Thoughts on the Literature Review and GT

Alvita Nathaniel, DSN

Thinking about epistemic questions always reminds me
of Socrates’ cave allegory. In Plato’s most famous book,
The Republic, Socrates talks to a young follower named
Glaucon. I would like to include here a short excerpt of
their conversation and discuss how this relates to my
thoughts about preceding a classic GT study with a
thorough literature review.

[Socrates] Imagine human beings living in a
underground, cave like dwelling, with an entrance a
long way up, which is both open to the light and as
wide as the cave itself. They’ve been there since
childhood, fixed in the same place, with their necks
and legs fettered, able to see only in front of them,
because their bonds prevent them from turning their
heads around. Light is provided by a fire burning far
above and behind them. Also behind them, but on
higher ground, there is a path stretching between
them and the fire. Imagine that along this path a
low wall has been built, like the screen in front of
puppeteers above which they show their puppets

[Glaucon] I’m imagining it.

[Socrates] Then also imagine that there are people
along the wall, carrying all kinds of artifacts that
project above it—statues of people and other
animals, made out of stone, wood, and every
material. And, as you’d expect, some of the carriers
are talking, and some are silent.

[Glaucon] It’s a strange image you’re describing,
and strange prisoners.

[Socrates] They’re like us. Do you suppose, first of
all, that these prisoners see anything of themselves
and one another besides the shadows that the fire
casts on the wall in front of them?

[Glaucon] How could they, if they have to keep
their heads motionless throughout life?

[Socrates] What about the things being carried
along the wall? Isn’t the same true of them?

[Glaucon] Of course.

[Socrates] And if they could talk to one another,
don’t you think they’d suppose that the names they
used applied to the things they see passing before

[Glaucon] They’d have to.

[Socrates] And what if their prison also had an
echo from the wall facing them? Don’t you think
they’d believe that the shadows passing in front of
them were talking whenever one of the carriers
passing along the wall was doing so?

[Glaucon] I certainly do.

[Socrates] Then the prisoners would in every way
believe that the truth is nothing other than the
shadows of those artifacts.

[Glaucon] They must surely believe that.

[Socrates] Consider, then, what being released….
What do you think he’d say, if we told him that what
he’d seen before was inconsequential…. …if we
pointed to each of the things passing by, asking
what each of them is, and compelled him to answer,
don’t you think he’d be at a loss and that he’d
believe that the [shadows] he saw earlier were truer
than the [objects] he was now being shown? (Plato,
trans. 1997)

There is more to the story, of course. Light at the
opening of the cave represents knowledge. The people
chained at the bottom of the cave are situated as far from
knowledge as they could possibly be. As they sit there,
they begin to interpret meaningless clues and to attach
meaning to them. Given enough time, they will surely
develop theories and then, if released, go off somewhere to
teach and write about them—or so I imagine. The other
people in the cave are climbing to the opening, moving
toward true knowledge. Coming out of the cave, or even
moving toward the opening, these people can see what is
real—not a flickering shadow obscured by smoke, but the
object as it really exists. This suggests that anyone who
seeks true knowledge must move toward the light where
phenomena are clearly visible.

How can we relate this ancient allegory to a discussion
about literature review and grounded theory? I believe it
relates in two ways. First, one can gain knowledge about
particulars only if they are clearly seen and honestly
portrayed. Glaser (1978) wrote that the goal of grounded
theory “is to generate a theory that accounts for a pattern
of behavior which is relevant and problematic for those
involved” (p. 93). From this grounded source, (i.e., those
involved) we gather evidence that can be best trusted. This
inductive method perhaps confuses many PhD dissertation
committees who are more comfortable with deduction.
Second, untrustworthy data and flawed interpretation
hinder understanding of the phenomenon. Thus, the
investigator should not contaminate grounded theory with
non-grounded data, deductive conclusions, or mediated
beliefs of others. Extant literature holds the potential to
mislead the grounded theorist since even extremely
respected leaders in any discipline can be extremely
mistaken. Glaser (1978) makes this point clearly.
Grounded theory should not be corrupted by received
ideas, preconceptions or logical elaboration. Valid grounded
theory emerges from systematic data gathering and
rigorous analysis.

This is not to suggest that it is possible for any person
to begin the grounded theory process as a tabula rasa.
Original research and theory building are reserved for those
at the pinnacle of their fields. Years of study and practical
experience create an investigator/analyst with a breadth
and depth of discipline-specific knowledge. I suggest that
along with this understanding comes a measure of curiosity
and motivation to fill in the gaps, to understand what is
heretofore unknown. At this place, this gap in what is
known, inquiry begins. We must understand that these
gaps are only visible to one who has a sweeping
perspective of the larger body of knowledge. Therefore, the
person doing GT necessarily possesses a broad and general
knowledge of the literature when the process begins—
having spent time and effort climbing out of the cave,
toward the light, so to speak.

I offer one word of caution related to the literature.
Knowledge of the literature imparts a discipline-specific
language. When the investigator begins to formulate a
research proposal, he or she should step back and make an
objective non-partisan examination of the concepts and
words used in the research proposal and those that may be
used in qualitative interviews. Professional language is
replete with jargon, loaded words, easily misunderstood
words, or words that have different meanings to different
people. Thus, even a general overview of the literature can
influence the data if words derived from it are not used
carefully. For example, when I interviewed participants for
my theory of moral reckoning in nursing, I purposely
avoided using the term moral. A very astute member of my
dissertation committee brought the problem to my
attention. Would participants think of moral in terms of
moral vs. immoral, religious doctrine, or professional
ethics? I did not know. So, in the interviews, I used the
term troubling, a vague term that has little disciplinespecific
meaning. Use of the word troubling elicited exactly
the type of information that I needed without confusing the
issue with an Ambiguous, easily misunderstood term
(Nathaniel, 2004).

What is the best use of extant literature? Glaser
suggests that once the analysis is well underway, the
grounded theorist may use the literature to support and
illustrate the emerging theory. Thus, if the emerging theory
is similar to extant literature, the two independently
generated works support and strengthen each other. Since
GT is modifiable, i.e. composed of a set of tentative
hypotheses, a discussion of the dissimilarities is productive
in that it can serve to be selfcorrecting. This is very similar
to what philosopher Charles Sanders Peirce suggested
about use of the scientific method. Peirce proposed that
the scientific method (including GT) moves humankind
toward the final opinion (Houser & Kloesel, 1992). Thus,
each work adds to or corrects those before it leading us
closer to knowledge that is true and correct.

The grounded theorist can also use the literature to
complete the theory, especially if extant grounded theory is
available. Glaser and Strauss (1967) suggest that
sometimes in the final write up, grounded theorists
discover gaps in the theory. If the information sources are
no longer available or if time or funding restraints makes it
unreasonable to resume field work and if the extant
literature can reliably be used to fill in the gaps, using the
literature is a good solution.

Finally, the grounded theorist can use the emerging
theory to refute established, deductive, preconceived
theory. Glaser, himself, taught me this lesson. I struggled
to reconcile a non-grounded theory that seemed
incongruent with my emerging theory. Glaser suggested
that my fledgling theory, because it was grounded in the
data and based upon information obtained from people for
whom the problem was “relevant and problematic,” easily
refuted the extant theory, which was based upon nothing
more than unsubstantiated logic—smoke on the cave wall.

What should the PhD candidate do if the dissertation
chair, committee, or examiners request a thorough
literature review prior to data gathering? In a practical
sense, the candidate seeks to obtain the degree and thus
needs to satisfy the requirements of the examiners. This
problem occurs very frequently and may be unavoidable
since literature review is often part of the predissertation
course work. If required, the PhD candidate should
complete a thorough literature review with an objective
perspective. It may take a period of time, perhaps a few
months, before the student theorist is able to disassociate
his or her mindset from established ideas and concepts.
However, this is a necessary step since ideas in the
literature may otherwise derail the emerging theory. The
grounded theorist allows the theory to emerge from the
data, rather than support or refute established ideas. As
this occurs, the theory may turn in unexpected directions,
rendering the initial literature review irrelevant. If this
happens, the student remains open to the emerging
theory. After the theory develops, the student should
perform a more pertinent literature review, thus completing
the circle.

In conclusion, the grounded theorist should avoid a
thorough literature review before beginning the GT process
in order to avoid contamination from mediated beliefs,
preconceptions, distorted values, and false premises. The
grounded theorist should use the literature to support,
corroborate, and illustrate the emerging theory. Once the
grounded theorist understands the emerging theory, the
extant literature is a wonderful place to go for
substantiation and for examples to weave into the
emerging theory. As the theory fully emerges, it becomes a
powerful instrument which can clarify, synthesize, and
organize prior grounded theories and refute flawed
theories, thus moving closer to a clear understanding of the


Alvita K. Nathaniel, DSN, APRN, BC
Coordinator of Family Nurse Practitioner Track
Assistant Professor
West Virginia University, School of Nursing
3110 MacCorkle Avenue, SE
Charleston, West Virginia 25304


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grounded theory: Theoretical sensitivity. Mill Valley,
CA: Sociology Press.

Glaser, B. G., & Strauss, A. L. (1967). The discovery of
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Houser, N. & Kloesel, C. (Eds.). (1992). The essential
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Nathaniel, A.K. (2004). A grounded theory of moral
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Plato. (trans. 1997). Republic. (G. M. A Grube, C. D. C
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