chemistry education literature review

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Chemistry Education Research and Practice

The free to access journal for teachers, researchers and other practitioners in chemistry education

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Impact factor: 3.0*

Time to first decision (all decisions): 25.0 days**

Time to first decision (peer reviewed only): 40.0 days***

Editor: Scott Lewis

Chair: David F Treagust

Indexed in Scopus and Web of Science

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Chemistry Education Research and Practice (CERP) is the journal for teachers, researchers and other practitioners at all levels of chemistry education. It is published free of charge electronically four times a year, thanks to sponsorship by the Royal Society of Chemistry's Education Division. Coverage includes the following:

• Research, and reviews of research, in chemistry education
• Evaluations of effective innovative practice in the teaching of chemistry
• In-depth analyses of issues of direct relevance to chemistry education

The objectives of the journal:

• To provide researchers with the means to publish their work in full in a journal exclusively dedicated to chemistry education
• To offer teachers of chemistry at all levels a place where they can share effective ideas and methods for the teaching and learning of chemistry
• To bridge the gap between the two groups so that researchers will have their results seen by those who could benefit from using them, and practitioners will gain from encountering the ideas and results of those who have made a particular study of the learning process

Guidance on the nature of acceptable contributions can be found in Recognising quality in reports of chemistry education research and practice .

Meet the team

Find out who is on the editorial and advisory boards for the  Chemistry Education Research and Practice (CERP) journal.

David F Treagust ,  Curtin University of Technology, Australia

Scott  Lewis ,  University of South Florida, USA

Deputy editor

Nicole Graulich , Justus-Liebig Universität Gießen, Germany

Associate editors

Jack Barbera , Portland State University, USA

Mageswary Karpudewan , Universiti Sains Malaysia (USM)

James Nyachwaya , North Dakota State University, USA

Editorial board members

Mei-Hung Chiu , National Taiwan Normal University, Taiwan

Resa Kelly , San Jose State University, USA

Gwen Lawrie , University of Queensland, Australia

David Read , University of Southampton, UK

Bill Byers , University of Ulster, UK

Melanie Cooper , Michigan State University, USA

Onno de Jong, University of Utrecht, Netherlands Iztok Devetak , University of Ljubljana, Slovenia

Odilla Finlayson , Dublin City University, Ireland

Loretta Jones , University of Northern Colorado, USA

Orla Catherine Kelly , Church of Ireland College of Education, Ireland

Scott Lewis, Editor, University of South Florida, USA

Iwona Maciejowska, Jagiellonian University, Poland Rachel Mamlok-Naaman , The Weizmann Institute of Science, Israel

David McGarvey, Keele University, UK Mansoor Niaz , Universidad de Oriente, Venezuela MaryKay Orgill , University of Nevada, Las Vegas, USA George Papageorgiou , Democritus University of Thrace, Greece Ilka Parchmann , University of Kiel, Germany Michael K. Seery , University of Edinburgh, UK

Keith Taber , University of Cambridge, UK Daniel Tan , Nanyang Technological University, Singapore

Zoltán Toth , University of Debrecen, Hungary

Georgios Tsaparlis , (Founding Editor), University of Ioannina, Greece

Jan H van Driel , The University of Melbourne, Australia

Mihye Won , Monash University, Australia

Lisa Clatworthy , Managing Editor

Helen Saxton , Editorial Production Manager

Becky Webb , Senior Publishing Editor

Laura Cooper , Publishing Editor

Hannah Dunckley , Publishing Editor

Natalie Ford , Publishing Assistant

Journal specific guidelines

The intended emphasis is on the process of learning, not on the content. Contributions describing alternative ways of presenting chemical information to students (including the description of new demonstrations or laboratory experiments or computer simulations or animations) are unlikely to be considered for publication. All contributions should be written in clear and concise English. Technical language should be kept to the absolute minimum required by accuracy. Authors are urged to pay particular attention to the way references are cited both in the text and in the bibliography.

The journal has three objectives.

First  to provide researchers a means to publish high quality, fully peer reviewed, educational research reports in the special domain of chemistry education. The studies reported should have all features of scholarship in chemistry education, that is they must be:

• original and previously unpublished
• theory based
• supported by empirical data
• of generalisable character.

The last requirement means that the studies should have an interest for and an impact on the global practice of chemistry, and not be simply of a regional character. Contributions must include a review of the research literature relevant to the topic, and state clearly the way(s) the study contributes to our knowledge base. Last but not least, they should conclude with implications for other research and/or the practice of chemistry teaching.

Second   to offer practitioners (teachers of chemistry at all levels) a place where they can share effective ideas and methods for the teaching and learning of chemistry and issues related to these, including assessment.

The emphasis is on effectiveness, the demonstration that the approach described is successful, possibly more so than the alternatives. Contributions are particularly welcome if the subject matter can be applied widely and is concerned with encouraging active, independent or cooperative learning.

Of special interest are methods that increase student motivation for learning, and those that help them to become effective exploiters of their chemical knowledge and understanding. It is highly desirable that such contributions should be demonstrably based, wherever possible, on established educational theory and results.

Third  to help to bridge the gap between educational researchers and practitioners by providing a single platform where both groups can publish high-quality papers with the realistic hope that researchers will find their results seen by those who could benefit from using them.

Also, practitioners will gain from encountering the ideas and results of those who have made a particular study of the learning process in finding better ways to improve their teaching and the learning experience of their students.  

Articles should be submitted using ScholarOne , the Royal Society of Chemistry's article review and submission system. A printed copy of the manuscript will not be required. Your submission will be acknowledged as soon as possible. 

Exceptions to normal Royal Society of Chemistry policy

Submissions to Chemistry Education Research and Practice do not require a table of contents entry. Submissions to the journal should use Harvard referencing.

Citations in the text should therefore be made by use of the surname of the author(s) and the year of the publication, at the appropriate place. Note that with one or two authors the name(s) are given, while if the source has three or more authors, it is cited with the first named author as 'Author et al. '

When more than one source is cited in the text, they should be listed in chronological and then alphabetical order for example, '(Jones, 2001; Smith, 2001; Adams, 2006)'. The references themselves are given at the end of the final printed text, in alphabetical and, if the same author is cited more than once, chronological order. An example of a journal article reference as it would be presented is Taber K. S., (2015), Advancing chemistry education as a field, Chem. Educ. Res. Pract. , 16 (1), 6–8.

Article types

Chemistry Education Research and Practice  publishes:

Perspectives

Review articles.

Perspectives are short readable articles covering current areas of interest. They may take the form of personal accounts of research or a critical analysis of activity in a specialist area. By their nature, they will not be comprehensive reviews of a field of chemistry. Since the readership of Chemistry Education Research and Practice is wide-ranging, the article should be easily comprehensible to a non-specialist in the field, whilst at the same time providing an authoritative discussion of the area concerned.

We welcome submissions of Perspective articles that:

• Communicate new challenges or visions for teaching chemistry framed in current chemistry education research or theories with evidence to support claims.
• Propose frameworks (theoretical, conceptual, curricular), models, pedagogies or practices informed by personal expertise and supported by research outcomes (either the author’s own research or the wider body of education research).
• Argue theoretical stances accompanied by recommendations for how these can be applied in teaching practice or measured in student conceptualisation of knowledge, with examples.

For more information on Perspective articles please see our 2022 Editorial (DOI: 10.1039/D2RP90006H )

These are normally invited by the Editorial Board and editorial office, although suggestions from readers for topics and authors of reviews are welcome.

Reviews must be high-quality, authoritative, state-of-the-art accounts of the selected research field. They should be timely and add to the existing literature, rather than duplicate existing articles, and should be of general interest to the journal's wide readership.

All Reviews and Perspectives undergo rigorous peer review, in the same way as regular research papers.

Review articles published in Chemistry Education Research and Practice include narrative, integrative or systematic reviews and meta-analyses and should align with the goals and scope of the journal.

Thought experiments outlining a theoretical position or personal opinion without including a literature basis, pedagogical recommendations or evidence of implementation are not considered in the journal.

For more information on preparing a review-style article please see our 2021 Editorial (DOI: 10.1039/D1RP90006D )

Full papers contain original scientific work that has not been published previously.

Comments and Replies are a medium for the discussion and exchange of scientific opinions between authors and readers concerning material published in Chemistry Education Research and Practice. 

For publication, a Comment should present an alternative analysis of and/or new insight into the previously published material. Any Reply should further the discussion presented in the original article and the Comment. Comments and Replies that contain any form of personal attack are not suitable for publication. 

Comments that are acceptable for publication will be forwarded to the authors of the work being discussed, and these authors will be given the opportunity to submit a Reply. The Comment and Reply will both be subject to rigorous peer review in consultation with the journal’s Editorial Board where appropriate. The Comment and Reply will be published together.

Readership information

Chemical education researchers and teachers of chemistry in universities and schools

Subscription information

Chemistry Education Research and Practice is free to access thanks to sponsorship by the Royal Society of Chemistry's Education Division

Online only : ISSN 1756-1108

*2022 Journal Citation Reports (Clarivate Analytics, 2023)

**The median time from submission to first decision including manuscripts rejected without peer review from the previous calendar year

***The median time from submission to first decision for peer-reviewed manuscripts from the previous calendar year

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Augmented Reality in Chemistry Education: A Literature Review of Advantages on Learners

Journal of Natural Science and Integration

Education moves forward together with technology. In recent years, application of modern technology known as Augmented Reality (AR) has significantly shifted the paradigm of learning process in education, including Chemistry education. Many researchers have explored the potential of AR in education. Unfortunately, literatures on its benefits for leaners in Chemistry education are limited and inaccessible. This research-based paper manifests underlying usefulness of AR in teaching and learning process of chemistry education in terms of (i) Mastering chemistry content and (ii) motivation, interest and attitude. The researchers aspired that with the contents of this paper, other researchers and interested parties could use them for their literature and as incentive to improve current available AR software or develop further advance technology program of AR in chemistry.Keywords: augmented reality, chemistry, education, technology, advantages.

Related Papers

K.A Dilini T Kulawansa

Augmented Reality (AR) has been rapidly spreading out through the younger generation because it is providing capability of combining virtual objects on a realworld image towards cognitive processes. There are many applications related to different domains such as medical, tourism, urban planning, marketing, which are based on AR. Specially AR is affected on education sector which can be used to improve students’ understanding towards subjects. Learning chemistry is also based on conceptual things like microstructures, composition of substances and atoms. Therefore, imaginative ability is the most important things in chemistry. In this review discusses about use of AR for learning chemistry to improve students’ capability of imagination. Furthermore, it describes about the key challenges which are existing in chemistry towards AR. Keywords— Augmented reality, Virtual Reality, Learning chemistry, Imaginative ability

Apertura Revista

The usage of augmented reality (AR) in the process of Organic Chemistry Teaching-learning it´s considered as an innovation in didactics of this type of content and an opportunity area for the known education 4.0. The aim of this article was to evaluate learning in Organic Chemistry in High school students’ trough the usage of AR. A mixed focus was used, using a rubric as principal tool for the evaluation of the augmented reality projects designed trough HP Reveal®, such as a quiz that allowed to evaluate Specific learning on the students. The results showed a mean grade of 8.3/10 on the augmented reality projects, the mean obtained on the quiz was 7.94/10. As a conclusion manner, the usage of AR projects in high school students improves learning conditions in the domain of Chemistry trough the identification of formulas and organic compounds.

Zeynep Taçgın , Ersin Özüağ

Augmented Reality has been accepted as an effective educational method and this review depends on philosophical background of cognitive science. This means, several channels –aural, visual, and interactivity, etc.-have been used to offer information in order to support individual learning styles. In this study, Natural User Interface-and Human Computer Interaction-based Augmented Reality application has been developed for the chemistry education. The purpose of this study is to design and develop a student-centered Augmented Reality environment to teach periodic table, and atomic structure of the elements and molecules. Head Mounted Display has been used to develop Augmented Reality system, and user control has been executed with hand motions (grab, drag, drop, select and rotate). The hand motion control has been used to improve spatial abilities of students in order to maximize the transferred knowledge. Use of the most common natural controlling tools (fingers and hands) to interact with virtual objects instead of AR markers or other tools provides a more interactive, holistic, social and effective learning environment that authentically reflects the world around them. In this way, learners have an active role, and are not just passive receptors. Correspondingly, the developed NUI-based system has been constructed as design-based research and developed by using instructional design methods and principles to get reach of more effective and productive learning material. Features of this developed material consist of some fundamental components to create more intuitive and conductive tools in order to support Real World collaboration.

Kuo-Liang Ou

Material structures and chemical equilibrium are important learning units in high school chemistry. In this study, an augmented reality (AR) system is developed to assist high school students in learning chemistry. Students can use AR cards to conduct virtual chemistry experiments, and the submicroscopic view of a chemical reaction will be displayed according to the chemical equation specified by the reactants and coefficients on AR cards. They can change the AR cards to observe the experimental results and obtain the simplest integer ratio in a chemical equation. It is helpful for understanding that a chemical reaction changes the composition of reactants to form new products and that the process obeys the law of conservation of mass. Empirical research has been conducted in which the experimental group used the AR system and the control group used the traditional teaching method for learning chemistry. The analytical results show that the AR system is more effective than the tradi...

World Journal of Chemical Education

Johannes Huwer

Based on the example of Augmented Reality (AR) this article examines the use of digital media over tablets in chemistry lessons. The structure of an AR-centered learning environment for chemical experiments is explained against the background of learning success, motivation and self-determination. The results of an empirical case study for comparison with analog media are presented, according to which AR can be regarded as a promising tool for visualization in chemistry lessons.

IJASS JOURNAL

This article provides additional findings to the result of other systematic literature reviews where, more attention has been focused on natural science subjects however, giving limited attention to individual subjects, particularly in the field of chemistry education. Sufficient evidence is therefore, required to ascertain the effectiveness of implementing virtual and augmented reality technologies in chemistry education at the secondary school and undergraduate levels where result of this study would be of tremendous benefit. Background: The 4 th industrial revolution has highlighted the need for embracing modern technology in many sectors of the society, which did not leave educational sector behind. This led to the exploration and implementation of educational technology in teaching and learning of chemistry towards promoting a fascinating educational experience and enhancing teachers" and students" overall academic performance. Research Questions: 1) What are the advantages of VR and AR systems in teaching and learning chemistry? 2) What are the disadvantages of VR and AR systems in teaching and learning chemistry? 3) What are the challenges of VR and AR systems in teaching and learning chemistry? Methodology: Selection of articles was done via manual and automatic search from Scopus, Science Direct, springer link and Web of Science databases spanning from 2015 to 2020. 778 articles were retrieved but only 46 were found relevant for this study. Findings: It was found that the most reported advantage of adopting VR and AR in teaching and learning chemistry is enhancing better understanding followed by improving learning achievement. However, the highest reported disadvantage and challenge are that they cause fatigue /nausea and technical problems, respectively.

Dr. Prakash A . Bansode

Vincentas Lamanauskas

Most information technologies, including television, books and computers may have main impact on the educational process. A computer creates a qualitatively new relationship between those who study, and an important area of knowledge as the latter one is being acquired having a clear aim. Studying becomes more active and self-dependent. Hereby, this knowledge forms child's intellect (Papert, 1980).

Emilio Camahort

Journal of Engineering Education Transformations

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Chemistry Education Research and Practice

Writing a review article: what to do with my literature review.

* Corresponding authors

a Institute of Chemistry Education, Justus-Liebig-University, Giessen, Germany

b Department of Chemistry, University of South Florida, USA

c Department of Chemistry, Fort Hays State University, USA

d Department of Chemistry and Biochemistry and School of Education, North Dakota State University, USA

e School of Chemistry & Molecular Biosciences, The University of Queensland, St Lucia, Australia E-mail: [email protected]

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N. Graulich, S. E. Lewis, A. Kahveci, J. M. Nyachwaya and G. A. Lawrie, Chem. Educ. Res. Pract. , 2021,  22 , 561 DOI: 10.1039/D1RP90006D

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University Library

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What is a Literature Review?

Key questions for a literature review, examples of literature reviews, useful links, evidence matrix for literature reviews.

• Annotated Bibliographies

The Scholarly Conversation

A literature review provides an overview of previous research on a topic that critically evaluates, classifies, and compares what has already been published on a particular topic. It allows the author to synthesize and place into context the research and scholarly literature relevant to the topic. It helps map the different approaches to a given question and reveals patterns. It forms the foundation for the author’s subsequent research and justifies the significance of the new investigation.

A literature review can be a short introductory section of a research article or a report or policy paper that focuses on recent research. Or, in the case of dissertations, theses, and review articles, it can be an extensive review of all relevant research.

• The format is usually a bibliographic essay; sources are briefly cited within the body of the essay, with full bibliographic citations at the end.
• The introduction should define the topic and set the context for the literature review. It will include the author's perspective or point of view on the topic, how they have defined the scope of the topic (including what's not included), and how the review will be organized. It can point out overall trends, conflicts in methodology or conclusions, and gaps in the research.
• In the body of the review, the author should organize the research into major topics and subtopics. These groupings may be by subject, (e.g., globalization of clothing manufacturing), type of research (e.g., case studies), methodology (e.g., qualitative), genre, chronology, or other common characteristics. Within these groups, the author can then discuss the merits of each article and analyze and compare the importance of each article to similar ones.
• The conclusion will summarize the main findings, make clear how this review of the literature supports (or not) the research to follow, and may point the direction for further research.
• The list of references will include full citations for all of the items mentioned in the literature review.

A literature review should try to answer questions such as

• Who are the key researchers on this topic?
• What has been the focus of the research efforts so far and what is the current status?
• How have certain studies built on prior studies? Where are the connections? Are there new interpretations of the research?
• Have there been any controversies or debate about the research? Is there consensus? Are there any contradictions?
• Which areas have been identified as needing further research? Have any pathways been suggested?
• How will your topic uniquely contribute to this body of knowledge?
• Which methodologies have researchers used and which appear to be the most productive?
• What sources of information or data were identified that might be useful to you?
• How does your particular topic fit into the larger context of what has already been done?
• How has the research that has already been done help frame your current investigation ?

Example of a literature review at the beginning of an article: Forbes, C. C., Blanchard, C. M., Mummery, W. K., & Courneya, K. S. (2015, March). Prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors . Oncology Nursing Forum, 42(2), 118+. Retrieved from http://go.galegroup.com.sonoma.idm.oclc.org/ps/i.do?p=HRCA&sw=w&u=sonomacsu&v=2.1&it=r&id=GALE%7CA422059606&asid=27e45873fddc413ac1bebbc129f7649c Example of a comprehensive review of the literature: Wilson, J. L. (2016). An exploration of bullying behaviours in nursing: a review of the literature.   British Journal Of Nursing ,  25 (6), 303-306. For additional examples, see:

Galvan, J., Galvan, M., & ProQuest. (2017). Writing literature reviews: A guide for students of the social and behavioral sciences (Seventh ed.). [Electronic book]

Pan, M., & Lopez, M. (2008). Preparing literature reviews: Qualitative and quantitative approaches (3rd ed.). Glendale, CA: Pyrczak Pub. [ Q180.55.E9 P36 2008]

• Write a Literature Review (UCSC)
• Literature Reviews (Purdue)
• Literature Reviews: overview (UNC)
• Review of Literature (UW-Madison)

The  Evidence Matrix  can help you  organize your research  before writing your lit review.  Use it to  identify patterns  and commonalities in the articles you have found--similar methodologies ?  common  theoretical frameworks ? It helps you make sure that all your major concepts covered. It also helps you see how your research fits into the context  of the overall topic.

• Evidence Matrix Special thanks to Dr. Cindy Stearns, SSU Sociology Dept, for permission to use this Matrix as an example.
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• Last Updated: Jan 8, 2024 2:58 PM
• URL: https://libguides.sonoma.edu/chemistry

Some Student Misconceptions in Chemistry: A Literature Review of Chemical Bonding

• Published: June 2004
• Volume 13 , pages 147–159, ( 2004 )

Cite this article

• Haluk Özmen 1  

4969 Accesses

129 Citations

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Students' misconceptions before or after formal instruction have become a major concern among researchers in science education because they influence how students learn new scientific knowledge, play an essential role in subsequent learning and become a hindrance in acquiring the correct body of knowledge. In this paper some students' misconceptions on chemical bonding reported in the literature were investigated and presented. With this aim, a detailed literature review of chemical bonding was carried out and the collected data was presented from past to day historically. On the basis of the results some suggestions for teaching were made.

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Abimbola, I. O. (1988). The problem of terminology in the study of students' conceptions in science. Science Education 72: 175-184.

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Özmen, H. Some Student Misconceptions in Chemistry: A Literature Review of Chemical Bonding. Journal of Science Education and Technology 13 , 147–159 (2004). https://doi.org/10.1023/B:JOST.0000031255.92943.6d

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What Lies Behind Teaching and Learning Green Chemistry to Promote Sustainability Education? A Literature Review

1 School of Tourism & Health, Zhejiang A&F University, Hangzhou 311300, China; nc.ude.ufaz@8791amc

Eila Jeronen

2 Department of Educational Sciences and Teacher Education, University of Oulu, FI-90014 Oulu, Finland; [email protected]

Anming Wang

3 College of Materials, Chemistry and Chemical Engineering, Hangzhou Normal University, Hangzhou 311121, China

In this qualitative study, we aim to identify suitable pedagogical approaches to teaching and learning green chemistry among college students and preservice teachers by examining the teaching methods that have been used to promote green chemistry education (GCE) and how these methods have supported green chemistry learning (GCL). We found 45 articles published in peer-reviewed scientific journals since 2000 that specifically described teaching methods for GCE. The content of the articles was analyzed based on the categories of the teaching methods used and the revised version of Bloom’s taxonomy. Among the selected articles, collaborative and interdisciplinary learning, and problem-based learning were utilized in 38 and 35 articles, respectively. These were the most frequently used teaching methods, alongside a general combination of multiple teaching methods and teacher presentations. Developing collaborative and interdisciplinary learning skills, techniques for increasing environmental awareness, problem-centered learning skills, and systems thinking skills featuring the teaching methods were seen to promote GCL in 44, 40, 34, and 29 articles, respectively. The results showed that the integration of green chemistry teaching (GCT), e.g., with sustainable education, promoted GCL by fostering environmental consciousness and behavioral change and cognitive processes in a sustainable direction.

1. Introduction

Sustainable development has been considered a major global goal since the launch of Agenda 21 in 1992 [ 1 ]. It has also been confirmed recently with Agenda 2030 and its sustainable development goals [ 2 ]. According to the report Our Common Future [ 3 ], sustainable development is development that meets the needs of the present without compromising the ability of future generations to meet their own needs. Here, the long-term aspect of sustainability is emphasized, and justice is introduced as the ethical principle for achieving equity between the present and future generations [ 4 ]. To tackle the challenge from ecological and environmental crises such as “white pollution” [ 5 , 6 ] and “endocrine disrupting chemicals (EDCs) amplification effects” [ 7 ], sustainable development goals call for chemists, engineers and decision-makers [ 8 , 9 ] to take responsibility for sustainable solutions to these crisis and complex problems. However, recognizing the concept is not enough; it is also necessary to deliver results and teach the values and views of the sustainability of green chemistry to tomorrow’s chemists, engineers and decision-makers during their professional studies [ 8 ] and to ensure the implementation of the sustainability based on the advance of green chemistry [ 10 ].

A main objective of green chemistry education (GCE) is to foster and improve scientific literacy in sustainability and to develop the corresponding skills among the present and future generations [ 11 ]. However, 25 years after the interdisciplinary emergence, green chemistry practices are possibly more incremental than transformative if the XII Principles [ 12 ] are not considered to be a uniform system establishing the “hows” and “whys” of these practices [ 13 ]. According to Anastas, sustainability has been little incorporated into the curricula and education of green chemists and engineers [ 14 ]. In addition to reducing waste and hazards, GCE could also address the wider societal impact of responsible technology innovation [ 15 ]. This calls for the active search for different solutions to societal challenges [ 16 ] and incorporation of additional humanistic principles such as a fair and equitable distribution of benefits based on at least one of the Sustainable Development Goals (SDGs) [ 17 ] to ensure sustainability in the broadest sense.

According to Rhoten et al. [ 18 ] and Klein and Newell [ 19 ],, interdisciplinary education is understood as a mode of curriculum design and instruction in which teachers integrate information and theories from various disciplines to foster and improve students’ capacity to create new solutions and approaches to existing problems. Unfortunately, to date, little attention has been paid to integrative teaching methods promoting sustainability education (SE) in higher education [ 20 , 21 ]. In this study, sustainability education is defined as education based on the concept of sustainability [ 22 ]. It must be interdisciplinary, collaborative, experiential, and potentially transformative. A popular way to achieve integration in a curriculum is to address a theme or topic through the lenses of different subjects [ 23 ]. Because interdisciplinarity is a complex psychological and cognitive process [ 24 , 25 ], interdisciplinary pedagogy is not synonymous with a single process, method or technique; different teaching methods are needed to support and promote interdisciplinary learning outcomes [ 24 , 26 ] depending on a discipline’s history, traditions and ways of thinking.

Thus, based on the ultimate goals of green chemistry, environmental protection and the prevention of environmental pollution [ 12 ], when teaching green chemistry integrated with sustainability education, in addition to providing high-quality content knowledge and pedagogical content knowledge, it is important to foster environmental awareness and consciousness, positive attitudes towards environmental issues [ 27 ] and behavior change motivation in a sustainable direction. Content knowledge [ 28 ]’refers to the amount and organization of knowledge per se in the mind of the teacher.’ Pedagogical content knowledge involves teachers’ interpretations and transformations of content knowledge to facilitate student learning [ 12 ]. Teaching knowledge alone cannot change people’s behavior, but sustainability education, which incorporates, e.g., positive psychology [ 29 ], can effect such change. Sustainability education aims to promote education as a critical tool to prepare young people for responsible citizenship in the future [ 30 ] and to initiate and steer mainstream culture in a sustainable direction [ 31 ]. Teaching and learning green chemistry for sustainability education can fully utilize the applied learning models that connect real-world circumstances with the broader human concerns of environmental, economic, and social systems [ 32 ].

GCE also aims to achieve sustainability [ 33 ], and its task is to teach students how to make chemical and societal decisions depending on multidimensional green chemistry metrics and the consideration of social factors related to green chemistry and sustainable development [ 30 ]. Because only a few reviews on GCE exist [ 34 ] and there is a need to elaborate on them, we investigated the integration of green chemistry with other disciplines and the teaching methods used in colleges and teacher education to find integrative ideas incorporated in the selected articles. This was expected to contribute to develop interdisciplinary curriculum and green chemistry teaching, and thus help close the gap between the interdisciplinary green chemistry teaching and single-disciplinary teaching. This study was guided by the following questions:

• (1) How is the multidimensional integration of green chemistry teaching with other disciplines achieved to promote sustainability?
• (2) What are the teaching methods used in GCE and sustainability education to achieve the sustainable development goals in colleges and in teacher education?
• (3) What kind of features concerning the teaching methods are included to support green chemistry learning (GCL)?
• (4) According to the teaching methods used in GC, what are the levels of the knowledge taught and the levels of the thinking skills required of students to promote GCE?

2. Literature Review

The literature review begins with a brief examination of the relationship of green chemistry to other disciplines from the perspective of teaching and learning principles to promote sustainability. It then investigated the ways in which green chemistry education is taught and the features of teaching methods in supporting green chemistry learning. Figure 1 clarifies the links between the literature review and the research questions in the present study.

Schematic role of green chemistry teaching and learning in promoting sustainability education.

2.1. Integrated Teaching and Learning Topics Promoting Sustainability in Green Chemistry Education

Science and technology alone cannot solve our food, energy, environmental, and health problems. Meeting goals in these areas requires interdisciplinary science. Tripp and Shortlidge [ 35 ] define the concept ‘interdisciplinary science’ as follows:

Interdisciplinary science is the collaborative process of integrating knowledge/expertise from trained individuals of two or more disciplines-leveraging various perspectives, approaches, and research methods/methodologies-to provide advancement beyond the scope of one discipline’s ability. As an interdisciplinary science [ 36 ], green chemistry aims to secure a sustainable future [ 33 ] and to promote collaboration between life scientists and social scientists to develop and implement practical solutions [ 10 ]. The knowledge and creativity of individual researchers in different disciplines [ 35 ], such as biology, mathematics, engineering, and psychology, can contribute to ecological protection [ 10 ] when developing the chemical industry [ 37 ].

The first implemented green chemistry course at the college level was created by professor Terry Collins at Carnegie Mellon University [ 38 ]. Later, this course was opened to graduate students and advanced undergraduates. The topics of this course include issues relevant to clean chemistry, nontoxic chemistry, and biotechnology. Moreover, besides relationships of fundamental chemical concepts with the real-world impacts of chemical products and processes, sustainability ethics are also an important part of the course program.

Other important topics are interdisciplinary education [ 37 ] and sustainability education [ 39 ]. For an interdisciplinary green chemistry curriculum, it needs to be preferably integrated with other science-related courses, such as biology and artificial intelligence, and non-science-related courses, such as psychology, business, ethics, law and regulatory affairs [ 37 ]. The greatest challenge of GCT is to encourage people to adopt the idea of sustainability [ 33 ]. In this case, the individual plays a critical role [ 40 ]. Since education should be thought of as something other than just training [ 27 ], the design of this courses are intended to increase students’ motivation to learn and to create attitudinal changes [ 41 , 42 ] towards sustainability.

In implementing these topics, integration of green chemistry with other disciplines [ 43 , 44 ] problem-oriented perspectives [ 45 ] included in “real-world” case studies and laboratory work have been seen to be effective approaches in GCE [ 37 , 46 ]. These studies offer an important chance for students to develop their holistic and global knowledge [ 47 ] and practical skills for their careers.

2.2. Teaching Objectives and Strategies in Green Chemistry Education for Sustainable Development

Previous studies show that the sustainability and ecological (environmental), economic and social dimensions of sustainable development need to be designed in GCE curricula [ 48 ] and included in teaching, studying and learning processes. Therefore, an interdisciplinary framework, an interdisciplinary curriculum and interdisciplinary methods [ 43 , 49 ] should be considered when integrating the sustainable development goals into the GCE.

An important objective in GCE is to learn to participate in societal debate and in the societal processes of democratic decision-making about issues concerning applications of chemistry and chemical engineering technology [ 49 , 50 ]. To achieve this objective, a useful approach is student-centered pedagogy, where teaching and learning take place in the field, in interaction with stakeholders, and through participation in civic activities or student-led research [ 51 ]. In this way, in addition to cognitive skills, students also learn transferable skills, i.e., the ability to work in teams, to create and to think critically, to communicate and to collaborate when reflecting on complex problems and look for solutions to these problems [ 52 ]. If the skills are grounded in a base of knowledge to be mastered [ 53 ], green chemistry students learn sustainability competence. They will be able to work in an interdisciplinary manner [ 47 ] using collaborative work [ 41 ] and problem-based learning (PBL) [ 54 ] concerning green chemistry principles and sustainability [ 55 , 56 ]. Problem solving, an essential skill that fits with interdisciplinary curriculum, is also necessary for GCE [ 54 ]. When discussing theoretical and practical principles concerning the challenges of sustainable development and sustainability education, interdisciplinary thinking [ 57 ],, design thinking [ 41 ], systems thinking [ 13 , 58 , 59 ] and eco-reflexive thinking [ 60 , 61 ] are considered essential for green chemistry teaching (GCT). In addition, with the help of positive psychology, motivational skills can be developed [ 29 , 62 ] to change students’ thinking towards a more positive, sustainable direction [ 63 ].

Understanding how to teach issues in an interdisciplinary curriculum is one of the key factors of interdisciplinary learning. Due to the nature of unsustainability problems, interdisciplinary learning on this topic often requires collaboration. Interdisciplinary green chemistry learning can be developed by exploring how cognitive, social, and emotional factors interact with each other to promote an understanding of issues and problems. Interdisciplinary learning often also requires group experiences whereby key elements of the development of thinking skills include reflection on the problems, the comparison of information from different disciplines, the promotion of the leverage effect of integration, and the willingness to critically evaluate [ 64 ]. Students’ tasks are to construct their sustainability knowledge and understanding of the human world; to learn decision making based on ethical, social, environmental and economic issues; and to learn to act and behave in accordance with sustainable development thinking. In this case, in addition to sustainability theories, positive psychology can offer different lenses to understand the relationship between social values and well-being.

3. Material and Methods

3.1. data collection.

The well-known search engine Web of Science was used to search the articles; this search engine is connected to many scientific databases, such as the American Chemistry Society, Wiley, Elsevier, the Royal Society of Chemistry, and other important professional databases. The search strategy was based on a systematic organization, categorization and selection of Boolean keywords related to GCE and sustainability education [ 65 , 66 , 67 ]. First, a word search was carried out concerning the terms GCE, instruction, interdisciplinary, integration, teaching methods, sustainable development, sustainability, biotechnology, psychology and artificial intelligence. Then, a hierarchical search strategy was used for each scientific database, moving from the simplest combination of Boolean forms and then logically to more complex forms. This is mainly to move our research and education directions to Education for Sustainable Development (ESD).

A total of 1251 search results were obtained based on the combination of the initial searches of scientific databases with manual examinations of scientific journals, and 85 articles were chosen for review. In this phase, the criteria were the integration of green chemistry and green chemistry education with other disciplines, such as psychology, ecology, biotechnology, artificial intelligence, and beyond, and the mention of a teaching method. 45 articles were finally selected according to the correlation with sustainability education and sustainable development to carry out the present study. Thereafter, the following criteria were used to choose materials for a more detailed analysis of teaching methods:

• (a) Scope: International research;
• (b) Type of research: Empirical research on teaching methods in GCE and sustainability;
• (c) Period: January 2000–April 2020;
• (d) Target groups: students in colleges and preservice teachers;
• (e) Languages: English;
• (f) Quality: Academic papers published in peer-reviewed journals.

Only academic papers that were published in peer-reviewed journals were used in the review because they had been subjected to rigorous review and therefore were highly qualified documents. Articles that did not specifically refer to teaching methods for GCE or sustainability education were excluded. Out of 85 articles discussing GCT in 32 journals concerning GCE and sustainability education, 45 articles in 19 journals were further selected and subjected to a detailed analysis ( Table 1 ).

The selected journals and the analyzed articles.

3.2. Analysis Methods

3.2.1. methodological procedures for analyses.

Learning environments, teaching methods and features of teaching methods were subjected to inductive content analysis [ 107 ]. Knowledge levels and thinking skills, psychomotor skills, emotions and attitudes, and evaluation methods were subjected to deductive content analysis [ 108 ]. The analysis was carried out based on what the author (authors) of the articles had explicitly written. Researcher triangulation was a necessary part of our analysis process. To avoid subjective interpretation, we jointly discussed each article and then determined the type of aspects of the instructional process emphasized in the article. Because of the dialogical nature of the analysis, we did not see a need to calculate interrater reliability.

3.2.2. The Multidimensional Integration of Green Chemistry Teaching with Other Disciplines

To characterize the multidimensional integration of GCT with other disciplines, used in the articles, a theory-based content analysis [ 107 , 108 , 109 ] was first carried out deductively on the different aspects of the integrated green chemistry curriculum taught to the students. Then these findings were classified into three different categories: the integration of green chemistry with natural science, the integration of green chemistry with social science, and the integration of green chemistry with philosophy. The categorization was performed independently by two researchers, and the final classification decisions were made by agreement between the researchers.

3.2.3. The Teaching Methods and the Features of Teaching Methods in Green Chemistry Education

According to Prince and Felder [ 110 ], a teaching method (a method of teaching, an instructional method) is the practical realization or application of a teaching (instructional) approach. The teaching methods can be classified either as deductive (direct) or inductive (indirect). Traditional instruction is deductive, beginning with theories and progressing to the applications of those theories. Inductive instruction begins with concrete, experience, details, and examples and ends with rule and generalization, abstraction [ 110 ]. While particular methods are often associated with certain strategies, some methods may be found within a variety of strategies. Teaching strategies determine the approach a teacher may take to achieve learning objectives.

Recent interest in promoting learning and developing important interpersonal skills began in the late 1980s, and since then, various, teaching methods have been promoted, researched, and implemented. Despite widespread familiarity with the terms of teaching methods, they have been consistently muddled, used interchangeably, and used imprecisely to describe what students are doing during learning processes. This inaccurate use of the terms has confounded, e.g., teachers’ understanding of the forms of group work such as collaborative learning, cooperative learning, and problem-based learning and the relationships between them [ 111 ]. In this study, predefined measuring instruments [ 30 , 64 , 94 ] were applied when categorizing the GCT methods utilized in the selected articles. The teaching methods appearing in the articles were independently listed by two studies and in the absence of a suitable top-level concept, a new top-level concept was formed, such as teacher presentation, online learning and games. The classification decisions were based on a jointly negotiated outcome.

The features of the teaching methods were analyzed using a deductive content analysis in relation to the levels of knowledge and thinking skills [ 52 , 66 , 108 ]. Additionally, the features of the teaching methods appearing in the articles were independently listed by two studies. The classification decisions were based on a jointly negotiated outcome. Each teaching method was selected in this study according to the theory and practice of teaching [ 112 ] included green chemistry teaching [ 63 ].

3.2.4. The Levels of Knowledge and Thinking Skills in Green Chemistry Education

In exploring how teaching methods support the learning of green chemistry, two researchers independently examined the levels of knowledge and thinking skills supported by teaching methods presented in the articles [ 31 ]. Bloom’s new taxonomy [ 66 , 113 ] was used to analyze the levels of knowledge ( Table 2 ). To further analyze the levels of thinking skills and cognitive categories and types ( Table 2 ) that may have been achieved by teaching methods and that had been introduced in the selected 45 articles, an evaluation using the reported strategies [ 114 , 115 ] and Stanny’s verbs [ 113 ] was carried out. Finally, based on the criteria common to the two researchers, a list was compiled of the data on the features of the teaching methods used in the teaching of green chemistry.

The knowledge levels and thinking levels, cognitive categories and types according to Bloom’s revised taxonomy for chemistry [ 107 , 108 , 114 , 115 , 122 , 123 , 124 ].

In addition, to promote the sustainability education in green chemistry teaching and learning [ 9 , 10 , 45 ], sustainability including life cycle assessment [ 84 ], psychology [ 105 , 106 , 116 ] and environmental justice [ 85 , 117 , 118 , 119 , 120 ], etc., are integrated into this curriculum to further improve students’ the level of knowledge such as method knowledge and metacognitive knowledge and the level of thinking skills such as evaluation and synthesis/creation. Compared to general chemistry, green chemistry class is implemented with Teaching Personal and Social Responsibility (TPSR) [ 121 ] to improve the student’s responsibility and satisfaction and the social climate of the classroom. By this method, it may be expected to elevate the level of thinking skill.

4. Findings and Discussion

4.1. the multidimensional integration of green chemistry teaching with other disciplines to promote sustainability.

In the 45 articles analyzed, at least two dimensions were considered for integration of green chemistry; half of the articles considered the three-dimensional integration of green chemistry, such as integration with natural science, social science and philosophy [ 43 , 84 , 85 ]. Natural science, such as biotechnology, ecology, physiology and artificial intelligence, was found to be integrated with GCE in 23 articles. Psychology was integrated with GCE in six articles, which illustrated the vital contributions of behavioral sciences to environmental sustainability efforts. Philosophy was included in 29 of the selected articles. Thus, one, two and three dimensions of integration of GCT with natural science, social science and philosophy were found, respectively.

Ecology is part of the natural sciences and synthesizes knowledge about the interactions between organisms and their abiotic environments [ 125 ]. It is necessary to take GCT into account in ecology since the supreme goals of green chemistry are environmental protection and the prevention of environmental pollution [ 12 ]. Industrial ecology includes life cycle assessment (LCA) and cleaner production [ 126 ]. Life cycle assessment is a strategy for assessing the effect of a product, process or activity on the environment throughout its lifecycle. Cleaner production aims to make more efficient use of natural resources and reduce the generation of waste [ 126 ]. Thus, the integration of GCE with ecology is crucially important.

Our results support previous studies [ 41 , 81 ] that show that raising environmental and health awareness among students is important. One reason for this is that the interaction between humans and nature increases not only well-being but also health throughout human life [ 127 ]. Our results also show, as in previous studies, that more discussions on the interconnections of nature with human well-being are needed in GCT.

Based on our findings, it can be argued that an important component of pedagogical content knowledge (PCK) in GCE is a teaching design that considers educational sociology, psychology and philosophy. This idea can be justified by the fact that interdisciplinarity is a complex psychological and cognitive process; thus, green chemistry as an interdisciplinary subject cannot be taught using a single approach or discipline [ 24 ]. Sociology, when integrated with GCE, can support students’ participation in societal debate and in the societal processes of democratic decision-making about questions and discussions concerning applications of chemistry and chemical engineering technology [ 49 , 50 ].

Educational psychology can strengthen students’ environmental awareness about recovering waste resources and reusing them, which would reduce the burden on the ecosystem and environment. Additionally, positive psychology supports the idea of hope that is based on realistic, positive expectations that one’s behavior will be effective and that one can trust one’s own performance in challenging situations [ 62 ]. It also plays an important role in developing an understanding of how social values affect individual subjective well-being and intentionally deliver sustainability interventions [ 29 ]. In the analyzed articles, environmental psychology was seen to be important in GCE, perhaps because it aims to promote a better understanding of the relationship between human behavior and the physical environment [ 116 ]. Thus, due to its interdisciplinarity, green chemistry integrated with educational, positive and environmental psychology can play an integral role in moving students’ thinking in a more positive, sustainable direction [ 63 ].

The integration of green chemistry into philosophy supports the discussion of an interdisciplinary holistic view of intertwined, complex problems and thus a (synthetic) holistic conception of how these problems relate to each other, to find a starting point for practical actions to live harmoniously with nature [ 128 ]. This legitimate value base, which combines social and ecological sustainability through common values, is also important for green chemistry research, which can help identify this starting point.

4.2. Teaching Methods Used in GCE and Sustainability Education for Sustainable Development in College and Preservice Teacher Education

In total, 21 different teaching methods were found in the analyzed articles ( Table 3 ). Both teacher-centered and learner-centered teaching methods were applied to teach green chemistry. While teacher-centered learning prioritizes the experience of teachers or instructors, student-centered learning emphasizes the experience of students [ 129 ]. In the studied articles, it was common that the teachers used a mixture of teaching methods to boost and promote GCL (44 articles). Power balance, course content function, teacher and student roles, responsibility for learning, and assessment purposes and processes varied during teaching situations [ 130 ].

The teaching and learning methods mentioned in the 45 articles analyzed.

One of the ways of teaching is ‘group learning’, from which teachers have numerous variations to choose. In 19 articles, the term ‘group learning’ was stated as a teaching method. Based on the descriptions provided, it was not possible to classify the working methods it contained more precisely. Based on the previous research, most popular group learning methods are collaborative learning, problem based learning and cooperative learning [ 111 ]. They all favor e.g., active engagement, small-group learning and development of thinking capabilities. They aim to encourage development of content knowledge and related skills, even though there are differences in methodology.

“Collaborative learning” is an umbrella term for a variety of educational approaches involving joint intellectual effort by students, or students and teachers together [ 14 , 131 ]. In collaborative learning, the focus is on working with each other (but not necessarily interdependently) toward the same goal, toward the discovering, understanding, or production of knowledge [ 111 ]. Central to the work is that everyone participates as partners or in small groups. in finding and working on the learning material by asking questions, problematizing or questioning things to create solutions, meanings or product. Collaborative learning never uses assigned group roles [ 111 ]. Cooperative learning is defined by a set of processes which help people interact together in order to accomplish a specific goal or develop an end product that is usually content specific. It is more directive than a collaborative system of governance and closely controlled by the teacher [ 132 ].

According to Rowntree, the interdisciplinary approach is “one in which two or more disciplines are brought together, preferably in such a way that the disciplines interact with one another and have some effect on one another’s perspectives” [ 133 ]. So, in interdisciplinary learning, the material and the problems to be solved are always based on the integration of multidisciplinary knowledge across a central program theme or focus. It fosters a problem-focused integration of information consistent with more complex knowledge structures [ 134 ].

As collaborative learning and interdisciplinary learning, problem-based learning also uses appropriate problems to increase knowledge and understanding [ 135 ]. According to Davidson and Major, unlike collaborative learning, problem-based learning always has a ‘real-life’ problem to solve [ 111 ]. Problem-based learning, as well as cooperative learning, can aim to teach social skills through group-building activities, simultaneous interaction, classroom management such as quiet signal and timed activities, roles and extrinsic rewards [ 111 ]. Collaborative learning and problem-based learning differ from cooperative learning in that community-building activities, supporting the understanding of different views and giving positive feedback on good performance for low-level students can be present in some models/varieties of cooperative learning but not in collaborative learning and problem-based learning [ 111 ].

Collaborative and interdisciplinary learning, and problem-based learning were utilized in 38 and 35 articles, respectively. The cooperative learning (project work) was used less than them (20 mentions). The results are in line with expectations since understanding green chemistry principles and sustainability [ 55 , 56 ] are important learning objectives for tackling uncertainty and solving future problems [ 54 ]. An interdisciplinary framework [ 43 ] can efficiently promote green chemistry and sustainability science when sustainable development goals are integrated into the mainstream and course of green chemistry. When developing green chemicals, the interdisciplinary nature of green chemistry, which involves technology, environmental health, social sciences, politics, and business, promotes sustainable development [ 43 ]. Thus, interdisciplinarity can bring new perspectives on how to include sustainable development in GCE. Interdisciplinary collaborative work in GCE [ 41 ] can help to develop sustainability competence of green chemistry students [ 54 ]. Since interdisciplinary green chemistry involves the integration of chemistry with natural science, social science and philosophy [ 43 , 84 , 85 ], the corresponding knowledge preparation is very important for green chemistry learning. Problem-based learning can facilitate the understanding of green chemistry principles and sustainability [ 55 , 56 ]. Thus, efficient solutions to problems may depend on interdisciplinary models and problem-oriented perspectives being taught in green chemistry education [ 45 ]. Case study teaching was mentioned separately in 27 articles. It involves problem-based learning and challenges students to devise, describe, and defend solutions to the problems presented by each case [ 136 ]. In GCT, such cases can be found for instance when looking for sustainable solutions to environmental, health and social problems. In addition, GCT and GCL integrated with sustainability education [ 43 , 44 ] offer an important opportunity for green chemistry students to develop their holistic and global knowledge [ 47 ].

Teachers’ presentation was also a popular way of teaching (38 mentions). It means the transmission of information from teachers to students through lectures. Perhaps its popularity is explained by the fact that it is an old and perceived safe method. Although teacher’s presentation was a popular teaching method, instructional conversation (teaching discussion) and teacher’s questions were not (25, 10 mentions, respectively). Perhaps one reason is that a good instructional conversation is difficult to implement. According to Goldenberg and Gallimore, instructional conversation is at its best: interesting and engaging; has an interesting focus; has a large number of participants; the teacher and students participate equally; it aims to reach a new level of understanding [ 137 ]. Also drawing up good questions can be problematic. Teacher’s questions serve many purposes, such as: provoking students and making them listen carefully, analyzing their thoughts and thinking critically, and initiating discussion and reviewing material [ 138 ]. Questioning also have effects on a classroom atmosphere and the development of students’ thinking skills [ 139 ].

Laboratory resources-based learning was mentioned in 22 articles. Relatively small number of mentions was surprising because laboratory practice is important part of GCE [ 140 ]. Different laboratory methods leading to greener results are critical for how chemistry educators equip chemists for today and the future. When students practice green chemistry, they learn to think critically about the global impact of their field and are interested in studying the principles and techniques of green chemistry. Experimental learning and group work can be seen as parts of the laboratory resources-based learning but in the studied articles they were mentioned independently (20, 19 mentions, respectively). Typically, in experimental learning students are exposed to real problems and they solve them as part of decision making group with a goal to gain new knowledge or to approve existing knowledge by researching the influence of different variables [ 141 ]. According to Brown (1992, p. 8).

groupwork provides a context in which individuals help each other ; it is a method of helping groups as well as helping individuals; and it can enable individuals and groups to influence and change personal, group, organizational and community problems [ 142 ].

The learning of chemical theories and facts alone cannot raise students’ capabilities for coping with sustainable development issues to the necessary level by themselves. Adding a more society-oriented, multi-dimensional approach to green chemistry education gives the little extra shove which is needed to achieve this goal [ 143 ]. Art instruction, hands-on instruction and service learning are new methods mentioned in several articles (15, 11, 19 mentions, respectively). Art instruction is an approach to teaching and learning through which content standards are taught and assessed equitably in and through the arts. Yakman defines the arts as going beyond aesthetics and includes the liberal arts relating the subjects through interdisciplinary approaches [ 144 ]. Hands-on-approach is a method where students are guided to gain knowledge by experience [ 145 ]. This means that students get the opportunity to manipulate the objects they are studying. Service learning again can be seen as part of place-based learning in local environments and communities through the use of local phenomena [ 146 ], and issues as context and scaffolding for content. These kinds of approaches should be taken more into account also in green chemistry education. They can generate a broader understanding for different solutions to societal challenges [ 16 ] and incorporation of additional humanistic principles in to the curriculum of green chemistry education.

Online learning was mentioned in many articles (15 mentions). Online learning is described by most authors as access to learning experiences via the use of some technology. It is identified as a more recent version of distance learning that improves access to educational opportunities for learners [ 147 ]. The purpose of ICT (8 mentions) in education is, in part, generally to familiarize students with the use and workings of computers and related social and ethical issues [ 148 ]. The references to online learning and ICT mentions are not surprising. With the development of information science and technology, online learning can facilitate students’ learning because GCT and learning can also be carried out conveniently outside the classroom. In addition, virtual reality and augmented reality can play a potentially important role in promoting GCE and teaching in the information technology era.

Argumentation teaching was mentioned in 15 articles. Argumentation is a method and process of reasoning [ 149 ] in which the aim of an argument is to guarantee the correctness of an argument [ 150 ]. In argumentation teaching is central to paying attention to the use of scientific concepts [ 151 ]. It is important also in green chemistry education. Explaining the phenomenon in an understandable way, creating, justifying and validating the explanation, as well as assessing the acceptability of the arguments, are the points in the argumentation chain that should be paid attention to in argumentation teaching [ 152 ]. Ability to argue is essential in solving environmental problems.

Experiential learning, interactive learning, games and story-reading were mentioned separately in some articles (10, 6, 3, 3 mentions, respectively). According to Kolb ([ 153 ], p. 41), experiential learning is “the process whereby knowledge is created through the transformation of experience. Knowledge results from the combination of grasping and transforming experience.” Experiential learning has the four-stage learning cycle, and the concrete experience forms the basis for observations and reflections. These reflections are assimilated and distilled into abstract concepts from which new implications for action can be drawn. These implications can be actively examined and serve as guides in creating new experiences. Instructional game is often designed to train or to promote learning, and it has six key dimensions such as fantasy, rules/goals, sensory stimuli, challenge, mystery, and control. Interactive learning relies on the usage of computer technology as the collaborative medium between student and teacher [ 132 ]. Storyr-eading means that the reader holds a book in his hand and followes the printed text to give the class [ 154 ]. The reason for the low use of these methods may be that the methods in question are hardly known and the related teaching material is hardly available in the field of teaching green chemistry.

4.3. The Features of the Teaching Methods Promoting Green Chemistry Learning

Our findings show that the features of the teaching methods ( Table 4 ) that promote GCL are connected to various and multifaceted teaching and learning methods. Developing collaborative and interdisciplinary learning skills, techniques for increasing environmental awareness, problem-centered learning skills, and systems thinking skills were reported to efficiently promote green chemistry learning in 44, 40, 34, and 29 analyzed articles, respectively, and are seen to be the most important features of teaching methods.

The features of the teaching methods promoting green chemistry learning in the 45 articles analyzed.

Developing collaborative and interdisciplinary learning skills runs throughout GCT. Complex problems cannot be solved with knowledge in only one discipline. Diverse disciplines can offer their respective contributions to sustainable design, including that of green chemicals, which have the potential to minimize the simultaneous influence on environmental- and health-related issues [ 43 ]. This finding indicates the need for and importance of organizational psychology in management and communication [ 155 ]. Moreover, sustainability entails holism and ecological balance in societal development, and thus, systems thinking should also include social issues. To accomplish balanced sustainability, systematic chemical thinking is highlighted and advocated, considering chemistry under global social circumstances, expanding and delivering rational thinking in chemistry and accounting for not only the technological dimension but also the social and ethical dimensions [ 13 ]. The cybernetic-systemic approaches in life cycle assessment (LCA) [ 156 ] can offer an interdisciplinary and non-reductionist pathway to systematically design renewable products that promote sustainability [ 13 , 58 , 59 ], which can be supported by cognitive psychology [ 157 ].

The development of techniques to increase environmental awareness was considered important in 40 articles. This view can be justified, e.g., by cases describing the negative impact of environmental pollution, such as bisphenol A, which is potentially toxic and has been identified as an endocrine disruptor [ 158 ]. For all green chemistry students, increasing environmental awareness [ 158 ] is the first step by which GCT promotes SE according to the goal of green chemistry because environmental pollution is the result of human behavior. Here, environmental psychology aims to achieve a better understanding of the interaction between human behavior and the physical environment [ 116 ], which would facilitate embedding the philosophy and consciousness of green chemistry into students’ perspectives and work by enabling them to learn the corresponding subjects. In addition, teaching personal and social responsibility (TPSR) [ 121 ] can be designed and applied in achieving the personal responsibility goals of participation, effort, and self-direction, and the social responsibility goals of respecting and caring for others [ 159 ]. This educational focus will help green chemistry students and youth learn how to transfer these competencies to other areas of their lives. Once the attitude of responsibility is established, continuously and persistently maintaining these didactic-pedagogical intervention strategies in GCE can foster responsibility and autonomy in green chemistry learning and may promote attitudes and values regarding an active life, which are their ultimate educational goal [ 160 ]. Through implementing TPSR in class, prosocial behaviors can be developed in students such as respect, empathy, effort, autonomy, cooperation, helping others and leadership, an approach considered effective at specific times in learning. Prosocial behavioral changes involving student responsibility may help activate their interest and motivation in green chemistry learning.

Problem-centered learning skills inspired by cognitive psychology [ 157 ] are necessary because the goal of green chemistry is to address environmental pollution and ecological crises. During all stages of risk events and crises, people often engage themselves in various ways to learn new knowledge [ 161 ], to improve themselves, to reduce uncertainty and to gain personal control over the event [ 162 ]. Thus, learning in crisis [ 163 ] and learning activities [ 164 ] incorporated with problem-based discussion are expected to be an effective educational strategy for green chemistry students to push green chemistry learning.

Developing problem-centered learning skills was seen to be necessary for green chemistry students in 34 articles. This is understandable because the goal of green chemistry is to address environmental pollution and unsustainability [ 12 ]. Teaching and learning problem-centered learning skills can be considered important because the solutions to the challenges in eco-crises will be found at the interfaces of chemistry, biology, physics, engineering, and social sciences. In previous studies, including problem-based discussion (PBD) into learning activities [ 164 ] and learning in crisis [ 163 ] was considered an effective educational strategy in green chemistry both for teaching chemistry and non-chemistry students to overcome and manage crisis events.

Developing ICT skills was mentioned in only 13 articles, which is somewhat surprising, especially as online learning and ICT were mentioned in many articles (cf. Table 3 ) as important teaching methods. Additional mentions were also expected because the use of ICT equipment, network connections and software is expected to improve the planning, implementation and evaluation of teaching and learning to achieve the goals of these activities [ 165 ].

4.4. The Levels of Knowledge and Thinking Skills Regarding Green Chemistry Teaching

According to Zoller and Pushkin, levels of knowledge can be presented as a three-level hierarchy: declarative knowledge, procedural knowledge, and conditional knowledge [ 122 ]. The category of declarative knowledge contains factual information as well as information about concepts and the connections between them. Procedural knowledge is knowledge of how something is done. The conditional knowledge at the top of the hierarchy expresses why, when, and in which situations it is appropriate to use a particular strategy. Conditional knowledge connects declarative and procedural knowledge, so it plays a very central role in the chemistry problem-solving process [ 122 ].

As shown in Table 5 , the lower levels of knowledge (fact and concept) were included in all 45 selected articles. The type of knowledge was based on the topic learned, such as biorefinery, bioplastics, artificial intelligence (AI), systems thinking, green chemistry, interdisciplinary course, eco-psychology and life cycle assessment (LCA). Most articles also covered higher levels of knowledge, such as procedural (method) knowledge (29 articles) and conditional (metacognitive) knowledge (33 articles). For example, method knowledge was delivered and taught in GCT and GCL by establishing a method for producing bioplastics using waste sour milk as a raw material [ 86 ] and by conducting inquiry-based experimental green chemistry laboratory experiments.

The levels of knowledge skills [ 122 , 123 ] and thinking skills [ 124 ] in the 45 articles analyzed.

This exercise can efficiently allow students to make a connection to relevant sustainable development goals by considering the entire system and applications other than bioplastics. Thus, green chemistry students can gradually recognize that the process demonstrated is used in the creation of paneer.

According to Zoller and Pushkin, the levels of thinking form a hierarchy: lower-order thinking (remembering, understanding and application) an higher-order thinking (analysis, evaluation, synthesis/creation) [ 122 ]. Lower levels of thinking skills (remembering and understanding) were discussed in most analyzed articles (44 and 43, respectively). Higher levels of thinking skills, such as synthesis (creating) and evaluation, were less frequently mentioned in the analyzed articles (17 and 22, respectively). Synthesis (creating) was promoted by designing a procedure to solve unsustainability problems or demonstrating an idea for reducing the toxicity of the obtained chemicals. In the students’ learning activities, evaluation was implemented by assessing the justification of a statement or criticism of an idea or procedure. Synthesis and evaluation are necessary in GCL because they are essential to finding the solution to environmental crises and tackling unsustainability [ 33 , 64 , 156 ]. Moreover, little attention has been paid to systems thinking, which is one of the basic skills for LCA when evaluating the greenness of chemicals and guiding and piloting research and GCE [ 68 , 69 ]. In addition, higher-level thinking skills and systems thinking are needed to promote competencies for young students to become scientifically and sustainability literate [ 166 ], empowered and globally responsible citizens and professionals [ 54 , 166 ]. Hence, it can be argued that to develop higher-level thinking skills and systems thinking among students, green chemistry courses and teaching methods will need to look at different examples of what is essential and what is advanced in green chemistry [ 55 , 88 , 98 ]. To achieve these aims, cognitive psychology needs to be incorporated in this GCT process, including teaching design.

5. Conclusions

In summary, based on our findings and theoretical framework, we can conclude that integrating GCE with natural sciences, psychology and philosophy can promote GCT and GCL. First, the integration of GCE with ecology can deepen students’ understanding of the relationships between the natural environment and human beings. Second, the integration of GCE with psychology can support students’ understanding of the synthesis and integration of intangible links between nature and human well-being and motivate students to study green chemistry and the dimensions of SD. Third, the integration of GCE with philosophy can support reflections on an interdisciplinary holistic view of the intertwined complex problems and thus develop a holistic conception of how things relate to each other.

In addition to integrating GCE with other disciplines, systems thinking approaches and high levels of thinking skills, such as synthesis (creativity) and evaluation, need to be raised, e.g., to support the green process design and the LCA studies of green chemistry students. The development of ICT education skills and deepening the digital expertise of students and teachers in GCE are also important because achieving learning objectives requires collaboration with actors outside the university, such as researchers and representatives of different professional groups.

Most importantly, fostering students’ environmental awareness through the integration of green chemistry studies with sustainability development and sustainability issues is crucial since the protection of the environment and the reduction of environmental pollution are the core goals of green chemistry. To achieve this aim, prosocial behavior changes in students resulting from teaching personal and social responsibility (TPSR) for students may play a key role due to the importance of TPSR as one of the best models for promoting responsibility, values, and life skills [ 167 ].

Author Contributions

Conceptualization, M.C., E.J., A.W.; Formal analysis, M.C., E.J., A.W.; Investigation, M.C., A.W., Methodology, M.C., E.J., A.W.; Supervision, E.J.; Writing—original draft, M.C., E.J., A.W.; Writing—review & editing, M.C., E.J., A.W. All authors have read and agreed to the published version of the manuscript.

This study was supported by the Ministry of Education of the People’s Republic of China under Grant (14YJCZH010), National Natural Science Foundation of China (22078079, 21576062), Classroom Teaching Reform Project for Higher Education in Zhejiang Province (jg20190389), Natural Science Foundation of Zhejiang Province (LY18B060009).

Conflicts of Interest

The authors declare no conflict of interest.

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• Open access
• Published: 05 December 2023

A scoping review to identify and organize literature trends of bias research within medical student and resident education

• Brianne E. Lewis 1 &
• Akshata R. Naik 2  

BMC Medical Education volume  23 , Article number:  919 ( 2023 ) Cite this article

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Physician bias refers to the unconscious negative perceptions that physicians have of patients or their conditions. Medical schools and residency programs often incorporate training to reduce biases among their trainees. In order to assess trends and organize available literature, we conducted a scoping review with a goal to categorize different biases that are studied within medical student (MS), resident (Res) and mixed populations (MS and Res). We also characterized these studies based on their research goal as either documenting evidence of bias (EOB), bias intervention (BI) or both. These findings will provide data which can be used to identify gaps and inform future work across these criteria.

Online databases (PubMed, PsycINFO, WebofScience) were searched for articles published between 1980 and 2021. All references were imported into Covidence for independent screening against inclusion criteria. Conflicts were resolved by deliberation. Studies were sorted by goal: ‘evidence of bias’ and/or ‘bias intervention’, and by population (MS or Res or mixed) andinto descriptive categories of bias.

Of the initial 806 unique papers identified, a total of 139 articles fit the inclusion criteria for data extraction. The included studies were sorted into 11 categories of bias and showed that bias against race/ethnicity, specific diseases/conditions, and weight were the most researched topics. Of the studies included, there was a higher ratio of EOB:BI studies at the MS level. While at the Res level, a lower ratio of EOB:BI was found.

Conclusions

This study will be of interest to institutions, program directors and medical educators who wish to specifically address a category of bias and identify where there is a dearth of research. This study also underscores the need to introduce bias interventions at the MS level.

Peer Review reports

Physician bias ultimately impacts patient care by eroding the physician–patient relationship [ 1 , 2 , 3 , 4 ]. To overcome this issue, certain states require physicians to report a varying number of hours of implicit bias training as part of their recurring licensing requirement [ 5 , 6 ]. Research efforts on the influence of implicit bias on clinical decision-making gained traction after the “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” report published in 2003 [ 7 ]. This report sparked a conversation about the impact of bias against women, people of color, and other marginalized groups within healthcare. Bias from a healthcare provider has been shown to affect provider-patient communication and may also influence treatment decisions [ 8 , 9 ]. Nevertheless, opportunities within medical education curriculum are created to evaluate biases at an earlier stage of physician-training and provide instruction to intervene them [ 10 , 11 , 12 ]. We aimed to identify trends and organize literature on bias training provided during medical school and residency programs since the meaning of ‘bias’ is broad and encompasses several types of attitudes and predispositions [ 13 ].

Several reviews, narrative or systematic in nature, have been published in the field of bias research in medicine and healthcare [ 14 , 15 , 16 ]. Many of these reviews have a broad focus on implicit bias and they often fail to define the patient’s specific attributes- such as age, weight, disease, or condition against which physicians hold their biases. However, two recently published reviews categorized implicit biases into various descriptive characteristics albeit with research goals different than this study [ 17 , 18 ]. The study by Fitzgerald et al. reviewed literature focused on bias among physicians and nurses to highlight its role in healthcare disparities [ 17 ]. While the study by Gonzalez et al. focused on bias curricular interventions across professions related to social determinants of health such as education, law, medicine and social work [ 18 ]. Our research goal was to identify the various bias characteristics that are studied within medical student and/or resident populations and categorize them. Further, we were interested in whether biases were merely identified or if they were intervened. To address these deficits in the field and provide clarity, we utilized a scoping review approach to categorize the literature based on a) the bias addressed and b) the study goal within medical students (MS), residents (Res) and a mixed population (MS and Res).

To date no literature review has organized bias research by specific categories held solely by medical trainees (medical students and/or residents) and quantified intervention studies. We did not perform a quality assessment or outcome evaluation of the bias intervention strategies, as it was not the goal of this work and is standard with a scoping review methodology [ 19 , 20 ]. By generating a comprehensive list of bias categories researched among medical trainee population, we highlight areas of opportunity for future implicit bias research specifically within the undergraduate and graduate medical education curriculum. We anticipate that the results from this scoping review will be useful for educators, administrators, and stakeholders seeking to implement active programs or workshops that intervene specific biases in pre-clinical medical education and prepare physicians-in-training for patient encounters. Additionally, behavioral scientists who seek to support clinicians, and develop debiasing theories [ 21 ] and models may also find our results informative.

We conducted an exhaustive and focused scoping review and followed the methodological framework for scoping reviews as previously described in the literature [ 20 , 22 ]. This study aligned with the four goals of a scoping review [ 20 ]. We followed the first five out of the six steps outlined by Arksey and O’Malley’s to ensure our review’s validity 1) identifying the research question 2) identifying relevant studies 3) selecting the studies 4) charting the data and 5) collating, summarizing and reporting the results [ 22 ]. We did not follow the optional sixth step of undertaking consultation with key stakeholders as it was not needed to address our research question it [ 23 ]. Furthermore, we used Covidence systematic review software (Veritas Health Innovation, Melbourne, Australia) that aided in managing steps 2–5 presented above.

Research question, search strategy and inclusion criteria

The purpose of this study was to identify trends in bias research at the medical school and residency level. Prior to conducting our literature search we developed our research question and detailed the inclusion criteria, and generated the search syntax with the assistance from a medical librarian. Search syntax was adjusted to the requirements of the database. We searched PubMed, Web of Science, and PsycINFO using MeSH terms shown below.

Bias* [ti] OR prejudice*[ti] OR racism[ti] OR homophobia[ti] OR mistreatment[ti] OR sexism[ti] OR ageism[ti]) AND (prejudice [mh] OR "Bias"[Mesh:NoExp]) AND (Education, Medical [mh] OR Schools, Medical [mh] OR students, medical [mh] OR Internship and Residency [mh] OR “undergraduate medical education” OR “graduate medical education” OR “medical resident” OR “medical residents” OR “medical residency” OR “medical residencies” OR “medical schools” OR “medical school” OR “medical students” OR “medical student”) AND (curriculum [mh] OR program evaluation [mh] OR program development [mh] OR language* OR teaching OR material* OR instruction* OR train* OR program* OR curricul* OR workshop*

Our inclusion criteria incorporated studies which were either original research articles, or review articles that synthesized new data. We excluded publications that were not peer-reviewed or supported with data such as narrative reviews, opinion pieces, editorials, perspectives and commentaries. We included studies outside of the U.S. since the purpose of this work was to generate a comprehensive list of biases. Physicians, regardless of their country of origin, can hold biases against specific patient attributes [ 17 ]. Furthermore, physicians may practice in a different country than where they trained [ 24 ]. Manuscripts were included if they were published in the English language for which full-texts were available. Since the goal of this scoping review was to assess trends, we accepted studies published from 1980–2021.

Our inclusion criteria also considered the goal and the population of the study. We defined the study goal as either that documented evidence of bias or a program directed bias intervention. Evidence of bias (EOB) had to originate from the medical trainee regarding a patient attribute. Bias intervention (BI) studies involved strategies to counter biases such as activities, workshops, seminars or curricular innovations. The population studied had to include medical students (MS) or residents (Res) or mixed. We defined the study population as ‘mixed’ when it consisted of both MS and Res. Studies conducted on other healthcare professionals were included if MS or Res were also studied. Our search criteria excluded studies that documented bias against medical professionals (students, residents and clinicians) either by patients, medical schools, healthcare administrators or others, and was focused on studies where the biases were solely held by medical trainees (MS and Res).

Data extraction and analysis

Following the initial database search, references were downloaded and bulk uploaded into Covidence and duplicates were removed. After the initial screening of title and abstracts, full-texts were reviewed. Authors independently completed title and abstract screening, and full text reviews. Any conflicts at the stage of abstract screening were moved to full-text screening. Conflicts during full-text screening were resolved by deliberation and referring to the inclusion and exclusion criteria detailed in the research protocol. The level of agreement between the two authors for full text reviews as measured by inter-rater reliability was 0.72 (Cohen’s Kappa).

A data extraction template was created in Covidence to extract data from included full texts. Data extraction template included the following variables; country in which the study was conducted, year of publication, goal of the study (EOB, BI or both), population of the study (MS, Res or mixed) and the type of bias studied. Final data was exported to Microsoft Excel for quantification. For charting our data and categorizing the included studies, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews(PRISMA-ScR) guidelines [ 25 ]. Results from this scoping review study are meant to provide a visual synthesis of existing bias research and identify gaps in knowledge.

Study selection

Our search strategy yielded a total of 892 unique abstracts which were imported into ‘Covidence’ for screening. A total of 86 duplicate references were removed. Then, 806 titles and abstracts were screened for relevance independently by the authors and 519 studies were excluded at this stage. Any conflicts among the reviewers at this stage were resolved by discussion and referring to the inclusion and exclusion criteria. Then a full text review of the remaining 287 papers was completed by the authors against the inclusion criteria for eligibility. Full text review was also conducted independently by the authors and any conflicts were resolved upon discussion. Finally, we included 139 studies which were used for data extraction (Fig.  1 ).

PRISMA diagram of the study selection process used in our scoping review to identify the bias categories that have been reported within medical education literature. Study took place from 2021–2022. Abbreviation: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Publication trends in bias research

First, we charted the studies to demonstrate the timeline of research focused on bias within the study population of our interest (MS or Res or mixed). Our analysis revealed an increase in publications with respect to time (Fig.  2 ). Of the 139 included studies, fewer studies were published prior to 2001, with a total of only eight papers being published from the years 1985–2000. A substantial increase in publications occurred after 2004, with 2019 being the peak year where most of the studies pertaining to bias were published (Fig.  2 ).

Studies matching inclusion criteria mapped by year of publication. Search criteria included studies addressing bias from 1980–2021 within medical students (MS) or residents (Res) or mixed (MS + Res) populations. * Publication in 2022 was published online ahead of print

Overview of included studies

We present a descriptive analysis of the 139 included studies in Table 1 based on the following parameters: study location, goal of the study, population of the study and the category of bias studied. All of the above parameters except the category of bias included a denominator of 139 studies. Several studies addressed more than one bias characteristic; therefore, we documented 163 biases sorted in 11 categories over the 139 papers. The bias categories that we generated and their respective occurrences are listed in Table 1 . Of the 139 studies that were included, most studies originated in the United States ( n  = 89/139, 64%) and Europe ( n  = 20/139, 20%).

Sorting of included research by bias category

We grouped the 139 included studies depending on the patient attribute or the descriptive characteristic against which the bias was studied (Table 1 ). By sorting the studies into different bias categories, we aimed to not only quantitate the amount of research addressing a particular topic of bias, but also reveal the biases that are understudied.

Through our analysis, we generated 11 descriptive categories against which bias was studied: Age, physical disability, education level, biological sex, disease or condition, LGBTQ + , non-specified, race/ethnicity, rural/urban, socio-economic status, and weight (Table 1 ). “Age” and “weight” categories included papers that studied bias against older population and higher weight individuals, respectively. The categories “education level” and “socio-economic status” included papers that studied bias against individuals with low education level and individuals belonging to low socioeconomic status, respectively. Within the bias category named ‘biological sex’, we included papers that studied bias against individuals perceived as women/females. Papers that studied bias against gender-identity or sexual orientation were included in its own category named, ‘LGBTQ + ’. The bias category, ‘disease or condition’ was broad and included research on bias against any patient with a specific disease, condition or lifestyle. Studies included in this category researched bias against any physical illnesses, mental illnesses, or sexually transmitted infections. It also included studies that addressed bias against a treatment such as transplant or pain management. It was not significant to report these as individual categories but rather as a whole with a common underlying theme. Rural/urban bias referred to bias that was held against a person based on their place of residence. Studies grouped together in the ‘non-specified bias’ category explored bias without specifying any descriptive characteristic in their methods. These studies did not address any specific bias characteristic in particular but consisted of a study population of our interest (MS or Res or mixed). Based on our analysis, the top five most studied bias categories in our included population within medical education literature were: racial or ethnic bias ( n  = 39/163, 24%), disease or condition bias ( n  = 29/163, 18%), weight bias ( n  = 22/163, 13%), LGBTQ + bias ( n  = 21/163, 13%), and age bias ( n  = 16/163, 10%) which are presented in Table 1 .

Sorting of included research by population

In order to understand the distribution of bias research based on their populations examined, we sorted the included studies in one of the following: medical students (MS), residents (Res) or mixed (Table 1 ). The following distributions were observed: medical students only ( n  = 105/139, 76%), residents only ( n  = 19/139, 14%) or mixed which consisted of both medical students and residents ( n  = 15/139, 11%). In combination, these results demonstrate that medical educators have focused bias research efforts primarily on medical student populations.

Sorting of included research by goal

A critical component of this scoping review was to quantify the research goal of the included studies within each of the bias categories. We defined the research goal as either to document evidence of bias (EOB) or to evaluate a bias intervention (BI) (see Fig.  1 for inclusion criteria). Some of the included studies focused on both, documenting evidence in addition to intervening biases and those studies were grouped separately. The analysis revealed that 69/139 (50%) of the included studies focused exclusively on documenting evidence of bias (EOB). There were fewer studies ( n  = 51/139, 37%) which solely focused on bias interventions such as programs, seminars or curricular innovations. A small minority of the included studies were more comprehensive in that they documented EOB followed by an intervention strategy ( n  = 19/139, 11%). These results demonstrate that most bias research is dedicated to documenting evidence of bias among these groups rather than evaluating a bias intervention strategy.

Research goal distribution

Our next objective was to calculate the distribution of studies with respect to the study goal (EOB, BI or both), within the 163 biases studied across the 139 papers as calculated in Table 1 . In general, the goal of the studies favors documenting evidence of bias with the exception of race/ethnic bias which is more focused on bias intervention (Fig.  3 ). Fewer studies were aimed at both, documenting evidence then providing an intervention, across all bias categories.

Sorting of total biases ( n  = 163) within medical students or residents or a mixed population based on the bias category . Dark grey indicates studies with a dual goal, to document evidence of bias and to intervene bias. Medium grey bars indicate studies which focused on documenting evidence of bias. Light grey bars indicate studies focused on bias intervention within these populations. Numbers inside the bars indicate the total number of biases for the respective study goal. * Non-specified bias includes studies which focused on implicit bias but did not mention the type of bias investigated

Furthermore, we also calculated the ratio of EOB, BI and both (EOB + BI) within each of our population of interest (MS; n  = 122, Res; n  = 26 and mixed; n  = 15) for the 163 biases observed in our included studies. Over half ( n  = 64/122, 52%) of the total bias occurrences in MS were focused on documenting EOB (Fig.  4 ). Contrastingly, a shift was observed within resident populations where most biases addressed were aimed at intervention ( n  = 12/26, 41%) rather than EOB ( n  = 4/26, 14%) (Fig.  4 ). Studies which included both MS and Res (mixed) were primarily focused on documenting EOB ( n  = 9/15, 60%), with 33% ( n  = 5/15) aimed at bias intervention and 7% ( n  = 1/15) which did both (Fig.  4 ). Although far fewer studies were documented in the Res population it is important to highlight that most of these studies were focused on bias intervention when compared to MS population where we documented a majority of studies focused on evidence of bias.

A ratio of the study goal for the total biases ( n  = 163) mapped within each of the study population (MS, Res and Mixed). A study goal with a) documenting evidence of bias (EOB) is depicted in dotted grey, b) bias intervention (BI) in medium grey, and c) a dual focus (EOB + BI) is depicted in dark grey. * N  = 122 for medical student studies. b N  = 26 for residents. c N  = 15 for mixed

Addressing biases at an earlier stage of medical career is critical for future physicians engaging with diverse patients, since it is established that bias negatively influences provider-patient interactions [ 171 ], clinical decision-making [ 172 ] and reduces favorable treatment outcomes [ 2 ]. We set out with an intention to explore how bias is addressed within the medical curriculum. Our research question was: how has the trend in bias research changed over time, more specifically a) what is the timeline of papers published? b) what bias characteristics have been studied in the physician-trainee population and c) how are these biases addressed? With the introduction of ‘standards of diversity’ by the Liaison Committee on Medical Education, along with the Association of American Medical Colleges (AAMC) and the American Medical Association (AMA) [ 173 , 174 ], we certainly expected and observed a sustained uptick in research pertaining to bias. As shown here, research addressing bias in the target population (MS and Res) is on the rise, however only 139 papers fit our inclusion criteria. Of these studies, nearly 90% have been published since 2005 after the “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” report was published in 2003 [ 7 ]. However, given the well documented effects of physician held bias, we anticipated significantly more number of studies focused on bias at the medical student or resident level.

A key component from this study was that we generated descriptive categories of biases. Sorting the biases into descriptive categories helps to identify a more targeted approach for a specific bias intervention, rather than to broadly intervene bias as a whole. In fact, our analysis found a number of publications (labeled “non-specified bias” in Table 1 ) which studied implicit bias without specifying the patient attribute or the characteristic that the bias was against. In total, we generated 11 descriptive categories of bias from our scoping review which are shown in Table 1 and Fig.  3 . Furthermore, our bias descriptors grouped similar kinds of biases within a single category. For example, the category, “disease or condition” included papers that studied bias against any type of disease (Mental illness, HIV stigma, diabetes), condition (Pain management), or lifestyle. We neither performed a qualitative assessment of the studies nor did we test the efficacy of the bias intervention studies and consider it a future direction of this work.

Evidence suggests that medical educators and healthcare professionals are struggling to find the appropriate approach to intervene biases [ 175 , 176 , 177 ] So far, bias reduction, bias reflection and bias management approaches have been proposed [ 26 , 27 , 178 ]. Previous implicit bias intervention strategies have been shown to be ineffective when biased attitudes of participants were assessed after a lag [ 179 ]. Understanding the descriptive categories of bias and previous existing research efforts, as we present here is only a fraction of the challenge. The theory of “cognitive bias” [ 180 ] and related branches of research [ 13 , 181 , 182 , 183 , 184 ] have been studied in the field of psychology for over three decades. It is only recently that cognitive bias theory has been applied to the field of medical education medicine, to explain its negative influence on clinical decision-making pertaining only to racial minorities [ 1 , 2 , 15 , 16 , 17 , 185 ]. In order to elicit meaningful changes with respect to targeted bias intervention, it is necessary to understand the psychological underpinnings (attitudes) leading to a certain descriptive category of bias (behaviors). The questions which medical educators need to ask are: a) Can these descriptive biases be identified under certain type/s of cognitive errors that elicits the bias and vice versa b) Are we working towards an attitude change which can elicit a sustained positive behavior change among healthcare professionals? And most importantly, c) are we creating a culture where participants voluntarily enroll themselves in bias interventions as opposed to being mandated to participate? Cognitive psychologists and behavioral scientists are well-positioned to help us find answers to these questions as they understand human behavior. Therefore, an interdisciplinary approach, a marriage between cognitive psychologists and medical educators, is key in targeting biases held by medical students, residents, and ultimately future physicians. This review may also be of interest to behavioral psychologists, keen on providing targeted intervening strategies to clinicians depending on the characteristics (age, weight, sex or race) the portrayed bias is against. Further, instead of an individualized approach, we need to strive for systemic changes and evidence-based strategies to intervene biases.

The next element in change is directing intervention strategies at the right stage in clinical education. Our study demonstrated that most of the research collected at the medical student level was focused on documenting evidence of bias. Although the overall number of studies at the resident level were fewer than at the medical student level, the ratio of research in favor of bias intervention was higher at the resident level (see Fig.  3 ). However, it could be helpful to focus on bias intervention earlier in learning, rather than at a later stage [ 186 ]. Additionally, educational resources such as textbooks, preparatory materials, and educators themselves are potential sources of propagating biases and therefore need constant evaluation against best practices [ 187 , 188 ].

This study has limitations. First, the list of the descriptive bias categories that we generated was not grounded in any particular theory so assigning a category was subjective. Additionally, there were studies that were categorized as “nonspecified” bias as the studies themselves did not mention the specific type of bias that they were addressing. Moreover, we had to exclude numerous publications solely because they were not evidence-based and were either perspectives, commentaries or opinion pieces. Finally, there were overall fewer studies focused on the resident population, so the calculated ratio of MS:Res studies did not compare similar sample sizes.

Future directions of our study include working with behavioral scientists to categorize these bias characteristics (Table 1 ) into cognitive error types [ 189 ]. Additionally, we aim to assess the effectiveness of the intervention strategies and categorize the approach of the intervention strategies.

The primary goal of our review was to organize, compare and quantify literature pertaining to bias within medical school curricula and residency programs. We neither performed a qualitative assessment of the studies nor did we test the efficacy of studies that were sorted into “bias intervention” as is typical of scoping reviews [ 22 ]. In summary, our research identified 11 descriptive categories of biases studied within medical students and resident populations with “race and ethnicity”, “disease or condition”, “weight”, “LGBTQ + ” and “age” being the top five most studied biases. Additionally, we found a greater number of studies conducted in medical students (105/139) when compared to residents (19/139). However, most of the studies in the resident population focused on bias intervention. The results from our review highlight the following gaps: a) bias categories where more research is needed, b) biases that are studied within medical school versus in residency programs and c) study focus in terms of demonstrating the presence of bias or working towards bias intervention.

This review provides a visual analysis of the known categories of bias addressed within the medical school curriculum and in residency programs in addition to providing a comparison of studies with respect to the study goal within medical education literature. The results from our review should be of interest to community organizations, institutions, program directors and medical educators interested in knowing and understanding the types of bias existing within healthcare populations. It might be of special interest to researchers who wish to explore other types of biases that have been understudied within medical school and resident populations, thus filling the gaps existing in bias research.

Despite the number of studies designed to provide bias intervention for MS and Res populations, and an overall cultural shift to be aware of one’s own biases, biases held by both medical students and residents still persist. Further, psychologists have recently demonstrated the ineffectiveness of some bias intervention efforts [ 179 , 190 ]. Therefore, it is perhaps unrealistic to expect these biases to be eliminated altogether. However, effective intervention strategies grounded in cognitive psychology should be implemented earlier on in medical training. Our focus should be on providing evidence-based approaches and safe spaces for an attitude and culture change, so as to induce actionable behavioral changes.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Abbreviations

• Medical student

Evidence of bias

• Bias intervention

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Acknowledgements

The authors would like to thank Dr. Misa Mi, Professor and Medical Librarian at the Oakland University William Beaumont School of Medicine (OWUB) for her assistance with selection of databases and construction of literature search strategies for the scoping review. The authors also wish to thank Dr. Changiz Mohiyeddini, Professor in Behavioral Medicine and Psychopathology at Oakland University William Beaumont School of Medicine (OUWB) for his expertise and constructive feedback on our manuscript.

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Brianne E. Lewis

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Akshata R. Naik

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A.R.N and B.E.L were equally involved in study conception, design, collecting data and analyzing the data. B.E.L and A.R.N both contributed towards writing the manuscript. A.R.N and B.E.L are both senior authors on this paper. All authors reviewed the manuscript.

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Lewis, B.E., Naik, A.R. A scoping review to identify and organize literature trends of bias research within medical student and resident education. BMC Med Educ 23 , 919 (2023). https://doi.org/10.1186/s12909-023-04829-6

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Received : 14 March 2023

Accepted : 01 November 2023

Published : 05 December 2023

DOI : https://doi.org/10.1186/s12909-023-04829-6

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