In the context of scoping reviews, maintaining a broad approach in the first instance improves the possibility to generate a breadth of coverage and allows setting parameters based on the scope and volume of references generated. For this scoping study, the overarching research question is the following:

Answering this question will not only require a thorough examination of the extent to which PhD students are considering possible ethical issues during the design phase of their study but also if and how the ethical implications of their research findings are discussed in their dissertation.

For this study, we will use the definition of technology as defined by Jacques Ellul as the underlying ethical framework and theory [20]. Ellul argues that the basis of all technologies are techniques, systems that make a process more efficient [20]. Technologies are typically devices or systems that automate 1 or more techniques. On the basis of this view, this proposal considers technology to be broader than mere electronic devices and equipment and also include techniques such as health economics, risk management, health quality assurance, and genomics [20]. The importance of understanding the impact of techniques and technology, such as the ethical implications, is thus crucial in fully comprehending the full effect of new technologies. A list of technologies (Textbox 1) presented in the World Health Organization (WHO) report, “Human Resources for Medical Devices, the Role of Biomedical Engineers” [21], will be used to identify current technologies and techniques used worldwide. The WHO listing was selected because of the comprehensive nature and scope of technologies and techniques. The list includes not only devices but also techniques to help manage health care delivery, which is in line with the definition of technology and technique as identified by Ellul [20]. To confirm the validity of using these terms concerning ethics and health care technologies, we will perform a search among all original peer-reviewed publications written in English and listed in PubMed in the period 2009 to 2019. The search will explore to what extent publications are mentioning ethics accompanying technologies. The following searches will be performed:

Findings will be entered into a matrix describing the number of articles identified by each search combination. A total of 168 searches (56 terms x 3 searches) will be performed during this stage.

To identify dissertations as comprehensively as possible for answering the research question of this study, the search strategy will involve searching broadly via multiple sources. Electronic databases will primarily be used, but other sources will be considered in the context of practicability. The following databases will be prioritized, based on topic and coverage:

To identify dissertations that refer or mention ethics in relation to technology or techniques defended in the US and Sweden during the last 10 years, each database will be searched for the terms used by WHO in the report, “Human Resources for Medical Devices, the Role of Biomedical Engineers” [21] (Textbox 1). The following search strategy will be used:

Unlike systematic reviews, inclusion and exclusion criteria in scoping reviews are developed posthoc, once there is familiarity with the literature. However, all dissertations written in a language other than English or Swedish will be excluded. Our focus is on PhD dissertations researching a technique or technology intended to improve or impact the health of individuals or a population. This will include health treatments, diagnostic and testing equipment, health monitoring systems, and quality assurance and health economics systems. Even though we anticipate most dissertations to be from health sciences such as medicine, nursing, and physical therapy, other disciplines will also be included as indicated to assure an accurate and comprehensive overview.

The process for classifying and synthesizing the data retrieved involves 2 steps: first, to map how the dissertations are distributed according to the search terms, that is, technology and technique terms and ethics, and second, to map in relevance to the research question.

Charting the data retrieved will involve classifying and synthesizing the data identified in the dissertations. The steps for mapping the data will be the following:

Selected and included dissertations will be manually assessed by using a self-developed Dissertation Ethics Assessment Tool recording; 1) year, 2) discipline, 3) name of University, 4) topic area, 5) discussion of research ethics “Quotations of texts”, 6) discussion of unintended effects of ethical issues of the research findings “Quotations of texts”, 7) suggestions regarding ethics or unintended effects offered “Quotations of texts”, and 8) comments. Data coding and categorization will be performed by 2 researchers independently, and findings will be compared and discussed. When there is a difference in assessment, the researchers will discuss to come to a consensus. If no consensus is achieved, the dissertation will be excluded from the study.

Processing of the results in a scoping review does not emphasize the level or quality of evidence presented, but instead develops a thematic framework based on the existing literature relating to the research question. This study will focus on the sections found in the dissertations that pertain to (1) research ethics and (2) ethical implications of the research that are described.

This will be qualitatively analyzed by using the Web-based research tool, Covidence. Any sections from dissertations that mention ethics will be entered into Covidence for coding and analysis purposes. After the data are entered, data analysis will be based on the work of Cobin et al [22,23]. First, qualitative data analysis will focus on identifying codes, phrases, or words with an objective to organize the data. Second, a unified coding system will be developed, and codes will be collapsed into categories while continuing to code the data when relevant. Finally, the categories will be abstracted into themes, and narrative descriptions will be written for each theme. The Covidence tool was selected as it allows for several researchers to code and analyze the same dataset simultaneously and is specifically intended for use for this type of research. The authors will follow and adapt Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines for systematic reviews to accurately report the analysis process and the outcomes from the study [24].