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International
Perspectives on
Undergraduate
Research
Policy and Practice

Edited by
Nancy H. Hensel · Patrick Blessinger
International Perspectives on Undergraduate
Research
Nancy H. Hensel • Patrick Blessinger
Editors

International
Perspectives on
Undergraduate
Research
Policy and Practice
Editors
Nancy H. Hensel Patrick Blessinger
Laguna Woods, CA, USA International Higher Education
Teaching and Learning Association
New York, NY, USA

ISBN 978-3-030-53558-2    ISBN 978-3-030-53559-9 (eBook)

https://doi.org/10.1007/978-3-030-53559-9

© The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer
Nature Switzerland AG 2020
This work is subject to copyright. All rights are solely and exclusively licensed by the
Publisher, whether the whole or part of the material is concerned, specifically the rights of
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microfilms or in any other physical way, and transmission or information storage and retrieval,
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The use of general descriptive names, registered names, trademarks, service marks, etc. in this
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exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information
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 Foreword to International
Undergraduate Research

From the United States to the United Arab Emirates, undergraduate

research (UGR) is capturing and maintaining the focused attention of uni-
versity faculty, administrators and especially of students. International
Undergraduate Research demonstrates why. The thinking required by, and
developed through, UGR is valuable not only to those within the univer-
sity, but increasingly to employers and politicians who want graduates with
the capacity to solve issues of current concern to society, entrepreneurs
who craft whole new ways of working in the world.
There are common challenges across the book’s chapters of inadequate
university budgets and lack of country-wide mandate, but the diversity of
approaches to deal with these and other issues is a big illuminating feature
of the book. For example, numerous chapters view UGR in terms of its
capacity to build disciplinary knowledge and Makhanya emphasises the
need for UGR knowledge development to align to national socio-­
economic challenges and priorities. Elshimi, however, provides a contrast
of emphasis for Egyptian UGR, shifting from the more common focus on
building the discipline to solving the problems of pressing community and
environmental issues. In all chapters, however, UGR is seen to result in
substantial, sometimes life-changing, skills and attitudes of research that
students develop and apply broadly and deeply on graduation.
Blessinger and Hensel note that UGR has been declared a high-impact
practice, yet the nature of the impact depends on how effectively UGR is
implemented. Sengupta and Blessinger consider UGR in India, Malaysia
and Iraq and note that determining the impact of UGR remains a

v
vi Foreword to International Undergraduate Research

challenge in most countries. However, knowing the nature of, and limita-
tions to, UGR impact is vital to work on context-sensitive ways of improv-
ing it, whether through tweaking, adaptation or implementation of new
models. There is the possibility of negative impact through bad experi-
ences, such as under-equipped mentors, poor scaffolding of skills needed
for research projects in the curriculum or even culturally unaware
implementations.
Because of the risk of sub-optimal UGR, various chapters deal with
mechanisms for improving the teaching/supervision aspects of
UGR. Makhanya provides understanding about professional development
and Donnelly, McAvinia and McDonnell focus on peer learning. The for-
mation of UGR societies, following on from the Council on Undergraduate
research in the USA, has emerged in regions such as Australasia (Brew and
Mantai), but such formation is noted as lacking in the majority of chap-
ters. Readership groups, such as university clusters in one country, will be
interested to read factors that have led to the development of UGR societ-
ies and factors that have been inhibitive of them. However, the role of
such societies on the upskilling of faculty and the long-term impact on
student learning is in need of research attention.
While some countries have focused on the model of mentored UGR
that relies on faculty research agendas, others are more invested with in-­
curricular models, and still more countries entertain blended or multiple
models. However, there are challenges with evaluating the impact of dif-
ferent models of UGR, and Wuetherick considers the state of play in
Canada of mentored and curriculum-embedded models. Mentored mod-
els have the challenge of accounting for UGR outcomes not just com-
pared to other models of learning, but with reference to increased
resourcing and its direct or indirect costs. A major issue, then, for global
UGR, is the sustainability of mentored models when compared to in-­
curricula models. Hybrid models that, for example, use students with
experience of UGR to mentor less experienced students also need to be
researched.
Issues of equity, including of who gains access to UGR and who is able
to persist, and benefit are vital for determining impact. This is particularly
important in mentored UGR, which has limits to involvement and, typi-
cally, selection criteria for inclusion. Chng Huang Hoon and Siew Mei
focus on the more inclusive model of UGR embedded in the curriculum
in Singapore, which provides opportunities for all. However, this model
too has challenges for evaluation. The curriculum space occupied by UGR
 Foreword to International Undergraduate Research  vii

has its own costs, for example in terms of reduced content coverage, and
evaluation of impact must take into consideration controversies of content-­
covering versus skills-based curriculum.
There is a variety of experiences in the book in terms of how long since
UGR was first promoted explicitly in the country of focus, with the USA
(Ambos) witnessing an evolving clear mandate over more than four
decades that has included engagement with, and funding from, the
nation’s Congress. Ironically, Germany (Deicke and Mieg), the homeland
of the Humboldtian model of research universities, has not had under-
graduate enrolment until recent times, so the chapter provides insights for
a system just starting to promote UGR, as does the chapter on Japanese
UGR (Imafuku). New Zealand (Spronken-Smith) has national legislation
that calls for close links between teaching and research, yet its university
system nevertheless provides patchy opportunities for UGR.
Taken together, the book does not imply one superior model for UGR,
but rather the need for creative and thoughtful implementations that are
context-savvy and that embrace a willingness to improve and improvise.
As this book is readied for publication in the dark days of the COVID-19
crisis, I commend the ambition and dedication that the authors convey for
the development of graduates who will light the way through their contri-
bution to solving each country’s and our global problems using the skills
and attitudes that they learn in UGR.

Adelaide, Australia John Willison

 April 2020
14
 Preface

Undergraduate research is becoming part of the student research experi-

ence for students in many countries. Undergraduate research is not a new
pedagogy. Its history is often/widely attributed to the work of Wilhelm
von Humboldt, who founded the University of Berlin in 1810. Humboldt
stressed an educational approach that unified teaching, learning, and
research, and the continuing process of inquiry. American universities, as
with most universities around the world today, grew out of the German
model. For instance, in the United States, the Massachusetts Institute of
Technology (MIT) began formally involving undergraduate students in
research in 1969. After Professor Margaret MacVicar founded the
Undergraduate Research Opportunity Program at MIT, many other US
institutions began similar programs over the next few years.
The Council on Undergraduate Research was founded in the United
States in 1978 to assist colleges and universities in developing undergradu-
ate research programs and advocating for federal funding to establish
undergraduate research programs. While there are common roots for the
concept of undergraduate research, there is no consensus within the inter-
national community of scholars on its parameters. It is the differences in
emphasis, program implementation, funding, and policies that make the
study of undergraduate research across the globe both an exciting topic
and a resource for future program development and implementation.
While approaches to student research vary, there is however common
agreement that undergraduate research positively impacts student learn-
ing and contributes to career preparation.

ix
x Preface

The purpose of this book is to explore the implementation of research-­

based teaching and learning in countries around the world. International
collaboration in high-impact, experiential learning is a significant interest
of both editors. Patrick Blessinger founded HETL (International Higher
Education Teaching and Learning Association) to advance the scholarship
and practice of teaching and learning around the world. He has brought
together international scholars to engage in cutting-edge research to
develop innovative practices in global higher education, including high-­
impact areas such as inquiry-based learning, education for sustainable
development and social responsibility, university partnerships, equity,
inclusion, and leadership. Under his leadership, HETL has grown into
one of the largest and most active research networks of educators around
the world. While Nancy H. Hensel was the executive director of the
Council on Undergraduate Research (CUR), she invited practitioners and
scholars of undergraduate research from many countries to contribute to
the CUR Quarterly and participate in CUR activities. During her leader-
ship, CUR began several international collaborations.
Blessinger and Hensel identified leading educators from 15 countries
to contribute to this book. As they identified potential authors, they
wanted a range of perspectives on undergraduate research. They also
wanted to include countries from every continent (except Antarctica).
They approached scholars whom they knew to be involved in undergradu-
ate research and were leaders in their field. They asked them to consider
how student research is defined in their country, organizations that might
support student research, national policies and initiatives for student
research, and curricular models for implementing undergraduate research.

Chapter Summaries
In Chap. 1 Patrick Blessinger and Nancy H. Hensel discuss how the
demand for global higher education of all types has increased significantly
over the past few decades and how this has prompted educational leaders
to enlarge and improve their educational offerings by developing a more
learner- and learning-centered approach to education in order to increase
student engagement. An increasing number of educational institutions
around the world have implemented undergraduate research because it has
been shown to be a high-impact learning activity for students, if designed
 Preface  xi

and implemented properly. This chapter discusses the common elements of

successful undergraduate research programs and the common factors that
should be considered when designing and implementing such programs.
Based on the research from the chapters in this book, the authors propose
a generalized undergraduate research model that can be used in a variety of
contexts across institutions and grade levels and disciplines.
In Chap. 2 Elizabeth L. Ambos discusses how undergraduate research
in the United States has grown in concert with the development of the
Council on Undergraduate Research (CUR).
The author discusses the history of CUR and its role as a leader in pro-
moting CUR around the world as well its plan to diversify and expand its
role in the future.
In Chap. 3 Angela Brew and Lilia Mantai discuss the development of
undergraduate research in Australia over the past decade. The authors
explain the challenges in developing a culture of undergraduate research
in higher education institutions in Australasia. For instance, they explain
that creating the Australasian Conferences of Undergraduate Research
was important in establishing undergraduate research in Australasia and
how the use of seminars and workshops helped raise awareness of under-
graduate research across Australasia and how these efforts led to the estab-
lishment of the Australasian Council for Undergraduate Research as a
membership organization.
In Chap. 4 Chng Huang Hoon and Wu Siew Mei define undergraduate
research as a student-centered inquiry that makes an original academic or
creative contribution to a discipline. In this chapter, the authors discuss
undergraduate research within the context of National University of
Singapore across the disciplines of engineering, science, computing, and
arts and social sciences. The authors argue that it is possible to create sym-
biotic connections between university research and student education by
integrating undergraduate research and learning into the curriculum and
across disciplines.
In Chap. 5 Amani Elshimi discusses undergraduate research practices at
different universities in an attempt to identify an overarching strategy and
guiding vision. The author explains that most Egyptian universities focus
undergraduate research on problem-solving for environmental and commu-
nity issues where the student learning experience is shaped within the context
xii Preface

of economic development. The author uses the American University in Cairo

as a case study and examines the goals, infrastructure, funding, staffing, and
outreach of the program. The author highlights the area of university part-
nerships as well as the alignment of objectives of different units across campus
as key factors for undergraduate research success.
In Chap. 6 Rintaro Imafuku provides an introduction to undergradu-
ate research in Japan and discusses the future of undergraduate research
in Japan. The author discusses how Japanese higher education institu-
tions have emphasized final- year projects but have increasingly adopted
undergraduate research across disciplines as an effective pedagogical
approach. The author discusses the challenges associated with imple-
menting undergraduate research such as the absence of a supporting
organization. The author recommends developing a community of
practice that will allow professors to share their experiences and best
practices.
In Chap. 7 Enakshi Sengupta and Patrick Blessinger discuss the benefits
and challenges of undergraduate research as presented in the academic
literature. The time needed to implement undergraduate research is sig-
nificant. The authors focus on undergraduate research in India, Malaysia,
and the Kurdistan region of Iraq. They discuss the results of survey of
faculty members teaching undergraduate students and the faculty experi-
ences are discussed. The findings of the survey suggest that undergraduate
research programs in these countries have been limited as a result of finan-
cial constraints and lack of support staff.
In Chap. 8 Ana Lucia Manrique and Douglas da Silva Tinti discuss how
Brazil has implemented scientific initiation research programs to support
undergraduate research. The authors discuss the results of a survey on the
implementation of undergraduate research related to the faculty supervi-
sor’s projects and lines of research.
In Chap. 9 Roisin Donnelly, Claire McAvinia, and Claire McDonnell
discuss the impact of faculty and student learning related to sharing
inspirational practices and creating multimedia at a university in
Ireland. The authors discuss the increasing demand for professional
 Preface  xiii

development, the importance of a peer learning, the development of

multimedia artifacts for undergraduate supervision, and the national
context for this type of work.
In Chap. 10 Mandla S. Makhanya discusses three areas for integrated
research development: niche research themes aligned to national socio-
economic priorities, targeted development of inter- and transdisciplinary
research, and of higher education institutions. Makhanya discusses the
preparation of researchers who will help level the global research playing
field and contribute to national development.
In Chap. 11 Isabelle Mirbel and Margarida Romero discuss how a
national research ecosystem has been developed to promote excellence in
academic research. The authors note that a research-­oriented curriculum
at the undergraduate level has yet to be considered at a national policy
level. The authors also note that, in spite of this, various initiatives exist
within higher education institutions to encourage the participation of
undergraduate research activities. The authors discuss current initiatives
for engaging undergraduate students in research projects, especially those
research activities that develop the research competencies that allow
undergraduate students to engage in research after graduation.
In Chap. 12 Wolfgang Deicke and Harald A. Mieg discuss how the
Bologna Reform process and the introduction of a two-cycle BA/MA
degree system impacted the German higher education system. The authors
highlight how policy initiatives such as the Quality Pact for Teaching
(QPT) facilitated new approaches to research-based teaching and learning
in German higher education since 2012.
In Chap. 13 Jase Moussa-Inaty discusses how the global trend of stu-
dents engaging in undergraduate research holds true in the United Arab
Emirates (UAE) as well. The author discusses how undergraduate research
in the UAE is recognized as an important part of student learning and
engagement. The author discusses some of the most recent attempts made
to encourage undergraduate research.
In Chap. 14 Rachel Spronken-Smith discusses recent legislation that
calls for a close link between research and teaching at New Zealand uni-
versities and how this new legislation has put a renewed focus on creating
more and higher-quality undergraduate research programs. Yet, the author
notes that opportunities for undergraduate students to engage in research
xiv Preface

are limited. The author also notes that only a fraction of undergraduate
programs scaffold the development of research skills throughout the cur-
riculum toward a culminating capstone project. As a result, notes the
author, although undergraduate research is pervasive across New Zealand
universities, it is not always well supported.
In Chap. 15 Brad Wuetherick discusses how undergraduate research
has a strong tradition across Canadian higher education institutions. The
author notes that institutions are still challenged to ensure that all under-
graduate students are engaged in high-impact research over the course of
their university experience. Thus, the author explores the state of both
mentored (co-curricular) and curriculum-embedded undergraduate
research experiences at universities across Canada.
In Chap. 16 Luísa Soares discusses the undergraduate research experi-
ence in Portugal. The author explores whether or not undergraduate stu-
dents are cognitively and emotionally mature enough to carry out
high-quality, scientifically rigorous research. The author argues that it is
possible for undergraduate students to carry out rigorous undergraduate
research but it must be accompanied with a solid foundation in ethical
research principles.

Conclusion
The research findings and case studies presented in this book provide an
important knowledge base for those educational professionals thinking
about designing, developing, and implementing undergraduate research
at their own institution as well as those interested in improving an already
existing undergraduate research program. This book not only provides an
overview of undergraduate research—its purpose and principles—but it
also provides an overview of the current undergraduate research landscape
by examining authentic programs and experiences across a diverse set of
higher education institutions around the world. As such, for those inter-
ested in implementing undergraduate research, this book offers a mean-
ingful guide to that end.

Laguna Woods, CA, USA Nancy H. Hensel

New York, NY, USA Patrick Blessinger
 Contents

1 Undergraduate Research as a High-Impact Educational

Practice  1
Patrick Blessinger and Nancy H. Hensel

2 Undergraduate Research in the United States: Diversity,

Growth, and Challenges 19
Elizabeth L. Ambos

3 Turning a Dream into Reality: Building Undergraduate

Research Capacity Across Australasia 39
Angela Brew and Lilia Mantai

4 Undergraduate Research in the University Curriculum:

An Institutional Perspective 57
Chng Huang Hoon and Wu Siew Mei

5 Preliminary Perspectives on Undergraduate Research in

Egypt 79
Amani Elshimi

6 Undergraduate Research in Japan: Beyond the Dichotomy

of Product-Oriented and Process-Oriented Approaches 99
Rintaro Imafuku

xv
xvi Contents

7 Undergraduate Research from Three Asian Countries115

Enakshi Sengupta and Patrick Blessinger

8 Undergraduate Research in Brazil: A Study of the

Contributions and Challenges for the Education of Young
Researchers131
Ana Lucia Manrique and Douglas da Silva Tinti

9 Finding Inspiration: Sharing Practice and Developing

Authentic Multimedia Artifacts for Supervision of
Undergraduate Research in Irish Higher Education147
Roisin Donnelly, Claire McAvinia, and Claire McDonnell

10 Research in Transforming Contexts: Ensuring Relevance

and Impact177
Mandla S. Makhanya

11 Undergraduate Research in France205

Isabelle Mirbel and Margarida Romero

12 Undergraduate Research in German Higher Education:

Tradition, Policy, and Innovation219
Wolfgang Deicke and Harald A. Mieg

13 A Closer Look at Undergraduate Research in the United

Arab Emirates237
Jase Moussa-Inaty

14 The Status of Undergraduate Research in New Zealand:

Promoted and Pervasive?251
Rachel Spronken-Smith

15 Transforming Undergraduate Research at Canadian

Universities265
Brad Wuetherick
 Contents  xvii

16 Critical Thinking and Scientific Integrity: Are University

Students Ready Enough to Be Engaged?281
Luisa Soares

17 Conclusions and Recommendations295

Nancy H. Hensel and Patrick Blessinger

Index 303
 Notes on Contributors

Elizabeth L. Ambos served as the Council on Undergraduate Research’s

fourth executive officer from 2012 to 2019. From 2006 to 2012, Ambos
was assistant vice chancellor for research initiatives and partnerships for the
California State University system. Prior to that, she held positions
at California State University, Long Beach, including Associate Vice
President for research, Graduate Dean, Associate Dean in sciences,
and Geology Professor. Ambos received her AB in Geology from
Smith College and her MS and PhD from the University of Hawai’i
at Mānoa in Marine Geology and Geophysics.
Patrick Blessinger is an adjunct associate professor of education at St.
John’s University, an educator with the New York State Education
Department, and chief research scientist of the International Higher
Education Teaching and Learning Association (in consultative status with
the United Nations). Blessinger is an educational policy analyst and con-
tributing writer with UNESCO’s Inclusive Policy Lab, University World
News, The Hechinger Report, The Guardian, and Higher Education
Tomorrow, among others. Blessinger teaches courses in education,
leadership, and research methods and serves on doctoral dissertation
committees. Blessinger founded and leads a global network of educa-
tors focused on improving teaching and learning and is an expert in
inclusion, equity, leadership, policy, democracy, rights, and sustainability.
He has received several educational awards, including: Fulbright Senior
Scholar to Denmark (Department of State, USA), Governor’s Teaching

xix
xx Notes on Contributors

Fellow (Institute of Higher Education, University of Georgia, USA), and

Certified Educator (National Geographic Society, USA).
Angela Brew is Emeritus Professor and previously Professorial Fellow in
the Learning and Teaching Centre at Macquarie University, Australia. She
is an elected Fellow of the UK’s Society for Research into Higher Education
(SRHE), a Life Member of the Higher Education Research and
Development Society of Australasia (HERDSA), and an Australian Senior
National Teaching Fellow.
Chng Huang Hoon is Associate Professor of English Language &
Literature and serves concurrently as Associate Provost (Undergraduate
Education) and Director (Chua Thian Poh Centre for Community
Leadership) at the National University of Singapore. She is a member of
the International Society for the Scholarship of Teaching and Learning
(ISSOTL) and currently serves on the ISSOTL Board of Directors as co-
President Elect and was formerly ISSOTL’s Regional Vice President (Asia
Pacific). She is active in promoting SoTL, particularly through the regional
network called SoTL-Asia, which she established with her NUS colleagues
in 2016.
Douglas da Silva Tinti graduated in Mathematics (2006) and
Postgraduate Studies in Applied Statistics (2008) from the Methodist
University of São Paulo. He holds a master’s (2012) and a PhD (2016) in
Mathematics Education from the Pontifical Catholic University of São
Paulo (PUC-SP). He is Professor, Department of Mathematics Education
of the Federal University of Ouro Preto, Minas Gerais, Brazil. His research
interests lie in teacher education and mathematics education.
Wolfgang Deicke read Sociology and Politics at Hamburg University
and later at the Postgraduate School of Peace Studies in Bradford.
Before becoming the coordinator of the bologna.lab at Humboldt-
Universität zu Berlin in 2012, he variedly taught Sociology, Politics
and the History of European Thought and Society at the (now)
University of Northampton, School of Oriental and African Studies in
London and Ruskin College, Oxford. In Northampton and Oxford, he
gained comprehensive experience in course and curriculum develop-
ment and the development of curricula for active learning. His current
 Notes on Contributors  xxi

research interests are the development of (student) research competen-

cies and organizational development in higher education.
Roisin Donnelly is Head of Learning Development for the College of
Business in the new TU Dublin. This role sees her supporting the College
in achieving impact and excellence in teaching and learning through part-
nership and program provision, promoting enhanced [e]learning strate-
gies and Business Education communities of practice. This builds on her
previous positions as Lecturer, Program Chair/Coordinator, Academic
Developer for 18 years and as sectoral Project Manager for the initial
national implementation of the Professional Development Framework for
teachers in Irish higher education. She is a member of the national
Professional Development (PD) Advisory Group established to shape how
the National Forum for the Enhancement of Teaching and Learning
achieves sectoral strategic objectives in relation to PD. She is a fellow of
the UK Staff and Educational Development Association (FSEDA), a fel-
low of the Higher Education Academy (FHEA), and coeditor of the Irish
Journal of Academic Practice.
Amani Elshimi is Senior Instructor of Rhetoric and Composition, and
Founding Director of the Office of Undergraduate Research at the
American University in Cairo. She is a devoted advocate of undergraduate
student scholarship, and an active practitioner of engaging pedagogies,
including community-based learning, senior capstone experiences,
and course-based internships. She has over 25 years of experience in
higher education teaching, faculty development, curriculum design,
assessment, and program administration.
Nancy H. Hensel was the first president of The New American Colleges
and Universities, serving from 2004 until 2011. Previously, she served as
chief executive officer of the Council on Undergraduate Research in
Washington, D.C. for seven years. During her tenure at CUR, she was co-
principal investigator for seven National Science Foundation grants to
assist faculty and institutions develop undergraduate research programs.
She initiated an undergraduate research program at the University of
Maine at Presque Isle where she served as president. Prior to her presi-
dency, she was provost at the University of Maine Farmington and profes-
sor of education and department chair at the University of Redlands.
xxii Notes on Contributors

Hensel holds a doctorate degree in early childhood education from the

University of Georgia, masters’ degrees in theater and early childhood
education from San Francisco State University and a Bachelor of Arts in
theater also from San Francisco State. In 2003, Hensel was inducted into
the Maine Women’s Hall of Fame for her work in promoting higher edu-
cation in Maine and supporting the role of women in higher education.
She is the author of Course-Based Undergraduate Research: Educational
Equity and High Impact Practice and several articles and monographs
about undergraduate research.
Rintaro Imafuku is an assistant professor of Medical Education
Development Center at Gifu University, Japan. He holds an MA (Applied
Linguistics) from Monash University and PhD (Education) from the
University of Hong Kong. His work focuses on interactional and ethno-
graphic exploring of students’ learning in learner-centered inquiry-based
educational environments, including PBL, undergraduate research
and interprofessional education. He is editing a volume on
Interactional Research into Problem-based Learning (with Susan Bridges,
Purdue University Press) and has guest-edited Interdisciplinary
Journal of Problem-Based Learning. He is also an editorial board mem-
ber of several journals, including BMC Medical Education.
Mandla S. Makhanya was appointed Principal and Vice Chancellor of
the University of South Africa on January 1, 2011 and is a prominent
proponent of higher education leadership and advocacy. Makhanya is past
President of the International Council for Distance Education (ICDE),
Treasurer of the African Council for Distance Education (ACDE),
and President of the Higher Education Teaching and Learning
Association. Makhanya is a Deputy Chairperson of the South Africa
National Commission for UNESCO. He has also been a member of
the National Committee of the Memory of the World (MoW). In the
1990s, he served in various leadership roles in the South African
Sociological Association, including as Deputy President I 1998, for
International Association of Sociology (ISA). Makhanya is on the
advisory board of JRODel (Journal of Research in Open, Distance and
e-Learning).
 Notes on Contributors  xxiii

Ana Lucia Manrique graduated in mathematics, University of São Paulo,

Brazil (1987). She holds a master’s degree in Mathematics (1994) and a
PhD in Education (2003), Pontifical Catholic University of São Paulo
(PUC-SP). Manrique obtained a postdoctorate in Education,
Pontifical Catholic University of Rio de Janeiro (2008). She is
Professor on the Mathematics Education Program, PUC-SP, Brazil
and Productivity Researcher at CNPq (PQ2). She has coordinated
projects financed by Brazilian development agencies (Capes, CNPq,
and Fapesp). Her research interests lie in inclusive education, teacher edu-
cation, and mathematics education.
Lilia Mantai is Academic Lead, Course Enhancement at The University
of Sydney Business School. She was awarded a PhD for research on
researcher development of doctoral students in 2017 at Macquarie
University. She is a senior fellow of the Advance HE/Higher Education
Academy.
Claire McAvinia is an academic developer at the Learning, Teaching and
Technology Centre (LTTC) in TU Dublin. She is currently LTTC
Programs Chair and lectures on the Centre’s accredited postgraduate pro-
grams and modules in learning and teaching, and e-learning. Her interests
are in academic development, digital literacies, curriculum design, and
open education. Claire is engaged in supervision of students in master and
doctoral programs. She has published on a range of topics in e-learning
and academic development, and in 2016 completed a book based on her
doctoral research, Online Learning and its Users: Lessons for Higher
Education. Claire is Fellow of the UK Staff and Educational Development
Association (SEDA) and the UK Higher Education Academy. Together
with Dr. Roisin Donnelly and Dr. Kevin O’Rourke, she coedits the Irish
Journal of Academic Practice (IJAP).
Claire McDonnell is Assistant Head at the School of Chemical and
Pharmaceutical Sciences in TU Dublin. Her interests include facilitating
learner transition to higher education and the application of technology to
support student learning and collaboration. She has implemented several
approaches to embed research and enquiry skills in the curriculum, includ-
ing context- and problem-based learning and community-­engaged learn-
ing. She spent a 3-year secondment with the TU Dublin Learning,
xxiv Notes on Contributors

Teaching and Technology Centre from 2013 to 2016 where she was pro-
gram coordinator for MA in Higher Education. Claire is a founding mem-
ber of the Chemistry Education Research Team at TU Dublin, which won
a DELTA award from the Irish National Forum for the Enhancement of
Teaching and Learning in 2018.
Harald A. Mieg is (Honorary) Professor of Metropolitan Studies at the
Humboldt-Universität zu Berlin and also affiliated to the Swiss Federal
Institute of Technology, Zurich. He was the initiator and coordinator of a
German national research project on undergraduate research in Germany
(“ForschenLernen,” during 2014–2018; 15 universities were involved).
In this context, he coordinated the edition of a series of books on under-
graduate research and inquiry-based learning in Germany.
Isabelle Mirbel is an associate professor in computer sciences. Her
research activities are in the fields of information systems engineering,
method engineering and requirements engineering. From 2012 to 2018,
she was a vice-dean of the Faculty of Sciences in charge of professional
integration and relations with companies and then in charge of pedagogy.
For the past two years, she has been coordinating activities to implement
competency-based education within the Faculties of Université Côte
d’Azur. She is also in charge of the “Sciences à la carte” project, in collabo-
ration with the digital thematic university, Unisciel, which aims to develop
online digital resources and more precisely self-­positioning tests to facili-
tate the orientation of undergraduate students.
Jase Moussa-Inaty is Associate Professor of Educational Psychology at
Zayed University. She is actively engaged in conducting research on vari-
ous topics such as cognitive load, metacognition, enhancing thinking
skills, blended learning, motivation, self-efficacy, science anxiety, parental
involvement, and effective teaching and learning processes. She has been
heavily involved in undergraduate research and was one of the found-
ing researchers to establish the Undergraduate Research and Creative
Projects symposium at Zayed University.
Margarida Romero is a research director of the Laboratoire d’Innovation
et Numerique pour l’Éducation (LINE), a research lab in the field of
Technology Enhanced Learning (TEL, full-time professor at Université
Côte d’Azur (France) and an associate professor at Université Laval
(Canada). Her research is oriented toward the inclusive, humanistic,
 Notes on Contributors  xxv

and creative uses of technologies (co-design, game design, and robot-

ics) for the development of creativity, problem solving, collaboration,
and computational thinking.
Enakshi Sengupta is Associate Director of the International Higher
Education Teaching and Learning Association (HETL) and is responsible
for the advancement of HETL in Asia, Middle East, and Africa. Sengupta
is also the Director of the Center for Advanced Research in Education
(CARE), Associate Series Editor of the book series, Innovations in Higher
Education Teaching and Learning, Emerald Group Publishing. She is
Managing Editor of the Journal of Applied Research in Higher Education,
Emerald Publishing, and serves as Vice Chair of the Editorial Advisory
Board of the Innovations in Higher Education Teaching and Learning
book series, Emerald Publishing. Sengupta is Senior Manager of the
Research, Methodology, and Statistics in the Social Sciences forums on
LinkedIn and Facebook responsible for managing all aspects of those
forums. Sengupta holds a PhD from the University of Nottingham in
research in higher education, prior to which she completed her MBA with
merit from the University of Nottingham and master’s degree in English
Literature from the Calcutta University, India. Sengupta has previously
held leadership positions in higher education institutions.
Luisa Soares is a researcher at Larsys – Interactive Technologies Institute.
Clinical psychologist, coordinator of psychology service at Madeira
University and Course Director of Psychology course 1st cycle, she teaches
Clinical Psychology, Neuropsychology and Psychopathology of infancy
and adolescence.
Rachel Spronken-Smith is a professor in Higher Education and
Geography. She holds a PhD in Geography (UBC, Canada) and PGDip.
in Tertiary Teaching (Otago, NZ). After lecturing in Geography at
Canterbury University, she moved into Higher Education at the University
of Otago, NZ. Rachel has led national projects on inquiry-based learning
and graduate attributes. She has won teaching awards at both Canterbury
and Otago, and a national tertiary teaching award in 2015. In 2016,
she won the TERNZ-HERDSA medal for Sustained Contribution to
the Research Environment in NZ, and gained a Fulbright Scholar
Award for doctoral education research in 2018.
Wu Siew Mei is an associate professor of Applied Linguistics and Director
at the Centre for English Language Communication, National University
xxvi Notes on Contributors

of Singapore. She currently serves on the Editorial Board for the Asian
Journal for the Scholarship of Teaching and Learning. She is a key leader in
the regional network called SoTL-Asia and has published with Higher
Education Research and Development Society of South Australasia
(HERDSA).
Brad Wuetherick is Executive Director, Learning and Teaching in the
Office of the Provost and VP Academic and Centre for Learning and
Teaching at Dalhousie University, Atlantic Canada’s preeminent
medical-­
­ doctoral research university. He has been actively engaged in
researching, and supporting the implementation of, undergraduate
research since 2003, while working at three different medical-doctoral
research universities across Canada.
 List of Figures

Fig. 1.1 Undergraduate research model 9

Fig. 3.1 Hexagonal model of universities as inclusive scholarly
knowledge-­building communities (Brew 2006, p. 32) 44
Fig. 6.1 A summary of the UR programs discussed in this chapter 108
Fig. 8.1 Percentage share of the grants per year of the Pibic in the
regions, in 2001 and in 2013. (Source: CGEE (2017)) 136
Fig. 8.2 Percentage participation of enrolments per year in higher
education in the regions, in 2001 and in 2013. (Source:
CGEE (2017)) 136
Fig. 8.3 Percentage distribution per year and sex of Pibic grantees
between 2001 and 2013. (Source: CGEE (2017, p. 23)) 138
Fig. 8.4 Percentage share per year and sex of Pibiti grantees between
2001 and 2013. (Source: CGEE (2017, p. 23)) 138
Fig. 8.5 Total beneficiaries of Pibic/CNPq in the period from 2001 to
2017. (Source: Adapted from the Panel of Institutional
Programmes of Scientific and Technological Initiation (CNPq)) 139
Fig. 8.6 Total beneficiaries of Pibic/CNPq, from 2001 to 2017, by
area of knowledge. (Source: Adapted from the panel of
Institutional Programmes for Scientific Initiation and
Technological Development (CNPq)) 139
Fig. 8.7 Percentage distribution of investments in the areas of Exact
and Earth Sciences and Human Sciences from 2001 through
2017. (Source: Adapted from the Panel of Institutional
Programmes of Scientific Initiation and Technological
Development (CNPq)) 142

xxvii
xxviii List of Figures

Fig. 8.8 Segmentation by sex of total beneficiaries of Pibic/CNPq

from 2001 through 2017. (Source: Adapted from the Panel of
Institutional Programmes of Scientific Initiation and
Technological Development (CNPq)) 142
Fig. 9.1 Video resource for final year students by Camila D’Bastiani 158
Fig. 9.2 Mindmap to support supervisors and students by Jennifer Byrne 159
Fig. 9.3 Infographic to support supervisors and students by Martina
Ozonyia160
Fig. 9.4 Video resource to support students by Michelle Bermingham 161
Fig. 9.5 Website to support students by Niall Minto 162
Fig. 9.6 Findings on good practice in undergraduate supervision 165
Fig. 11.1 Organization of the PEPE program 210
 List of Tables

Table 5.1 Brew (2003, 6) 81

Table 8.1 Distribution of Pibic scholarships computed by 1000
students enrolled by region, in 2001 and 2013 137
Table 8.2 Percentage distribution of investments per year and by areas
of knowledge 141
Table 9.1 Constructive alignment within the PD module 155
Table 9.2 Authentic multimedia artifacts on undergraduate supervision 158
Table 10.1 Times Higher Education (THE) World University Rankings
2019—Top 20 179
Table 10.2 QS World University Rankings 2020 and 2019—Top 10 181
Table 10.3 Times Higher Education (THE) World University Rankings
2018 edition ranked top South African universities 181
Table 10.4 Research focus/themes in (South) African universities,
indicating geo-environmental and indigenous foci and
developmental priorities 194
Table 12.1 Students’ perceptions of links between research and teaching
2001–2013 (percentages, by type of institution) 226
Table 12.2 Students’ perception of the importance of links between
research and teaching in Bachelor degrees at University and
in Applied Colleges of Higher Education (percentages, by
disciplines)227
Table 13.1 List of URC 2019 winning universities 240
Table 13.2 GEN 185 Methods of Scientific Research and Development
final project sample research topics 242
Table 13.3 Minor in Applied Research Methods Modules 245

xxix
xxx List of Tables

Table 14.1 The range of dimensions of undergraduate research and

inquiry-based learning 252
Table 14.2 Embedding of undergraduate research and inquiry activities
into core papers of the ecology degree at the University of
Otago259
 CHAPTER 1

Undergraduate Research as a High-Impact

Educational Practice

Patrick Blessinger and Nancy H. Hensel

Introduction
Over the past several decades, the demand for higher education around the
world has increased substantially (UNESCO 2018). Several factors have
fueled the growing demand. As higher-education institutions expand their
services to accommodate the increased demand for education, they have
also put greater emphasis on academic engagement and quality to increase
student retention and graduation rates. UNESCO (2018) estimates that
by 2040 nearly 600 million students will be enrolled in colleges and uni-
versities around the planet, up from 216 million students in the year 2016.
This statistic is striking when one considers that the global college-age
population will reach 800 million in 2040. Much of the growth in

P. Blessinger (*)
International Higher Education Teaching and Learning Association,
New York, NY, USA
e-mail: [email protected]
N. H. Hensel
Laguna Woods, CA, USA
e-mail: [email protected]

© The Author(s) 2020 1

N. H. Hensel, P. Blessinger (eds.), International Perspectives on
Undergraduate Research,
https://doi.org/10.1007/978-3-030-53559-9_1
2 P. BLESSINGER AND N. H. HENSEL

college-age people will come from African countries. Also reflected in

these numbers are millions of additional students who enroll in free
courses through open education platforms like MIT’s OpenCourseWare
as well as nonformal learning platforms like Khan Academy. It is fair to say
that in many countries higher education has reached a universal status, as
defined by Martin Trow (UNESCO 2018). Since higher education is
viewed by many as a critical factor in attaining employability and social
mobility through knowledge acquisition and skill development, it comes
as no surprise that many people are enrolling in colleges and universities,
and other learning programs, in record numbers.
This increased demand in higher education has also created increased com-
petition for students, which, in turn, has put greater pressure on institutions
to improve their services. One way they are doing this is by implementing
undergraduate research programs, mainly because it is seen as one of the most
beneficial high-impact learning activities in existence (Kuh and Hu 2001; Kuh
2008). Campuses have acknowledged the documented benefits of under-
graduate research and expanded opportunities for student engagement in
research. It is vital to understand deeply the impact of undergraduate research
so that context-sensitive ways of improving UGR may be found, whether that
be small tweaks, major adaptations or implementations of whole new models
(Komarraju et al. 2010; Lopatto 2006, 2007; Webber et al. 2012).
The benefits of undergraduate research include but are not limited to:
improved faculty teaching performance, increased faculty–student collabora-
tion/mentoring, increased student engagement, improved teamwork skills,
increased academic achievement, higher-order thinking and inquiry skills,
improved perseverance in problem-solving, and increased self-­confidence.
These benefits, in turn, help improve student persistence and retention.
Intellectual, psychological, and social characteristics are also crucial in
preparing students for graduate studies and professional employment. In
some cases, involvement in undergraduate research helps students to
reevaluate and fine-tune their career choices, especially for those who may
still be unsure about what graduate program or career to go into (Kuh
2008; Gentile et al. 2017).
Undergraduate research is identified as a high-impact learning practice
and, as such, it is linked to improved student achievement and institu-
tional advancement. Undergraduate research can take different forms
depending on how it is utilized. With respect to scope of integration, it
can be used as a one-off extracurricular activity or it can be a one-off cur-
ricular activity where it is integrated into a single course as a learning activ-
ity or it can be integrated across a set of related courses as part of a broader
 1 UNDERGRADUATE RESEARCH AS A HIGH-IMPACT EDUCATIONAL… 3

program or departmental undergraduate research effort where the research

continues across semesters (Lopatto 2009; Gentile et al. 2017).
With respect to level of research, it can be used as one of several differ-
ent types of learning activities a student must perform, say with lower or
equal grade weighting, or it can be the main learning activity that is
weighted relatively heavily. The level of the research refers to the intensity
of the research performed. The level of research is on a spectrum of inten-
sity from low level to medium level to high level. A low-level (i.e., low
intensity) research activity may only involve collecting and analyzing sec-
ondary data. In contrast, a high-intensity research activity involves collect-
ing and analyzing primary data. The level of research performed is often a
function of several factors, including grade and course level, and the
degree of collaboration with the faculty member or mentor.
With respect to type of research, it can be used with any of the main
learning domains (arts, humanities, science), and thus, the type of research
will depend on the specifics of the domain, the discipline, the field, and the
particular course. For instance, STEM fields use the scientific method as
the main problem-solving approach and they rely on experimental meth-
ods to collect and analyze empirical data. In nonscientific fields such as the
arts and humanities, they also use evidence (data) to carry out research but
the data is often qualitative, collected and analyzed by nonexperimental
methods. The common denominator across the domains is the use of the
research process to collect evidence to answer research questions
(Blessinger 2017; Hensel 2018). Appendix A provides a high-level over-
view of the research process.
The faculty member is in the best position to determine the scope,
level, and type of research to be conducted by students, how best to scaf-
fold the research process, and the nature of the research question to be
answered. Regardless of the scope, level, and type of research conducted,
the ultimate objective of undergraduate research is for the students to
make, to one degree or another, an original contribution to the field of
study related to the course. Although students may work independently to
carry out the research, they typically collaborate with a faculty member.
The degree of collaboration will depend on the scope, level, and type of
research, among other factors (Kinkead and Blockus 2012; Gentile
et al. 2017).
4 P. BLESSINGER AND N. H. HENSEL

The Purpose and Value of Undergraduate Research

Apart from the benefits of undergraduate research, it is essential to under-
stand the underlying mechanisms that create the value proposition of
undergraduate research, and that defines its purpose. Research is the pro-
cess of conducting a systematic inquiry to produce original knowledge.
Research involves the systematic analysis of data in order to answer research
the question(s). Thus, the purpose of research is to generate new knowl-
edge, which involves collecting and analyzing data, both secondary and
primary. The type of data collected and the way the data is analyzed will
depend on the research methodology used, which in turn, will depend on
such factors as the research question(s) and the research objectives as well
as the knowledge domain, discipline, and field. Research is an inquiry-­
based learning activity, so research begins and ends with the research ques-
tion and objectives.
Embedding undergraduate research into a course is not the only way to
implement undergraduate research. The apprenticeship model—one pro-
fessor and a few students—is another way to implement undergraduate
research. Other ways to implement undergraduate research might include
integrating it with study abroad experiences, internships, service-learning,
and student learning communities, among others. Undergraduate research
can also be integrated into extracurricular activities. Any activity that
would lend itself to the research process could be a viable candidate for
undergraduate research.
Although collecting primary data is often considered the heart of the
undergraduate research experience, collecting and analyzing secondary
data is also essential. Since research is a process of inquiry that can be used
in any discipline or field, it lends itself to a wide variety of ways to integrate
it into courses and programs. On one end of the research spectrum, it
could be limited to researching secondary data, such as reading and ana-
lyzing data from existing literature. This type of research might be consid-
ered low-intensity or low-end research. In contrast, research involving the
collecting and analyzing of original, primary data could be considered
high-intensity or high-end research. High-intensity research incorporates
more intense higher-order thinking, the use of more structured research
methodologies, and collaboration with faculty or other mentors.
High-intensity research is inclusive of secondary data research. Data
that comes from existing sources (e.g., journals, books, reports) is vital as
it allows the researcher to understand what research has already been
 1 UNDERGRADUATE RESEARCH AS A HIGH-IMPACT EDUCATIONAL… 5

conducted, and it allows the researcher to identify any knowledge gaps in

the field. Conducting a review of the existing literature is a prerequisite
part of conducting primary research. Conducting secondary research is
important research in itself. Developing expertise in conducting secondary
research is important regardless of what domain or discipline or field one
is in. Conducting secondary research allows students to increase their
knowledge on the subject prior to conducting primary research.
Undergraduate research is a data-driven process. As such, the quality of
the data is of paramount importance. By conducting research, students
learn to understand the importance of data quality and the methods and
procedures that can be used to help ensure data quality. Several character-
istics define data quality, including the accuracy and completeness of the
data, as well as timeliness and relevance of the data. Appropriate proce-
dures must be followed in order to maintain the high quality of the data.
The specific procedures and protocols used in undergraduate research will
depend on the knowledge domain, discipline, and field, as well as the par-
ticular research methodology used. Ultimately, however, the quality of the
data is determined by how well it allows or aids the researcher to answer
the research questions and meet the research objectives.
Research ethics and professional standards are other areas of concern
for undergraduate researchers. Research involving the participation of
humans (especially children) or the use of animals requires adherence to
strict research ethics and protocols and often requires the approval of a
research ethics board or an institutional review board. With human sub-
jects’ research, the researcher must be trained in research ethics (e.g., prin-
ciples of informed context and do no harm as well as issues of confidentiality).
Human subjects’ research also requires direct supervision from an
approved faculty member.
Thus, given the legal and ethical issues involved in human subjects’
research, undergraduate research is often confined to research that does
not utilize human subjects for the purpose of data collection. Even with
research involving animals, proper training must be given to students so
that they adhere to established protocols, procedures, and ethics. Engaging
undergraduate students in research allows students to be inculcated in the
research process and initiated into the research community as well as
involving them in those areas that impact research (Blessinger 2017;
Hensel 2018).
6 P. BLESSINGER AND N. H. HENSEL

The Undergraduate Research Experience

In addition to increased student engagement and increased academic
achievement, undergraduate research also helps to improve students’ work
habits, communication skills, and career choice clarification. As an authen-
tic form of experiential learning, undergraduate research can take the form
of an apprenticeship wherein they learn how their field of study operates
through hands-on training. Not only do students acquire disciplinary
knowledge, but they also learn the research skills specific to their field.
These skills involve all those elements common to the research process:
research strategy and design, data collection and analysis, and communica-
tion of results. Students also have the opportunity to publish their results,
where they become part of the community of practice (Kuh 2008; Lopatto
2010; Gentile et al. 2017).
Auchincloss et al. (2014) identified five dimensions of the undergradu-
ate research experience from a faculty point of view: use of scientific prac-
tices, discovery, broadly relevant or important work, collaboration, and
iteration. Based on these dimensions, Gentile, Brenner, and Stephens
(2017, pp. 34–35) have identified the following core characteristics as
important to the undergraduate research experience in the STEM
disciplines:

• Emphasis on engaging students in research practices and arguing

from evidence
• Emphasis on generating new data and replicating preliminary results
• Emphasis on significant and relevant problems of interest to STEM
researchers
• Emphasis on collaboration and teamwork
• Emphasis on research questions, experimental design, and data
collection
• Emphasis on mastering research techniques
• Emphasis on engaging students in problem-solving reflection
• Emphasis on communication of results
• Emphasis on mentorship and increasing ownership of the research
project over time

The high-level process is also similar for non-STEM fields in that the
research process is an evidence-driven, inquiry-based, problem-solving
process. Fundamentally, undergraduate research is an investigation into a
 1 UNDERGRADUATE RESEARCH AS A HIGH-IMPACT EDUCATIONAL… 7

research question that the researcher wants to answer. Therefore, the par-
ticulars of the problem-solving process are specific to the domain and the
discipline and the field of study. So, the research topic and the research
question(s) will also be specific to the domain, discipline, and field.
Research in the arts or the humanities, for instance, is just as rigorous and
beneficial and important as research in the natural and social sciences.
Domains are inherently different from another, not inherently better than
another (Blessinger 2017; Hensel 2018).
In undergraduate research, students typically work with mentors to
help guide them through the process. Depending on the type of research
being undertaken, the mentor may be a faculty member or a graduate
student or a postdoc researcher or even an industry professional researcher.
Mentorship and collaboration are key to a successful undergraduate expe-
rience as it has been positively correlated with increased academic achieve-
ment in students.
In addition, high-quality mentoring is key to improving a student’s
continued education in the research field. Finally, research allows students
to learn more than what is in the curriculum (e.g., textbooks) and more
than what is provided from lectures and classroom discussions. Thus,
undergraduate research is a high-impact learning activity because it allows
students to operate at the top end of Bloom’s Taxonomy (i.e., higher-­
order thinking) for sustained periods of time (Kuh 2008; Lopatto 2009).
It also builds up mental stamina and critical thinking skills.

Types of Undergraduate Research

There are many different types of undergraduate research. As mentioned
before, the type of research conducted depends on several factors, and that
combination of factors will ultimately drive the experience for the student.
For instance, Gentile, Brenner, and Stephens (2017, p. 35) note that,
“developing technical skills and knowledge is often a focus in early research
learning experiences, while opportunities to learn how to deal with failure
and develop resiliency tend to emerge as students get more deeply involved
in a research project.”
In addition, Brownell and Kloser (2015) note that a course limited
solely to secondary data collection is unlikely to educate students on how
to actually conduct research. Further, a course in research methods may
teach the technicalities of research but may not engage students in actually
doing research competently. The key to developing higher-order research
8 P. BLESSINGER AND N. H. HENSEL

skills is to learn by doing in order to internalize the full depth and breadth
of real-world research. Undergraduate research may go by different names,
depending on the institution, the domain, the discipline, the field of study,
etc. Gentile, Brenner, and Stephens (2017) have identified several differ-
ent types of undergraduate research that may go by different names:

• Individual faculty research (student as apprentice)

• Cumulative capstone courses and senior theses
• Internships and co-op experiences
• Study abroad and international programs
• Project-based and problem-based courses and programs
• Community-based and field-based programs

There are many ways to integrate undergraduate research into the cur-
riculum (or outside the curriculum for that matter) and several models on
how to create a meaningful undergraduate research experience for stu-
dents. Although much has been written about these undergraduate mod-
els (Kierniesky 2005; Kortz and van der Hoeven Kraft 2016; Pukkila et al.
2007; Reinen et al. 2007; Rueckert 2007; Temple et al. 2010), much can
still be learned by examining the current state of undergraduate
research today.

Modeling the Undergraduate Research Experience

The undergraduate research experience is multifaceted and varies by disci-
pline, mentoring type, duration, complexity, etc. Depending on how these
factors come together for the student and how the faculty member scaf-
folds the research activities for the student, the outcomes of undergradu-
ate research will therefore vary with respect to its impact on one’s future
studies, to one’s career choice, etc. Given the diverse nature of under-
graduate research, it is difficult to develop a single model that applies in all
situations. Nonetheless, based on a review of the literature and the chap-
ters in this volume, Fig. 1.1 attempts to provide a high-level, process-­
oriented and product-oriented view of undergraduate research to serve as
a general guide in designing, developing, and implementing undergradu-
ate research.
This model does not offer a cookbook approach to undergraduate
research but rather a high-level guide to steer faculty members, mentors,
and others in the right direction. As the model shows, the undergraduate
 1 UNDERGRADUATE RESEARCH AS A HIGH-IMPACT EDUCATIONAL… 9

Fig. 1.1 Undergraduate research model

research experience should be embedded within the learning objectives of

the course the student is taking or within the learning objectives of the
program the student is involved in, which itself is likely to be embedded in
a domain, discipline, and field of study. Thus, the learning objectives that
the student is expected to achieve drives the whole process and drives the
goals of the undergraduate research experience. The instructor or pro-
gram manager should carefully reflect on and define those specific learning
objectives in order to scaffold the research activities appropriately. The
model also serves as a guide in the course or program design process
involving undergraduate research.

Define Course Learning Objectives and Teaching Strategies In order

for course learning objectives to be meaningful, they must be coherent,
10 P. BLESSINGER AND N. H. HENSEL

specific, and measurable. In a learner-centered environment, they must

also be written from the learners’ point of view and with the students in
mind. To effectively design a course or learning program, each learning
objective should be in response to the following statement: “by the con-
clusion of the course, students will be able to….”

Each learning objective should then conclude with a specific, actionable

outcome the students are to attain, with respect to knowledge and skills.
The words and phrases used in crafting the learning objectives should
reflect the level of thinking and the mastery of knowledge and skills (e.g.,
using Bloom’s Taxonomy) that students are expected to achieve. In addi-
tion, the assessments given (both formative and summative) should be
consistent with the learning objectives and in alignment with the under-
graduate research expected to perform.
For example, a learning objective that is limited to secondary data
sources, say for an introductory course or a lower-level course or, for
instance, a course in world history, might look like: Explain the effect of
the Great Depression on the rise of fascism around the world by writing
an academic essay that analyzes and evaluates why and how Mussolini was
able to seize power in Italy. Alternatively, the statement could be phrased
in the form of a research question: How did the Great Depression affect
the rise of fascism around the world and why and how was Mussolini able
to seize power in Italy? Another learning objective for this course might
look like: Explain the effect of immigration on German culture in the
twenty-first century by writing an academic essay that analyzes and evalu-
ates why and how German immigration policies led to a massive influx of
immigrants. In both objectives, students are expected to engage in higher-­
order thinking skills.
Primary data is any type of data the student is expected to collect him-
self/herself. There are several ways to collect primary data, such as obser-
vations, interviews, and surveys. If students have not had a course in
research methods, the course designer must design learning objectives
based on the students’ background knowledge and level of experience in
the subject matter and based on their current research knowledge and
skills. A learning objective that includes collecting and analyzing primary
data also involves higher-order thinking skills but the research process is at
a higher level of intensity. For example, a learning objective that includes
collecting primary data, say for a course in public health, might look like:
Explain the effects of New York City’s proposed ban on soft drink size by
 1 UNDERGRADUATE RESEARCH AS A HIGH-IMPACT EDUCATIONAL… 11

surveying a random sample of New York City residents and then discuss
your findings in the form of a research report.

Design Student Learning Activities for Undergraduate Research After

crafting the learning objectives, the course designer must design the stu-
dent learning activities that the student must perform to fulfill the objec-
tive. The learning activity is a more detailed explanation of the learning
objective. If the objective requires only secondary research, then the
course designer must explain the criteria and the scope of the activity and
provide the student with guidance about how to fulfill the objective. In
order to maximize the learning for students, learning activities must be
carefully designed by the course designer (e.g., faculty, mentor, program
manager).

Collect and Analyze Secondary Data Even if the learning activity

involves collecting primary data, research projects should also involve col-
lecting and analyzing secondary data because such projects involve con-
ducting preliminary research in order to discover the knowledge that
currently exists on the topic. Examining secondary data on a topic is
important because it also helps the researcher understand what the key
issues are for a given topic, and it helps identify the knowledge for a given
topic. In short, looking at secondary data better prepares the researcher to
properly carry out the primary data collection.

Some research projects require the collection of primary data because

there may be little written about the topic in secondary sources or because
primary data is needed to gain a deeper understanding of the topic and to
fulfill the learning objectives. To become an expert in research ethics and
research methods, it is important to know how to use both secondary and
primary data sources and how to integrate the two different sources into
the final research product.

Collect and Analyze Primary Data In primary research, certain estab-

lished strategies are often used. These strategies are typically classified as
quantitative strategies or qualitative strategies or mixed strategies. The
strategy used depends on the research questions and learning objectives
one is trying to achieve. In quantitative research, for instance, typical strat-
egies used include nonexperimental and experimental strategies, as well as
12 P. BLESSINGER AND N. H. HENSEL

the meta-analysis strategy. In qualitative research, for instance, typical

strategies used include grounded theory, ethnography, phenomenology,
narrative inquiry, and historical research. Mixed research includes case
studies, action research, and assessment research.

Whereas the research strategy defines the high-level approach to be

used and defines the focus of the research, the research analysis part of the
project defines the data collection techniques used and the data analysis
procedures used. For quantitative data (numeric data from samples), typi-
cal techniques used include questionnaires, interviews, observations, and
tests. For qualitative data (text, images, videos), typical techniques used
include questionnaires, interviews, focus groups, and observations. These
methods are commonly used in the humanities and social sciences. The
arts will have their own methods as will the natural sciences, which rely
primarily on experimental methods.

Assess Student Learning Outcomes An assessment helps determine

how well the student has mastered the topic (i.e., achieved the learning
objective) in those areas that are being assessed (i.e., knowledge, skills,
etc.) with respect to appropriate learning standards and competencies. No
matter what type of assessment is used, the assessment should reflect the
learning objectives for the course and the learning activity. Bloom’s
Taxonomy, for instance, is a helpful guide because it informs one about
the level of learning taking place. The assessment must be in alignment
with the learning objective(s) and activities. The assessment must accu-
rately and completely assess the level, scope, and type of learning that
occurred. Thus, the assessment may take the form of a test, an essay, a
report, or a project, among others, and it should include a scoring rubric
so that both the students and the assessor know what criteria will be used
to grade the assessment.

In addition, prior to designing an undergraduate research learning

activity, it is helpful to first think about the relevant questions involved in
doing so. Though not a comprehensive list, when thinking about whether
or not to integrate undergraduate research into the curriculum or into a
specific course, one should ask the following questions:

What are the benefits and advantages of undergraduate research?

How will undergraduate research enhance the course?
 1 UNDERGRADUATE RESEARCH AS A HIGH-IMPACT EDUCATIONAL… 13

What are the likely costs and benefits for the students?
What are the likely challenges and prerequisites for the students?
What are the responsibilities and expectations for the students?
What are the responsibilities and expectations for the faculty?
What specific undergraduate research (scope, level, type, etc.) will the stu-
dents undertake?
How are the research topic, research questions, and research objectives
determined?

These questions will allow the course designer to reflect more deeply
on how best to design the undergraduate research experience to increase
student engagement and student success and thereby improve student
retention and graduation rates.

Conclusion
Undergraduate research is becoming more important around the world as
colleges and universities strive to improve their undergraduate experience.
More institutions around the world are implementing it into their student
experience because it has been shown to be a high-impact educational
practice. Depending on the institution and the country and other factors,
different models of undergraduate research are being used. As undergrad-
uate research becomes more international, as illustrated through the chap-
ters in this volume, institutions are learning from each other about the
best way to implement it within their own context.

Appendix A

Educational Research Methodology Framework: Patrick

Blessinger (2017)

Research phase Attributes/Key questions:

Research question What do you want to investigate and why ?

Review the academic literature (lit All educational research attempts to better
review) on your research topic to understand (meaning-making)a particular
better understand the existing phenomenon and the nature of relationship among
knowledge base related to it variables through a systematic inquiry-based analysis
and interpretation of data
(continued)
14 P. BLESSINGER AND N. H. HENSEL

(continued)
Research phase Attributes/Key questions:

Define the specific research topic The topic area of the research project
Define the specific research aim The purpose and scope of the research project
Define the specific research The specific research question(s) you want to answer
question(s) you want to answer
Define the specific research The question put in the form of specific research
objective(s) objectives
Develop a written research plan Your research plan should describe how you propose
proposal so conduct the research; it includes the following
sections: introduction, purpose, literature review,
research question(s), research strategy, research
methods (participants/sample, data collection
instruments, data analysis procedures), and
conclusion
In a research study, everything
begins and ends with the research
question(s) you want to answer
Research perspective researcher(s) What worldview guides your investigation of the
worldview & assumptions) research question(s)?
Philosophies (view on the nature
of reality and knowledge)
 Positivism (objective reality, Interprets reality mainly via value-free, scientific test
socially independent) data
 Realism (objective reality, Interprets reality mainly via senses and social
socially dependent) conditioning
 Interpretivism (subjective reality, Interprets reality mainly via symbols/meaning/
socially constructed) values/roles
 Pragmatism (multiple realities/ Best research design depends mainly on the nature
views acceptable) of research question
Approaches problem-solving
seasoning)
 Deductive (mainly a positivist Conclusion deduced from empirical facts; typically
approach) tests hypothesis/theory
 Inductive (mainly an Conclusion inferred from empirical facts, typically
interpretivist approach) build hypothesis theory
Research design (research strategy How will you answer the research question(s)?
used)
(continued)
 1 UNDERGRADUATE RESEARCH AS A HIGH-IMPACT EDUCATIONAL… 15

(continued)
Research phase Attributes/Key questions:

Strategic (research design strategy Strategy used will determine what type(s) of data
for collecting and analyzing data; will be collected:(Quant: random or nonrandom
the strategy most appropriate sampling, Qual: purposive sampling)
depends on research questions) Focus is mainly on controlled context to test
 Quantitative (uses sampling and hypotheses. Quantitative designs operate on
statistics with logic & theory) continuous from descriptive to relational to
  Survey, correlational, predictive to cause effect using descriptive statistics
causal-comparative, experimental and inferential statistics
(single subject, quasi, true: to
test null hypothesis), and
meta-analysis (research about
previous research)
 Qualitative (uses sampling and
coding with logic & theory)
   Grounded theory (emerged Focus is real life context to build hypothesis or
from sociology) theory
   Ethnography (emerged from Focus is real life context and personal stories via
anthropology) their cultural context
  Phenomenology (emerged Focus is real life context to explain personal meaning
from philosophy & psychology) of person/group
  Narrative inquiry Focus is real life context and meaning from stories
(multidisciplinary) told by the individual
  Historical research Focus is die examination of a past event, activity,
(multidisciplinary) person, subject, place, etc
 Quantitative or Qualitative or
Mixed
   Case study research Focus is real life context (defined by unit of analysis,
(multidisciplinary) not by methodology)
   Action research (emerged Focus is organizational context to create change
from organizational behavior) (research by actors for actors)
  Evaluation research Focus is on the merit of a program, policy, process,
(multidisciplinary) need, activity, etc
   Mixed method research Combine quantitative and qualitative method:
(multidisciplinary) include exploratory research
Methods (techniques and (what) and explanatory research (how, why) and the
procedures—see below) triangulation of methods
 Mono (1 data collect technique
and l analysis procedure)
 Multiple (>1 data collect
technique and analysis
procedures)
(continued)
16 P. BLESSINGER AND N. H. HENSEL

(continued)
Research phase Attributes/Key questions:

Tuneframe
 Cross-sectional Study a particular phenomenon at a particular time
 Longitudinal Study change and development over a period of time
Research analysis (data methods Who (sample), what (data), when, where, how
used) (techniques/procedures), and why will you
Techniques (data collection collect/analyses data relevant to the research
techniques: participates/ question(s)?
instruments)
 Qualitative Data Collects mainly numeric data from sample for
  Surveys (questionnaires, statistical analysis. Random sampling: random,
interviews, observation), Tests simple, stratified, cluster, systematic, nonrandom
(scores), Documents/Records/ sampling: convenience, purposive, quota). Random
Artifacts sampling with controls is preferred. Collects mainly
 Quantitative Data nonnumeric data from sample for conceptual analysis
  Surveys (questionnaires, (which purposive sampling method to use—
interviews/focus groups, intensity, homogenous, criterion, snowball, or
observations), Documents/ random purposive—depends on the nature of the
Records/Artifacts study)
Procedures (data analysis
procedure)
 Quantitative Data (data analyzed Analyzes mainly numeric and categorical data.
statistically by researcher(s) Analyzes independent and dependent variables
using statistics, tables, charts) across different scales: nominal (categorical), ordinal
(ranked), and interval/ratio. Tests: descriptive stats
(frequencies, percentages, X, SD) & inferential stats
(correlations, regressive, t, ANOVA, Chi-square,
etc.)
 Qualitative Data (data analyzed Analyzes mainly non-numeric data (words, images,
conceptually by researcher(s) videos) that are usually coded through thematic
using codes, categories, themes) analysis, then translated into overarching themes
Research conclusions What have you learned from your research?
(researches(s) interpretations of the
data)
 Explain your findings (results of What results did you analysis reveal? Are they
the data analysis) reliable and valid?
 Discussion (researches(s) How did you interpret the results and why (e.g.,
reflection on the findings) relative to existing theory)?
 Draw your main conclusions your answer(s) to your research question(s)
(key points)
 Discuss the implications for Based on your conclusions, what are the implication
future research for future research?

Sources: Frankel et al. (2009) How to design and evaluate research… Gay et al. (2009) Educational
research… Saunders et al. (2009) Research methods…
 1 UNDERGRADUATE RESEARCH AS A HIGH-IMPACT EDUCATIONAL… 17

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M., Trautmann, N. M., Varma-Nelson, P., Weston, T. J., & Dolan, E. L. (2014).
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Brownell, S. E., & Kloser, M. J. (2015). Toward a conceptual framework for mea-
suring the effectiveness of course-based undergraduate research experiences in
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Gentile, J., Brenner, K., & Stephens, A. (2017). Undergraduate research experi-
ences for STEM students: Successes, challenges, and opportunities. Washington,
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Hensel, N. (2018). Course-based undergraduate research: Educational equity and
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Kinkead, J., & Blockus, L. (2012). Undergraduate research offices & programs:
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interaction in developing college students’ academic self-concept, motivation,
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graduate research experience. Journal of Geoscience Education, 64(1), 24–36.
Kuh, G. (2008). High-impact educational practices: What they are, who has access to
them, and why they matter. Washington, DC: Association of American Colleges
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Kuh, G. D., & Hu, S. (2001). The effects of student-faculty interaction in the
1990s. Review of Higher Education, 24, 309–332.
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Pukkila, P., DeCosmo, J., Swick, D. C., & Arnold, M. S. (2007). How to engage
in collaborative curriculum design to foster undergraduate inquiry and research
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 CHAPTER 2

Undergraduate Research in the United

States: Diversity, Growth, and Challenges

Elizabeth L. Ambos

History of Undergraduate Research in the United

States and CUR’s Origins and Development
The theory and practice of undergraduate research (UR) in the United
States (US) emerged from a number of overlapping intellectual, social,
and education traditions. The goal of this chapter is to represent US UR’s
history, current practices, and future directions, while making connections
to the wider international UR movement. To the latter point, I would
begin by citing the seminal influence of eighteenth-century German poly-
maths (and brothers) Alexander and Wilhelm von Humboldt on US UR
origins. Alexander von Humboldt pioneered many of the fields of natural
science that engage current-day researchers and had a remarkable facility
for communicating and globalizing scientific investigations (e.g. Wulf
2015). Wilhelm von Humboldt envisioned, designed, and helped to
implement Prussian university educational systems conjoining original

E. L. Ambos (*)
Council on Undergraduate Research, Washington, DC, USA
e-mail: [email protected]

© The Author(s) 2020 19

N. H. Hensel, P. Blessinger (eds.), International Perspectives on
Undergraduate Research,
https://doi.org/10.1007/978-3-030-53559-9_2
20 E. L. AMBOS

research and instruction, a model that many German (and US) institutions
strive to encompass today (e.g. Mieg 2019).
Within the US, UR has been an element of undergraduate education
for at least a century. As described by Kinkead (2012) in her cogent his-
torical summary, two organizations, the Research Corporation for Science
Advancement (RCSA) and the National Science Foundation (NSF), pro-
vided organizing frameworks and most importantly, funding, for twentieth-­
century research programming. Disciplinary societies such as the American
Chemical Society and Sigma Xi were certainly prominent agents promot-
ing UR as an avenue for research development. National studies of the
state of US undergraduate education (e.g. Boyer Commission 1998) also
provided support for UR’s expansion.
Although several colleges in the Northeast/Midwest US may claim a
century or more of UR tradition, most UR historians agree that the first
formally recognized UR opportunities program was created in the 1960s
at the Massachusetts of Institute of Technology (MIT) (Institute Archives-­
MIT Libraries 2019). Since the 1960s, UR has proliferated and expanded
in a variety of educational environments, and was launched as a US orga-
nized movement with the formation of the Council on Undergraduate
Research (CUR) in the late 1970s.
CUR originated in 1978 with ten faculty members in chemistry-related
disciplines. CUR was fueled by the zestful energy of a small group of
people, a shared and inspiring vision, and driven by both challenge and
opportunity. One challenge was the perception amongst many US aca-
demics that research was the province of faculty members and graduate
students at research-intensive, doctoral-granting institutions. The faculty
members who wished to overturn this ruling paradigm tended to be well-­
qualified researchers who had trained at the top research universities in the
country, now pursuing faculty careers at small, predominantly undergrad-
uate institutions (PUIs). Mostly hailing from the sciences, these faculty
members pursued diverse strategies to remain active in their research pro-
grams. Early CUR leaders seized upon the opportunity to enlarge the
research aims of faculty at small PUIs through expanding research activi-
ties to undergraduate students, resulting in better educational outcomes
for students, and research support for faculty scholarly endeavors. These
two imperatives—supporting faculty research as well as student success—
arguably remain the most potent drivers of the US undergraduate research
movement.
 2 UNDERGRADUATE RESEARCH IN THE UNITED STATES: DIVERSITY… 21

Apart from the availability of funding, which is certainly an essential

factor in UR’s development, I believe that three other major trends domi-
nate UR’s evolution in the U.S. First, undergraduate research’s appeal has
broadened to engage faculty not only within science, technology, engi-
neering, and mathematics (STEM) fields, but also those in social and
health sciences, business, and arts and humanities disciplines (Crawford
et al. 2014). Increasing disciplinary diversity correlates with more aca-
demic institution-wide support for undergraduate research infrastructure,
faculty and student recognition and reward systems, faculty professional
development, and creation of centralized undergraduate research offices.
Second, faculty demographic changes within the last two decades—
changes that will accelerate with waves of retirements of faculty who are
part of the so-called baby boomer generation—mean that faculty now
being hired tend to have enjoyed their own undergraduate research expe-
riences, are from groups historically underrepresented in higher educa-
tion, and wish to replicate and expand these experiences for their own
students (Webber et al. 2013).
Third, research conducted by scholars such as George Kuh and col-
leagues at Indiana University (Kuh et al. 2007; Kuh 2008; Kuh and
O’Donnell 2013); David Lopatto at Grinnell College (Lopatto 2010);
Sandra Gregerman and colleagues at University of Michigan (e.g. Nagda
et al. 1998; Hathaway et al. 2002); Silvia Hurtado and colleagues at
University of California at Los Angeles (e.g. Hurtado et al. 2014; Eagan
et al. 2013); and several other groups (Finley and McNair 2013; Laursen
et al. 2010; Schmitz and Havholm 2015) have demonstrated a correlation
between undergraduate research participation and student success, exam-
ining such parameters as grades, graduation rates, and transitions to grad-
uate school or workplace. This participation is particularly impactful for
students from groups historically underrepresented in higher education.
Student success—principally (but not exclusively) defined as degree
completion—is currently of paramount importance in the US. Given the
high cost of most undergraduate degree programs, skyrocketing student
loan debt, the promise that UR offers to help close achievement gaps
between majority and historically underrepresented groups, and the career
advancement offered by undergraduate degree acquisition, institutional
investments in undergraduate research have increased appreciably within
the last decade, and are mirrored by the rapid growth of CUR’s member-
ship, programs, and services. Three brief and highly readable syntheses of
literature on UR’s positive impact are Crowe and Brakke (2008), Osborn
22 E. L. AMBOS

and Karukstis (2009), and Altman, Chiang, Hamann, Peterson, and

Orel (2019).
Given these trends, it is not surprising that present-day CUR spans all
academic disciplines through its 13 divisions, engaging more than 10,000
individual members at close to 1000 academic institutions, including a
growing number outside of the US. It has also enlarged its institutional
membership base from the core PUI constituency to embrace most types
of institutions, including doctoral-granting research intensives and com-
munity colleges. I would note that in the US, institutions are sorted into
what is termed the Carnegie classification system, which is oriented pri-
marily to levels of research activity, the numbers of students enrolled as
undergraduates and/or graduates, and whether an institution is public or
private (Carnegie Classification n.d.). In 2011, CUR formally merged
with the National Conference on Undergraduate Research (NCUR), a
more student-focused organization that had developed the infrastructure
to support a student research conference attracting several thousand stu-
dents yearly.
Throughout its 40-year history, the CUR’s mission has been repeatedly
affirmed: “to support and promote high-quality undergraduate student-­
faculty collaborative research and scholarship.” While it would be inaccu-
rate to state that there is a unified definition for high-quality undergraduate
research shared by all institutions of higher education in the US, there is a
definition formally supported by the CUR. According to the CUR
(Council on Undergraduate Research n.d.-a), undergraduate research is
“an inquiry or investigation conducted by an undergraduate student that
makes an original intellectual or creative contribution to the discipline.”
Although the primacy of the concept of “originality” is strongly held
within CUR, CUR members embrace a variety of modalities through
which original research, scholarship, and/or creative inquiry can be
accomplished. Increasingly, the strategy of curricular “scaffolding” of
experiences and skill acquisition to help prepare students to achieve origi-
nal research contributions has received significant focus (e.g. Nadelson
et al. 2010; Shanahan 2012; Chamely-Wiik et al. 2014). The most com-
mon metric for defining originality of contribution is publication of stu-
dent research, or presentations at disciplinary conferences or NCUR.
Exploring the Variety of Random
Documents with Different Content
surface should be at right angles to the mucous membrane. The blade of
the knife should not wound the vesical mucous membrane.

Fig. 41. Sims’s Operation for the Fig. 42. Simon’s Operation for the
Repair of a Vesico-vaginal Fistula. Repair of a Vesico-vaginal Fistula.
Letters as in the preceding figure.
a. Bladder mucous membrane.
b. Vaginal wall.
c. Suture passed but not tied.
d. Section of denuded surface.
e, e'. Liberating incisions.
f. The fistula.

After the bleeding has ceased, the sutures, which may be of silk or
catgut, are passed by means of the needle through the pared edge of
the fistula on one side, passing across the fistula, and piercing the raw
surface on the opposite side. The entry of the needle should be made
about 1/4 – 1/3 of an inch from the raw edge (Fig. 44). Emmett’s hook,
shaped like a button-hook, is useful to produce counter-pressure against
the needle point. The sutures are tied, and milk is injected into the
bladder to test the accuracy of the union.
As a rule, fistulæ are bounded by rather scanty and inelastic walls, owing
to the presence of cicatricial tissue; it is therefore more advantageous
not to remove any tissue in order to produce a raw surface, or as little as
possible. To fulfil this condition, the method of dédoublement or flap-
splitting, as practised by Walcher, may be carried out (Fig. 43, a, b, and
c).
 Fig. 43. Repair of a Vesico-vaginal Fistula by Dédoublement.
a. The flap-splitting stage.
b. The flaps separated and the suture passed.
c. Suture tied, approximating the flaps.
a. Bladder mucous membrane.
b. Vaginal wall.
c. Suture.
e, e'. Liberating incisions.
k, k'. Flap-splitting incisions.

In a the flap-splitting is seen in section (k, k'); in b the flaps have

been everted towards the bladder and vagina respectively and the
suture passed. In c this suture has been tied; liberating incisions, e,
e', have been made on the vaginal surface to prevent tension in
the wound.
The patient is placed, as before, in the lithotomy position, and the cervix
is pulled down, while the edges of the fistula are kept steady by a
volsella on either side. The margin of the orifice is then split all round to
a depth of from a quarter to half an inch. Vesical and vaginal mucous
membrane flaps are thus produced, giving a large raw surface without
any loss of substance. The sutures are passed as shown in Fig. 43, c.
 Fig. 44. Repair of a Vesico-vaginal
Fistula. Sims’s Operation. The
edge of the fistula has been
denuded and the sutures have
been passed.
a.v.w. Anterior vaginal wall.
cl. Clitoris.
s', s''. Retractors.
sp. Posterior speculum.
t. Tenaculum.
u. Orifice of urethra.
v.v.f. Vesico-vaginal fistula.

After-treatment. This is very simple: if the patient is able, she should

pass water, either in the dorsal or genu-pectoral position, otherwise a
catheter should be passed every six hours.
Modifications of this operation have been devised, more especially for
the larger fistulæ: they will be briefly mentioned.
1. Repair by turning up vaginal flaps to form the base of the bladder is
recommended by A. Martin of Berlin. He first frees the adherent edges of
the fistula and then raises the flaps from the vaginal wall and brings
them over the opening, suturing them carefully together. By this method
the mucous membrane of the vagina forms the new lining to the bladder,
and the exposed raw surface a new anterior vaginal wall. The edges of
this latter denuded surface are united by sutures, as in the operation of
colporrhaphy.
2. Closure of the fistula by detaching the bladder from the vagina and
suturing it independently is described and practised by Mackenrodt.
The patient is placed in the lithotomy position, and the fistula is
exposed: the cervix is drawn downwards and backwards by means of a
wire loop or tenaculum, and the urethral prominence held with a pair of
hooked forceps. An incision is then made in the median line extending
across the fistula and through the vaginal walls down to the bladder, in
this way exposing the entire base of the bladder. The edges of the fistula
are then split so that the bladder and the vaginal walls are separated.
The two vesical flaps are now carefully and separately sutured by catgut
and the edges of the vaginal wound are brought together as much as
possible: if necessary, the fundus of the uterus may be used to assist in
closing the opening.
For vesico-utero-vaginal or juxta-cervical fistula.
In this affection the cervix is involved, and it must therefore be carefully
differentiated from the vesico-vaginal variety, in which the cervix is
intact.
In operating upon such cases the chief difficulty will be found in
denuding the surfaces necessary for the introduction of the sutures,
owing to the density of the cicatricial tissues, which are always present.
This is best overcome by drawing the cervix forcibly downwards and
backwards and incising the anterior cul-de-sac; the bladder wall with its
fistulous opening is then dissected off the anterior surface of the cervix
and carefully sutured independently of the cervical laceration; the latter
is treated by suture in the usual way (see p. 128). In the deeper forms
of juxta-cervical fistula, the above technique is impossible, and
suprapubic incision and suture of the bladder must be substituted.

RECTO-VAGINAL FISTULA
This condition may be defined as an opening between the rectum and
vagina through which flatus, or fæces, or both, may pass from the
former into the latter; it is chiefly the result of an imperfect union
subsequent to an operation for complete perineum laceration. It may
also be caused by the rupture of a pelvic abscess or by the spread of
primary malignant disease of the rectal wall.

Operation. If the sphincter ani is incompletely united, it will be

found much the most satisfactory proceeding to divide the healed
portions of the perineum and make a complete perineal laceration; this
may then be treated as described above (see p. 128).
If, however, the sphincter is intact and serviceable the fistula should be
pared and the edges brought together by silk sutures. It is not
infrequently necessary to perform a temporary colostomy (see Vol. II) in
order to divert the fæcal contents of the bowel during the process of
healing.

OPERATIONS FOR CYSTOCELE

In cystocele there is prolapse of the anterior vaginal wall and the
corresponding area of the posterior bladder wall. Cystocele often
complicates rectocele and prolapsus uteri, and operation upon it is often
carried out in combination with colpo-perineorrhaphy.
Operation. The operation for the cure of this affection is very
simple, and may be performed:—
(1) By denuding an oval space over the swelling and bringing the raw
edges together.
(2) By Stoltz’s operation, which is really purse-string suture.
The instruments necessary are a bladder sound, two tenacula, sharp-
pointed angular scissors, a needle-holder and fine silk.
(1) The parts are exposed with a Sims’s or Auvard’s speculum and a
volsella, or silver wire is passed through the cervix, by means of which
traction downwards and backwards may be exerted. The cystocele itself
is fixed by tenacula, and, with the sound in the bladder, an oval incision
is carried completely round the base of the cystocele. The whole area
contained in this incision is denuded by knife or scissors, care being
taken to avoid wounding the bladder mucous membrane.
Any bleeding having been controlled, a spiral buried suture, as in the
operation for perineorrhaphy (see p. 128), is passed antero-posteriorly,
thus reducing the size of the raw area and making a solid support in the
median line. The raw edges are then brought together by sutures. The
catheter should be passed every eight hours for three days, and then the
patient should be allowed to micturate on her hands and knees.
 Fig. 45. Stoltz’s Operation for
Cystocele. The oval surface
has been denuded and the
circumferential suture passed
but not tied.
1,1',2,3. The four points first
selected as boundaries for
denudation.
s. Suture, the arrows
denoting the direction in
which it is passed.
sp. Retractor.
t. Tenaculum.
u. Urethral orifice.

(2) Stoltz’s operation. The instruments necessary are: a No. 8 male

bladder sound; two tenacula; hooked forceps; sharp-pointed angular
scissors, and a needle-holder (Schauta’s for preference).
The patient is placed in the lithotomy position and the parts are exposed
by means of an Auvard’s speculum. A silver wire or tenaculum is passed
through the posterior lip of the cervix, by means of which downward and
backward traction may be exerted. Four points must be selected: two
lateral (Fig. 45, 1, 1'), fixing the external boundaries of the surface to be
denuded; one immediately behind the orifice of the urethra (2); and a
fourth in front of the cervix (3). These four points should be capable of
close approximation. They are carefully joined by curved incisions so that
the area to be denuded is almost oval in shape. The bladder sound is
now passed, and the mucous membrane of the vagina kept on the
stretch by pressure on its point. The process of denudation should be
carried out with a scalpel or pointed curved scissors. It will be found that
bleeding rarely gives any trouble. The point of the needle threaded with
silk is inserted on the operator’s right side of the urethral orifice and a
little below it; it pierces the mucous membrane on the left side of the
median line, and again appears upon the surface. By an in-and-out stitch
all the way round the circle which has been pared, the point finally
issues on the operator’s left side of the urethra and below it: by traction
on these two ends the edges of the denuded surface are drawn together
and the prolapsed bladder is sutured in its normal situation. A puckered
cicatrix results. This method is valuable for prolapsus uteri when
combined with the operation of posterior colporrhaphy.

CHAPTER XIV

OPERATIONS UPON THE VULVA AND VAGINA

OPERATIONS UPON BARTHOLIN’S GLANDS

The glands of Bartholin, or the vulvo-vaginal glands, are two racemose
structures about the size of a pea, lodged between the layers of the
triangular ligament, one on each side of the orifice of the vagina. Their
ducts open a little in front of the fossa navicularis, on each side of the
vaginal orifice, in the groove between the attached border of the hymen
and the labium minus.
Removal of a cyst of Bartholin’s gland. These cysts
really arise in the ducts rather than in the gland itself. The orifice of the
main duct is very liable to become blocked from inflammation of the
vulva, and leads to the formation of a single cyst varying in size from a
cherry to an orange. Less common is the blocking of the secondary
ducts, wherefrom a collection of small cysts results. The cyst forms a
characteristic tense ovoid or pyriform swelling in the posterior third of
the labium majus. The chief symptoms the patient complains of are
discomfort in walking and pain on coitus.
Operation. The best procedure is complete excision of the cyst. A
longitudinal incision is made over its cutaneous surface, and the cyst
carefully dissected out, together with the gland itself: care must be taken
not to perforate the vaginal mucous membrane stretched over the inner
surface of the cyst. Brisk bleeding from vessels at the base of the cyst,
usually follows from the cavity which contained the cyst and this must be
carefully arrested, otherwise a large hæmatoma may result. The cavity is
closed by five or six interrupted catgut sutures, passing deeply through
its sides and floor, so as to ensure complete closure. A gauze drain may
be inserted and retained for twenty-four hours.
The method of incising the cyst, swabbing its interior with undiluted
carbolic acid, and packing it with gauze is not to be recommended, for
cure is neither so rapid nor so certain as in excision.

Incision of an abscess of Bartholin’s gland.

Abscesses arise by infection passing into the gland along the ducts, and
are a very frequent accompaniment of gonorrhœa. The orifice of the
duct can usually be seen red and prominent, and may exude pus if
pressure be made over the abscess-sac. Sometimes the abscess bursts
and spontaneous recovery may follow, but it is very liable to recur, for
infection lurks among the smaller ducts and is carried to a fresh part of
the gland, and the process may continue until the whole gland has been
thus destroyed.
Operation. The abscess must be freely incised and all pockets and
septa broken down. It is stuffed with iodoform gauze, which is changed
daily, and the cavity is allowed to granulate up from the bottom. If the
abscess recurs, or if it consists only of a small collection of pus
surrounded by brawny œdema, the whole gland should be excised.

OPERATIONS FOR ATRESIA OF THE HYMEN AND THE VAGINA

Occlusion of the hymen is the commonest form observed. The vagina
becomes slowly distended with blood, forming an elastic pelvic swelling
(hæmato-colpos) upon which the uterus is, so to speak, perched. Later
in the course of the disease, this organ itself (hæmato-metra) and the
Fallopian tubes (hæmato-salpinx) may become affected similarly.

Indications. In atresia of the hymen symptoms only commence

after puberty; there is then congenital amenorrhœa with periodic pelvic
pain and gradual formation of a pelvic swelling. On inspection the hymen
is distended and the blood-tumour above it gives a bluish tint to its
surface.
Operation. After administration of an anæsthetic, careful palpation
of the tubes should be made per rectum: if they are distended it is better
to open the abdomen, ligature and remove them; if not, the hymen
should be incised by means of a crucial opening and the characteristic
tarry fluid allowed to escape: no hypogastric pressure should be used.
Irrigation and packing with gauze may be resorted to as after-treatment,
but are considered unnecessary by a large number of operators.
Atresia of the vagina may be congenital or acquired. In the latter case
the condition results from contraction of adhesions developed from
damage done during labour; or it may follow acute septic vaginitis, the
introduction of acids or irritating materials to produce abortion, or as a
sequel to typhoid fever.
Treatment is by slow dilatation with Hegar’s bougies over an extended
period of time; relapse is common.

DILATATION OF THE VULVAL ORIFICE

Indications. This is done for vaginismus due to a pathological
spasm of the levator ani and resulting in more or less complete
obstruction to coitus.

Operation. Under an anæsthetic the vulval orifice

should be thoroughly dilated by means of the thumbs,
and for some days subse quently graduated Sims’s
‘vaginal rests’ (Fig. 46) should be inserted twice daily Fig. 46. Sims’s
Vaginal Rest.
and worn for twenty minutes at a time. This treatment
may be necessary for a fortnight or longer. In many
cases of dyspareunia the cause will be found to be due to a thick, fleshy,
and unruptured hymen or to tenderness about the remnants of that
organ. Under these circumstances, exsection is the better plan to
pursue. The hymen is seized with a pair of toothed forceps and removed
with curved scissors along its entire base of attachment. Free bleeding
often occurs from the raw surface, which must be controlled by ligatures.
The two almost parallel cut edges must then be carefully brought
together either by continuous or interrupted suture.

COLPOTOMY OR VAGINAL CŒLIOTOMY

By colpotomy is meant making an opening into the peritoneal cavity
through the vagina; the operation is known as anterior or posterior
colpotomy, according to whether the opening is made through the
anterior or posterior fornix.
Colpotomy has certain advantages over abdominal section. There is less
interference with the peritoneum and intestines, and therefore less
shock; if pus is present, there is less risk of infecting the general
peritoneal cavity, and better drainage; there is no abdominal scar, and
therefore no risk of hernia; lastly, there are certain pathological products
which can be more easily reached by this route. The operation is difficult
in a nullipara, where the vagina is narrow, and easier in a multipara,
where the vagina is more capacious, and it is still easier if the cervix can
be drawn down as far as the vaginal orifice.
A serious disadvantage is that, during the course of the operation, it may
be found impossible to deal adequately with the conditions for which the
operation is being performed; in the case of a tumour, for instance, its
size, position, or the presence of adhesions may render it necessary to
complete the operation by the abdominal route. Further, in more than
one instance, the abdomen has had to be opened after the completion of
the operation on account of bleeding, the source of which could not be
dealt with by the vagina.
Therefore, before deciding upon the removal of a tumour by colpotomy,
all the above points must be taken into consideration.
Indications. When the above conditions are fulfilled, colpotomy is
suitable for:—
(i) The evacuation of collections of pus or blood in Douglas’s pouch.
(ii) The removal of fibro-myomata, ovarian tumours of small size, and
early tubal pregnancies.
(iii) The drainage of collections of pus or the removal of the appendages
in cases of acute inflammation where immediate operation is necessary.
(iv) Conservative operations upon the Fallopian tubes or ovaries.
(v) A preliminary to the performance of vaginal hysteropexy.
(vi) Those cases in which the patient’s general condition is unfavourable
to the performance of exploration by the abdominal route.
Anterior colpotomy is more suitable for removing small tumours growing
from the anterior wall of the uterus, or for conservative operations on
the ovaries. Posterior colpotomy is more suitable for removing inflamed
appendages, and for evacuating collections of pus or blood from
Douglas’s pouch.

Fig. 47. Pozzi’s Retractors.

Posterior colpotomy has been used for many years for the opening of
abscesses and hæmatoceles in Douglas’s pouch. The anterior operation
is of more recent date, and its relative advantages and disadvantages
and the indications for its use have not yet been definitely agreed upon
by the majority of gynæcologists. Taking all things into consideration, the
disadvantages of colpotomy seem to outweigh its advantages, and,
except for the evacuation or drainage of collections of blood or pus
behind the uterus, the operation may be said to have few indications.

Anterior colpotomy. A posterior Pozzi’s (Fig. 47) or Péan’s

retractor is passed into the vagina, and the cervix is seized with a
volsella and drawn downwards and backwards. A sound passed into the
bladder defines its lower limit. A T-shaped incision is now made through
the vaginal mucous membrane, the transverse portion just below the
point to which the bladder has been found to extend (Fig. 48, b). This
incision should pass completely through the vaginal mucous membrane,
but no further, and should extend across the whole width of the anterior
surface of the cervix. Some operators use a simple longitudinal or a
transverse incision. The vaginal mucous membrane is now carefully
pushed upwards with the pulp of the finger until the lower limit of the
bladder is defined. Great help is gained at this stage by the use of the
bladder sound. On pushing up the vaginal mucous membrane still further
the peritoneum is reached, and is recognized by its white glistening
appearance, and by the fact that its two
opposed surfaces glide freely over one another
under the finger. The next step is to open the
peritoneum: it is picked up with catch-forceps,
and a small transverse incision is made into it
with a pair of scissors; the finger is passed
through, and the incision is extended on either
side, care being taken not to pass too far
outwards for fear of injuring the ureters or
uterine vessels.
After the peritoneum has been opened, the
pelvic organs can be carefully examined with
the fingers, and the purposes for which the
operation has been undertaken can be
proceeded with. The next step usually consists
in drawing out the fundus of the uterus, by
which much more room and much better
access to the pelvic organs is gained. To Fig. 48. Anterior
accomplish this, the uterus is caught with a Colpotomy.
volsella in the middle line, as high up as The patient is in the
possible, and drawn downwards and forwards. lithotomy position, the
If necessary, a second volsella is applied above speculum is passed and
the first, and so on, until the uterus is the cervix pulled down by
delivered. A very complete examination of the a tenaculum. The T-
shaped incision has been
appendages can now be made, for the tubes made.
and ovaries can be drawn out of the wound
b. Outline of bladder.
and examined directly. c. Cervix.
When the object of the operation has been cl. Clitoris.
attained, and all the blood has been carefully l.m. Labium minus.
sp. Speculum.
removed by swabs, the next and final step u. Urethral orifice.
consists in closing the peritoneal and vaginal v,v',v''. Volsella.
wounds. The uterus is replaced, and the
peritoneal incision is closed by a single layer of
catgut sutures; the vaginal incision is similarly dealt with. The vagina is
cleared from blood-clot and gently irrigated with an antiseptic solution. A
gauze plug is inserted lightly, and the patient is put back to bed. The
catheter should be used every six or eight hours for the first twenty-four
hours.
Posterior colpotomy. A posterior speculum is passed and the
cervix drawn downwards and slightly forwards with a volsella. A
transverse incision is then made through the vaginal mucous membrane
at the junction of the posterior fornix with the cervix. This exposes the
peritoneum more or less easily, and this structure is picked up with
catch-forceps, and a transverse incision made into it with scissors; a
finger is passed through this, and the incision is extended on either side.
The pelvic organs can now be explored and the tubes and ovaries drawn
down and examined. The peritoneal and vaginal incisions are then closed
by separate layers of catgut sutures.
To open a collection of pus in Douglas’s pouch, the best method is to
pass a pair of sinus-forceps, with the blades closed, into the most
prominent part of the swelling. The blades are then opened and the
forceps withdrawn. The finger passed into the abscess cavity gently
breaks down any adhesions. The cavity is then irrigated with hot salt
solution and a drainage tube inserted, which projects just outside the
vulva: the lower end of the tube should be carefully packed around with
cyanide gauze. The tube should be changed every day and the vagina
douched with an antiseptic. Another method is to plunge a Martin’s
trochar (Fig. 49) into any softened spot in the swelling and then
withdraw the needle, leaving a blunt dilating forceps to extend the
opening.

Fig. 49. Martin’s Trochar for Pelvic Abscess.

In opening an abscess, the most stringent precautions against sepsis
should be observed. The vagina must be most carefully prepared
beforehand, by rubbing over with swabs and ethereal soap, and by a
subsequent copious douche of 1 in 1,000 perchloride of mercury:
otherwise continual reinfection of the abscess cavity occurs, and healing
is much delayed.
Lateral colpotomy—Paravaginal section.
Indications. The object of the operation is to increase the amount of
room in the vagina in certain cases of vaginal hysterectomy in elderly
virgins, or in women who have a small vagina.
Operation. The same preliminaries are carried out as before. The
incision is carried completely round the cervix at its junction with the
vagina. The lateral margin of the vulva is then held tense, and an
incision is made, beginning at the circumcervical incision running down
the lateral vaginal wall, through the margin of the vulva and on to the
skin externally, ending at a point midway between the perineum and the
ischial tuberosity, i.e. about 1½ inches to the side, and in front of the
perineum; the incision may be lateral only or bilateral. In sewing up, it is
important to reunite the cut edges of the levator ani, or pelvic weakness
will result.

CHAPTER XV

OPERATIONS UPON THE UTERUS

PASSAGE OF THE UTERINE SOUND

This is an operation which is much less frequently resorted to than
formerly, owing partly to the risks of sepsis attending its performance
and partly to the greater perfection of the bimanual examination. Passing
the uterine sound should always be looked upon as a surgical operation.
The facts learnt by the use of the sound are: (1) the length and direction
of the uterine cavity; (2) the condition of the endometrium: bleeding as
a rule follows withdrawal in fibro-myomata and endometrial disease; (3)
whether a fibroid growth is projecting into the uterine cavity, and if so,
how much.
 Fig. 50. The Passage of the Fig. 51. The Passage of the
Uterine Sound. Introduction Uterine Sound.
of the point into the Commencement of the
external os uteri. tour de maître.
The sound may be passed in the dorsal position (Fig. 61), the cervix
being held by a volsella and exposed by means of a posterior speculum,
or in the left lateral position, the method usually adopted in the
consulting room. In the latter the right index-finger is passed up to the
anterior lip of the cervix, the sterilized sound is taken in the left hand
with its concavity backwards and its bulbous end is slid gently along the
palmar surface of the finger in the vagina until the os uteri externum is
reached; through this it should be passed for about a quarter of an inch
(Fig. 50). The instrument should now be steadied by the thumb and the
two distal joints of the second finger of the right hand, and its
subsequent movements controlled by the left (Fig. 51).
If the uterus is in a state of retroversion, the bulbous end will gradually
enter the uterine cavity by pressing the handle of the sound forward and
at the same time giving an upward and slightly backward impulse to its
tip; the rough surface of the handle will be found to be looking towards
the sacrum. Should the uterus be anteverted, the handle is held in the
left hand as before and passed through an arc of a circle by raising the
handle and turning it forward until it lies beneath the symphysis pubis, in
the median line (tour de maître) (Fig. 52). The rough surface of the
handle now looks anteriorly and the bulbous end is pressing against the
internal os uteri; now bring back the handle directly to the perineum and
it will glide into the uterine cavity (Fig. 53).

Fig. 52. The Passage of the Fig. 53. The Passage of the
Uterine Sound. Completion Uterine Sound. Entry of the
of the tour de maître. sound into the uterine
cavity.

Difficulties to be met with will be: (1) An acutely anteflexed uterus; if

traction is made on the cervix with a volsella the canal is straightened
and the difficulty overcome. (2) Spasmodic contraction of the internal os
uteri; this soon passes off with a little steady pressure. (3) A fibroid may
project into the lumen of the canal. (4) Congenital or acquired stenosis
of the external os uteri.
When there is a septic discharge from the vagina, the sound should be
passed in the dorsal position and through a speculum.

REPOSITION OF A CHRONIC UTERINE INVERSION

Indications. Chronic inversion of the uterus, with severe

hæmorrhage and bearing-down pain. The uterine fundus presents in the
vagina and simulates a fibroid polypus in process of extrusion.
Operation. This is most likely to be successful if continuous pressure
be brought to bear against the inverted fundus while an attempt is made
simultaneously to dilate the contracted cervix.
The patient is placed under an anæsthetic in the
dorsal position and the whole hand is passed
gradually into the vagina. The tips of the fingers
and thumb should be pressed into the circular
space at which the flexion of the walls of the body
on the cervix has occurred. With the palm of the
hand upward pressure is made, counter-pressure
being exerted by the other hand over the lower
hypogastrium. Reduction usually begins by a slight
Fig. 54. Chronic Uterine
dimpling of the inverted fundus. Inversion. Aveling’s
A more scientific method of exerting continuous repositor in place with
elastic cords a, b, and
pressure is by the application of Aveling’s sigmoid
c, in action.
repositor and elastic cords (Fig. 54). This
instrument consists of a vulcanite cup into which is
secured a steel S-shaped rod terminating below in a loop. The cup is
made of various sizes and should always be smaller than the inverted
fundus over which it fits.
After it has been applied, the instrument is carefully packed round with
gauze to keep it in place. Two elastic bands in front and two behind are
fastened by one end to the steel loop and by the other end to an
abdominal belt. By this means constant and direct pressure is obtained
on the fundus uteri in the direction of the pelvic axis.
Pain is usual and must be relieved by morphine. The cup usually elevates
the fundus and corrects the inversion in about twenty-four hours, but as
much as three days has been occupied in the process.

CURETTING THE UTERUS—CURETTAGE

The term ‘curetting’ is applied to the operation of scraping away the
lining membrane of the uterus, either for the relief of some pathological
condition or for diagnostic purposes.
The endometrium is not removed in its entirety by curetting, for the
uterine glands dip down to a slight extent between the muscle fibres of
the uterine wall. The endometrium is removed as far down as the
muscular coat, and, consequently, those parts of the glands lying
amongst the muscular fibres are left intact.
Indications. These may be divided into the cases in which the
operation is (1) Remedial and (2) Diagnostic in nature.
The diseased states of the endometrium are many and their exact
pathology is still under discussion. It is, therefore, more practical to
consider the remedial indications for curetting from the point of view of
symptoms.
(i) Uterine hæmorrhage is the chief symptom which calls for curetting.
The causes of the hæmorrhage may be certain forms of endometritis.
Thus hæmorrhage is a prominent symptom of the so-called ‘hypertrophic
glandular endometritis’, a diffuse overgrowth or adenomatous condition
of the endometrium, probably the after-result of a previous
inflammation. There is one form which gives rise to specially profuse
hæmorrhage—the ‘polypoid’ or ‘villous’ form, which arises usually in
women over forty years of age.
The hæmorrhage from fibro-myoma of the uterus may require removal
of the endometrium in order to relieve the bleeding temporarily at any
rate. When milder measures fail, curetting is of great service in arresting
the profuse menorrhagia which so often accompanies subinvolution of
the uterus.
Certain cases in which the actual cause of the hæmorrhage is not
evident are relieved by curetting; amongst these are such conditions as
arterio-sclerosis of the uterine vessels.
(ii) A leucorrhœal discharge is another symptom for which curetting is
sometimes indicated.
It may be called for when the endometrium is congested and
œdematous from such conditions as displacements of the uterus and
chronic subinvolution.
It is better not to curette for a purulent uterine discharge; extension of
the infection may be caused and give rise to pyosalpinx.
(iii) Sterility. Curetting should follow dilatation, in the hope that the new
endometrium formed may afford a better nidus for the ovum.
(iv) Frequent abortion in the early months. Curetting often cures this by
removing the diseased endometrium.
(v) Inoperable carcinoma of the cervix. Removal of the redundant
portions of the growth by the curette, followed by cauterization or other
measures, relieves the hæmorrhage and foul discharge. Great caution
must be exercised, lest the peritoneum or bladder be opened into by the
curette and the sufferings of the patient thereby increased. Cells of the
disease may also be pushed into the pelvic lymphatics; considerable
febrile disturbance may also follow the operation. In this condition a
blunt curette (Fig. 60, b) may be gently used; the same instrument is
safest in abortion up to the eighth week of pregnancy; after this date it
is better to use the fingers only.
Fragments removed by the curette are subjected to microscopical
examination for diagnostic purposes. The various conditions which may
have to be diagnosed are:—
1. Carcinoma of the body of the uterus.
2. Retained products of conception.
3. Tuberculosis of the endometrium.
4. Chorio-epithelioma malignum.

Operation. The following instruments are required: a volsella (Fig.

55); a self-retaining weighted speculum (Fig. 37); uterine dilators (Figs.
56, 57); a uterine sound; a Bozemann’s tube (Fig. 58); Budin’s celluloid
catheter (Fig. 59); and one or other flushing curettes.

Fig. 55. Volsella for fixing the Cervix.

Fig. 56. Hegar’s Dilators (three sizes) for
dilatation of the Cervix Uteri.

Fig. 57. Metal Bougies for

Fig. 58. Bozemann’s Double-channelled Tube. dilatation of the Cervix.

a. As used by the author.

b. Ends of bougies
considered unsuitable.

Fig. 59. Budin’s Celluloid Catheter.

There are many varieties of curettes, and each has its own adherents.
The most generally useful is Murray’s sharp flushing curette, which has a
groove for the recurrent flow (Fig. 60, a). There are many varieties of
blunt curettes. The model depicted in Fig. 60, b, enables the operator to
clear out the uterine cornua and is of the best shape.

Fig. 60. a, Murray’s Flushing Curette; b, Blunt Curette.

The patient is placed in the lithotomy position and the various antiseptic
precautions already described are carried out. A speculum is passed and
the cervix is steadied by a volsella applied to the anterior lip.
The cervix is first dilated up to a suitable degree for the passage of the
curette; up to No. 12 Hegar is usually sufficient. The curette is now
taken and passed into the uterus. In performing the operation a definite
plan should always be followed so as to ensure that no part of the
uterine cavity is missed. The curette is passed up to the top of the
fundus uteri with its cutting edge directed to the posterior wall. It is then
drawn downwards with steady pressure to just below the internal os. It
is then again passed upwards and the manœuvre repeated with just
sufficient change of direction to ensure the curette passing over fresh
tissue. This is repeated until the whole of the posterior wall has been
thoroughly dealt with from side to side. The anterior wall and sides of
the uterus are then treated in turn in the same way. Finally the fundus is
curetted by a lateral movement of the instrument, especial attention
being paid to the Fallopian tube angles, which are very apt to escape the
curette.
A rasping or grating sound indicates that the endometrium over a given
part has been removed and that the muscular walls have been reached.
In spite of the most careful attention it is very difficult to remove the
endometrium completely. If a uterus be scraped, as it is thought,
thoroughly, and be examined post mortem, strips of mucous membrane
will often be found untouched, showing the difficulties of complete
removal.
After the operation an intra-uterine douche of 1 in 2,000 perchloride of
mercury or some other suitable antiseptic is given with a Bozemann’s
tube or Budin’s catheter. If a flushing curette has been used, this of
course has already been done. After the douche, some application may
be made to the interior of the uterus: the best is iodized phenol (liquid
carbolic acid, 2 parts; tincture of iodine, 1 part). To do this the interior of
the uterus is first dried with a Playfair’s probe armed with cotton-wool;
another similar probe is then taken, dipped into the solution, and passed
into the uterus. The vagina is protected by inserting a plug of cotton-
wool into the posterior fornix. The uterus is then lightly packed with
ribbon gauze. If there is hæmorrhage, the packing should be firmer, and
a vaginal tampon should be placed in below the cervix. The packing
should be removed in twenty-four hours. The patient may get up at the
end of a week and resume her ordinary duties in a fortnight.

DILATATION OF THE CERVIX

Indications. Dilatation may be performed:—
(i) As a means of diagnosis.
As a preliminary to the use of the curette or to removal of intra-
(ii)
uterine growths.
(iii) As a method of cure for spasmodic dysmenorrhœa.
Contra-indications to the rapid method of dilatation of the cervix are very
few: a recent attack of peri- or parametritis would certainly be one, but
when the effects of a salpingitis have quieted down there seems very
little reason against its use. Where carcinoma of the body of the uterus
is known to exist, and in old age, it should only be resorted to with the
greatest caution, if at all.

Methods:—
(a) Rapid dilatation by means of graduated metal bougies.
(b) Gradual dilatation by means of tents.
(c) Combined gradual and rapid dilatation.
In a large majority of cases rapid dilatation is the operation selected. Its
one disadvantage is that when a great degree of dilatation is necessary,
or when the operation is performed too rapidly, the cervix is liable to be
torn, an event which is especially liable to occur when the tissues of the
cervix are rigid. These lacerations are longitudinal in direction and in the
neighbourhood of the internal os uteri. They sometimes result in
hæmorrhage, which can easily be controlled by plugging the cervical
canal. Unless strict asepsis be maintained, these lacerations of course
form a channel for infection of the pelvic cellular tissue.
It is obvious that dilatation will be easier to perform, and laceration less
liable to occur, if the cervix is in a softened condition—a physiological
state which is always present during pregnancy and labour. Efforts
should therefore be directed, when possible, to ensure a soft state of the
cervix before performing rapid dilatation.
Immediately after the cessation of a period, the cervix is soft and
somewhat patent, and advantage may be taken of this fact. The
introduction of a glycerine tampon two hours beforehand produces a
certain amount of softening. But nothing ensures so much softening as
the introduction of a tent into the cervix about twelve hours previous to
the rapid dilatation.
It is therefore recommended in all cases, where possible, to perform
dilatation by this latter means, viz. a combination of the gradual and
rapid methods.
Rapid dilatation by means of graduated metal bougies. Hegar’s
original dilators (Fig. 56) were solid vulcanite bougies, graduated from 1
to 26, the numbers corresponding to the diameter of the bougie in
millimetres. Each was 5¼ inches in length, the handle measuring 1½
inches and the bougie the remainder. The bougie formed a slight curve
and tapered off to a blunt point.
These bougies were rather short and too sharply pointed, and they could
not be sterilized by boiling. To overcome these disadvantages, uterine
dilators are now made about the same length as a male catheter, with a
sharper curve than Hegar’s original one, and a blunter point; the larger
sizes are of hollow metal for the sake of lightness. There are many
varieties of dilator, each with minor differences as to length, curve,
handle, and shape of the point.
The author uses metal bougies. These have somewhat the shape of the
ordinary uterine sound, are thirty-five in number, and graduated in size.
Like the sound, the upper portion is bent at an angle of about 160° with
the solid handle, a circular shallow depression indicating the 2½ inch
mark in the smaller numbers; in the larger this is not considered
necessary.
Operation. Instruments: an Auvard’s self-retaining weighted flushing
speculum; a volsella; a Bozemann’s tube or Budin’s catheter; a uterine
sound; and a set of dilators.
The patient is anæsthetized and placed in the lithotomy position with the
legs supported by a crutch. Strict asepsis must be observed; the labia
must be shorn of long hairs; this is followed by cleansing of the vagina
and a vaginal douche, and finally the vulva is washed with antiseptic
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