal article
Meta-analysis or metasynthesis Analyze statistically the results of various quantitative studies or systematic analysis of themes or concepts across qualitative studies to draw cross-study conclusions
  • Thesis research study
  • Journal article
Scoping review, Integrative review Identify and categorize themes from a comprehensive analysis of all available literature in a particular area, without specific analysis of the quality of the studies
  • Thesis research study
  • Journal article
Note. Adapted from "Introduction to literature reviews," by University of British Columbia Library, 2019 (http://guides.library.ubc.ca/litreviews); How to conduct a literature review: Types of literature reviews," by University of Southern Californian Libraries, 2019 (http://guides.lib.ua.edu/c.php?g=39963&p=253698); "Types of literature reviews," by University of Toledo University Libraries, 2019 (http://libguides.utoledo.edu/c.php?g=284354&p=1893889); and "Introduction to different types of literature reviews," Western University Libraries, 2019 (https://www.lib.uwo.ca/tutorials/typesofliteraturereviews/).

Moving down the list in Figure 4.2.1, the types of reviews become more systematic, rigorous, and comprehensive. Critical reviews, systematic reviews, meta-analyses, metasyntheses, scoping, and integrative reviews are most often used as thesis research studies or elements of larger research projects; these reviews could then be published as journal articles. These are typically too time-consuming and demanding for course assignments.

Methodological reviews are commonly proposed in research methods texts, where the focus is on critical evaluation of the methodology, rather than the outcomes, of various studies. In some cases, these also form a foundation for research proposals, where the focus is more specifically on research methodology.

Mostly commonly, you will encounter course assignments that require traditional/narrative, theoretical, conceptual, and sometimes historical or state-of-the-art reviews. These types of reviews are not necessarily mutually exclusive; you may integrate elements of several within one literature review depending on the topic you select. In addition, they all have several things in common:

Depending on the nature of the assignment, you may be required to draw on a specific range of sources from the professional literature. These types of literature reviews also can be used to form a foundation for your thesis research proposal and later become a chapter in your thesis or a manuscript for publication. If you choose the course-based exit route, you may develop a journal article drawing on one or more of these types of literature reviews. In each case, you should clearly state both the topic and the objective of your review in a way that communicates both the levels of learning targeted and the scope and nature of your review. You can use the other types of literature reviews as resources for writing your own paper. Some of these (e.g., critical reviews, systematic reviews, meta-analyses) provide excellent overviews of a research topic.


Now that you have a topic and an objective for your professional writing, it is time to begin to gather and analyze appropriate sources. As noted in Section 3 Establishing a Scholarly Foundation, most graduate writing requires you to draw on peer-reviewed journal articles as your primary sources of information. At this point, you will engage in a process of deconstruction that involves dismantling or breaking something apart the better to understand it. This process of deconstruction is an important first step in writing a graduate level literature review, but it is just the first step! The questions below support deconstruction of the professional literature:

There is no single, correct way to write a literature review or to engage other forms of professional writing. Frequently, writing is a recursive process wherein you review the literature; organize the literature; identify core ideas or themes; then go back to the literature; and subsequently, revise themes, ideas, and sometimes even topics! Figure 4.3.1 (below) provides a visual representation of the professional writing process that emphasizes its recursive nature. You explore the literature and come up with what you think is a solid thesis and argument for your paper (addressed in Section 5); then later, you find an article that causes you to shift your perspective, which impels you to modify your thesis and arguments. You can systematically follow the diagram below in a clockwise fashion, or you can discover that it works better for you to work back and forth between all of the steps in a nonlinear way.

Figure 4.3.1

The Process of Professional Writing

This figure has six text boxes arranged in a circle to suggest the nonlinear and recursive process of professional writing. At the top of the figure is a text box labeled, deconstruction, described as the critical review of existing literature. Following the process clockwise, the next component is reconstruction, which refers to the analysis of themes, trends, contexts, and unanswered questions emerging from the deconstruction of the professional literature. Next is the thesis or problem statement, which introduces a debatable assertion, application, concern, or gap related to theory, research, or practice. At the bottom of the diagram is key arguments, which are the rationale to support the thesis or problem statement. Next is synthesis and integration of the literature to support those key arguments. Finally, is either a conclusion which involves revisiting the thesis statement, or in the case of a research project, an introduction to the research, including purpose, significance, and research questions.

An audio file is provided below for students who are visually challenged.

The process of deconstruction may appear less significant in this diagram than the remaining processes (addressed in Section 5), because deconstruction reflects only 1/6 of the content. However, you cannot really begin to write a graduate paper until you fully appreciate the professional context of the topic about which you want to write. There are a number of important skills involved in generating and organizing the ideas that you draw from the professional literature; and then reading, thinking, and writing critically about them. These skills and processes will be addressed in the following subsections.


There are many techniques for starting to develop the content of your paper. Here are two suggestions:

Making Meaning of the Professional Literature

Before the days of computers, many graduate students gathered their notes on slips of paper and then arranged and re-arranged them on their desk until they had a clear sense of the meaning of the literature they were reading. You may still find this a useful activity. However, it is very easy to use a Microsoft Word file to arrange your ideas on particular topic. While I was creating the original content upon which this resource has been built, I was working on a theoretical/conceptual literature review in the area of social justice and career practice. I have used this review (below) to demonstrate how I organized information as I read and reflected critically on the academic body of knowledge in this area. This is just one way to organize and keep track of ideas from various sources as you conduct your initial research on a topic. It is organized into three days, during which I continued to read the literature and to add to my research summary.

My Background Research: Day 1

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My Background Research: Day 2

Sections 1 and 2 of my notes remained the same at this point, but I added in some new ideas under two new themes below.

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My Background Research: Day 3

I did not make any changes to Section 1 the next time I sat down to add to my background research; however, I added content to other sections and created a couple of new categories or themes.

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Optimizing Your Time Investment

When I find a topic area that interests me, I often start by creating a document like the one in the previous subsection that covers more content than I will use in any given paper. The final paper will not necessarily follow this structure, but I will have, at my fingertips, the information to support the key points and subpoints I select for each paper. Notice that the way in which I have pulled together this information reflects higher order learning objectives. For example, I did not simply list one point from one source; instead, I synthesized and integrated ideas across sources as I read and make notes as I demonstrate below. Notice that I have put in red any citation that I have not yet read fully in the original, so that I do not inadvertently include them in a final document before reading them.

The shifting demographics of Canadian society and increased systemic barriers to career and life success (Arthur & Collins, 2005b) are bringing social justice back to the forefront (Arthur & Collins, 2005a; Fouad et al., 2006), particularly in the area of career development (Toporek & Chope, 2006).

I am also evaluating the literature:

Attention to social class is highlighted in the literature (Blustein et al., 2005; Liu & Ali, 2005). It is important to understand the way in which social class forms a cultural schemata that impacts career development values, beliefs, assumptions, aspirations, and goals (Blustein et al., 2005; Liu & Ali, 2005).

The intellectually challenging climate and the opportunity to articulate and debate ideas with other people were the things I found most exciting about graduate school. I still seek out opportunities to work collaboratively with my colleagues on projects that will push me to think critically, creatively, and beyond my current points of view. This often creates a synergy that results in new ideas and directions I might not have generated on my own.

I hope that you will have many opportunities throughout your graduate program to engage in this type of co-constructive learning process. Engaging with the professional literature as you write your graduate papers offers you a similar opportunity, if you approach it with a critical mindset. You bring your ideas, worldview, and expertise to create an interactive process that can result in exciting new perspectives. I hope that you will welcome this challenge, as I do.


Thinking About Your Thinking

Throughout your graduate program, you will be expected to explore alternatives with an open mind, and then establish a personal position on certain issues, supporting your points of view with various forms of evidence, theory, or plausible lines of reasoning that will stand up under the healthy review and scrutiny of your classmates and instructors. You will be asked to respond to your instructors and peers from a place of curiosity and scepticism, key components of a scholarly attitude. You must develop the ability to read, think, and write critically, which is reflected in the following FHD Program Outcomes.

Breadth & depth of knowledge. Analyze critically and systematically the breadth and depth of knowledge in the health-related academic discipline or professional practice area, including emerging trends.

Critical analysis. Demonstrate critical reading, thinking, and writing.

Generalization of knowledge. Analyze critically, apply, and generalize knowledge to new questions, problems, or contexts.

If these expectations are new for you, welcome the challenge and the excitement of academic thought and discussion. Each invites you into a process of thinking about your thinking.

Exercise 4.5.1

Take a moment to write your own personal definition of critical thinking. Then review the definition(s) of critical thinking on the Foundation for Critical Thinking website. What I like about their approach is the emphasis on shared intellectual values across disciplines, the importance of developing the lifelong habit of thinking critically, the attention to motivation, both in presenting your own views and in analyzing critically the perspectives of others, and the caution about attending to, and suspending, personal biases so that you can read and critique with an open mind.

Here are some suggestions for optimizing your contributions to your own scholarly and critical thinking community.

A fundamental objective of critical thinking is to consider how, or whether, you might make personal and professional use of particular information. (Recall the focus on discerning appropriate information sources in Section 3.1.) Information must hold up under critical scrutiny and offer useful understandings of some aspect of professional theory or practice. Probing beyond the surface of any assertion requires discipline, and answering some of the questions in Exercise 4.5.2 as you read can be particularly helpful.

Exercise 4.5.2

Choose a journal article on a topic in which you are interested or one about which you are currently writing. Apply the following questions to enhance your critical reading, thinking, and writing as you work through that article.

  • What are the primary assertions being made by the author(s)?
  • How clear, concise, consistent, comprehensive, and coherent are these assertions? Could you make these assertions understandable to someone unfamiliar with your discipline?
  • How are these assertions supported? Do you agree with the evidence offered, and the way it was obtained (i.e., the appropriateness, and proper use, of the research methods used)? Are the author(s)’ claims fully supported by the evidence?
  • What do other authors or researchers in the field think of these assertions and the evidence used to support them?
  • What assumptions are implicit in these assertions? Do these have any cultural (e.g., ethnocentric, sexist, classist) or other blind spots? Do you agree with the relevance of the assumptions to the subject?
  • How well do these assertions fit with your own values, beliefs, and worldview? Do they push you to consider personal cognitive, attitudinal, or behavioural change?
  • What are the relative strengths and weaknesses of the assertions being made?
  • What alternative metaphors, conclusions, or analogies for these assertions can you suggest? How can you develop these into other, more plausible, lines of thinking?
  • Where, when, and with whom would the author(s)’ assertions not hold up? Why? Who might take exception with these assertions? Why?
  • Do these assertions make a genuine contribution to better understanding the subject, even if they are different from understandings that are a better fit for you?
  • How do these assertions look in practice? Would they be recognizable, generalizable, and usable?

In class discussions, group work, and written work, you are expected to go beyond what you have read to show others how you have made, or not made, information from various sources your own (i.e., how you have integrated it into your own thinking) and why you consider that information useful, or not useful, to you or others. This requires you to engage in the higher levels of learning (i.e., analysis, synthesis, evaluation) addressed in Section 4.1. Fowler (2005) articulated the relationship between these levels of learning, and I have adapted their material below.


Fostering Cognitive Complexity

Engaging in critical reading, thinking, and writing requires you to be able to step back, to think about your thinking, and to identify barriers to critical thinking. One of those barriers is cognitive rigidity. Consider the following FHD Program Outcome, and then complete Exercise 4.5.3, drawn from Collins (2018a), to explore the skill of cognitive complexity further.

Cognitive complexity. Be tolerant of ambiguity, and foster cognitive complexity to enable you to see beyond your own values, worldview, and sociocultural contexts.

Exercise 4.5.3

Think about your thinking by comparing and contrasting the characteristics of cognitive complexity versus cognitive rigidity below. Honestly appraise your own cognitive tendencies, and consider how these might be assets or barriers to engaging in critical reading, thinking, and writing. It is very important not to fall into either/or thinking; this applies to your thinking about thinking as well, because you will likely recognize both thinking patterns in yourself. Identify the contexts, relationships, issues, or other variables that might incline you towards one or the other. What meaning do you make of these observations? What are some implications of the cognitive style toward which you incline for your professional writing practices?

Cognitive Complexity

Cognitive Rigidity

  • Able to navigate ambiguity, paradox, and cognitive dissonance
  • Uses both/and thinking
  • Integrates multiple and broad frames of reference
  • Acknowledges that some questions can’t be answered
  • Draws on multiple, interrelated concepts or constructs
  • Recognizes and values multiple realities
  • Sees multiple points of entry into, and solutions for, a problem
  • Discounts conflicting or incongruent information
  • Operates with either/or thinking
  • Relies on a singular and narrow frame of reference
  • Believes firmly that all questions are answerable
  • Relies overly on only a few concepts or constructs that have simple relationships
  • Holds rigidly to truth claims, and filters out information that challenges existing beliefs
  • Thinks in a linear, causal way

Applying a Critical Lens to Attitudes and Beliefs

In keeping with Bloom’s (1956) emphasis on affective learning, and as a member of an applied health discipline, you will also be challenged throughout your graduate program to reflect on the various lenses through which you view the world. You will be expected to reflect actively on cultural and social biases and to explore how those might affect the quality of your writing. The goal of self-reflection is not to move to a value-neutral position, but rather to move to a point of awareness where your own personal values can be consciously suspended temporarily, so that you can most accurately hear what is being said by others. You will also be expected to reflect on, and to evaluate critically, your own beliefs and values in light of professional literature, ethics, and values. For example, you might currently believe that people are poor, because they are too unhealthy to work. However, once you spend time exploring the professional literature, that belief will probably be turned on its head, and you will instead embrace the opposite assumption: Poverty is most often a precursor to ill health (Allan & Smylie, 2015; Collins et al., 2014; Mental Health Commission of Canada, 2012). The expectation to reflect critically on your own attitudes and beliefs is reflected in the following FHD Program Outcomes.

Cultural diversity. Value, respect, and be responsive to cultural diversity.

Social justice. Take action to safeguard the welfare of others and to promote social justice.

Self-awareness. Value self-awareness, and engage actively in continued exploration of values, beliefs, and assumptions.

Critical thinking is the foundation and benchmark of graduate education! Your ability to read critically, think critically, and then translate your ideas into writing critically is what will make you a successful writer.

Exercise 4.5.4

If you want to learn more about critical thinking, check out the work of Kevin deLaplante of the Critical Thinker Academy. He has created a playlist in YouTube of videos on critical thinking that offer a great alternative for those of you who are more visual or auditory learners.

You may also find the following resources helpful.

Planning and drafting your paper are the most demanding tasks in the writing process. They require you to analyze carefully the assignment criteria, shift into a critical thinking mode, and demonstrate your ability to engage in higher order learning. Some students skip the critical thinking phase of their writing entirely by simply gathering ideas from other sources, rearranging them into some logical order, and assuming they have, thus, created the basis for a graduate paper.

However, the beauty of graduate school is that you are no longer considered to be simply a consumer of other people’s ideas. Instead, you are expected to engage critically with others’ ideas, to bring forward your own lens and experience, and to be an active participant in advancing the understanding of issues, theories, and practices in the health disciplines. The cornerstone of professional writing is the insertion of your own voice, your own critical analysis, and your own position on, or assertion about, the topic. Do not wait until you complete your program; you can begin to develop your professional voice, and to join that voice with credible, scholarly voices from others in your field of study, in your very first graduate paper.


I have copied Figure 4.3.1 (below) as a reminder of the recursive and iterative process of writing a literature review or other forms of professional writing. In this section, we pick up at the point of reconstruction.

Figure 4.3.1

The Process of Professional Writing

This figure has six text boxes arranged in a circle to suggest the nonlinear and recursive process of professional writing. At the top of the figure is a text box labeled, deconstruction, described as the critical review of existing literature. Following the process clockwise, the next component is reconstruction, which refers to the analysis of themes, trends, contexts, and unanswered questions emerging from the deconstruction of the professional literature. Next is the thesis or problem statement, which introduces a debatable assertion, application, concern, or gap related to theory, research, or practice. At the bottom of the diagram is key arguments, which are the rationale to support the thesis or problem statement. Next is synthesis and integration of the literature to support those key arguments. Finally, is either a conclusion which involves revisiting the thesis statement, or in the case of a research project, an introduction to the research, including purpose, significance, and research questions.

An audio file is provided below for students who are visually challenged.

To move from your critical deconstruction of existing literature (Section 4 above) to writing your own literature review, start by stepping back and asking yourself the following questions:

These questions encourage you to develop your own voice, point of view, position, or perspective on the literature you have been reading. You are now moving from the process of deconstruction to one of reconstruction (i.e., putting the literature back together in an original and creative way). Deconstructing and reconstructing the professional literature is a process you will each continue to engage throughout your graduate program and throughout your careers as scholar-practitioner-advocate-leaders.


Literature reviews can be structured to accomplish different purposes even though they draw on (and reconstruct) the same overview or summary of existing literature. Regardless of the route you choose to complete your graduate program, writing a literature review effectively is a skill you are expected to develop. There are two basic purposes for a literature review: (a) as a rationale or justification for research (e.g., in a thesis proposal, or in the introduction to a research article) or (b) to support a conceptual or theoretical argument (e.g., in a course assignment, or in other non-research-based articles for publication).

In either case, the basic structure of a literature review is similar; it leads the reader from a broad thesis or problem statement, through a series of key arguments, to a particular conclusion (see Figure 5.2.1). In the case of a literature review that is used to justify research (i.e., a thesis or research study proposal), the conclusion reached is the research question(s). Where the literature review supports a conceptual or theoretical article, the conclusion is usually related to implications for practice, advancement or critique of theory, application of a particular construct or principles, and so on.

Figure 5.2.1

Basic Structure of a Literature Review for Research Versus Conceptual or Theoretical Papers

Literature Review as a Foundation for Research

Literature Review as a Theoretical or Conceptual Paper

The image on the left hand side of this figure illustrates how to set up a literature review as a foundation for research. There are four elements nested within an upside down triangle. At the top is problem statement. Next is key arguments. These key arguments then lead to the purpose and significance of the proposed research. Finally, at the bottom, is research questions(s).

Audio version:

The image on the right hand side of this figure illustrates how to set up a literature review for the purposes of a theoretical or conceptual paper. There are four elements nested within an upside down triangle. At the top is thesis statement. Next is key arguments. These key arguments then lead to the significance. Finally, at the bottom, are implications and conclusions.

Audio version:

As you can see from the diagrams above, problem or thesis statements provide a broad starting place for your writing. As you build your arguments, you progressively narrow the focus to lead logically to either (a) your research question(s) or (b) the implications and conclusions you want to present to readers. In Table 5.2.1 (below), the same assertion is used as a problem statement and a thesis statement to provide a foundation for (a) a literature review to justify potential research and (b) a conceptual literature review. Notice how much of the content in black applies to both writing projects. The content in blue shows areas where your writing might diverge based on the different objectives of these two literature reviews.

Table 5.2.1

Content Comparison of Literature Reviews for Research Versus Conceptual or Theoretical Papers


Research Literature Review

Theoretical or Conceptual Literature Review

Topic Social justice action in counselling
Problem or thesis statement Healthcare practitioners are not well-prepared to engage in social justice actions with, or on behalf of, their clients/patients, which may limit their ability to respond in an effective and culturally sensitive way.
Key arguments
  1. Clients/patients often present with issues or problems that are influenced by contextual or systemic factors.
  2. In many cases, these broader issues are tied to cultural oppression, lack of privilege or power, or other forms of social injustice.
  3. It is important for healthcare practitioners to be able to discern when external influences are impacting a client and to engage in interventions aimed at systems change.
  4. However, most health disciplines graduate programs do not train students in social justice interventions or facilitate attainment of specific social justice competencies.
  1. Patients/clients often present with issues or problems that are influenced by contextual or systemic factors.
  2. In many cases, these broader issues are tied to cultural oppression, lack of privilege or power, or other forms of social injustice.
  3. It is important for healthcare practitioners to be able to discern when external influences are impacting a client and to engage in interventions aimed at systems change.
  4. Collaborating with patients/clients to implement social justice interventions places the locus of responsibility for change where it belongs and empowers patients/clients to effect change in the context and systems that affect their lives.
Purpose of study To identify the competencies that students need to address social injustice effectively with, or on behalf of, their clients/patients. N/A
Significance Locating the problem within the client/patient risks blaming them for their misfortunes, inadvertently engaging in cultural oppression, and supporting an unjust status quo. Providing students with advocacy and other competencies supports the goals of building a just society and preventing problems associated with social injustices. Locating the problem within the client/patient risks blaming them for their misfortunes, inadvertently engaging in cultural oppression, and supporting an unjust status quo. Implementing advocacy and other competencies supports the goals of building a just society and preventing problems associated with social injustices.
Potential research questions


Implications and conclusions
  1. What are the competencies that students require to engage effectively in social justice action?
  2. What are the current gaps in counsellor education for social justice?
  3. How might learning activities or processes best support attainment of these competencies?
  1. Students in graduate health disciplines programs may require specific competencies to engage in social justice action.
  2. Given that this is an emergent challenge, practitioners currently in practice should have access to continuing education in this area
  3. It might be important to revisit various guidelines for professional practice to ensure that social justice competencies are integrated into these key documents.

The bottom line is that, as scholar-practitioner-advocate-leaders, you are responsible to respect and mirror the body of literature in the health disciplines, and you are also called to contribute to that body of literature. You might do this through engagement in research, or you might do this by contributing a theoretical or conceptual article to a journal, writing for a professional magazine, or presenting your work at a conference or a professional meeting. In each case, you may find this basic structure of a literature review helpful as a guide for your writing.


Now that you have a sense of the big picture of what is involved in a writing a literature review, and you have gathered enough information from the professional literature to get a clear sense of what you would like to say about the topic, I recommend that you take a break from your research to craft a thesis/problem statement for your paper. A thesis/problem statement is a sentence (or two) that tells the reader what you intend to argue about a particular topic. It is the main assertion or central position that forms the backdrop against which the relevance of everything else in your paper is assessed.

Let’s pick up on the objectives from Table 4.1.2 (Section 4.1 above) to differentiate between the objectives of a paper and its thesis or problem statements. Notice in Table 5.3.1 below, the thesis statements are also aligned with the level of learning targeted.

Table 5.3.1

Coordinating Thesis or Problem Statements with the Objective of the Paper

Level of Learning


Thesis or Problem Statement

Analysis The purpose of this paper is to critically analyze the similarities and differences between an individualistic and an ecological approach to client/patient care. Although there are some similarities between the individualistic and ecological approaches to client/patient care, the core values, locus of control, and locus of intervention are substantively different.
Synthesis and evaluation My objective in this paper is to build a solid case for an ecological approach to patient/client care based on best practices and clinical research. An ecological approach to patient/client care must begin with a systems level analysis of the presenting concern, engage the patient/client actively in intervention/treatment planning, attend to the impact of social determinants of health, and build in inter-professional collaboration where appropriate.
Commitment In this paper, I intend to reflect on, and position, my values and beliefs about how to best care for each unique individual I encounter. As a health care practitioner, I embrace the values of the ecological approach to patient/client health (i.e., respect, collaboration, and social justice); however, I struggle to reconcile them with some of my core personal/professional values for individual patient/client care (i.e., self-responsibility, practicality, immediacy of intervention/treatment, and personal autonomy).

You will notice that a number of different thesis statements have been drawn from the topic, Approaches to Client/Patient Care. The thesis statement depends on (a) the objective of the paper, (b) what you discover in your preliminary research (deconstruction of the professional literature), and (c) your interests and opinions about the topic.

Exercise 5.3.1

To explore further the difference between the topic, objective (purpose), and thesis of your paper, you may want to review the following Web resources:

Each thesis/problem statement can be evaluated against the following criteria:

What should be clear from the list above is that the final writing of your literature review cannot be completed until after you have gathered, summarized, and critically analyzed the existing literature to such a degree that you can come up with your own thesis or problem statement. However, this is likely to be a recursive process that requires you to go back and forth a number of times between what you have learned from the literature and what you want to assert in your literature review. The result will be the unique position that you want to argue. Your position statement derives from the body of literature, but it offers something new and original.

A strong thesis or problem statement indicates to readers the single most important idea that you want to communicate, and it often provides them with a preview of how your arguments will be laid out in the paper. You may revise your thesis statement as you continue to develop your paper. Normally, you position your thesis statement prominently in your introduction, often as the last line.

Exercise 5.3.2

Complete Exercise 5.3.2a to test your understanding of how to create a strong thesis statement. Then work through Exercise 5.3.2b to practice generating problem statements and corresponding research questions. Check out the Exercise 5.3.2b Possible Responses to ensure that you are on the right track. There are no right answers to these activities, because many different objectives, levels of learning, thesis or problem statements can emerge from a single topic.


As you explore the professional literature or engage in applied practice contexts, you may discover that there are particular concepts and theories that shed light on the topic about which you are curious. These concepts and theories may influence how you or others think about your topic. Most graduate papers do not require you to develop a conceptual framework. However, you may be expected to do so for a research proposal in your methods of inquiry course or as part of your thesis work (if you choose that exit route). The conceptual and methodological congruence of your research plan and implementation will be dependent on your level of clarity about the lenses (i.e., concepts and theories) you adopt. You may also benefit from including a conceptual framework in other course assignments or culminating program activities. The decision to include a conceptual framework depends, to a large degree, on the topic and the objective of your writing or, if you are planning to engage in research, on how you position your research.

A framework is basically a broad structure that provides meaning and direction for your research or writing. This framework is most often built upon a number of interrelated concepts. I am using the term, concept, to refer to an abstract representation, in language, that characterizes a particular experience or phenomena. In some cases, specific concepts are already clustered together in a purposeful way within a particular theory or model. In this case, the relationships among those concepts has already been explored and articulated. Normally, the relationships between concepts in a theory are more definitive, developed, or “tested”; whereas, conceptual relationships in a model tend to be more tentative and exploratory (McConnelly, 2014). In other cases, the concepts of interest to you may be loosely interconnected, or they may not yet have been connected to the phenomenon you are interested in studying.

It is your job, as a writer and researcher, to make these connections. In most cases, you develop the connections through your literature review, and then enter into your writing or research with a conceptual framework in mind. Although the terms, conceptual framework and theoretical framework, are often ill-defined or used interchangeably in the literature (Green, 2013; McConnelly, 2014; Ravitch & Riggan, 2017), I am using the term, conceptual framework, as the broader, umbrella term (Ravitch & Riggan, 2017). This choice is based, in part, on the argument by Green (2013), who proposes that theories are rarely used whole to support research; rather, particular interrelated concepts are highlighted to support a specific purpose within any study. I define a conceptual framework as a visual representation of the relationship between theories, models, and concepts (as well as variables in the case of quantitative research) that makes transparent the way in which you, as the researcher, are thinking about the various elements that influence your research questions and research design. Ravitch and Riggan (2017) reinforce this definition by arguing that to create a conceptual framework “you must critically read and make connections between, or integrate and synthesize, existing work related to your emerging research topic and its multiple theoretical and practical contexts" (p 11).

Your paradigmatic position (i.e., the assumptions you make about the nature of reality, what is knowable, and how knowledge is created) also needs to be stated in your research; however, it is not typically represented directly in the conceptual framework. Having said this, the paradigm that you gravitate towards (e.g., positivist/postpositivist, constructivist/interpretive, critical/emancipatory/transformative, Indigenous, pragmatic) may have considerable influence on the theories and concepts you highlight in your conceptual framework and how you position the relationships among them (Green, 2013; Mertens, 2015). For example, addictions research among the poor may be positioned quite differently if an emancipatory/critical lens, rather than a positivist/postpositivist lens, is applied to the research. The former is much more likely to draw on concepts such as social determinants of health, equity, social injustice and to position the locus of research at the level of systems rather than at the level of the individual. Your paradigm might also influence the nature of the relationships you envision among the concepts (e.g., causal, correlational, explanatory).

Many writers and researchers articulate a conceptual framework during the literature review and problem exploration stage of the research. Many more could, and should, have done so at that point to make their thinking about the context of the research more transparent to consumers. However, there are some methods of inquiry in which one might argue that the conceptual framework is intended to arise from the research, because the goal is to generate theory (e.g., grounded theory) (Green, 2013; McConnelly, 2014). It is important to be aware that, even when then the conceptual framework is provided up front, it may be modified, clarified, or expanded upon based on the research outcomes.

Take, for example, the broad topic of graduate studies in the health disciplines. A literature review might reveal a number of important concepts (e.g., critical thinking, reflective practice, cognitive complexity), which all influence the development of professional competency. In addition, you might encounter some important principles from adult learning theories (e.g., experiential learning, practice-based learning, authentic assessment). All of these elements influence your conceptual framework. In this case, they are also all consistent with a constructivist paradigmatic lens. Figure 5.4.1 provides an example that illustrates how a visual representation of the conceptual framework makes the interconnections among these concepts clearer.

Figure 5.4.1

Hypothetical Conceptual Framework for Understanding Competency Development Among Graduate Students

In the diagram that makes up this figure, there are three sections. At the top there is a single textbox that says: Competency development in the health disciplines. Then there are two sections that feed into this textbox. The first section on the right starts with a textbox labelled, transformative learning. Below transformative learning are three other textboxes with arrows pointing toward transformative learning: (a) experiential learning, (b) practice-based learning, and (c) authentic assessment. Each of these is an element of adult learning theory, which represents this cluster of the diagram. On the left-hand side of the diagram is another cluster with the main textbox labelled, cognitive complexity. Beneath that are two other textboxes with arrows pointing toward cognitive complexity: critical thinking and reflective practice. This cluster of textboxes represents metacognitive concepts

An audio file is provided below for students who are visually challenged.

Exercise 5.4.1

To expand further your understanding of conceptual frameworks in research, review the following YouTube videos:

© NurseKillam (2013, November 3)

© NurseKillam (2014, November 6)


Now that you have a clear thesis or problem statement for your paper, your task is to create a convincing argument in support of that overriding assertion or position. A graduate professional paper is organized according to a set of key points or arguments; it should not simply follow a topic outline based on your gathering of ideas from the professional literature as discussed in Section 4. The arguments you make to support the thesis of your paper should be clear, succinct, and well-organized. This requires you to take a step back and consider how best to support the thesis or problem statement you have generated, as expressed in the following FHD Program Outcome.

Thesis & arguments. Articulate and support an original thesis and sustained, well-reasoned arguments.


Building Effective Arguments

The example in Figure 5.5.1 is drawn from my own research and might form the foundation for a paper I write on the topic of multicultural counselling and social justice. Apply the principles we have examined above to the objective and thesis statement. Then consider the key arguments (in bold) and subpoints I have chosen to support those arguments. Both reflect my critical analysis of the literature and my own professional experience and perspectives (i.e., my voice).

Figure 5.5.1

Building an Effective Argument

Topic. Multicultural counselling and social justice
Objective. To evaluate the positions of multicultural counselling and social justice in the profession of counselling.
Thesis Statement. Multicultural counselling and social justice are inextricably intertwined; both are central to competent and ethical practice with all clients.
  1. All counselling is multicultural in nature, and culture-infused counselling forms a foundation for working with all clients (Paré, 2013; Paré & Sutherland, 2016).

    • Personal cultural identity reflects a wide range of factors, including gender/gender identity, ethnicity, sexual orientation, age, ability, religion, socioeconomic status, and their intersections (Nassar-McMillan, 2014; Sinacore et al., 2011).
    • Culture is co-constructed through the interface of client and environment and in the relationship between counsellor and client (Bava et al., 2018; Christopher et al., 2015; Combs & Freedman, 2018).
    • The counsellor, the client, and the counselling relationship are all influenced by the interface of client–counsellor cultural identities (Paré, 2013; Socholotiuk et al., 2016).
    • Infusing awareness of culture into the counselling process brings these influences into awareness and facilitates more culturally relevant and appropriate practices (Ratts et al., 2015, 2016; Paré, 2013).
  2. The interface of client–counsellor cultural identities cannot be fully appreciated without deliberate attention to relative social locations (Collins & Arthur, 2018; Ratts et al., 2015, 2016).

    • Nondominant cultural identity is defined, not by relative population numbers, but by relative positioning in personal, interpersonal, and group power and privilege (Arthur & Collins, 2016; Trahan & Lemberger, 2014).
    • There are significant discrepancies between the social, economic, and political positions of dominant and nondominant cultural groups in North America (Arthur & Collins, 2016; Nejaime & Siegel, 2015).
    • Individuals and groups who do not form part of the dominant culture are more likely to experience social exclusion, including barriers to services and resources, cultural oppression and marginalization, as well as limitation to social, economic, and political inclusion and advancement (Allan & Smylie, 2015; Singh & Moss, 2016; Talley et al., 2014).
    • In contrast, individuals and groups who reflect the dominant culture often experience unearned privileges by virtue of their social location (Audet, 2016; Paré, 2013; Trahan & Lemberger, 2014).
    • Without active attention to the relative privilege of counsellor and client, it is impossible to build an effective therapeutic relationship with clients, and there is a significant risk of inadvertently perpetuating cultural oppression within the counselling process (Houshmand et al., 2017; Ratts et al., 2015, 2016; Yarhouse & Johnson, 2013).
  3. Awareness of the complexity of client cultural identities and social locations necessitates critical analysis of client contexts (Audet & Paré, 2018; Ratts & Pedersen, 2014) and client experiences of social injustices (Dollarhide et al., 2016; Scheel et al., 2018) in both case conceptualization and intervention planning.

    • . . .
    • . . .
    • . . .
  4. Engaging clients actively in a collaborative and co-constructive counselling process optimizes the potential for minimizing power differences (Combs & Freedman, 2018; Mizock & Konjit, 2016) and ensures the counselling process is client-driven (Brown, 2010; Collins & Arthur, 2018; Fitzpatrick et al., 2015).

    • . . .
    • . . .
    • . . .

Although I am drawing on the research I have conducted in this area, each of the key points and subpoints are in my own words. They are my analysis, synthesis, and evaluation of the literature. This does not mean I do not need to give credit to the sources I have reviewed. I inserted them to ensure I do not lose track of whom I need to credit to support my ideas. Think of each of the key points or arguments in Figure 5.5.1 as the foundation for a paragraph or set of paragraphs in your paper. As I created my argument above, I systematically and purposefully organized each of the key points to build my overall argument. I had to reorganize my argument a number of times to make sure there was a logical flow. In this case, I have opted to move from broad assertions down to more narrowly focused points. I corrected a few flaws in the progression of my ideas as I read them through sequentially.

A solid argument is composed of an organized and logical set of the following elements.

Exercise 5.5.1

To learn more about building effective arguments, you may want to review the following resources.


Differentiating an Argument from a Topic Outline

It is important to distinguish between building an argument, which is essential in graduate and professional writing, and creating a topic outline (which may have been acceptable in some undergraduate contexts). Contrast the argument outlined in Figure 5.5.1 with the topic outline in Figure 5.5.2. The latter is organized by topic rather than argument and does not clearly lead the reader to a logical conclusion or position (thesis).

Figure 5.5.2

A Topic Outline

Topic. Multicultural counselling and social justice
Objective. To evaluate the positions of multicultural counselling and social justice in the profession of counselling.
Thesis Statement. No thesis statement created
  1. Nature of counselling

    • Personal cultural identity
    • Co-construction of culture
    • Interface of client–counsellor cultural identities
    • Infusing awareness of culture
  2. Social location

    • Definition of nondominant cultural identity
    • Discrepancies between dominant and nondominant cultural groups
    • Social exclusion
    • Unearned privilege
    • Attention to relative privilege of counsellor and client
  3. Case conceptualization and intervention planning

    • . . .
    • . . .
    • . . .
  4. Collaborative and co-constructive counselling process

    • . . .
    • . . .
    • . . .

It would be very difficult to write a solid argument based on the topic outline in Figure 5.5.2. You would be much more likely to end up with a descriptive paper (i.e., one that demonstrates only knowledge and comprehension), rather than a paper that takes a particular position and systematically supports that position.

Table 5.5.1 provides an example of an argument on the topic of our food supply and compares it to a topic outline. I have stated each key point clearly in one sentence. The logical flow between the key points is clear. I have nested (indented) the subpoints to make the flow of the argument clear. I based this sample argument on a book I was reading.

Table 5.5.1

Comparing an Argument to a Topic Outline

Key Points in An Argument

Topic Outline

Thesis statement. The large-scale industrialization of food production is seriously compromising the quality of our food, and without a revolution of the masses both human beings and the planet will experience dire consequences. Introduction
The industrial revolution has opened doors to new methods and models of food production; however, innovation does not always mean increased quality. Industrial revolution and food
  • The family farm, a traditional foundation of the North American food industry, has been rendered obsolete and noncompetitive.
  • Loss of the family farm
  • Mass production has become the focus of the industry, with most of the agricultural and grazing land now controlled by large corporations running massive food production factories.
  • Mass production
  • Food is no longer assessed by its nutritional value and taste; the new criteria include durability for transport, size consistency, ripening time, and volume of produce.
  • Change in assessment criteria
Changing the values that drive production has resulted in serious consequences for the quality of food we eat. Impact on food quality
  • The vitamin and mineral content of most fruits and vegetables has been reduced by half in less than 50 years.
  • Nutritional value
  • What has been added to the food instead are pesticides and other hazardous materials that are by-products of industrialization.
  • Chemical exposure
  • Most North Americans have now forgotten what it is like to savour the flavour of a field-fresh tomato; whole foods are losing flavour and losing their appeal.
  • Lack of appeal
Both the loss of nutritional value and the addition of chemical toxins are already having dramatic effects on human health. Impact on human health
  • . . .
  • . . .
  • . . .
  • . . .

Note. Adapted from “The end of food: How the food industry is destroying our food supply – and what you can do about it,” by T. F. Pawlick, 2006, Douglas & McIntyre.

Critically analyzing, and extrapolating upon, the argument presented by another writer, as I have demonstrated in Table 5.5.1, is a good way to summarize the ideas that you may want to incorporate into your own paper. It forces you to think critically and to synthesize the information into succinct statements (using your own words). However, do not use this as the argument for your paper as if it reflects your own ideas. Remember, copying another author’s argument is a form of plagiarism.


Refining Your Arguments

Coming up with a clear thesis or problem statement and logical flow of arguments in support of that assertion requires time and energy. However, making this investment will improve your writing exponentially. Consider these additional tips for refining your arguments. In this case, I have worded these in relation to a literature review for the purpose of a research proposal (recall the structure of literature reviews for various purposes in Section 5.2), although the same basic principles apply to all professional writing.

Exercise 5.5.2

Consider the sample argument in Figure 5.5.3, which is intended to form the foundation for a research proposal. Apply each of the principles above to critique the quality of the proposed argument. In this case, a problem statement is used (in lieu of a thesis statement), and the arguments lead logically to the purpose of the study and potential research questions.

Figure 5.5.3

Drafting an Argument for a Research Proposal

Topic. Stresses on graduate students in the health disciplines
Problem Statement. Graduate programs may inadvertently erect barriers to student academic and long-term career success by failing to attend to the struggles of graduate students experience as they endeavor to manage family, work, and other external demands (Markus et al., 2018; Stewart & Lee, 2020; Von Tromp, 2019).
  1. In many professions, including certain health disciplines, graduate education is no longer an option; it is a core requirement for entry to the profession (Hannah et al., 2019; Centre for Graduate Consultation [CGC], 2020). The accessibility of graduate education has not kept pace with entry-to-practice requirements (CGC, 2020; Estefan, 2017; Ryan & Burke, 2018).

  2. In recent years, the economic downturn has resulted in increased tuition costs concurrent with increased financial stresses on individuals and families (CGC, 2020; McLeod et al., 2019). Students face a more difficult balancing act, and must carefully assess the cost-benefit analysis of graduate education (Jerry, 2019).

  3. The average age of students entering most graduate programs has also increased (CGC, 2020; Ministry of Advanced Education [MAE], 2018), which means that many of them have immediate and extended family responsibilities, employment and related economic, time, and relational demands in addition to the demands of graduate school (Adveral & Clock, 2018; Bailor et al., 2016; Winterowd, 2018).

  4. Student life has always come with its own stressors; however, higher levels of stress may be reflected in trends towards increased (a) early withdrawals from graduate programs (MAE, 2018; Zwierner, 2020), (b) physical and mental health challenges among graduate students (CGC, 2020; Lowe et al, 2019), and (c) conflicts and tensions with peers and/or instructors (Jerry, 2019).

  5. Graduate health disciplines students (e.g., developing counsellors) are expected to engage in deeper levels of personal development, as part of their educational process, than liberal arts or science students, for example (Wong & Jackson, 2016). This intense reflective process may be challenging when one is under stress, and it may itself increase overall stress levels (Audette, 2017; Guielle et al., 2018; Sampson & Winterowd, 2019).

  6. Little recent research has been conducted specifically on graduate students in the health disciplines from either the perspective of supports for success or the elimination of existing barriers (CGC, 2020; MAE, 2018).
Purpose of Study. The purpose of the proposed study is to identify both student and program factors that pose barriers to the academic and long-term career success of graduate students in the health disciplines.
Potential Research Questions:
  1. What do graduate students in the health disciplines perceive as the barriers to their success within both their own lives and graduate programs?
  2. To what degree are the barriers to success faced within graduate programs in the health disciplines a result of student factors versus program factors?

Note. The sample problem statement and argument provided above have been constructed for the purpose of this activity and do not necessarily reflect the current professional literature. The citations provided are fictitious.

Exercise 5.5.3

The purpose of this exercise is to practice developing clear key points in an overall argument. Take each of the thesis/problem statements below and generate a series of key points (arguments) to support that assertion. Notice that on the topic of developing writing skills, it is possible to argue two very different positions. I deliberately set up two contradictory thesis/problem statements to demonstrate that these must be arguable. Organize your key points according to a logical flow that persuades the reader that your thesis or argument is worthy of their consideration.

Thesis/problem statement 1. Developing solid writing skills early on will facilitate success in both graduate education and professional roles.

Thesis/problem statement 2. The emphasis on writing skills in graduate programs distracts from the central mandate of developing applied professional competencies.

In Figure 5.5.4 (below), I provide a brief synthesis of an assignment that requires students to write a literature review for the Methods of Inquiry course in the FHD Master of Counselling program. I then provide a video, designed to support that assignment, in which I reinforce what it means to draw on the professional literature to create a problem statement and a set of arguments to support future research. This video reiterates the content provided in this section.

Figure 5.5.4

Sample Research Proposal Assignment

The content below is excerpted from the literature review assignment instructions in GCAP 691: Methods of Inquiry.

  1. Choose a topic within the fields of counselling and psychology. Then glean what is already out there in the literature, and develop your own ideas on the topic. Start by critically analyzing at least 15 peer-reviewed journal articles on your topic (7 must be research studies, and all must be either recent or seminal articles). You will be graded on your appropriate selection of sources.
  2. Organize the content from these articles in a meaningful way. Try to develop a system that will allow you to see the interconnections across articles as well as the gaps within and between them.
  3. Create an original problem statement as the central thread for your writing. Then delineate a clear set of arguments (typically 5‒8) to form the foundation of your literature review.
  4. Demonstrate awareness of professional ethics and respect for cultural diversity and social justice in your problem statement and arguments. Professional writing is evaluated on both the quality of the argument and the nature of the argument, which must fit within the values of the profession.
  5. Flesh out your argument(s) by integrating, synthesizing, citing, and critiquing the literature you reviewed.
  6. Ensure that you provide appropriate citations for all of the ideas you pull from the literature, and support all of your ideas with appropriate references to the professional literature.
  7. Define and discuss any major concepts or theoretical frameworks you reference.
  8. Draft an introduction and a conclusion, ensuring that your problem statement is clear and that you contextualize it within the existing literature. The conclusion should reference your objective in researching the topic area.

For those with visual or audio challenges, please review the Word version of the video transcript.

Exercise 5.5.4

Consider the problem statements and arguments for the research proposals (linked below) to reinforce your learning. Attend carefully to the ways in which the arguments lead logically toward the proposed research study. Consider how you might instead use the same arguments for conceptual/theoretical paper by listing implications and conclusions, instead of the purpose of the study.

Practicum Supervision in Psychology: A Call for Mandatory Training

New Moms on Campus: Understanding the Needs of Graduate Counselling Students as They Adapt to Motherhood


Synthesizing and Integrating Effectively

At this point in your writing process, you have a clear argument drafted with key points and subpoints to support your thesis or problem statement. Make sure that each paragraph (or group of paragraphs) relates to one of the key points in your argument. You may want to copy each of your key points to the first line of the paragraph that elaborates on that point. The key point becomes the topic sentence for that paragraph and ensures that the reader can easily follow the flow of your argument. Your next task is to integrate the ideas of others effectively to support your arguments to meet the following FHD program outcome.

Synthesis & Integration. Integrate, critique, and synthesize the professional literature.

There are several reasons why it is important to cite, accurately, the work of others throughout your paper.

If you have effectively tracked the sources of your ideas, you may have supported some of the key points and subpoints in your argument already; in other cases, you may need to revise the paragraph(s) to provide sufficient evidence to support the key point. You can go back to the ideas you generated and organized through your preliminary research on the topic (Section 4), or you can search out additional sources to inform and support your points.

Students sometimes have difficulty understanding how the objective of a paper, which addresses the nature of the assignment and levels of learning targeted, influences how they integrate material from other sources and how they word the points and subpoints in their paper. Table 5.6.1 provides some examples of the kinds of statements you might make if you were attempting to demonstrate various levels of learning (Bloom, 1956). Read the descriptors associated with each level, and then analyze the statements on the right to see how well they reflect these criteria. Notice how the nature of the statements changes as the level of learning targeted advances. Please note that it is difficult to accomplish all the goals associated with a particular learning outcome in one or two statements; these are intended simply as examples. I have not included the skills domain, because this would rarely be assessed through a written assignment. I have added fictional citations to reinforce the importance of synthesizing the professional literature to support your points. Even when you are speaking about your own attitudes, beliefs, and values (i.e., affect), it is important to tie your assertions to the professional literature.

Table 5.6.1

Synthesis of the Literature To Reflect the Level of Learning Targeted

Cognitive Domain

Level of Learning


Synthesis of Literature

  • observe and recall information
  • know major ideas
  • describe the subject matter accurately
The social determinants of health include racism, poverty, poor housing, lack of access to education, and social isolation (Brown, 2015; Frankel, 2012; Young & Pedersen, 2015).
  • understand content and grasp meaning
  • interpret, compare, and contrast facts
  • provide examples
These issues are considered social determinants of health because they are most often outside of the individual’s control (Brown, 2015), and they affect diverse groups in society differently (Collins & Anderson, 2013).
  • use information, methods, concepts, theories in new situations
  • solve problems using acquired skills or knowledge
The social determinants of health provide a useful conceptual model for arguing against a purely individualistic approach to patient/client care (Dunkel et al., 2014; Young & Pedersen, 2015). For example, framing poverty as a social determinant of health places responsibility on society to effect change in the inequitable distribution of resources rather than making it the individual's responsibility to rise above these inequities (Dunkel et al., 2014; Jamison, 2013)
  • identify patterns and draw connections
  • recognize hidden meanings or implications
All of the negative social determinants of health share these commonalities: they apply to groups of individuals, the influence across groups differs, groups with less power and privilege are more vulnerable to, and more negatively affected by, them (Dunkel et al., 2014; Edgeworthy, 2010; Williams & Grant, 2011). The social determinants of health are a reflection of broader social narratives about who is more deserving of access to resources and services (Williams & Grant, 2011). These narratives are often built on misrepresentations of justice and equality (Brown, 2015; Frankel, 2012).
  • use old ideas to create new ones or generalize them to new situations
  • integrate knowledge from several areas
  • predict, draw conclusions
A logical extension to the social determinants of health argument is that the responsibility for change rests predominantly with those of us who benefit from inequities and social injustices (Frankel, 2012; Nuttgens, 2016). Society will be able to shift the balance of power and privilege only by increasing awareness of these inequities (Frankly, 2016) and fully embracing social justice (Brown, 2015; Nuttgens, 2016).
  • compare and discriminate between ideas or models
  • assess value of theories and concepts
  • make choices based on reasoned argument
  • recognize subjectivity and potential biases
Although I am arguing in favour of applying a social determinants of health lens to our understanding of health problems and solutions, this approach is not without its weaknesses. It potentially paints groups of people with the same brush and masks individual differences; it opens the door to top-down interpretations of change; and it may overwhelm and lead to immobilization rather than action (Dunkel et al., 2014; Edgeworthy, 2010; Williams & Grant, 2011). It is also difficult to argue against the idea of social justice; therefore, it is important to break this broad concept down into specific assertions and practices to better engage in a balanced debate (Paul, 2010; Zimmerman, 2013).

Affective Domain

Level of Learning


Synthesis of Literature

  • demonstrate self-awareness, sensitivity towards others, personal responsibility
  • identify areas for personal change
I struggled at the outset of the course with the idea that doing nothing about racism or sexism in society is supporting the status quo (Lamonte, 2018). I did not understand that awareness without action meant I was not fulfilling my professional and ethical responsibilities. As the course progressed, however, I opened to the idea that unless I actively confront racism, sexism, and homophobia, I am supporting cultural oppression within the health professions and within the broader society (Allie, 2015; Gray, 2014; Lalande & Young, 2016).
  • adopt a self-reflective attitude toward personal and professional activities
  • exhibit values and attitudes appropriate to the context and professional role
  • seek personal and professional development
As a result of this new awareness, I have begun to seek out opportunities to apply what I have learned in practice. I have joined the Social Justice Chapter of the Canadian Counselling and Psychotherapy Association, and I am volunteering in a local immigrants’ society. I am also actively confronting these *isms by challenging oppressive comments, practices, and policies as they arise (Allie, 2015; Lalande & Young, 2016). For example, I have volunteered to rework our intake form to be more culturally sensitive. I have set a goal for myself to identify one specific task to undertake each month to increase my own understanding of cultural oppression and to share that learning with others.

Complete Exercise 5.6.1 to practice writing in a way that reflects the levels of learning targeted. Writing in a way that reflects analysis, synthesis, and evaluation may make the difference between a poor grade and a great grade on graduate papers.

Exercise 5.6.1

Using the topic, objective, and thesis/problem statement in Exercise 5.6.1, create three different sentences for each level of learning. Remember, you do not need to address all of the criteria in each statement. Only cognitive learning is targeted in this exercise, because of the topics selected, and because this is often the aspect of writing where students have the most difficulty distinguishing among and targeting specific levels of learning.

You should now have an almost complete draft of your paper. Carefully read through it to ensure that the criteria for demonstrating critical thinking (Section 4.5) are met throughout your writing. You may want to write in the margins the levels of learning you are demonstrating with each key point: evaluation, synthesis, awareness, and so on. If you cannot clearly identify which criteria apply, rethink and rewrite that section.


Drafting Your Introduction

Now that you have pulled together the literature to support your argument, take a step back to ensure that your objective and thesis/problem statement are still a good fit with your draft of the paper. You may need to massage them a bit based on new research you have discovered or the evolution of your argument. Then you are ready to craft your introduction. Drawing on Fowler et al. (2005), at minimum, your introduction should

You may also want to

I typically begin by introducing the topic and stating the objective of my paper, add any additional information, and then conclude with the thesis (or problem) statement. I have crafted a sample introduction in Figure 5.6.1 based on the topic, purpose, and thesis in Table 5.6.2 below.

Table 5.6.2

Sample Topic, Objective, and Thesis/Problem Statement



Thesis/Problem Statement

End of life care The purpose of this paper is to evaluate the similarities and differences between in-home and residential hospice care systems. Both in-home and residential hospice care programs offer critical medical and psychosocial support to patients and families; however, those patients with hands-on support from family and friends experience increased quality of life, autonomy, and sense of well-being by staying in their own homes.

Figure 5.6.1

Sample Introduction

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Exercise 5.6.2

Complete Exercise 5.6.2 to practice drafting introductions based on the topic, objective, and thesis statements used in earlier exercises. Check out the following resource for more tips on creating an effective introduction.


Drafting your conclusion

The conclusion to your paper is just as important as the introduction. Your conclusion typically begins with a brief summary of the arguments presented. It links to your thesis or problem statement to demonstrate how the main point of the paper has been supported through the body of your writing. Rather than simply copying your thesis statement, restate it in a new and interesting way. Depending on the nature of the paper, you can then choose to include some or all of the following:

Review the sample conclusion in Figure 5.6.2 (below). It is based on the topic, objective, and thesis from Table 5.6.2, which was used to craft the introduction in Figure 5.6.1 (above).

Figure 5.6.2

Sample Conclusion

This image has a page of text with comments in text bubbles. A pdf version is provided below to increase accessibility.

Click here for an accessible PDF version of this image.

Exercise 5.6.3

Test your skills at building an effective conclusion in Exercise 5.6.3, drawing on the two topic, objective, and thesis sequences in Exercise 5.6.2. Be sure to use the introduction you crafted in Exercise 5.6.2 as an additional reference point. Check out the following resource for more tips on creating an effective conclusion.

To summarize our journey so far: we have focused primarily on the first two phases of the writing process (i.e., planning and drafting), because the content of your message is the most important element of your paper.

  1. Planning. In the first phase, establish a general direction for your research and writing, gather appropriate resources, and organize the ideas from these sources in a meaningful way.
  2. Drafting. Through critical reading, and analysis of, the professional literature, take a position on the topic, identify the key points you want to make, organize these within the structure of your paper, and then craft your introduction and conclusion.

In this final section, I briefly introduce the next two phases, introduced in Section 1.2: revising and editing your paper.


The third phase of the writing process is revising your paper.

  1. Revising. Once you have a draft of your paper, it is time to review and revise the content of the paper. In this phase, you are examining your own critical thinking process and reading the paper with a view to ensuring that you have effectively communicated your ideas.

One of the best ways to engage in the purposeful process of revision is to work your way back through each of the elements of the writing process to double check that you have completed all tasks and that you are satisfied with the quality of your work. To support this process, I have organized the checklists below to parallel the main sections of this writing resource. Some of these ideas were adapted from Fowler et al. (2005).

1. Embracing Professional Writing

2. Exhibiting Academic Integrity and Intellectual Honesty

3. Establishing a Scholarly Foundation

4. Developing a Writing Plan: Critical Deconstruction

5. Drafting Your Paper: Critical Reconstruction

Click here for a Microsoft Word version of these checklists.


As noted at the beginning of this resource, the focus of the APA manual is editorial style, which comes into play in the last phase of the writing process.

  1. Editing. Although editing occurs throughout the entire writing process, you should also plan a deliberate editorial style review of your paper. This includes aligning grammar, writing style, citations and references, tables and figures, and overall format of your paper with the standards outlined in the current APA manual.

Some students decide to ignore APA formatting and forfeit the corresponding percentage of their grade; what they do not realize is that editorial skills may also impact the remaining portion of their grade. Your ability to demonstrate critical thinking, to reflect the levels of learning targeted in the course assignment, and to clearly and effectively articulate an argument is directly related to the quality of the writing. If you have a great idea, but you are not able to articulate it clearly, your instructor likely will not get it!

On the other hand, placing too much emphasis on editorial style (i.e., APA) early on can stifle your creativity, cause unnecessary anxiety, and restrict your freedom to make and learn from your mistakes. So, you may want to save the details of APA formatting for this phase of the writing process, until these become second nature. At this point, the more you are able to fine-tune your writing style through a careful editing process, the more meaningful and straightforward your communication will be.

The checklists below are intended as prompts to support you to perform a final edit on your paper. Guidance for addressing gaps you identify is found in the APA Manual. I have drawn some of these ideas from Fowler et al. (2005).

1. Writing Style

2. Citations and References

3. Formatting Your Paper

Click here for a Microsoft Word version of these checklists.

Note. You are not required, typically, to provide an abstract, table of contents, list of figures, or list of tables unless specified in course assignments. However, these elements are often required for theses and other culminating experiences in graduate programs. Please refer to the guidelines provided by the Faculty of Graduate Studies and the APA manual for additional formatting guidelines.

It is important to leave yourself at least three to four hours to complete the final formatting and proofreading of your paper. You may not need this much time, but I am almost always surprised at how much longer a task like this takes than I initially anticipated. After working hard to plan, draft, and revise your paper, it would be a shame to lose marks on these final editorial details.



Once you have completed all phases of the writing process, I recommend that you set your paper aside to clear your head. Then, you will find it easier to catch your own errors or to identify areas where the paper does not flow as well as you would like. It is important to proofread the entire document carefully to correct any spelling, typos, or similar errors that occur in most papers. When he was a graduate student, one of my colleagues kept a running list of the errors he commonly made, integrating instructor feedback with each new paper. I have a similar list in my head (e.g., split infinitives, ending sentences with a preposition) that I have developed through having my work professionally edited. Here are a few tips for final proofreading that you may find useful.


Inviting Peer Review

I strongly recommend that you set up a buddy system early on in your program or in each of your classes. Find at least one person with whom to exchange and peer review your papers before submitting your assignments. Work out a timeline, and stick to it. You may want to use the questions related to revising (Section 6.1) and editing (Section 6.2) as guides for your peer review process. The University of Wisconsin-Madison (n.d.) Peer Review page also provides some useful tips.


Engaging a Professional Editor Judiciously

Students sometimes choose to hire a professional editor for their graduate papers. Some programs will have specific regulations related to this practice. Generally, there is a distinction made between the following processes.

In most programs, you are free to use an editor for copy editing, once you have completed your paper. The downside of this practice is that it is very expensive, and it may take away from development of your own proficiency with APA editorial skills. However, if you use it as a learning experience, integrating the feedback you receive to improve your writing, it can be beneficial.

On the other hand, most graduate programs do not permit you to engage an editor for substantive editing, because the final paper is no longer evidence of your voice, your writing skills, or your critical thinking. Even when you engage in peer review, you must take responsibility for integrating (or not) the feedback you receive and for revising your paper.

Depending on the breadth and depth of the changes introduced by an editor, you may be putting yourself in a position where your ownership of your work is called into question. It is considered cheating to have someone else write or rewrite parts of your paper for you. So use your professional judgment to discern what is appropriate or not appropriate at this point in your writing process.


Congratulations! You have now covered the basics of professional writing. I hope your learning will put you well on the path to becoming proficient in the principles that will enable you to think and write critically, respect the work of others in your writing, clearly articulate and support your position, communicate your ideas effectively, and contribute your important voice to health disciplines theory, research, and practice.

Note. Many citations used in the examples in this resource are fictional or used solely for the purpose of demonstrating integration of professional literature, and those do not appear in this reference list.

Allan, B. & Smylie, J. (2015). First Peoples, second class treatment: The role of racism in the health and well-being of Indigenous peoples in Canada. Wellesley Institute. http://www.wellesleyinstitute.com/publications/first-peoples-second-class-treatment/

Association of College and Research Libraries. (2016). Framework for information literacy for higher education. American Library Association. http://www.ala.org/acrl/standards/ilframework

Bloom, B. S. (Ed.). (1956). Taxonomy of educational objectives: The classification of educational goals: Handbook I, cognitive domain. Longmans, Green.

Canadian Journal of Counselling and Psychotherapy. (n.d.). About the Journal. https://cjc-rcc.ucalgary.ca/about

Collins, S. (2020). Professional writing in the health disciplines. https://pressbooks.pub/professionalwriting/

Collins, S. (2018a). Culturally responsive and socially just counselling: Teaching and learning guide. https://pressbooks.pub/crsjguide/

Collins, S. (2018b). Enhanced, interactive glossary. In S. Collins (Ed.), Embracing cultural responsivity and social justice: Re-shaping professional identity in counselling psychology (pp. 868-1086). Counselling Concepts. https://counsellingconcepts.ca/

Collins, S., Audet, K., Irvine, K., Lehr, A., Seaborg, M., & Schmolke, C. (2014). Poverty, mental health, and counsellors for social justice: Reflections on an interactive workshop. Canadian Journal of Counselling and Psychotherapy, 48(3), 300-320. https://cjc-rcc.ucalgary.ca/

Council of Ministers of Education, Canada. (2007). Canadian degree qualifications framework. http://www.cmec.ca/Publications/Lists/Publications/Attachments/95/QA-Statement-2007.en.pdf

Fowle, W. B. (1956). The mind and heart: School and fireside reading for children. Morris Cotton. https://play.google.com/store/books/details?id=7BQtAAAAYAAJ

Fowler, H. R., Aaron, J. E., & McArthur, M. (2005). The little brown handbook (4th Canadian ed.). Pearson.

Green, H. (2014). Use of theoretical and conceptual frameworks in qualitative research. Nurse Researcher, 21(6), 34-38. http://dx.doi.org/10.7748/nr.21.6.34.e1252

Hook, J. N., & Watkins, C. E. (2015). Cultural humility: The cornerstone of positive contact with culturally different individuals and groups? American Psychologist, 70(7), 661-662. https://doi.org/10.1037/a0038965

McConnelly, L. M. (2104). Use of theoretical frameworks in research. Medsurg Nursing, 23(3), 187-188. http://www.medsurgnursing.net/cgi-bin/WebObjects/MSNJournal.woa

Mental Health Commission of Canada. (2012). Changing directions, changing lives: The mental health strategy for Canada. https://www.mentalhealthcommission.ca/sites/default/files/MHStrategy_Strategy_ENG.pdf

Mertens, D. M. (2015). Literature review and focusing the research. In D. M. Mertens (Ed.), Research and evaluation in education and psychology (pp. 87-125). Sage.

Neilsen, J. (2019). How to love your term paper. Athabasca University. http://counselling.athabascau.ca/write_on.php

Paré, D., & Sutherland, O. (2016). Re-thinking best practice: Centring the client in determining what works in therapy. In N. Gazzola, M. Buchanan, O. Sutherland, & S. Nuttgens (Eds.), Handbook of Counselling and Psychotherapy in Canada (pp. 181-202). Canadian Counselling and Psychotherapy Association.

Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2015). Multicultural and social justice competencies. Association for Multicultural Counseling and Development, Division of American Counselling Association. http://www.counseling.org/

Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2016). Multicultural and social justice counseling competencies: Guidelines for the counseling profession. Journal of Multicultural Counseling and Development, 44(1), 28-48. https://doi.org/10.1002/jmcd.12035

Ravitch, S. M., & Riggan, M. (2017). Reason & rigor; How conceptual frameworks guide research (2nd ed.). Sage.

Scheel, M. J., Stabb, S. D., Cohn, T. J., Duan, C., & Sauer, E. M. (2018). Counseling psychology model training program. Counseling Psychologist, 46(1), 6-49. https://doi.org/10.1177/0011000018755512

Singh, A. A., & Moss, L. (2016). Using relational-cultural theory in LGBTQQ counseling: Addressing heterosexism and enhancing relational competencies. Journal of Counseling & Development, 94(4), 398-404. https://doi.org/10.1002/jcad.12098


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Professional Writing in the Health Disciplines by Sandra Collins, Faculty of Health Disciplines, Athabasca University is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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