Abstract
Classroom discussions represent a common learning activity for students in schools. The prevailing discourse has focused on how to encourage as many students as possible to participate actively in classroom discussions with the assumption that only vocal students are engaged learners. The present essay critically challenges this position by drawing attention to how silent students may be similarly, if not more, engaged emotionally and cognitively than vocal students in classroom discussions. It uses the conceptual apparatus of the integrated perspective of student engagement to hypothesize a typology of six student learning patterns in discussions, namely, Silent-Acting, Silent-Feeling, Silent-Cognizing, Vocal-Acting, Vocal-Feeling, and Vocal-Cognizing. The typology is derived from examining interactions between the three dimensions of student engagement (behavioural, emotional, and cognitive engagement) and two types of student participation in classroom discussions (vocal versus silent participation). Implications for building a more inclusive classroom learning environment and suggestions for future research are discussed.
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Abdullah, M. Y., Bakar, N. R. A., & Mahbob, M. H. (2012). Student's participation in classroom: What motivates them to speak up? Procedia—Social and Behavioural Sciences,51, 516–522.
Alexander, R. (2006). Towards dialogic teaching: Rethinking classroom talk (3rd ed.). York: Dialogos.
Alrashidi, O., Phan, H. P., & Ngu, B. H. (2016). Academic engagement: An overview of its definitions, dimensions, and major conceptualisations. International Education Studies,9(12), 41.
Anthony, G., & Hunter, R. (2017). Grouping practices in New Zealand mathematics classrooms: Where are we at and where should we be? New Zealand Journal of Educational Studies,52(1), 73–92.
Applebee, A. N., Langer, J. A., Nystrand, M., & Gamoran, A. (2003). Discussion-based approaches to developing understanding: Classroom instruction and student performance in middle and high school English. American Educational Research Journal,40(3), 685–730.
Archambault, I., Janosz, M., Fallu, J., & Pagani, L. S. (2009). Student engagement and its relationship with early high school dropout. Journal of Adolescence,32, 651–670.
Astin, A. W. (1984). Student involvement: A developmental theory for higher education. Journal of College Student Personnel,25(4), 297–308.
Atkinson, P. (1981). Inspecting classroom talk. In C. Adelman (Ed.), Uttering, muttering (pp. 98–113). London: Grant Mclntyre.
Balas, A. (2000). Using participation to assess students’ knowledge. College Teaching,48(4), 122–122.
Barnes, D. (1976). From communication to curriculum. Hammondsworth: Penguin.
Bartholomew, K. J., Ntoumanis, N., Mouratidis, A., Katartzi, E., Thøgersen-Ntoumani, C., & Vlachopoulos, S. (2018). Beware of your teaching style: A school-year long investigation of controlling teaching and student motivational experiences. Learning and Instruction,53, 50–63.
Bean, J. C., & Peterson, D. (1998). Grading classroom participation. New Directions for Teaching and Learning,1998(74), 33–40.
Blankson, A. N., & Blair, C. (2016). Cognition and classroom quality as predictors of math achievement in the kindergarten year. Learning and Instruction,41, 32–40.
Blatchford, P., Bassett, P., & Brown, P. (2011). Examining the effect of class size on classroom engagement and teacher–pupil interaction: Differences in relation to pupil prior attainment and primary vs. secondary schools. Learning and Instruction,21(6), 715–730.
Brogt, E., & Comer, K. (2013). Interpreting differences between the United States and New Zealand university students' engagement scores as measured by the NSSE and AUSSE. Assessment & Evaluation in Higher Education,38(6), 713–736.
Brown, R., & Renshaw, P. D. (2000). Collective argumentation: A sociocultural approach to reframing classroom teaching and learning. In H. Cowie & G. van der Aalsvoort (Eds.), Social interaction in learning and instruction: The meaning of discourse for the construction of knowledge (pp. 52–66). Oxford: Pergamon.
Bryson, C., & Hand, L. (2007). The role of engagement in inspiring teaching and learning. Innovations in Education and Teaching International,44(4), 349–362. https://doi.org/10.1080/14703290701602748.
Braddock, R., Roberts, P., Zheng, C., & Guzman, T. (1995). Survey on skill development in intercultural teaching of international students. Sydney: Macquarie University, Asia Pacific Research Institute.
Byram, M. (1997). Teaching and assessing intercultural communicative competence. Multilingual matters (series). Clevedon, PA: Multilingual Matters.
Cappella, E., Kim, H. Y., Neal, J. W., & Jackson, D. R. (2013). Classroom peer relationships and behavioural engagement in elementary school: The role of social network equity. American Journal of Community Psychology,52(3–4), 367–379.
Cazden, C. B. (2001). The language of teaching and learning. In: The language of teaching and learning (pp. 348–369). Portsmouth, NH: Heinemann.
Cheng, H., Andrade, H. L., & Yan, Z. (2011). A cross-cultural study of learning behaviours in the classroom: From a thinking style perspective. Educational Psychology,31(7), 825–841.
Chi, M. T. H., & Wylie, R. (2014). The ICAP framework: Linking cognitive engagement to active learning outcomes. Educational Psychologist,49(4), 219–243.
Chiu, M. M., & Chow, B. W. Y. (2015). Classmate characteristics and student achievement in 33 countries: Classmates’ past achievement, family socioeconomic status, educational resources, and attitudes toward reading. Journal of Educational Psychology,107(1), 152.
Christenson, S., & Reschly, A. L. (2012). Jingle, jangle, and conceptual haziness: Evolution and future directions of the engagement construct. In S. L. Christenson, A. L. Reschly, & C. Wylie (Eds.), Handbook of research on student engagement (pp. 3–19). New York: Springer.
Clancy, P. (1986). The acquisition of communicative style in Japanese. In B. Schieffelin & E. Ochs (Eds.), Language and socialization across cultures (pp. 213–250). Cambridge: Cambridge University Press.
Clark, R., & Gieve, S. N. (2006). On the discursive construction of the Chinese learner. Language, Culture and Curriculum,19(1), 54–73.
Clarke, S. N. (2015). The right to speak. In L. Resnick, C. Asterhan, & S. Clarke (Eds.), Socializing intelligence through academic talk and dialogue (pp. 167–180). Washington, DC: American Educational Research Association.
Condon, M., & Ruth-Sahd, L. (2013). Responding to introverted and shy students: Best practice guidelines for educators and advisors. Open Journal of Nursing,3(7), 503–515.
Connell, J. P., Halpern-Felsher, B. L., Clifford, E., Crichlow, W., & Usinger, P. (1995). Hanging in there: Behavioural, psychological, and contextual factors affecting whether African American adolescents stay in high school. Journal of Adolescent Research,10(1), 41–63.
Coulthard, M., & Sinclair, J. (1975). Towards an analysis of discourse. London: Oxford University Press.
Dahlin, B., & Watkins, D. (2000). The role of repetition in the processes of memorising and understanding: A comparison of the views of German and Chinese secondary school students in Hong Kong. British Journal of Educational Psychology,70(1), 65–84.
Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behaviour. New York: Plenum Press.
Dillon, J. (1994). Using discussion in classrooms. Buckingham: Open University Press.
Eccles, J. S., & Wang, M. T. (2012). So what is student engagement anyway: Commentary on Section I. In S. Christenson, A. L. Reschy, & C. Wylie (Eds.), Handbook of research on student engagement. New York, NY: Springer.
Fang, B. (2009). From distraction to engagement: Wireless devices in the classroom. Educause Quarterly,32(4), 4–9.
Fassinger, P. A. (1995). Professors’ and students’ perception of why students participate in class. Teaching Sociology.,24, 25–33.
Fredricks, J. A., Blumenfeld, P. C., & Paris, A. H. (2004). School engagement: Potential of the concept, state of the evidence. Review of Educational Research,74, 59–109.
Fritschner, L. M. (2000). Inside the undergraduate college classroom: Faculty and students differ on the meaning of student participation. The journal of higher education, 71(3), 342–362.
Frymier, A. B., & Houser, M. L. (2016). The role of oral participation in student engagement. Communication Education,65(1), 83–104.
Furneaux, C., Locke, C., Robinson, P., & Tonkyn, A. (1991). Talking heads and shifting bottoms: The ethnography of academic seminars. In P. Adams, B. Heaton, & P. Howarth (Eds.), Socio-cultural issues in English for academic purposes (pp. 74–85). London: Modern English Publications/British Council.
Galton, M., Hargreaves, L., & Pell, T. (2009). Group work and whole-class teaching with 11- to-14-year-olds compared. Cambridge Journal of Education,39(1), 119–140.
Gavala, J., & Flett, R. (2005). Influential factors moderating academic enjoyment/motivation and psychological well-being for Maori university students at Massey University. New Zealand Journal of Psychology,34(1), 52–57.
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldire.
Goldberg, J. H., Stimson, M. J., Lewenstein, M., Scott, N., & Wichansky, A. M. (2002). Eye tracking in web search tasks: design implications. In Proceedings of the 2002 symposium on eye tracking research & applications (pp. 51–58). New York: ACM.
Green, G., Rhodes, J., Hirsch, A. H., Suarez-Orozco, C., & Camic, P. M. (2008). Supportive adult relationships and the academic engagement of Latin American immigrant youth. Journal of School Psychology,46, 393–412.
Greene, B. A., Miller, R. B., Crowson, H. M., Duke, B. L., & Akey, K. L. (2004). Prediction high school students’ cognitive engagement and achievement: Contributions of classroom perceptions and motivation. Contemporary Educational Psychology,29(4), 462–482.
Hagel, P., Carr, R., & Devlin, M. (2012). Conceptualising and measuring student engagement through the Australasian Survey of Student Engagement (AUSSE): A critique. Assessment & Evaluation in Higher Education,37(4), 475–486.
Hagenaars, J. A., & McCutcheon, A. L. (Eds.). (2002). Applied latent class analysis. Cambridge: Cambridge University Press.
Hatano, G., & Inagaki, K. (1991). Sharing cognition through collective comprehension activity. In L. B. Resnick, J. M. Levine, & S. D. Teasley (Eds.), Perspectives on socially shared cognition (pp. 331–348). Washington, DC: American Psychological Association.
Heflin, H., Shewmaker, J., & Nguyen, J. (2017). Impact of mobile technology on student attitudes, engagement, and learning. Computers & Education,107, 91–99.
Hennessy, S., Rojas-Drummond, S., Higham, R., Márquez, A. M., Maine, F., Ríos, R. M., … Barrera, M. J. (2016). Developing a coding scheme for analysing classroom dialogue across educational contexts. Learning, Culture and Social Interaction, 9, 16–44.
Hillman, D. C. A. (1997). Improving coding and data management for discourse analysis: A case study in face-to-face and computer-mediated classroom interaction. Doctoral Dissertation, University of Cambridge, Cambridge.
Hirschfield, P. J., & Gasper, J. (2011). The relationship between school engagement and delinquency in late childhood and early adolescence. Journal of Youth and Adolescence,40, 3–22.
Howard, J. R. (2004). What does research tell us about classroom discussion? In J. R. Howard (Ed.), Discussion in the college classroom: Applications for sociology instruction. Washington, DC: American Sociological Association.
Hunter, R., & Anthony, G. (2011). Forging mathematical relationships in inquiry-based classrooms with Pasifika students. Journal of Urban Mathematics Education,4(1), 98–119.
Hussein, G. (2010). The attitudes of undergraduate students towards motivation and technology in a foreign language classroom. International Journal of Learning and Teaching,2(2), 14–24.
Inagaki, K., Hatano, G., & Morita, E. (1998). Construction of mathematical knowledge through whole-class discussion. Learning and Instruction,8(6), 503–526.
Jones, J. F. (1999). From silence to talk: Cross-cultural ideas on students participation in academic group discussion. English for Specific Purposes,18(3), 243–259.
Jurik, V., Gröschner, A., & Seidel, T. (2014). Predicting students' cognitive learning activity and intrinsic learning motivation: How powerful are teacher statements, student profiles, and gender? Learning and Individual Differences,32, 132–139.
Kaufman, L., & Rousseeuw, P. J. (2009). Finding groups in data: An introduction to cluster analysis. New York: Wiley.
Khong, T. D. H., Saito, E., & Gillies, R. M. (2017). Key issues in productive classroom talk and interventions. Educational Review. https://doi.org/10.1080/00131911.2017.1410105.
Kuh, G. D., Kinzie, J., Buckley, J. A., Bridges, B. K., & Hayek, J. C. (2007). Piecing together the student success puzzle: Research, propositions, and recommendations. Higher Education Report,32(5), 1–182.
Kuhn, D., Shaw, V., & Felton, M. (1997). Effects of dyadic interaction on argumentative reasoning. Cognition and Instruction,15(3), 287–315.
Kutnick, P., Hodgkinson, S., Sebba, J., Humphreys, S., Galton, M., Steward, S., … Baines, E. (2006). Pupil grouping strategies and practices at Key Stage 2 and 3: Case studies of 24 schools in England. Department for Education and Skills Research Report, 796. London: DfES.
Larson, B. E., & Parker, W. C. (1996). What is classroom discussion? A look at teachers' conceptions. Journal of Curriculum and Supervision,11(2), 110–126.
Lei, H., Cui, Y., & Zhou, W. (2018). Relationships between student engagement and academic achievement: A meta-analysis. Social Behaviour and Personality: An International Journal,46(3), 517–528.
Lester, D. (2013). A review of the student engagement literature. Focus on Colleges, Universities, and Schools,7(1), 1–8.
Li, D., Babcock, J., & Parkhurst, D. J. (2006). openEyes: A low-cost head-mounted eye-tracking solution. In Proceedings of the 2006 symposium on Eye tracking research & applications (pp. 95–100). New York: ACM.
Lietaert, S., Roorda, D., Laevers, F., Verschueren, K., & De Fraine, B. (2015). The gender gap in student engagement: The role of teachers’ autonomy support, structure, and involvement. British Journal of Educational Psychology,85(4), 498–518.
Lipman, M. (1991). Thinking in education. Cambridge: Cambridge University Press.
Loveday, L. (1982). The sociolinguistics of learning and using a non-native language. Oxford: Pergamon.
Majid, S., Yeow, C., Ying, A. C., & Shyong, L. R. (2010). Enriching learning experience through class participation: A students’ perspective. Nanyang Technological University, Wee Kim Wee School of Communication & Information. Singapore: Nanyang Technological University.
Martin, A. J. (2007). Examining a multidimensional model of student motivation and engagement using a construct validation approach. British Journal of Educational Psychology,77, 413–440.
Mayer, R. E. (2004). Should there be a three-strikes rule against pure discovery learning? The case for guided methods of instruction. American Psychologist,59(1), 14–19. https://doi.org/10.1037/0003-066X.59.1.14.
Mazer, J. P. (2012). Development and validation of the student interest and engagement scales. Communication Methods and Measures,6, 99–125. https://doi.org/10.1080/19312458.2012.679244.
McPhail, G. (2013). Mixed pedagogic modalities: The potential for increased student engagement and success. New Zealand Journal of Educational Studies,48(1), 113–126.
McWilliam, R. A., Trivette, C. M., & Dunst, C. J. (1985). Behavior engagement as a measure of the efficacy of early intervention. Analysis and Intervention in Developmental Disabilities,5, 59–71.
Mehan, H. (1979). Learning lessons: Social organization in the classroom. Cambridge, MA: Harvard University Press.
Mercer, N., Wegerif, R., & Dawes, L. (1999). Children’s talk and the development of reasoning in the classroom. British Educational Research Journal,25(1), 95–111. https://doi.org/10.1080/0141192990250107.
Mercer, N., & Dawes, L. (2010s). The study of talk between teachers and students, from the 1970s until the 2010s. Oxford Review of Education,40(4), 430–445.
Meyer, K. R. (2007). Student engagement in the classroom: An examination of student silence and participation. Paper presented at the meeting of the National Communication Association, Chicago, IL.
Meyer, K. R., & Hunt, S. K. (2004). Rethinking evaluation strategies for student participation. Paper presented at the meeting of the Central States Communication Association, Cleveland, OH.
Meyer, K. R. (2009). Student classroom engagement: Rethinking participation grades and student silence. Doctoral Dissertation, Ohio University, Athens, OH.
Michaels, S., O’Connor, M. C., Hall, M. W., & Resnick, L. (2002). Accountable talk: Classroom conversation that works. Pittsburg: University of Pittsburgh.
Mortimer, E., & Scott, P. (2003). Making meaning in secondary science classrooms. Philadelphia, PA.: Open University Press.
Newmann, F. M. (1992). Student engagement and achievement in American secondary schools. New York, NY: Teachers College Press.
Osborne, J. F., Busch, K., Tseng, A., Berson, E., Borko, H., Khachatryan, E., & Million, S. (2014). Assessing the quality of classroom discourse and interaction in science teaching. In Annual conference of the national association for research in science teaching, Pittsburgh, PA.
O’Connor, C., Michaels, S., Chapin, S., & Harbaugh, A. G. (2017). The silent and the vocal: Participation and learning in whole-class discussion. Learning and Instruction,48, 5–13.
Olaussen, B. S. (1999). Student’s use of strategies for self-regulated learning: Cross-cultural perspectives. Scandinavian Journal of Educational Research,43(4), 409–422.
Perlmutter, H., & De Montmollin, G. (1952). Group learning of nonsense syllables. Journal of Abnormal Psychology,47(4), 762–769.
Pittelman, S. D., Levin, K. M., & Johnson, D. D. (1985). An investigation of two instructional settings in the use of semantic mapping with poor readers (Program Report No. 85-4). Madison: University of Wisconsin, Wisconsin Centre for Education Research.
Reeve, J. (2012). A self-determination theory perspective on student engagement. In S. L. Christenson, A. L. Reschly, & C. Wylie (Eds.), Handbook of research on student engagement (pp. 149–172). Boston, MA: Springer.
Reeve, J., & Lee, W. (2014). Students’ classroom engagement produces longitudinal changes in classroom motivation. Journal of Educational Psychology,106(2), 527.
Remedios, L., Clarke, D., & Hawthorne, L. (2008). The silent participant in small group collaborative learning contexts. Active learning in higher education,9(3), 201–216.
Resnick, L., Asterhan, C., & Clarke, S. (Eds.). (2015). Socializing intelligence through academic talk and dialogue. American Educational Research Association: Washington D.C.
Richardson, J. C., & Newby, T. (2006). The role of students’ cognitive engagement in online learning. American Journal of Distance Education,20(1), 23–37. https://doi.org/10.1207/s15389286ajde2001_3.
Riley, T., & White, V. (2016). Developing a sense of belonging through engagement with like-minded peers: A matter of equity. New Zealand Journal of Educational Studies,51(2), 211–225.
Roby, T. W. (1988). Models of discussion. In J. T. Dillon (Ed.), Questioning and discussion: A multidisciplinary study (pp. 163–191). New York: Ablex.
Sameroff, A. J., Seifer, R., Baldwin, A., & Baldwin, C. (1993). Stability of intelligence from preschool to adolescence: The influence of social and family risk factors. Child Development,64, 80–97. https://doi.org/10.1023/A:1015630930326.
Schindler, L., Burkholder, A., Morad, G., & Marsh, J. (2017). Computer-based technology and student engagement: A critical review of the literature. International Journal of Educational Technology in Higher Education,14(1), 1–28.
Siti Maziha, M., Nik Suryani, N. A. R., & Melor, M. Y. (2010). Factors influencing classroom participation: A case study of Malaysian undergraduate student. Procedia—Social and Behavioral Sciences,9, 1079–1084.
Sfard, A., & Kieran, C. (2001). Cognition as communication: Rethinking learning-by-talking through multi-faceted analysis of students' mathematical interactions. Mind, Culture, and activity, 8(1), 42–76.
Skinner, E., Furrer, C., Marchand, G., & Kindermann, T. (2008). Engagement and disaffection in the classroom: Part of a larger motivational dynamic? Journal of Educational Psychology,100(4), 765.
Skinner, E. A., Kindermann, T. A., & Furrer, C. J. (2009). A motivational perspective on engagement and disaffection: Conceptualization and assessment of children's behavioral and emotional participation in academic activities in the classroom. Educational and Psychological Measurement,69(3), 493–525.
Skinner, E. A., & Pitzer, J. R. (2012). Developmental dynamics of student engagement, coping, and everyday resilience. In S. L. Christenson, A. L. Reschly, & C. Wylie (Eds.), Handbook of research on student engagement (pp. 21–44). Boston, MA: Springer.
Soter, A., Wilkinson, I. A., Murphy, P. K., Rudge, L., & Reninger, K. B. (2006). Analyzing the discourse of discussion: Coding manual. Unpublished manuscript, Columbus, OH.
Stahl, S. A., & Clark, C. H. (1987). The effects of participatory expectations in classroom discussion on the learning of science vocabulary. American Educational Research Journal,24(4), 541–555.
Stahl, S. A., & Vancil, S. J. (1986). Discussion is what makes semantic maps work in vocabulary instruction. The Reading Teacher,40, 62–69.
Terenzini, P. T., Pascarella, E. T., & Lorang, W. G. (1982). An assessment of the academic and social influences on freshman year educational outcomes. Review of Higher Education,5, 86–110.
Thompson, B. (2004). Exploratory and confirmatory factor analysis: Understanding concepts and applications. Washington, DC: American Psychological Association.
Tinto, V. (1975). Dropout from higher education: A theoretical synthesis of recent research. Review of Educational Research,45(1), 89–125. https://doi.org/10.3102/00346543045001089.
Townsend, J. S., & Fu, D. (1998). Quiet students across cultures and contexts. English Education,31(1), 4–25.
Trowler, V. (2010). Student engagement literature review. Lancaster: Lancaster University. Retrieved from https://www.lancaster.ac.uk/staff/trowler/StudentEngagementLiteratureReview.pdf.
van der Veen, C., van Kruistum, C., & Michaels, S. (2015). Productive classroom dialogue as an activity of shared thinking and communicating: A commentary on Marsal. Mind, Culture, and Activity,22(4), 320–325.
Virtanen, T. E., Lerkkanen, M. K., Poikkeus, A. M., & Kuorelahti, M. (2015). The relationship between classroom quality and students’ engagement in secondary school. Educational Psychology,35(8), 963–983.
Vroomen, J., Collier, R., & Mozziconacci, S. (1993). Duration and intonation in emotional speech. Eurospeech,93(1), 577–580.
Waggoner, M., Chinn, C., Yi, H., & Anderson, R. C. (1995). Collaborative reasoning about stories. Language Arts,72(8), 582–589.
Walker, C. O., Greene, B. A., & Mansell, R. A. (2006). Identification with academics, intrinsic/extrinsic motivation, and self-efficacy as predictors of cognitive engagement. Learning and Individual Differences,16(1), 1–12.
Webb, N. M., & Mastergeorge, A. M. (2003). The development of students’ helping behaviour and learning in peer-directed small groups. Cognition and Instruction,21, 361–428.
Wells, G., & Arauz, R. M. (2006). Dialogue in the classroom. The Journal of the Learning Sciences,15(3), 379–428.
Wilkinson, A., Davies, A., & Atkinson, D. (1965). Spoken English. Birmingham: University of Birmingham.
Wilkinson, I. A., Murphy, P. K., & Binici, S. (2015). Dialogue-intensive pedagogies for promoting reading comprehension: What we know, what we need to know. In L. Resnick, C. Asterhan, & S. Clarke (Eds.), Socializing intelligence through academic talk and dialogue (pp. 35–48). Washington, DC: American Educational Research Association.
Wimpenny, K., & Savin-Baden, M. (2013). Alienation, agency, and authenticity: A synthesis of the literature on student engagement. Teaching in Higher Education,18(3), 311–326. https://doi.org/10.1080/13562517.2012.725223.
Witkowski, P., & Cornell, T. (2015). An investigation into student engagement in higher education classrooms. InSight: A Journal of Scholarly Teaching,10, 56–67.
Wood, J. (1996). Should class participation be required in the basic communication course? Basic Communication Course Annual, 8(1), 9.
Yuker, H. (1955). Group atmosphere and memory. Journal of Abnormal Psychology,51(1), 17–23.
Zepke, N., & Leach, L. (2010). Improving student engagement: Ten proposals for action. Active learning in higher education, 11(3), 167–177.
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Shi, M., Tan, C.Y. Beyond Oral Participation: A Typology of Student Engagement in Classroom Discussions. NZ J Educ Stud 55, 247–265 (2020). https://doi.org/10.1007/s40841-020-00166-0
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DOI: https://doi.org/10.1007/s40841-020-00166-0