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Journal of Service Management

ISSN : 1757-5818

Article publication date: 9 August 2011

The purpose of this paper is to put forth an expanded servicescape framework that shows that a perceived servicescape comprises physical, social, socially symbolic, and natural environmental dimensions.

Design/methodology/approach

This conceptual paper offers an in‐depth literature review on servicescape topics from a variety of disciplines, both inside and outside marketing, to advance a logical framework built on Bitner's seminal article (1992).

A servicescape comprises not only objective, measureable, and managerially controllable stimuli but also subjective, immeasurable, and often managerially uncontrollable social, symbolic, and natural stimuli, which all influence customer approach/avoidance decisions and social interaction behaviors. Furthermore, customer responses to social, symbolic, and natural stimuli are often the drivers of profound person‐place attachments.

Research limitations/implications

The framework supports a servicescape paradigm that links marketing, environmental/natural psychology, humanistic geography, and sociology.

Practical implications

Although managers can easily control a service firm's physical stimuli, they need to understand how other critical environmental stimuli influence consumer behavior and which stimuli might overweigh a customer's response to a firm's physical dimensions.

Social implications

The paper shows how a servicescape's naturally restorative dimension can promote relief from mental fatigue and improve customer health and well‐being. Thus, government institutions (e.g. schools, hospitals) can improve people's lives by creating natural servicescapes that have restorative potential.

Originality/value

The framework organizes more than 25 years of servicescape research in a cogent framework that has cross‐disciplinary implications.

• Servicescape
• Attention restoration theory
• Service design
• Environmental psychology
• Atmospherics
• Consumer behaviour
• Decision making

Rosenbaum, M.S. and Massiah, C. (2011), "An expanded servicescape perspective", Journal of Service Management , Vol. 22 No. 4, pp. 471-490. https://doi.org/10.1108/09564231111155088

Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

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Effects of Servicescapes on Interaction Quality, Service Quality, and Behavioral Intention in a Healthcare Setting

1 Graduate School of Service Management, Kyonggi University, Seoul 03753, Republic of Korea

Pyoungsoo Lee

2 Division of Business Administration, Kyonggi University, Suwon 16227, Republic of Korea

Choong Ho Shin

Associated data.

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to ethical issues.

This study develops a conceptual framework that encompasses servicescapes and customer perceptions and behaviors, and conducts an empirical investigation of healthcare service facilities. Structural equation modeling is performed using a sample of 271 patients who received treatment within one year at hospitals and clinics located in the metropolitan area of Seoul, South Korea. The results of the empirical analysis show that service quality improvements and patient revisits to healthcare facilities can be induced through servicescape improvements and interaction quality. These results make theoretical contributions to the service management literature and have practical implications for the operations of healthcare facilities.

1. Introduction

Servicescapes, defined as the physical surroundings in which customer experiences are created, are regarded as a key driver of customers’ overall perceptions of a service and their related behavior [ 1 , 2 ]. A servicescape provides customers with a first impression of the service, which inevitably has a significant impact on their overall evaluation of that service. Many studies have consistently provided empirical evidence on how servicescapes affect customers’ perceptions and behavioral responses. Customers’ overall evaluation of services has been studied, mainly based on service quality. However, the relationship between servicescapes and service quality has received relatively little attention. Specifically, these two concepts were not analyzed together using a structurally valid research model because of the overlap between them [ 3 ].

Traditionally, servicescapes include ambient conditions such as temperature, noise, and odor, as well as tangible elements such as furniture, signage, decorations, brochures, and other communication materials [ 1 , 3 , 4 ]. In other words, the physical environment is a concept that encompasses tangible and intangible elements. Many previous studies on service quality have also used tangible factors to measure it. Typically, SERVQUAL, the most widely used service quality measure, also evaluates service quality by including tangible factors. Additionally, interpersonal interactions, which are considered a vital factor in service, combine with these two concepts: tangibles and intangibles. For this reason, quality assessment through service environments may not have been dealt with in detail due to incompatible conceptualizations. Therefore, a few recent studies have made efforts to structurally analyze the impact of servicescapes on service quality and/or customer behavior [ 5 , 6 , 7 ]. Along this line of research, we investigate the relationship between servicescapes and customers’ perceptions of services using tangible and interactive aspects from conceptualizations used in previous studies. A customer’s perception is captured by the interaction quality and overall service quality, while the customer’s behavior is set as a revisit intention to present a conceptual framework encompassing the servicescape, customer perception, and behavior.

Services is a very broad term and is used as a concept encompassing that provided in fields such as education, hospitality, transportation, entertainment, healthcare, and so on. The conceptual model we propose is illustrated in the healthcare service, as healthcare delivery differs from other service industries. Although generally applicable theories on service evaluation and customer perception have been studied for a long time, it is difficult to apply these theories uniformly to all service industries. As healthcare services involve specialized technologies, personnel, and equipment, patients have difficulty in determining, measuring, and evaluating the technical nature of healthcare services [ 8 ]. As a result, the surroundings of facilities play an important role in determining the overall service quality [ 9 , 10 ] and also influence the nature of the relationship between staff and patients [ 8 , 11 , 12 ]. In addition, the influence of the mentioned environmental factors on service quality or relationship characteristics may show different characteristics from other services. Therefore, it is important to determine the components that can help patients achieve better outcomes [ 6 ].

The main purpose of this study is to increase the level of theoretical understanding of the role of servicescapes in determining patients’ perceptions of interpersonal interactions and overall service quality. Additionally, the theoretical framework is extended to patients’ intentions to revisit and practical implications are drawn by focusing on servicescape management in healthcare organizations.

2. Theoretical Background

2.1. servicescapes.

Even before the term servicescape appeared, scholars recognized the importance of the physical environment and tried to analyze its influence on consumers’ emotions or behavioral responses. For instance, Kotler [ 13 ] used the word “atmospherics” to define the physical factors that affect consumers, suggesting that they should be designed and controlled to generate certain emotions by providing consumers with a significant purchasing signal or reinforcement. The stimulus–organism–response (S–O–R) framework [ 14 ], which was proposed around the same time, has also been widely used to investigate the influence of the environment on consumers’ emotions and behaviors.

Baker [ 15 ] argued that the physical environment in the field of service management can stimulate purchases by creating a positive atmosphere. Subsequently, Bitner [ 1 ] coined the term “servicescape” as a compound of service and landscape and defined it as a “built environment”, that is, an artificial physical environment as opposed to the natural or social environment. She also explained that servicescapes should be able to support interactions by simultaneously satisfying the needs and preferences of employees and customers. Although some differences in servicescape dimensions have been suggested in previous studies, most of them use a multidimensional perspective. Baker [ 15 ] divided the dimensions of servicescapes into ambient, design, and social factors. Ambient factors include lighting in the service environment and an appropriate room temperature, which can be perceived indirectly by consumers. Design factors are elements that can be seen and include the exterior, color, stability, and functional aspects of service facilities. Social factors include the recognition that human interactions and stimuli influence customers’ experiences. Bitner [ 1 ] suggested that the dimensions of the servicescape are “ambient conditions”, “spatial layout and functionality”, and “signs, symbols, and artifacts”. Ambient conditions can be defined similarly to Baker [ 15 ], being background characteristics of the physical environment that can influence consumers’ feelings, reactions, and emotions. Spatial layout and functionality refer to the suitability of consumables or furniture arrangement for service facilities. Signs, symbols, and artifacts refer to various signals, building guide maps, company logos, symbolic objects, and ornaments that facilitate communication between consumers and employees.

In this section, the discussion focuses on the two subjects in servicescape research. The first one concerns the interaction between service employees and consumers. Baker [ 15 ] and Bitner [ 1 ], as the dominant typologies in this research stream, consider the factors related to the relationships between employees and consumers but differ in their approach as follows. Baker [ 15 ] explained these contents under a social dimension, whereas Bitner [ 1 ] introduced them into the overall servicescape concept in a somewhat indirect way rather than constructing and explaining them as an independent dimension. Based on Baker’s [ 15 ] cognitive system, some scholars treated social factors as the characteristics of employees or customers in the service environment [ 16 , 17 ]. However, social factors should be recognized as interactions that occur in the environment and not as environmental factors themselves. According to Bitner [ 1 ], servicescapes should be able to support interactions by simultaneously satisfying the needs and preferences of employees and customers; thus, it makes sense to analyze interactions as a result of environmental stimuli. Hutton and Richardson [ 9 ] supported this discourse by examining the effects of the factors in the physical healthcare environment on patient (customer) and staff (employee) behaviors and their outcomes.

The second argument is the controllability of servicescapes. Rosenbaum and Massiah [ 16 ] extended the view that uncontrollable factors such as the natural environment should also be included in servicescapes. This assertion emphasizes that factors such as the healing environment outside a medical service facility also needs to be analyzed, as this is conducive to the psychological stability of patients [ 18 ]. Further, drawing from Bitner [ 1 ], Wakefield and Blodgette [ 4 ] conceptualized the servicescape of leisure services by excluding uncontrollable ambient factors in the outdoor environment and adding a controllable dimension, such as cleanliness. However, unless research is intended to determine the location of a service facility, defining servicescapes in terms of uncontrollable factors such as the natural environment is rather limited. Hooper et al. [ 5 ] argued that, although there are various perspectives of the servicescape dimension, existing studies typically consist of elements such as ambient conditions, design, space and layout, equipment, hygiene, and cleanliness. Despite the relative ease with which this dimension can be controlled, Hoffman et al. [ 19 ] reported that cleanliness issues are the most frequently cited servicescape failures by consumers. More recently, Pai and Chary [ 20 ] conceptualized and analyzed healthscapes based on visual appeal and layout, amenity, and cleanliness and hygiene, and showed that cleanliness and hygiene are the most important aspects of a healthscape. This is likely because maintaining a clean and hygienic environment should be one of the cheapest and easiest servicescape dimensions to control. In medical facilities, hygiene is a factor directly related to patient health; therefore, it is necessary to analyze it as a servicescape. Nevertheless, hygiene has received relatively little attention in servicescape research. It is thus necessary to analyze hygiene together with other elements of the servicescape that are traditionally considered.

2.2. Interaction Quality

In service delivery, the service organization and consumers must form a relationship through interaction so that both can achieve positive results [ 21 , 22 ]. In relational marketing, employee–customer interactions have been treated as a vital marketing element [ 23 , 24 , 25 ]. In general, the relationship marketing perspective emphasizes satisfaction, trust, empathy, confidence, cooperation, interdependence, and social exchange as factors important for forming interpersonal relationships. Consumers can fulfil the role of co-producers through interactions with service providers in the service process, leading to continuous economic exchanges. This issue has been addressed in many empirical studies on the importance of interpersonal relationships in various service settings [ 26 , 27 , 28 , 29 ].

King and Garey [ 30 ] pointed out that a lack of interest in relational quality occurred in the interactions between customers and service staff, as a prerequisite for customer satisfaction. Since then, several studies have empirically shown that interpersonal interactions have a significant impact on customers’ perceptions of service quality [ 31 , 32 , 33 ]. Mattila and Enz [ 34 ] emphasized that consumers’ evaluations of the service process have a high correlation with the emotions that they feel while interacting with employees during the service delivery process. Jamal and Naser [ 35 ] and Ekinci and Dawes [ 36 ] showed that relational (interaction) quality directly affects customer satisfaction. Hooper et al. [ 5 ] explained that interpersonal relationships are created through interaction, and argued that interaction quality may differ from the overall service quality. It can thus be inferred that interaction quality is an important service quality factor between consumers and employees and a medium that can help and satisfy the needs of consumers.

The healthcare literature continues to emphasize the importance of interaction quality. For instance, Thom et al. [ 37 ] emphasized the importance of interaction in quality-of-care evaluations and found that the more the patient trusts the medical staff, the more positive is the intention to revisit a medical institution. Chang et al. [ 38 ] found that patients’ perceptions of the reliability and sincerity of medical staff in service encounters affects their satisfaction with the hospital. Additionally, several studies have attempted to analyze the effects on patient satisfaction by considering the interaction between the patient and medical staff through factors such as communication, responsiveness, and employee reaction [ 39 , 40 , 41 ]. Here, it should be noted that the quality of care depends primarily on the professional competence of the medical staff [ 37 , 38 , 42 ]. Therefore, experts need to improve competencies such as knowledge and technical skills to provide high-quality services [ 42 ]. However, the ability of the medical staff recognized by the patient is eventually transmitted through the interaction. According to Mosadeghrad [ 42 ], quality of care is determined through the cooperation of patients and providers in a supporting environment, which can be achieved when the competencies of the medical staff are premised. Previous studies have shown that if patients form a positive interaction with the medical staff, they trust the medical staff more, which can in turn lead to improved organizational performance. Therefore, the quality of interaction can be considered an important factor in the healthcare context, for which medical service organizations’ efforts to promote long-term relationships are necessary.

Employee–customer interaction is affected by the servicescape, which represents the surroundings of service encounters. Carù and Cova [ 43 ] emphasized that servicescape research should consider the interaction between customers and employees together. In this regard, several previous studies have suggested that although the elements of the servicescape that are important to each encounter are different, the servicescape affects interaction quality in various service settings [ 3 , 5 ]. Additionally, Parish et al. [ 12 ], who studied servicescapes in a hospital environment, showed that servicescapes affect employee attitudes.

2.3. Service Quality

Service quality can be defined as the customer’s judgment of the overall excellence or superiority of a service [ 44 ]. In recent decades, a great deal of service quality research has been devoted to the development of service quality measures. Among the numerous measurement models, SERVQUAL is an excellent instrument for measuring service quality and is widely applicable in various service industries [ 45 ]. According to SERVQUAL, five dimensions are used to assess the perceptions of service quality [ 44 , 46 ]:

• Reliability: ability to perform the promised service accurately;
• Tangibles: service facilities/conditions, equipment, and materials;
• Responsiveness: willingness to help customer and provide service promptly;
• Assurance: knowledge and courtesy of the employee and their ability to inspire confidence;
• Empathy: caring and individualized attention to customers.

Many researchers have conducted research on service quality using SERVQUAL, with several of them identifying limitations and potential difficulties in its application [ 45 , 47 , 48 , 49 , 50 , 51 ]. Although many problems have been identified in the literature, this study focuses on two main drawbacks of previous studies. The first issue is the problem of conceptualization and the dimensions of SERVQUAL [ 45 , 51 ]. This critique addresses the difficulties in applying and interpreting SERVQUAL [ 49 , 52 ]. The empirical findings of previous studies utilizing SERVQUAL showed a lack of convergent and discriminant validity among the SERVQUAL dimensions [ 53 ]. Additionally, the literature acknowledges that an interdimensional overlap may occur [ 47 , 49 ]. To compensate for this problem and analyze how the quality evaluation of services is performed, we focus on process orientation, which is an inherent property of services. A service is a process completed through the customer’s interaction with the service provider. When a service is performed by a person, the dimensions of reliability, assurance, empathy, and responsiveness are ultimately determined by the service provider’s abilities and attitudes [ 33 , 54 ]. Hanks et al. [ 55 ] also recognized responsiveness, assurance, and empathy as factors that can be evaluated through interaction and defined them as interpersonal (interaction) quality. Interaction quality can be evaluated according to the emotional exchanges between employees and consumers and the service situation in service encounters [ 34 ]. In other words, service encounters based on interpersonal relationships affect service quality significantly [ 38 ]. Similarly, Hooper et al. [ 5 ] found that employee quality acts as a leading factor in service quality, having a direct and positive effect. Previous studies in the healthcare setting also reported that the quality of service points based on interpersonal relationships affects the overall service quality [ 38 ].

Another issue we address are “tangibles”, which refer to physical evidence in service. This dimension of SERVQUAL captures some of the most important aspects of the servicescape [ 3 ]. However, it makes it difficult to explain the relationship between dimensions because tangibles are modeled as a factor that measures service quality along with other dimensions. In other words, SERVQUAL does not specify the role of tangibles in the service quality evaluation process. As previously mentioned, servicescapes and tangibles differ. In this study, the servicescape comprehensively identifies and analyzes the elements of the physical environment that the tangible cannot capture, such as ambient conditions, hygiene, and cleanliness. We believe that the servicescape can be a leading factor in overall quality perception by extracting it from SERVQUAL. This inference is based on Mehrabian and Russell [ 14 ], who considered that environmental stimuli are useful tools for eliciting customer responses. Specifically, environmental stimuli can elicit emotional states of pleasure and arousal, which ultimately influence behavior. Here, stimuli refer to physical features and can thus be interpreted as a servicescape. Reimer and Kuehn [ 3 ] argued that tangibles can capture the tangible parts of a servicescape as a dimension of SERVQUAL and analyzed the causal relationship between servicescapes and other dimensions. Additionally, several previous studies have revealed that the concept of servicescape conflicts with many service quality studies, which include tangible clues as a core dimension, along with various other service quality indicators [ 3 , 5 , 56 ]. Based on this literature stream, we believe that it is desirable to extract the tangible dimension from SERVQUAL and recognize it as the servicescape. However, the servicescape dealt with in this study is a concept that encompasses not only tangibles, but also the atmosphere and layout. As the servicescape is an immediate element recognized by customers, it is necessary to distinguish it from service quality; therefore, it is necessary to structure it as an antecedent of service quality perception [ 5 ].

2.4. Behavioral Responses

According to Berry et al. [ 57 ], because the customer evaluation of a service is based on performance rather than objectives, customers rely on the numerous clues inherent in performance when evaluating their service experience. Overall, the literature shows that favorable service experiences result in positive behavioral responses, with high levels of service quality [ 58 ]. Wakefield and Blodgett [ 4 ] argued that in the leisure service industry, consumers’ intentions to revisit increases when the physical environment is well designed. Similarly, Hooper et al. [ 5 ] found empirical evidence that the servicescape affects customers’ positive behavioral intentions through retail service research. Regarding interaction quality, Albrecht et al. [ 59 ] showed that the experiences from interactions with customers can make customers’ responses more positive. Therefore, we consider the servicescape, interaction quality, and overall quality as clues to the service experience and present their impact on customer responses. Previous studies of the healthcare industry by Sahoo and Ghosh [ 8 ] and Choi and Kim [ 60 ] have also been conducted under this premise.

Based on the above discussion, inferences about the relationships between the servicescape, interaction quality, service quality, and patients’ revisit intentions were derived, and the following hypotheses can be established:

The servicescape has a positive effect on interaction quality .

Interaction quality has a positive effect on overall service quality .

The servicescape has a positive effect on overall service quality .

The servicescape has a positive effect on patients’ revisit intentions .

Interaction quality has a significant effect on patients’ revisit intentions .

Overall service quality has a significant effect on patients’ revisit intentions .

3. Methodology

3.1. sample, procedures, and data collection.

In the Korean medical system, healthcare facilities are divided into medical clinic, hospital, general hospital, and tertiary hospital. A medical clinic is the smallest medical facility with less than 30 beds and mainly treats outpatients with mild symptoms, and also provides routine preventive care. With more than 30 beds, a hospital is a larger facility than a medical clinic and mainly provides medical services for inpatients while performing outpatient treatment like a clinic. General hospitals and tertiary hospitals are large-scale facilities equipped with a full complement of services and departments, typically housing the most experienced and widest range of specialist doctors. Variability in patients’ health status can greatly affect perceptions of environmental factors and interactions that we measure and evaluate. For example, severe or emergency patients who need very serious surgery may be placed in a psychological state in which they are not properly aware of the environment or interactions with medical staff. Therefore, we exclude general hospitals and tertiary hospitals, which are mainly visited by patients suffering from relatively severe diseases, in order to prevent the occurrence of bias due to these external factors in advance. In other words, the sample data we obtained were limited to outpatients who visited clinics and hospitals.

A questionnaire-based survey was administered to patients who received medical treatment within one year at 6 hospitals and 6 medical clinics located in the metropolitan area of Seoul, South Korea. The purpose of the study was explained through an online survey, and a self-administered questionnaire was used for data collection. The survey was conducted over one month, from August to September 2020. We selected 6 clinics and 6 hospitals as target facilities, respectively, and distributed 30 questionnaires each. After removing the discrepancies and incomplete data from the 271 responses collected out of the total of 360, 258 valid responses were used for the final data analysis. In addition, no difference at a 0.05 significance level was found among patient respondents according to hospital/clinic classification. The demographic characteristics of the respondents are summarized in Table 1 .

Demographic characteristics of respondents.

Notes: All currency values are in KRW (Korean Republic Won); KRW 1188 = USD 1 (date: 20 August 2020).

3.2. Measures

To ensure content validity, validated measures developed by other scholars were used and adjusted for application in the context of healthcare services. Table 2 shows the operational definitions of the constructs and the primary sources of the instruments. The measurement items for the servicescape were adapted from Wakefield and Blodgett [ 61 ], Hightower et al. [ 56 ], Reimer and Kuehn [ 3 ], and Hooper et al. [ 5 ]. A total of 15 items were used to measure the five dimensions of the servicescape: equipment, design, space, ambience, and hygiene. Interaction quality was assessed using five items, adapted from Stevens et al. [ 54 ] and Chang et al. [ 38 ]. Items relating to service quality were adapted from Grace and O’Cass [ 62 ] and Hooper et al. [ 5 ], whereas those relating to revisit intention were drawn from Zeithaml et al. [ 58 ]. The final measurement items for each construct are based on a five-point Likert-type scale, from “1” for “strongly disagree” to “5” for “strongly agree”. As this survey was conducted in Korea, it was necessary to translate the text into Korean. The original version of the questionnaire was translated into Korean by the corresponding author and then back translated into English by another bilingual scholar. Next, we proceeded with an item-by-item review, and the corresponding author confirmed that there was no difference between the two versions. The items for all constructs are presented in Appendix A .

Construct operationalization.

3.3. Data Analysis and Results

Survey data were analyzed using statistical techniques, including confirmatory factor analysis (CFA) and structural equation modeling. Prior to testing the hypotheses, we examined the validity and reliability of the two-step approach [ 63 , 64 ]. CFA was performed using AMOS 21 software to assess the factor loadings, internal consistency, and convergent validity of all measurement scales. Factor loadings and Cronbach alphas greater than 0.7 are considered acceptable [ 65 ]. All items in this study were retained, except for SP1, AM3, and AM4, which were removed due to low loadings. Composite reliability (CR) values were above the recommended value of 0.7 and all item loadings for each reflective construct were greater than 0.5. Additionally, there was no problem with convergent validity in that the average variance extracted (AVE) of all constructs exceeded 0.5. Table 3 reports the factor loadings, AVE, CR, and Cronbach alphas. According to Fornell and Larcker [ 65 ], when the square root of all AVEs exceeds all cross-correlation scores, there is no problem with discriminant validity. As shown in Table 4 , most of the square roots of AVE were higher than all cross-correlation scores. Although the interaction and service quality did not meet this criterion, the corresponding cross-correlation scores were not extremely high and their CR values were very high, at 0.873 and 0.911, respectively; thus, discriminant validity does not cause a serious problem [ 66 ]. Altogether, the results indicate that all constructs are statistically distinct and can be used to test the structural model.

Factor loading, average variance extracted, composite reliability, and Cronbach alpha.

Notes: *** p < 0.001; CR: composite reliability; AVE: average variance extracted.

Square root of AVE and correlations between constructs.

Notes: The diagonal elements indicate the square root of the AVE. AVE measures the amount of variance captured by the measures of a construct in relation to error variance of those items.

The model fit statistics indicate a good fit for the final measurement model and are well within the recommended thresholds: χ2/df = 1.999 (χ2 = 495.98, df = 248), RMSEA = 0.062, GFI = 0.686, CFI = 0.943, and IFI = 0.944. Path coefficients were used to test the hypotheses. H2, H5, and H6 were supported, while H3 and H4 were not. H1 was partially supported. First, for H1, space has a strong positive effect on interaction quality (β = 0.193, t = 2.760, p < 0.01). Hygiene also has a strong positive effect on interaction quality (β = 0.658, t = 7.109, p < 0.001). However, H1(a), H1(b), and H1(d) were not statistically supported as hypotheses related to equipment, design, and atmosphere, which are other components of the servicescape. The direct path from interaction quality to service quality (β = 0.875, t = 7.671, p < 0.001) thus supported H2. All paths from the servicescape to service quality and revisit intention were insignificant, thus leading to the rejection of H3 and H4. The results also indicate that H5 and H6 were supported by positive and significant paths from interaction quality (β = 0.531, t = 2.362, p < 0.05) and service quality (β = 0.450, t = 3.296, p < 0.001) to revisit intention. The results of the hypotheses testing are presented in Table 5 .

Results of the structural model.

Notes: * p < 0.05, ** p < 0.01, *** p < 0.001.

We used a bootstrapping approach with phantom variables to investigate the significance of mediating effects. According to Malhotra et al. [ 67 ], this method is preferred because it is statistically more powerful and robust than the methods of Baron and Kenny [ 68 ] and Sobel [ 69 ] for identifying mediation effects. In the case of analyzing multiple mediation in a model, the bootstrapping of individual indirect effects must be performed, so phantom variables were created and each indirect effect was expressed as a single coefficient for analysis [ 70 ]. Specifically, we used a bootstrap analysis of 2000 resamples, from which a bias-corrected 95% confidence interval was estimated. Mediating effect analysis focuses on the relationships in which interaction quality and service quality act as mediators in a proposed research model. First, we presented the mediating effects of interaction quality on the relationship between the servicescape and service quality. The results demonstrate that the impact of space and hygiene on service quality is significantly mediated by interaction quality. H3, the hypothesis that the servicescape has a direct and positive effect on service quality, was rejected; this result is very interesting. The mediating effect of interaction quality on revisit intention showed similar results. In other words, interaction quality has a significant mediating effect on the relationship between space, hygiene, and revisit intention. Second, we analyzed the mediating effects of service quality. In other words, this verifies whether service quality has a mediating effect on the relationship between interaction quality and revisit intention. The results confirmed that service quality significantly mediates the influence of interaction quality on revisit intention. Additionally, hygiene is statistically significant, as it has an indirect effect by mediating interaction between quality and service quality. The results of the mediating analysis using the estimates of the direct, indirect, and total effects are shown in Table 6 .

Direct, indirect, and total effects.

Note: * p < 0.05, ** p < 0.01.

4. Discussion

4.1. findings and managerial implications.

The space and hygiene of servicescapes were found to have substantial effects on interaction quality. Hooper et al. [ 5 ] used the same constructs for servicescapes as this study and reported that all factors of a servicescape significantly affect interaction quality, which is somewhat different from the results of this study. The importance of servicescapes may differ, depending on industry characteristics. Unlike contact employees in other service industries, medical staff must treat patients who visit facilities because of health concerns. In other words, the servicescape required by the medical staff can be the spatial element to provide services quickly and safely. Additionally, the importance of hygiene is revealed as an environmental factor that is directly related to health, which provides the essential value of healthcare services. This finding suggests that medical staff can elicit a high level of interaction with patients through an environment that can appropriately support rapid treatment or examination of medical conditions, rather than building design, ambience, and state-of-the-art equipment.

Interaction quality was found to have a significant influence on service quality. This result is in agreement with that of a previous study on service quality in a healthcare setting [ 38 ]. However, the direct effect of servicescapes on service quality has not yet been verified. Accordingly, we explored the indirect effect of servicescapes on service quality through a mediating effect analysis and drew interesting findings. Space and hygiene were found to have significant indirect effects on service quality. This result was confirmed by isolating interaction-related factors to explain the overall service perception. Specifically, we presented empirical evidence that space and hygiene not only directly affect interaction quality, as described above, but also affect the overall service quality perceived by patients through interaction quality. Therefore, the purpose of this study, to analyze how the servicescape can affect employees and customers from multiple angles, has been achieved. This finding suggests that healthcare organizations such as hospitals and clinics should not simply use a straightforward approach when managing servicescapes. In other words, maintaining a high level of hygiene and space may not directly affect customers’ perceptions of quality and behavior. The results indicate that factors such as hygiene and space also provide an environment in which employees can perform their jobs well. Although it is true that servicescapes affect everyone who encounters service surroundings, it is also undeniable that they have been mainly treated as a factor for customers, both theoretically and practically. This study emphasizes that hygiene and space management can encourage medical staff. This ultimately allows patients to feel satisfied and return.

The hypothesis test on revisit intention failed to test the direct positive influence of the servicescape. That is, the servicescape did not directly affect service quality or the intention to revisit. However, revisit intention was significantly affected by both interaction and service quality. Therefore, we analyzed whether the servicescape affects revisit intention by mediating service quality, finding that hygiene and space indirectly affect revisit intention. In particular, the effects of hygiene were stronger. Furthermore, hygiene was found to be the only servicescape factor affecting revisit intention through double mediation. This implies that hygiene is the most important servicescape factor in terms of patient revisits for healthcare services. Space is the second servicescape that can influence patient revisits. This further reinforces the evidence of the relationship between the servicescape and service quality. Since the space and hygiene of servicescapes indirectly affect not only service quality but also revisit intention, healthcare organizations should make efforts to foster space and hygiene aspects in making decisions about the facility environment. Additionally, interaction quality was found to have a significant effect on revisit intention, although not as much as the outcome of the service. This result implies that staff responses and attitudes toward patients can directly affect patients’ revisit intentions. These results suggest that in a service industry where human capabilities are important, such as medical services, interactions between customers and service employees can directly lead to customer revisits. In particular, it shows that the attitudes and behaviors of medical staff can help patients stabilize in healthcare facilities where patients visit in a state of psychological instability. In South Korea, where this study was conducted, there is already a system in place that allows all medical organizations’ staff to acquire the basic medical service mindset and service response knowledge necessary for patient response in the medical field.

4.2. Theoretical Contributions

This study contributes to the literature in two ways, as follows. The most significant theoretical contribution is the development of a framework for analyzing customer perceptions and behaviors. Many studies have emphasized that the physical environment of service facilities and the interactions between employees and customers are important factors in the overall perceptions of customers during service encounters. However, while attention has been paid to expanding the typologies of service quality or the servicescape, relatively little effort has been made to identify the relationships between the service elements perceived by customers while experiencing a service [ 38 , 42 ]. For example, SERVQUAL, one of the most widely accepted models for evaluating service quality, includes physical elements, such as tangibles, and interaction elements, such as responsiveness, assurance, and empathy. Moreover, the recently reported extended servicescape model includes interpersonal aspects, such as considering social factors in addition to the physical environment [ 16 , 17 , 71 ]. Therefore, it is necessary to propose a model that can structurally analyze environmental and interpersonal aspects, which cannot be identified in the extant theoretical frameworks, along with overall quality perception. This study contributes to the literature by proposing and empirically verifying the relationship between servicescapes, interaction quality, and overall service quality by reviewing previous studies of the service elements related to these aspects. Additionally, the above-mentioned structural model has been expanded by identifying the customer behavior the service organization places importance on as the patient’s intention to revisit.

The second contribution is specific to healthcare services. The research model was designed in consideration of the servicescape as an antecedent to patients’ perceptions and behavioral intentions, thus enabling the analysis of various relationships. However, the healthcare literature did not provide unified results in analyzing the effect of servicescapes on patient emotions or satisfaction. For example, Ayas et al. [ 72 ] argued that space, design, and ambience are important for a patient’s feeling of calmness, while Sahoo and Ghosh [ 8 ] reported that design and atmosphere are the main factors influencing patient satisfaction, and hygiene is not. Further, Pai and Chary [ 20 ] argued that hygiene is the most important factor, as opposed to design, space, and amenities. This study confirms that hygiene is the most influential factor among the servicescape dimensions. The implication is that, among the environmental factors of healthcare facilities, hygiene and space become direct driving forces for a smooth interaction with patients and can be strategic tools to promote service quality and patient revisits. Of course, it cannot be concluded that there are no patients who return to unsanitary facilities. In particular, there may be cases where a visit is unavoidable due to geographical proximity or because of the superior expertise of medical personnel, but these cases are considered exceptional or special ones. However, in a service area where expertise is important, such as medical service, a study on whether service expertise can dominate environmental factors needs to be conducted later. Securing the professionalism of medical staff is undoubtedly important in promoting the competitiveness of medical institutions. However, it is also important to discuss how to effectively utilize human resources. In other words, it is worth researching how to improve the quality of the interactions between the medical staff and patients. This study provides a framework for analyzing the relationships between environmental factors and the interactions between staff and patients. However, the roles of hygiene and space identified in this study may be due to the restrictions imposed by the COVID-19 pandemic. The pandemic has placed a tremendous psychological burden on both medical staff and patients. Accordingly, there is a possibility that when patients perceive the surroundings during service encounters, the hygiene and space aspects are more important than the other servicescape factors. Of course, as this may be a phenomenon that can be commonly applied not only to healthcare services but also to other service areas, further research is needed to verify whether these results are caused by the spread of infectious diseases. If a patient’s perception of the environment of healthcare services changes due to frequent epidemics, such as SARS, MERS, and COVID-19, additional research is needed to determine whether the results will be sustained.

4.3. Limitations and Future Research

Although this study makes significant contributions to the service and healthcare management literature and has important implications for practice, it also has several limitations and provides opportunities for future research. First, the data used in this study were collected during the COVID-19 pandemic, meaning that we need to pay attention to the phenomenon of selective attention. Focusing on one stimulus may have led to selective attention and actively ignoring the other stimuli. In other words, patients may be insensitive to other environmental stimuli because they pay much attention to prevention, owing to the spread of an infectious disease. For this reason, the effects of design, ambience, and equipment may be insignificant, which makes it the researcher’s responsibility to confirm the changes after the pandemic through further analysis. Second, the data include the perceptions of patients who have experienced healthcare services, including both hospitals and clinics. Therefore, there is a possibility that the servicescape effect may be somewhat distorted. Since the environmental factors for inpatient and outpatient values may differ, future studies will be able to enrich practical implications by classifying them and analyzing the differences. Finally, in the healthcare context, we have developed a broad picture of the servicescape, quality perception, and patient behavior. However, these relationships may not be the same in all medical fields (departments). For example, the effects shown in this study may be greater in otolaryngology than in orthopedics. Future research should thus investigate the effects of these characteristics in the general healthcare field. Another interesting research topic is the interpersonal aspects between customers. As mentioned in the literature review, social factors include not only the interactions between employees and customers but also those between customers. Instead of excluding the interactions between patients, our study focuses on interactions between customers and patients. Therefore, future research using the framework proposed in this study will also be conducted in hospitals that accommodate inpatients.

5. Conclusions

This study developed a conceptual framework that encompasses the servicescape and patients’ perceptions and behaviors, and conducted an empirical investigation of healthcare service facilities. With the recent spread of viruses such as COVID-19, social awareness of hygiene is increasing, and healthcare facilities in particular are managing the physical environment to a higher level than before. Along with these environmental factors, the intention was to analyze how the expertise of medical services and the interaction provided by medical staff ultimately affect the overall quality of medical facilities. Furthermore, it was analyzed in depth whether these factors were motivating patients to visit the facilities again. Through empirical investigation, it was found that service quality can be improved and patients’ revisits to the facilities can be induced through servicescape improvement and interaction quality.

Appendix A. Measurement Items

Funding statement.

This research received no external funding.

Author Contributions

Conceptualization, S.Y.A. and P.L.; formal analysis, S.Y.A.; methodology, S.Y.A.; validation, S.Y.A.; software, S.Y.A.; investigation, S.Y.A.; data curation, P.L. and C.H.S.; writing—original draft preparation, S.Y.A.; writing—review and editing, P.L. and C.H.S.; project administration, P.L. and C.H.S. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Ethical review and approval were waived for this study due to the survey being anonymous and considered to be a service evaluation in line with the Bioethics and Safety Act: https://elaw.klri.re.kr/kor_service/lawView.do?lang=ENG&hseq=52559 (accessed on 7 September 2023). According to this Enforcement Decree, ‘research conducted directly or entrusted by the state or local government to review and evaluate public welfare or service programs’ is excluded from IRB. No patient-identifiable information was collected as part of the study. The survey contained a statement, “We hope to publish the results from this survey as an original research article and present the results in the scientific journals”, to make clear the intentions of the use of anonymized data gathered.

Informed Consent Statement

Informed consent was obtained from all subjects participating in the study regarding the purpose of the study, its use and anonymity of responses to potential participants. Moreover, no experiment has been conducted; the sample simply had to rate a healthcare organization without revealing its precise name.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

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Servicescape cues and customer behavior: a systematic literature review and research agenda

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Patient Perceptions of Servicescape in Healthcare: A Systematic Review of the Literature

Affiliation.

• 1 Anadolu University, Eskişehir, Turkey, and University of Alabama at Birmingham assistant professor, Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham associate professor, Department of Health Services Administration, University of Alabama at Birmingham.
• PMID: 29533318
• DOI: 10.1097/JHM-D-16-00014

Many hospitals are competing for survival in their service areas. Because of intense competition within markets, hospitals are developing strategies to differentiate themselves. One way to do so is to create a physical infrastructure and service environment that generate a positive impact on patient perceptions. The purpose of this study is to review the literature on servicescape (i.e., a total impression of a service encounter developed through the use of human senses) and its effects on service quality and patient outcomes in healthcare settings. Servicescape studies have taken place in various healthcare settings (i.e., teaching hospitals, dental clinics, outpatient clinics) in 10 countries. Although servicescape in healthcare settings is a rarely researched topic at both the national and international levels, research indicates a significant positive association between servicescape and patient perceptions, patient satisfaction, and patient emotions. In light of the increasing emphasis in quality and value-based purchasing initiatives on patient experience and outcomes, more servicescape research in healthcare settings is needed. This systematic review underscores this need and enhances the knowledge base in this area.

Publication types

• Systematic Review
• Economic Competition*
• Health Knowledge, Attitudes, Practice*
• Patients / psychology*
• Surveys and Questionnaires

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Servicescapes: The Impact of Physical Surroundings on Customers and Employees

1992, Journal of Marketing

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Purpose This paper aims to explore the evolution of the service environment literature and speculates about future research in this area. This paper focuses on studies regarding how the interior and exterior environments of physical service settings (including retail stores) influence consumer response. Web atmospherics are not covered in this paper. In addition, while a number of studies have been conducted on retail and service atmospherics elements in other disciplines, such as environmental psychology and leisure and hospitality, the focus is on research published in marketing and consumer-related journals. Design/methodology/approach This paper reports the results of empirical studies; however, as there are few empirical studies on the effects of exterior environmental characteristics (e.g. storefronts) in marketing, two conceptual papers on this topic will be reviewed to set the stage for future research on exterior design. Findings Over the past 40 years, there has been a pro...

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Although management scholars have devoted considerable effort to researching the effects of servicescapes [Bitner, M.J. (1992). Servicescapes: The impact of physical surroundings on customers and employees. Journal of Marketing, 56(2), 57–71] on customer behavior, we still lack an up-to-date systematization of both theoretical and empirical findings. This paper aims at filling the gap with a systematic literature review based on rigorous criteria. In reviewing the 188 selected papers, attention has been devoted to an in-depth analysis of new research paths on the topic. Our research findings contribute to a deep understanding of the link between customer behaviors and new ways of interpreting specific features of the servicescape. We believe these implications are valuable for both managers and scholars.

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PurposeThe aim of this paper is to identify and describe important dimensions of the service process as defined by customers, and to compare the results from a specific use context with the recent conceptualization of the experience room.Design/methodology/approachPublic transport travellers were provided with a public transport travel diary and were encouraged to make detailed notes about their service experience during their journey. The diaries were than transcribed and coded in NVivo8 using a constant comparative method.FindingsThe qualitative analysis of the public transport travel diaries revealed six emerging themes of service experience: customer processes, other customers, physical environment, contact personnel, provider processes and wider environment. The interplay between these themes is what forms the service experience of customers. The inductive analysis of the empirical material contextualizes the experience room model in a utilitarian and facility‐driven service. T...

Treasa kearney

Centre for Real Estate Studies

Syarah Syazwani Arifin , Izran Sarrazin Mohammad

Facilities management (FM) is a vital function in order to create an environment that strongly supports the core business of the organization. To keep the business interesting, the servicescape in an environment should be well suited to the consumers. Servicescape needs by building or organization in order to deliver the services. Most of the studies that are related to servicescape have mostly from the marketing area. There are lacks study in FM area and limited research on the servicescape in FM context. More studies are needed to examine servicescape and in this paper, the researcher has focused on the FM context. Servicescape and FM are interrelated. Servicescape refers to the physical environment that is manmade environment while FM is responsible to create a pleasant environment that encompasses servicescape elements. Thus, the aim of this paper is conducted to understand the servicescape in facilities management (FM). This research adopts a comprehensive literature review from numerous published sources. All related references were discovered through an electronic database, journals, and books. The literature review is utilized to identify the definition of servicescape, elements of servicescape, and impact of servicescape on business performance. The elements of servicescape have been classified into four dimensions which are ambient condition, spatial layout and functionality, sign, symbol and artifacts, and cleanliness. Servicescape as efficient elements used to impact business performance. The elements of servicescape will impact on customers' action, which leads them to approach or avoid after experience in that environment. Hence, this paper provides new information and added value to the facility management context. Kennedy, 2012)  The role of servicescape and image perceptions of customers on behavioral intentions in the hotel industry (Durna, Dedeoglu, and Balikçioglu, 2015)  Servicescape attributes and consumers well-being (Sheng, Siguaw, and Simpson, 2016)

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Syarah Syazwani Arifin

Servicescape is known as a physical environment, which is a man-made environment, while facilities management (FM) is responsible to create a pleasant environment that encompasses servicescape elements. In the FM context, a lot of research on the impact of the servicescape are limited and are still lacking. The purpose of this study is to provide a literature review on measuring the impact of elements in servicescape on business performance. The methodology that was used for this paper consisted of a comprehensive literature review from numerous published sources; all the related references were discovered through electronic databases, journals, websites, and books. The literature review is utilised to examine the elements of servicescape and to measure the impact of servicescape elements on business performance. Specially, servicescape consists of four elements, they are ambient condition, spatial layout and functionality, sign, symbol and artifacts, and cleanliness. As such, the impact of elements in servicescape is the way people perceived the functionality of the surroundings. The individual internal responses such as comfort, pleasantness due to the environment, feeling of being safe, and happiness are strongly influenced by the servicescape elements. Accordingly, the result of this study will benefit the managers, facilities managers, investors, and the financial departments in their decision making in order to improve the performance of the organisation. This paper focuses solely on measuring the impact of elements in servicescape that are scarce in current studies. Hence, this paper makes an attempt to provide new information and added value to the investors, stakeholders, and the facilities management on the importance of the impact of the servicescape elements.

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Keywords Physical environment Servicescape Perceived value Hedonic approach Utulitarian approach Customer satisfaction Abstract Global competition in 21st century has made essential firms to differentiate from their competitors. Pyhsical environment elements in this needed differentiation have an important role. The physical environment, either in the differentiation of the atmosphere, changing the total perception of the product or creating the first impression in order to provide preferred, has become a strategic factor preferred by businesses. This paper aims to examine the effects of the physical environment on perceived value, customer satisfaction and loyalty in the context of the first class restaurants. In this sense, the data were collected by survey from customers who prefer first class restaurants which have tourism establishment certificates in İstanbul. A total of 425 usable questionnaires were analysed with Structural Equation Modeling. According to findings, servicescape has a positive influence on perceived value and perceived value has a positive moderating effect on customer satisfaction. Also customer satisfaction has a positive influence on customer loyalty. The fact that this study is the first to measure the effects of physical environment on both hedonic and utilitarian approaches so it reveals the specificity of the study Customer loyalty

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Exploring Territorial Elements in Servicescape: A Comprehensive Literature Review

• Wang Chunhui Management and Science University, Selangor, 40100, Malaysia
• Ooi Boon Keat Management and Science University, Selangor, 40100, Malaysia

This article aims to conduct a comprehensive literature review to delve into the territorial elements within servicescape. In the service industry, customer territoriality can reflect a customer’s identification with the business, enhance their purchasing inclination, or, conversely, lead to strong defensive or retaliatory behaviors towards other customers or employees, significantly affecting business operations. Understanding customer territoriality is crucial for comprehending customer behavior. The article begins by introducing the concepts of servicescape and territoriality, followed by the identification of territorial elements within servicescape. The literature review encompasses research on various aspects of servicescape, including physical factors and social factors, with the aim of revealing how territorial elements influence customer behavior and experiences. Through this literature review, we provide profound insights into territorial elements within servicescape, underscoring their importance for service quality and customer satisfaction. These research findings are expected to offer practical information to practitioners and researchers on optimizing servicescape to enhance customer experiences. Finally, we discuss future research directions to advance the understanding of territorial elements in various servicescape.

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5 Steps to Writing a Hassle-Free Literature Review

When you're tasked with writing a lengthy academic study such as a journal article, thesis or dissertation, a literature review will likely be a part of that process. The literature review portion of your research is perhaps one of the most difficult sections to write. A well-written literature review will provide a summary of the scholarly sources you've used in your research. It will also summarize the current knowledge and scholarship surrounding the topic you've chosen to study in more depth, including any patterns, themes, or gaps that are in the research. If the research you plan to conduct will fill any of these gaps, the literature review should mention that, as well.

Depending on the type of writing that will be required, your literature review could be a separate chapter, or it could part of the introduction or part of the theoretical framework . In some cases, a literature review might be written on its own as a survey of scholarly knowledge on a topic. However, in either case, here are the five steps to writing a hassle-free literature review.

Step 1—Narrow your topic

One of the first and easiest mistakes to make when writing a literature review is to start with a topic that is too broad. Since the literature review will provide a foundation for your research, it needs to be narrowed enough to provide a solid one.

For example, let's say you want to research the topic of childhood obesity. Obviously, there will be hundreds of scholarly sources that focus on that topic, so trying to summarize all of them would be not only difficult—it would be useless for the purposes of your own research.

However, you can break that topic down even further to narrow the scope of your research. For example, instead, you could research "childhood obesity and social development among middle-school-aged children." With this narrowed topic, the scholarly research you find will include all (or most) of the important keywords of your research: childhood obesity, social development, middle school. That makes your search for pertinent, relevant research a much easier task.

Step 2—Gather your sources and pick the right ones to use

Now that you have a narrowed topic, step two will be much easier than it would have been otherwise. In this step, you find recent, relevant research that includes your keywords and informs your knowledge on the topic. While reading the most recent scholarly articles or books, you'll begin to notice certain studies or theories that the authors consistently refer to as a foundation for their own study. This is usually a good indicator that you should include those previous studies and theories in your own literature review, to provide your readers with a summary of the most relevant ideas surrounding that topic.

To put it simply—determining which sources you will include in your literature review is really a matter of: 1) knowing how to identify the important, foundational ("landmark") studies that have been conducted and 2) knowing how to identify current, relevant studies.

Landmark studies

If you're researching in a field you've studied extensively already, you're likely to already know the relevant research that is important to note, otherwise known as "landmark studies." For example, in the field of Education, the early childhood development research of Jean Piaget, Erik Erikson, and John Dewey are foundational in almost any research related to a child's development. Therefore, many literature reviews will mention them and briefly summarize what they added to the scholarly knowledge foundational to the topic.

Current studies

While it's impossible to read everything that's published relating to a topic—even a narrow one—you can find the relevant research by noticing the attention it's getting and the number of times it's been cited in other studies. You can use several websites to discover how many times an article has been cited and this article provides easy links and instructions on how to do this.

However, just because an article or book has been often cited doesn't mean you have to use it for your own research. You can find other relevant articles by looking through abstracts and determining if the research is both credible and useful for your own. You should also use this opportunity to see if there is perhaps a gap in the research—something that needs to be explored that hasn't been thoroughly explored by other researchers. Or, is there a different approach you want to take in your own methodology that will close a gap or answer a question that is still out there in the scholarly writing available on your topic?

Step 3—Find connections, patterns, disagreements, pivotal changes and gaps

Now that you've determined which sources you plan to use, you can begin reading over them in more detail to look for connections, patterns, disagreements, pivotal changes and gaps in the literature. It's important at this step to find trends that keep showing up as you read, as well as themes that arise. You'll also want to note where different researchers agree or disagree, and why there is a discrepancy in their understanding or hypotheses.

You might also find that a certain past study changed scholarly discourse in a major way. That would be a pivotal moment to note in your literature review, since it is foundational in the overall scholarship surrounding the topic.

Finally, you want to find and acknowledge any gaps you note in the literature. For example, for our "childhood obesity and social development among middle-school-aged children," you might find that none of the research you've come across seems to take into account comorbidity of obesity and mental health issues in middle-school-aged children. Therefore, it's a gap in the research that you can address in your literature review and potentially fill in your research.

Step 4—Determine how you will organize your literature review

Now that you know which sources you plan to use to compile your literature review (and thus, inform your own research), it's important to organize the summary of these sources to make your analysis easier for your reader to follow.

Chronological

This is one of the easiest and most popular ways to organize a literature review. It's easy to do because you simply mention each source in the order it was published, beginning with the earlier, landmark studies. However, the problem with this organizational structure is it's easy to just list your summaries, one after the other, without pointing out any patterns or themes that occur among them. You'll need to focus on showing how the scholarship has changed and evolved over the years, as well as mention any important turning points that might have occurred.

Theoretical

Since the sources you have been reading have all resulted in a theoretical analysis or hypothesis, you can organize your literature review from a theoretical standpoint, showing how the framework was built. If there is a certain theoretical approach to your topic of study that you prefer above others, this might be the best way for you to organize your literature review.

Thematic organization of your literature review is the best way to approach it if you want to point out various themes that have come up in your exploration of the topic. For example, returning to our previously mentioned topic, "childhood obesity and social development among middle-school-aged children," we might find multiple themes that arise, such as "forming friendships," "self-confidence," "bullying," and "family bonds." If we want to study the topic within these four themes or parameters, a thematic-organized literature review will be the best bet.

Methodological

Methodological organization for your literature review will focus on the various methodologies used in prior studies and mention each based on that factor. For example, you might first look at quantitative studies that were done on the topic, then look at qualitative ones, comparing the results of both. Or, you might first analyze literature that shows empirical methodologies, then analyze a more theoretical approach.

Step 5—Write your literature review

Now that you've gone through the other steps, this should be the easy part. As you write, remember that your task is to summarize and synthesize all relevant scholarly work on your topic, while also analyzing any gaps, patterns, inconsistencies, or themes that emerge.

Note that as you write, you need to remain as critical and objective as possible in your overview of literature. If you feel that there were biases and you have a substantial case to make with it, include your analysis on that fact. If you feel that certain studies had stronger methodologies or frameworks than others, mention that, as well. The point of a literature review is to let your reader know that you have researched your topic in depth and have a credible, solid foundation from which to continue that study or pose hypotheses connected to it.

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