research paper and reflection paper difference

Organizing Your Social Sciences Research Assignments

• Annotated Bibliography
• Analyzing a Scholarly Journal Article
• Group Presentations
• Dealing with Nervousness
• Using Visual Aids
• Grading Someone Else's Paper
• Types of Structured Group Activities
• Group Project Survival Skills
• Leading a Class Discussion
• Multiple Book Review Essay
• Reviewing Collected Works
• Writing a Case Analysis Paper
• Writing a Case Study
• About Informed Consent
• Writing Field Notes
• Writing a Policy Memo
• Writing a Reflective Paper
• Writing a Research Proposal
• Generative AI and Writing
• Acknowledgments

Reflective writing is a process of identifying, questioning, and critically evaluating course-based learning opportunities, integrated with your own observations, experiences, impressions, beliefs, assumptions, or biases, and which describes how this process stimulated new or creative understanding about the content of the course.

A reflective paper describes and explains in an introspective, first person narrative, your reactions and feelings about either a specific element of the class [e.g., a required reading; a film shown in class] or more generally how you experienced learning throughout the course. Reflective writing assignments can be in the form of a single paper, essays, portfolios, journals, diaries, or blogs. In some cases, your professor may include a reflective writing assignment as a way to obtain student feedback that helps improve the course, either in the moment or for when the class is taught again.

How to Write a Reflection Paper . Academic Skills, Trent University; Writing a Reflection Paper . Writing Center, Lewis University; Critical Reflection . Writing and Communication Centre, University of Waterloo; Tsingos-Lucas et al. "Using Reflective Writing as a Predictor of Academic Success in Different Assessment Formats." American Journal of Pharmaceutical Education 81 (2017): Article 8.

Benefits of Reflective Writing Assignments

As the term implies, a reflective paper involves looking inward at oneself in contemplating and bringing meaning to the relationship between course content and the acquisition of new knowledge . Educational research [Bolton, 2010; Ryan, 2011; Tsingos-Lucas et al., 2017] demonstrates that assigning reflective writing tasks enhances learning because it challenges students to confront their own assumptions, biases, and belief systems around what is being taught in class and, in so doing, stimulate student’s decisions, actions, attitudes, and understanding about themselves as learners and in relation to having mastery over their learning. Reflection assignments are also an opportunity to write in a first person narrative about elements of the course, such as the required readings, separate from the exegetic and analytical prose of academic research papers.

Reflection writing often serves multiple purposes simultaneously. In no particular order, here are some of reasons why professors assign reflection papers:

• Enhances learning from previous knowledge and experience in order to improve future decision-making and reasoning in practice . Reflective writing in the applied social sciences enhances decision-making skills and academic performance in ways that can inform professional practice. The act of reflective writing creates self-awareness and understanding of others. This is particularly important in clinical and service-oriented professional settings.
• Allows students to make sense of classroom content and overall learning experiences in relation to oneself, others, and the conditions that shaped the content and classroom experiences . Reflective writing places you within the course content in ways that can deepen your understanding of the material. Because reflective thinking can help reveal hidden biases, it can help you critically interrogate moments when you do not like or agree with discussions, readings, or other aspects of the course.
• Increases awareness of one’s cognitive abilities and the evidence for these attributes . Reflective writing can break down personal doubts about yourself as a learner and highlight specific abilities that may have been hidden or suppressed due to prior assumptions about the strength of your academic abilities [e.g., reading comprehension; problem-solving skills]. Reflective writing, therefore, can have a positive affective [i.e., emotional] impact on your sense of self-worth.
• Applying theoretical knowledge and frameworks to real experiences . Reflective writing can help build a bridge of relevancy between theoretical knowledge and the real world. In so doing, this form of writing can lead to a better understanding of underlying theories and their analytical properties applied to professional practice.
• Reveals shortcomings that the reader will identify . Evidence suggests that reflective writing can uncover your own shortcomings as a learner, thereby, creating opportunities to anticipate the responses of your professor may have about the quality of your coursework. This can be particularly productive if the reflective paper is written before final submission of an assignment.
• Helps students identify their tacit [a.k.a., implicit] knowledge and possible gaps in that knowledge . Tacit knowledge refers to ways of knowing rooted in lived experience, insight, and intuition rather than formal, codified, categorical, or explicit knowledge. In so doing, reflective writing can stimulate students to question their beliefs about a research problem or an element of the course content beyond positivist modes of understanding and representation.
• Encourages students to actively monitor their learning processes over a period of time . On-going reflective writing in journals or blogs, for example, can help you maintain or adapt learning strategies in other contexts. The regular, purposeful act of reflection can facilitate continuous deep thinking about the course content as it evolves and changes throughout the term. This, in turn, can increase your overall confidence as a learner.
• Relates a student’s personal experience to a wider perspective . Reflection papers can help you see the big picture associated with the content of a course by forcing you to think about the connections between scholarly content and your lived experiences outside of school. It can provide a macro-level understanding of one’s own experiences in relation to the specifics of what is being taught.
• If reflective writing is shared, students can exchange stories about their learning experiences, thereby, creating an opportunity to reevaluate their original assumptions or perspectives . In most cases, reflective writing is only viewed by your professor in order to ensure candid feedback from students. However, occasionally, reflective writing is shared and openly discussed in class. During these discussions, new or different perspectives and alternative approaches to solving problems can be generated that would otherwise be hidden. Sharing student's reflections can also reveal collective patterns of thought and emotions about a particular element of the course.

Bolton, Gillie. Reflective Practice: Writing and Professional Development . London: Sage, 2010; Chang, Bo. "Reflection in Learning." Online Learning 23 (2019), 95-110; Cavilla, Derek. "The Effects of Student Reflection on Academic Performance and Motivation." Sage Open 7 (July-September 2017): 1–13; Culbert, Patrick. “Better Teaching? You Can Write On It “ Liberal Education (February 2022); McCabe, Gavin and Tobias Thejll-Madsen. The Reflection Toolkit . University of Edinburgh; The Purpose of Reflection . Introductory Composition at Purdue University; Practice-based and Reflective Learning . Study Advice Study Guides, University of Reading; Ryan, Mary. "Improving Reflective Writing in Higher Education: A Social Semiotic Perspective." Teaching in Higher Education 16 (2011): 99-111; Tsingos-Lucas et al. "Using Reflective Writing as a Predictor of Academic Success in Different Assessment Formats." American Journal of Pharmaceutical Education 81 (2017): Article 8; What Benefits Might Reflective Writing Have for My Students? Writing Across the Curriculum Clearinghouse; Rykkje, Linda. "The Tacit Care Knowledge in Reflective Writing: A Practical Wisdom." International Practice Development Journal 7 (September 2017): Article 5; Using Reflective Writing to Deepen Student Learning . Center for Writing, University of Minnesota.

How to Approach Writing a Reflection Paper

Thinking About Reflective Thinking

Educational theorists have developed numerous models of reflective thinking that your professor may use to frame a reflective writing assignment. These models can help you systematically interpret your learning experiences, thereby ensuring that you ask the right questions and have a clear understanding of what should be covered. A model can also represent the overall structure of a reflective paper. Each model establishes a different approach to reflection and will require you to think about your writing differently. If you are unclear how to fit your writing within a particular reflective model, seek clarification from your professor. There are generally two types of reflective writing assignments, each approached in slightly different ways.

1.  Reflective Thinking about Course Readings

This type of reflective writing focuses on thoughtfully thinking about the course readings that underpin how most students acquire new knowledge and understanding about the subject of a course. Reflecting on course readings is often assigned in freshmen-level, interdisciplinary courses where the required readings examine topics viewed from multiple perspectives and, as such, provide different ways of analyzing a topic, issue, event, or phenomenon. The purpose of reflective thinking about course readings in the social and behavioral sciences is to elicit your opinions, beliefs, and feelings about the research and its significance. This type of writing can provide an opportunity to break down key assumptions you may have and, in so doing, reveal potential biases in how you interpret the scholarship.

If you are assigned to reflect on course readings, consider the following methods of analysis as prompts that can help you get started :

• Examine carefully the main introductory elements of the reading, including the purpose of the study, the theoretical framework being used to test assumptions, and the research questions being addressed. Think about what ideas stood out to you. Why did they? Were these ideas new to you or familiar in some way based on your own lived experiences or prior knowledge?
• Develop your ideas around the readings by asking yourself, what do I know about this topic? Where does my existing knowledge about this topic come from? What are the observations or experiences in my life that influence my understanding of the topic? Do I agree or disagree with the main arguments, recommended course of actions, or conclusions made by the author(s)? Why do I feel this way and what is the basis of these feelings?
• Make connections between the text and your own beliefs, opinions, or feelings by considering questions like, how do the readings reinforce my existing ideas or assumptions? How the readings challenge these ideas or assumptions? How does this text help me to better understand this topic or research in ways that motivate me to learn more about this area of study?

2.  Reflective Thinking about Course Experiences

This type of reflective writing asks you to critically reflect on locating yourself at the conceptual intersection of theory and practice. The purpose of experiential reflection is to evaluate theories or disciplinary-based analytical models based on your introspective assessment of the relationship between hypothetical thinking and practical reality; it offers a way to consider how your own knowledge and skills fit within professional practice. This type of writing also provides an opportunity to evaluate your decisions and actions, as well as how you managed your subsequent successes and failures, within a specific theoretical framework. As a result, abstract concepts can crystallize and become more relevant to you when considered within your own experiences. This can help you formulate plans for self-improvement as you learn.

If you are assigned to reflect on your experiences, consider the following questions as prompts to help you get started :

• Contextualize your reflection in relation to the overarching purpose of the course by asking yourself, what did you hope to learn from this course? What were the learning objectives for the course and how did I fit within each of them? How did these goals relate to the main themes or concepts of the course?
• Analyze how you experienced the course by asking yourself, what did I learn from this experience? What did I learn about myself? About working in this area of research and study? About how the course relates to my place in society? What assumptions about the course were supported or refuted?
• Think introspectively about the ways you experienced learning during the course by asking yourself, did your learning experiences align with the goals or concepts of the course? Why or why do you not feel this way? What was successful and why do you believe this? What would you do differently and why is this important? How will you prepare for a future experience in this area of study?

NOTE: If you are assigned to write a journal or other type of on-going reflection exercise, a helpful approach is to reflect on your reflections by re-reading what you have already written. In other words, review your previous entries as a way to contextualize your feelings, opinions, or beliefs regarding your overall learning experiences. Over time, this can also help reveal hidden patterns or themes related to how you processed your learning experiences. Consider concluding your reflective journal with a summary of how you felt about your learning experiences at critical junctures throughout the course, then use these to write about how you grew as a student learner and how the act of reflecting helped you gain new understanding about the subject of the course and its content.

ANOTHER NOTE: Regardless of whether you write a reflection paper or a journal, do not focus your writing on the past. The act of reflection is intended to think introspectively about previous learning experiences. However, reflective thinking should document the ways in which you progressed in obtaining new insights and understandings about your growth as a learner that can be carried forward in subsequent coursework or in future professional practice. Your writing should reflect a furtherance of increasing personal autonomy and confidence gained from understanding more about yourself as a learner.

Structure and Writing Style

There are no strict academic rules for writing a reflective paper. Reflective writing may be assigned in any class taught in the social and behavioral sciences and, therefore, requirements for the assignment can vary depending on disciplinary-based models of inquiry and learning. The organization of content can also depend on what your professor wants you to write about or based on the type of reflective model used to frame the writing assignment. Despite these possible variations, below is a basic approach to organizing and writing a good reflective paper, followed by a list of problems to avoid.

Pre-flection

In most cases, it's helpful to begin by thinking about your learning experiences and outline what you want to focus on before you begin to write the paper. This can help you organize your thoughts around what was most important to you and what experiences [good or bad] had the most impact on your learning. As described by the University of Waterloo Writing and Communication Centre, preparing to write a reflective paper involves a process of self-analysis that can help organize your thoughts around significant moments of in-class knowledge discovery.

• Using a thesis statement as a guide, note what experiences or course content stood out to you , then place these within the context of your observations, reactions, feelings, and opinions. This will help you develop a rough outline of key moments during the course that reflect your growth as a learner. To identify these moments, pose these questions to yourself: What happened? What was my reaction? What were my expectations and how were they different from what transpired? What did I learn?
• Critically think about your learning experiences and the course content . This will help you develop a deeper, more nuanced understanding about why these moments were significant or relevant to you. Use the ideas you formulated during the first stage of reflecting to help you think through these moments from both an academic and personal perspective. From an academic perspective, contemplate how the experience enhanced your understanding of a concept, theory, or skill. Ask yourself, did the experience confirm my previous understanding or challenge it in some way. As a result, did this highlight strengths or gaps in your current knowledge? From a personal perspective, think introspectively about why these experiences mattered, if previous expectations or assumptions were confirmed or refuted, and if this surprised, confused, or unnerved you in some way.
• Analyze how these experiences and your reactions to them will shape your future thinking and behavior . Reflection implies looking back, but the most important act of reflective writing is considering how beliefs, assumptions, opinions, and feelings were transformed in ways that better prepare you as a learner in the future. Note how this reflective analysis can lead to actions you will take as a result of your experiences, what you will do differently, and how you will apply what you learned in other courses or in professional practice.

Basic Structure and Writing Style

Reflective Background and Context

The first part of your reflection paper should briefly provide background and context in relation to the content or experiences that stood out to you. Highlight the settings, summarize the key readings, or narrate the experiences in relation to the course objectives. Provide background that sets the stage for your reflection. You do not need to go into great detail, but you should provide enough information for the reader to understand what sources of learning you are writing about [e.g., course readings, field experience, guest lecture, class discussions] and why they were important. This section should end with an explanatory thesis statement that expresses the central ideas of your paper and what you want the readers to know, believe, or understand after they finish reading your paper.

Reflective Interpretation

Drawing from your reflective analysis, this is where you can be personal, critical, and creative in expressing how you felt about the course content and learning experiences and how they influenced or altered your feelings, beliefs, assumptions, or biases about the subject of the course. This section is also where you explore the meaning of these experiences in the context of the course and how you gained an awareness of the connections between these moments and your own prior knowledge.

Guided by your thesis statement, a helpful approach is to interpret your learning throughout the course with a series of specific examples drawn from the course content and your learning experiences. These examples should be arranged in sequential order that illustrate your growth as a learner. Reflecting on each example can be done by: 1)  introducing a theme or moment that was meaningful to you, 2) describing your previous position about the learning moment and what you thought about it, 3) explaining how your perspective was challenged and/or changed and why, and 4) introspectively stating your current or new feelings, opinions, or beliefs about that experience in class.

It is important to include specific examples drawn from the course and placed within the context of your assumptions, thoughts, opinions, and feelings. A reflective narrative without specific examples does not provide an effective way for the reader to understand the relationship between the course content and how you grew as a learner.

Reflective Conclusions

The conclusion of your reflective paper should provide a summary of your thoughts, feelings, or opinions regarding what you learned about yourself as a result of taking the course. Here are several ways you can frame your conclusions based on the examples you interpreted and reflected on what they meant to you. Each example would need to be tied to the basic theme [thesis statement] of your reflective background section.

• Your reflective conclusions can be described in relation to any expectations you had before taking the class [e.g., “I expected the readings to not be relevant to my own experiences growing up in a rural community, but the research actually helped me see that the challenges of developing my identity as a child of immigrants was not that unusual...”].
• Your reflective conclusions can explain how what you learned about yourself will change your actions in the future [e.g., “During a discussion in class about the challenges of helping homeless people, I realized that many of these people hate living on the street but lack the ability to see a way out. This made me realize that I wanted to take more classes in psychology...”].
• Your reflective conclusions can describe major insights you experienced a critical junctures during the course and how these moments enhanced how you see yourself as a student learner [e.g., "The guest speaker from the Head Start program made me realize why I wanted to pursue a career in elementary education..."].
• Your reflective conclusions can reconfigure or reframe how you will approach professional practice and your understanding of your future career aspirations [e.g.,, "The course changed my perceptions about seeking a career in business finance because it made me realize I want to be more engaged in customer service..."]
• Your reflective conclusions can explore any learning you derived from the act of reflecting itself [e.g., “Reflecting on the course readings that described how minority students perceive campus activities helped me identify my own biases about the benefits of those activities in acclimating to campus life...”].

NOTE: The length of a reflective paper in the social sciences is usually less than a traditional research paper. However, don’t assume that writing a reflective paper is easier than writing a research paper. A well-conceived critical reflection paper often requires as much time and effort as a research paper because you must purposeful engage in thinking about your learning in ways that you may not be comfortable with or used to. This is particular true while preparing to write because reflective papers are not as structured as a traditional research paper and, therefore, you have to think deliberately about how you want to organize the paper and what elements of the course you want to reflect upon.

ANOTHER NOTE: Do not limit yourself to using only text in reflecting on your learning. If you believe it would be helpful, consider using creative modes of thought or expression such as, illustrations, photographs, or material objects that reflects an experience related to the subject of the course that was important to you [e.g., like a ticket stub to a renowned speaker on campus]. Whatever non-textual element you include, be sure to describe the object's relevance to your personal relationship to the course content.

Problems to Avoid

A reflective paper is not a “mind dump” . Reflective papers document your personal and emotional experiences and, therefore, they do not conform to rigid structures, or schema, to organize information. However, the paper should not be a disjointed, stream-of-consciousness narrative. Reflective papers are still academic pieces of writing that require organized thought, that use academic language and tone , and that apply intellectually-driven critical thinking to the course content and your learning experiences and their significance.

A reflective paper is not a research paper . If you are asked to reflect on a course reading, the reflection will obviously include some description of the research. However, the goal of reflective writing is not to present extraneous ideas to the reader or to "educate" them about the course. The goal is to share a story about your relationship with the learning objectives of the course. Therefore, unlike research papers, you are expected to write from a first person point of view which includes an introspective examination of your own opinions, feelings, and personal assumptions.

A reflection paper is not a book review . Descriptions of the course readings using your own words is not a reflective paper. Reflective writing should focus on how you understood the implications of and were challenged by the course in relation to your own lived experiences or personal assumptions, combined with explanations of how you grew as a student learner based on this internal dialogue. Remember that you are the central object of the paper, not the research materials.

A reflective paper is not an all-inclusive meditation. Do not try to cover everything. The scope of your paper should be well-defined and limited to your specific opinions, feelings, and beliefs about what you determine to be the most significant content of the course and in relation to the learning that took place. Reflections should be detailed enough to covey what you think is important, but your thoughts should be expressed concisely and coherently [as is true for any academic writing assignment].

Critical Reflection . Writing and Communication Centre, University of Waterloo; Critical Reflection: Journals, Opinions, & Reactions . University Writing Center, Texas A&M University; Connor-Greene, Patricia A. “Making Connections: Evaluating the Effectiveness of Journal Writing in Enhancing Student Learning.” Teaching of Psychology 27 (2000): 44-46; Good vs. Bad Reflection Papers , Franklin University; Dyment, Janet E. and Timothy S. O’Connell. "The Quality of Reflection in Student Journals: A Review of Limiting and Enabling Factors." Innovative Higher Education 35 (2010): 233-244: How to Write a Reflection Paper . Academic Skills, Trent University; Amelia TaraJane House. Reflection Paper . Cordia Harrington Center for Excellence, University of Arkansas; Ramlal, Alana, and Désirée S. Augustin. “Engaging Students in Reflective Writing: An Action Research Project.” Educational Action Research 28 (2020): 518-533; Writing a Reflection Paper . Writing Center, Lewis University; McGuire, Lisa, Kathy Lay, and Jon Peters. “Pedagogy of Reflective Writing in Professional Education.” Journal of the Scholarship of Teaching and Learning (2009): 93-107; Critical Reflection . Writing and Communication Centre, University of Waterloo; How Do I Write Reflectively? Academic Skills Toolkit, University of New South Wales Sydney; Reflective Writing . Skills@Library. University of Leeds; Walling, Anne, Johanna Shapiro, and Terry Ast. “What Makes a Good Reflective Paper?” Family Medicine 45 (2013): 7-12; Williams, Kate, Mary Woolliams, and Jane Spiro. Reflective Writing . 2nd edition. London: Red Globe Press, 2020; Yeh, Hui-Chin, Shih-hsien Yang, Jo Shan Fu, and Yen-Chen Shih. “Developing College Students’ Critical Thinking through Reflective Writing.” Higher Education Research and Development (2022): 1-16.

Writing Tip

Focus on Reflecting, Not on Describing

Minimal time and effort should be spent describing the course content you are asked to reflect upon. The purpose of a reflection assignment is to introspectively contemplate your reactions to and feeling about an element of the course. D eflecting the focus away from your own feelings by concentrating on describing the course content can happen particularly if "talking about yourself" [i.e., reflecting] makes you uncomfortable or it is intimidating. However, the intent of reflective writing is to overcome these inhibitions so as to maximize the benefits of introspectively assessing your learning experiences. Keep in mind that, if it is relevant, your feelings of discomfort could be a part of how you critically reflect on any challenges you had during the course [e.g., you realize this discomfort inhibited your willingness to ask questions during class, it fed into your propensity to procrastinate, or it made it difficult participating in groups].

Writing a Reflection Paper . Writing Center, Lewis University; Reflection Paper . Cordia Harrington Center for Excellence, University of Arkansas.

Another Writing Tip

Helpful Videos about Reflective Writing

These two short videos succinctly describe how to approach a reflective writing assignment. They are produced by the Academic Skills department at the University of Melbourne and the Skills Team of the University of Hull, respectively.

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Guide on How to Write a Reflection Paper with Free Tips and Example

A reflection paper is a very common type of paper among college students. Almost any subject you enroll in requires you to express your opinion on certain matters. In this article, we will explain how to write a reflection paper and provide examples and useful tips to make the essay writing process easier.

Reflection papers should have an academic tone yet be personal and subjective. In this paper, you should analyze and reflect upon how an experience, academic task, article, or lecture shaped your perception and thoughts on a subject.

Here is what you need to know about writing an effective critical reflection paper. Stick around until the end of our guide to get some useful writing tips from the writing team at EssayPro — a research paper writing service

What Is a Reflection Paper

A reflection paper is a type of paper that requires you to write your opinion on a topic, supporting it with your observations and personal experiences. As opposed to presenting your reader with the views of other academics and writers, in this essay, you get an opportunity to write your point of view—and the best part is that there is no wrong answer. It is YOUR opinion, and it is your job to express your thoughts in a manner that will be understandable and clear for all readers that will read your paper. The topic range is endless. Here are some examples: whether or not you think aliens exist, your favorite TV show, or your opinion on the outcome of WWII. You can write about pretty much anything.

There are three types of reflection paper; depending on which one you end up with, the tone you write with can be slightly different. The first type is the educational reflective paper. Here your job is to write feedback about a book, movie, or seminar you attended—in a manner that teaches the reader about it. The second is the professional paper. Usually, it is written by people who study or work in education or psychology. For example, it can be a reflection of someone’s behavior. And the last is the personal type, which explores your thoughts and feelings about an individual subject.

However, reflection paper writing will stop eventually with one very important final paper to write - your resume. This is where you will need to reflect on your entire life leading up to that moment. To learn how to list education on resume perfectly, follow the link on our dissertation writing services .

Unlock the potential of your thoughts with EssayPro . Order a reflection paper and explore a range of other academic services tailored to your needs. Dive deep into your experiences, analyze them with expert guidance, and turn your insights into an impactful reflection paper.

Free Reflection Paper Example

Now that we went over all of the essentials about a reflection paper and how to approach it, we would like to show you some examples that will definitely help you with getting started on your paper.

Reflection Paper Format

Reflection papers typically do not follow any specific format. Since it is your opinion, professors usually let you handle them in any comfortable way. It is best to write your thoughts freely, without guideline constraints. If a personal reflection paper was assigned to you, the format of your paper might depend on the criteria set by your professor. College reflection papers (also known as reflection essays) can typically range from about 400-800 words in length.

Here’s how we can suggest you format your reflection paper:

How to Start a Reflection Paper

The first thing to do when beginning to work on a reflection essay is to read your article thoroughly while taking notes. Whether you are reflecting on, for example, an activity, book/newspaper, or academic essay, you want to highlight key ideas and concepts.

You can start writing your reflection paper by summarizing the main concept of your notes to see if your essay includes all the information needed for your readers. It is helpful to add charts, diagrams, and lists to deliver your ideas to the audience in a better fashion.

After you have finished reading your article, it’s time to brainstorm. We’ve got a simple brainstorming technique for writing reflection papers. Just answer some of the basic questions below:

• How did the article affect you?
• How does this article catch the reader’s attention (or does it all)?
• Has the article changed your mind about something? If so, explain how.
• Has the article left you with any questions?
• Were there any unaddressed critical issues that didn’t appear in the article?
• Does the article relate to anything from your past reading experiences?
• Does the article agree with any of your past reading experiences?

Here are some reflection paper topic examples for you to keep in mind before preparing to write your own:

• How my views on rap music have changed over time
• My reflection and interpretation of Moby Dick by Herman Melville
• Why my theory about the size of the universe has changed over time
• How my observations for clinical psychological studies have developed in the last year

The result of your brainstorming should be a written outline of the contents of your future paper. Do not skip this step, as it will ensure that your essay will have a proper flow and appropriate organization.

Another good way to organize your ideas is to write them down in a 3-column chart or table.

Do you want your task look awesome?

If you would like your reflection paper to look professional, feel free to check out one of our articles on how to format MLA, APA or Chicago style

Writing a Reflection Paper Outline

Reflection paper should contain few key elements:

Introduction

Your introduction should specify what you’re reflecting upon. Make sure that your thesis informs your reader about your general position, or opinion, toward your subject.

• State what you are analyzing: a passage, a lecture, an academic article, an experience, etc...)
• Briefly summarize the work.
• Write a thesis statement stating how your subject has affected you.

One way you can start your thesis is to write:

Example: “After reading/experiencing (your chosen topic), I gained the knowledge of…”

Body Paragraphs

The body paragraphs should examine your ideas and experiences in context to your topic. Make sure each new body paragraph starts with a topic sentence.

Your reflection may include quotes and passages if you are writing about a book or an academic paper. They give your reader a point of reference to fully understand your feedback. Feel free to describe what you saw, what you heard, and how you felt.

Example: “I saw many people participating in our weight experiment. The atmosphere felt nervous yet inspiring. I was amazed by the excitement of the event.”

As with any conclusion, you should summarize what you’ve learned from the experience. Next, tell the reader how your newfound knowledge has affected your understanding of the subject in general. Finally, describe the feeling and overall lesson you had from the reading or experience.

There are a few good ways to conclude a reflection paper:

• Tie all the ideas from your body paragraphs together, and generalize the major insights you’ve experienced.
• Restate your thesis and summarize the content of your paper.

We have a separate blog post dedicated to writing a great conclusion. Be sure to check it out for an in-depth look at how to make a good final impression on your reader.

Need a hand? Get help from our writers. Edit, proofread or buy essay .

How to Write a Reflection Paper: Step-by-Step Guide

Step 1: create a main theme.

After you choose your topic, write a short summary about what you have learned about your experience with that topic. Then, let readers know how you feel about your case — and be honest. Chances are that your readers will likely be able to relate to your opinion or at least the way you form your perspective, which will help them better understand your reflection.

For example: After watching a TEDx episode on Wim Hof, I was able to reevaluate my preconceived notions about the negative effects of cold exposure.

Step 2: Brainstorm Ideas and Experiences You’ve Had Related to Your Topic

You can write down specific quotes, predispositions you have, things that influenced you, or anything memorable. Be personal and explain, in simple words, how you felt.

For example: • A lot of people think that even a small amount of carbohydrates will make people gain weight • A specific moment when I struggled with an excess weight where I avoided carbohydrates entirely • The consequences of my actions that gave rise to my research • The evidence and studies of nutritional science that claim carbohydrates alone are to blame for making people obese • My new experience with having a healthy diet with a well-balanced intake of nutrients • The influence of other people’s perceptions on the harm of carbohydrates, and the role their influence has had on me • New ideas I’ve created as a result of my shift in perspective

Step 3: Analyze How and Why These Ideas and Experiences Have Affected Your Interpretation of Your Theme

Pick an idea or experience you had from the last step, and analyze it further. Then, write your reasoning for agreeing or disagreeing with it.

For example, Idea: I was raised to think that carbohydrates make people gain weight.

Analysis: Most people think that if they eat any carbohydrates, such as bread, cereal, and sugar, they will gain weight. I believe in this misconception to such a great extent that I avoided carbohydrates entirely. As a result, my blood glucose levels were very low. I needed to do a lot of research to overcome my beliefs finally. Afterward, I adopted the philosophy of “everything in moderation” as a key to a healthy lifestyle.

For example: Idea: I was brought up to think that carbohydrates make people gain weight. Analysis: Most people think that if they eat any carbohydrates, such as bread, cereal, and sugar, they will gain weight. I believe in this misconception to such a great extent that I avoided carbohydrates entirely. As a result, my blood glucose levels were very low. I needed to do a lot of my own research to finally overcome my beliefs. After, I adopted the philosophy of “everything in moderation” as a key for having a healthy lifestyle.

Step 4: Make Connections Between Your Observations, Experiences, and Opinions

Try to connect your ideas and insights to form a cohesive picture for your theme. You can also try to recognize and break down your assumptions, which you may challenge in the future.

There are some subjects for reflection papers that are most commonly written about. They include:

• Book – Start by writing some information about the author’s biography and summarize the plot—without revealing the ending to keep your readers interested. Make sure to include the names of the characters, the main themes, and any issues mentioned in the book. Finally, express your thoughts and reflect on the book itself.
• Course – Including the course name and description is a good place to start. Then, you can write about the course flow, explain why you took this course, and tell readers what you learned from it. Since it is a reflection paper, express your opinion, supporting it with examples from the course.
• Project – The structure for a reflection paper about a project has identical guidelines to that of a course. One of the things you might want to add would be the pros and cons of the course. Also, mention some changes you might want to see, and evaluate how relevant the skills you acquired are to real life.
• Interview – First, introduce the person and briefly mention the discussion. Touch on the main points, controversies, and your opinion of that person.

Writing Tips

Everyone has their style of writing a reflective essay – and that's the beauty of it; you have plenty of leeway with this type of paper – but there are still a few tips everyone should incorporate.

Before you start your piece, read some examples of other papers; they will likely help you better understand what they are and how to approach yours. When picking your subject, try to write about something unusual and memorable — it is more likely to capture your readers' attention. Never write the whole essay at once. Space out the time slots when you work on your reflection paper to at least a day apart. This will allow your brain to generate new thoughts and reflections.

• Short and Sweet – Most reflection papers are between 250 and 750 words. Don't go off on tangents. Only include relevant information.
• Clear and Concise – Make your paper as clear and concise as possible. Use a strong thesis statement so your essay can follow it with the same strength.
• Maintain the Right Tone – Use a professional and academic tone—even though the writing is personal.
• Cite Your Sources – Try to cite authoritative sources and experts to back up your personal opinions.
• Proofreading – Not only should you proofread for spelling and grammatical errors, but you should proofread to focus on your organization as well. Answer the question presented in the introduction.

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How to Write a Reflection Paper: Definition, Outline, Steps & Examples

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Reflection paper is an opportunity to look at a topic, concept or event and analyze it. It can involve personal introspection, observations of a particular situation or event, and even critical analysis of other works. Students should share their emotions, opinions, and reflections, exploring how the subject matter has impacted their thinking and personal growth. Unlike other types of essays, a reflection paper is usually written in the first person. 

Whether your teacher assigns an  internship reflection paper or any other type of a reflection paper, don't write about the image in the mirror. On the contrary,  study your thoughts on a given topic. Most students first encounter this type of writing when describing how they spent summer.  However, this type of academic writing can cover much more. In this article, you will find everything you need to know about this type of academic piece!

What Is a Reflection Paper: A Detailed Definition

Reflection paper refers to a type of academic writing where you should analyze your personal life, and explore specific ideas of how your changes, development, or growth turned out.  Consider this piece like diary entries. Except that others will be reading them. So it should have consistency, reasonable structure, and be easy to understand. In this respect, this work is very similar to any other academic assignment. Simply put, a reflective paper is a critique of life experiences. And with proper guidance, it is not very difficult to compose. Moreover, there are different types of reflection papers . After all, you can reflect on different things, not only your own experience. These types are:

• Educational reflection paper In this type of work you must write feedback about a book, movie, or seminar you attended.
• Professional paper It is usually written by people who study or work in education or psychology.
• Personal paper It goes without saying that this type is all about your own feelings and thoughts on a particular topic.

Reflection Paper Format: Which One to Choose

Reflection paper format can vary slightly depending on who your audience is. It is not uncommon that your paper format will be assigned specifically by your professor. However, some essential structural elements are typical for MLA, APA, or Chicago style formatting. These include introduction, body, and conclusion. You can find more information on paper formats in our blog. As always, paper writers for hire at StudyCrumb are at your hand 24/7.

How to Start a Reflection Paper: Guidelines

Here, we will explain how to begin a reflection paper. Working on how to start a body paragraph , review criteria for evaluation. This first step will help you concentrate on what is required. In the beginning, summarize brief information with no spoilers. Then professionally explain what thoughts you (if it is a personal paper) or a writer (if educational or professional paper) touch upon. But still, remember that essays should be written in first person and focus on "you."

Reflection Paper Outline

The best reflection paper outline consists of an introduction that attracts attention. After introduction, the plan includes the main body and, finally, conclusions. Adherence to this structure will allow you to clearly express your thinking. The detailed description of each part is right below.

Reflection Paper Introduction: Start With Hook

Reflection paper introduction starts with a hook. Find a way to intrigue your reader and make them interested in your assignment before they even read it. Also, you should briefly and informatively describe the background and thesis statement. Make it clear and concise, so neither you nor your reader would get confused later. Don't forget to state what it is you're writing about: an article, a personal experience, a book, or something else.

Number of Body Paragraphs in a Reflective Paper

Reflective paper body paragraphs explain how your thinking has changed according to something. Don't only share changes but also provide examples as supporting details. For example, if you discuss how to become more optimistic, describe what led to this change. Examples serve as supporting structure of your assignment. They are similar to evidence in, say, an argumentative essay.  Keep in mind that your work doesn't have to be disengaged and aloof. It is your own experience you're sharing, after all.

How to End a Reflection Paper

In the short reflection paper conclusion, you summarize the thesis and personal experience. It's fascinating that in this academic work, you can reflect forward or backward on your experience. In the first case, you share what role the essay plays in your future. In the second case, you focus more on the past. You acknowledge the impact that the essay's story has on your life. Reflect on how you changed bit by bit, or, maybe, grew as a person. Perhaps, you have witnessed something so fascinating it changed your outlook on certain aspects of your life. This is how to write conclusion in research paper in the best way possible.

How to Write Reflection Paper: Full Step-By-Step Guide

Writing reflection paper could be initiated by the teacher at college. Or we can even do it by ourselves to challenge our evaluation skills and see how we have changed. In any case, it's not an issue anymore since we've prepared a super handy guide. Just follow it step by step, and you will be amazed at the result.

Step 1. Answer the Main Questions Before Writing a Reflection Paper

A reflection paper means you should provide your thoughts on the specific topic and cover some responses. So before writing, research the information you want to apply and note every idea. If you're writing an educational or professional paper ask yourself several questions, for example:

• What was my viewpoint before reading this book?
• How do I consider this situation now?
• What does this book teach me?

If your goal is to reflect on personal experience, you can start with asking questions like:

• What was your viewpoint before the experience?
• How did this experience change your viewpoint?

The more details you imagine, the better you can answer these questions. 

Step 2. Identify the Main Theme of Your Reflection Paper

Reflection papers' suggested topics can be varied. Generally, it could be divided into four main categories to discuss:

• Articles or books.
• Social events.
• Persons or famous individuals.
• Personal experiences.

In any case, it's good to show your own attitude to a topic, and that it affects yourself. It is also suited to write about your own negative experiences and mistakes. You need to show how you overcame some obstacle, or maybe you're still dealing with the consequences of your choices. Consider what you learnt through this experience, and how it makes you who you are now.

Step 3. Summarize the Material for Reflection Paper

At this step of reflective paper, you can wait for inspiration and brainstorm. Don't be afraid of a blank sheet. Carefully read the topic suggested for the essay. Think about associations, comparisons, facts that immediately come to mind. If the teacher recommended particular literature, find it. If not, check the previous topic's background. Remember how to quote a quote that you liked, but be sure to indicate its author and source. Think of relevant examples or look for statistics, and analyze them. Just start drafting a summary of everything you know regarding this topic. And keep in mind, that main task is to describe your own thoughts and feelings.

Step 4. Analyze Main Aspects of Reflection Paper

A whole reflection paper's meaning lies in putting theory and your experience together. So fill in different ideas in your piece step by step until you realize there's enough material. If you may find some particular quotes, you should focus on your viewpoint and feelings. Who knows, maybe there is some relatable literature (or video material) that can highlight your idea and make it sound more engaging?

The Best Tips on Writing a Reflection Paper

We prepared tips on writing reflection paper to help you find evidence that your work was excellently done! Some, of course, go without saying. Edit your piece for some time after writing, when you cooled down a bit. Pay attention to whether your readers would be interested in this material. Write about things that not only are interesting for you, but have a sufficient amount of literature to read about. Below you will find more tips on various types of writing!

Tips on Writing a Critical Reflection Paper

Role of a critical reflection paper is to change your opinion about a particular subject, thus changing your behaviour. You may ask yourself how your experience could have been improved and what you have to do in order to achieve that. It could be one of the most challenging tasks if you choose the wrong topic. Usually, such works are written at the subject's culmination. This requires intensive, clear, evaluative, and critical context thinking.

• Describe experience in detail.
• Study topic of work well.
• Provide an in-depth analysis.
• Tell readers how this experience changed you.
• Find out how it will affect your future.

Tips on Writing a Course Reflection Paper

Course reflection paper is basically a personal experience of how a course at your college (or university) has affected you. It requires description and title of course, first of all. 

• Clearly write information you discussed, how class went, and reasons you attended it.
• Identify basic concepts, theories and instructions studied. Then interpret them using real-life examples.
• Evaluate relevance and usefulness of course.

How to Write a Reflection Paper on a Book

A reflection paper on a book introduces relevant author's and piece's information. Focus on main characters. Explain what problems are revealed in work, their consequences, and their effectiveness. Share your experience or an example from your personal life. 

How to Write a Reflection Paper on a Project

Main point of a reflection paper on a project is to share your journey during a process. It has the same structure and approach as previous works. Tell all about the obstacles that you needed to overcome. Explain what it took to overcome them. Share your thoughts! Compare your experience with what could have been if there were another approach. But the main task here is to support the pros or cons of the path you've taken. Suggest changes and recognize complexity or relevance to the real world.

How to Write a Reflection Paper on an Interview

A reflection paper on an interview requires a conclusion already in your introduction.

• Introduce the person.
• Then emphasize known points of view, focusing on arguments.
• Later, express what you like or dislike about this idea.

It is always a good idea to brainstorm and research certain interview questions you're planning on discussing with a person. Create an outline of how you want your interview to go. Also, don't digress from a standard 5-paragraph structure, keep your essay simple. You may need a guide on how to write a response paper as well. There is a blog with detailed steps on our website.

Reflection Paper Example

Before we've explained all fundamental basics to you. Now let's look at a reflection paper example. In this file, you'll find a visual structure model and way of thinking expressed.

Reflection Paper: Main Takeaways

A reflection paper is your flow of thoughts in an organized manner concerning any research paper topics . Format is similar to any other academic work. Start with a strong introduction, develop the main body, and end with conclusions. With the help of our article, you can write this piece only in 4 steps.

Our academic assistants are up for the task! Just pick a twitter to your liking, send them your paper requirements and they'll write your reflection paper for you!

Frequently Asked Questions About Reflection Paper

1. how long should a reflection paper be.

A reflection paper must be between 300 and 750 words. Still, it always depends on your previous research and original task requirements. The main task is to cover all essential questions in the narrative flow. So don't stick directly to the work's volume.

2. Do reflection papers need a cover sheet or title page?

A cover sheet or title page isn't necessary for reflection papers. But your teacher may directly require this page. Then you should include a front-page and format it accordingly.

3. Do I need to use citations and references with a reflection paper?

No, usually, you don't have to cite in your reflection paper. It should be only your personal experience and viewpoint. But in some cases, your teacher may require you to quote a certain number of sources. It's necessary that the previous research was completed, so check it beforehand.

4. What is the difference between a reflection paper and a reaction paper?

The research paper definition differs from reaction paper. Basically, the main point is in-depth of discussion. In the first case, you must fully describe how something affected you. While in the second one, it is just asked to provide a simple observation.

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• v.81(1); 2017 Feb 25

Using Reflective Writing as a Predictor of Academic Success in Different Assessment Formats

Cherie tsingos-lucas.

a University of Sydney, Sydney, Australia

b Graduate School of Health, University of Technology, Sydney, Sydney, Australia

Sinthia Bosnic-Anticevich

Carl r. schneider, lorraine smith.

Objectives. To investigate whether reflective-writing skills are associated with academic success.

Methods. Two hundred sixty-four students enrolled in a pharmacy practice course completed reflective statements. Regression procedures were conducted to determine whether reflective-writing skills were associated with academic success in different assessment formats: written, oral, and video tasks.

Results. Reflective-writing skills were found to be a predictor of academic performance in some formats of assessment: written examination; oral assessment task and overall score for the Unit of Study (UoS). Reflective writing skills were not found to predict academic success in the video assessment task.

Conclusions. Possessing good reflective-writing skills was associated with improved academic performance. Further research is recommended investigating the impact of reflective skill development on academic performance measures in other health education.

INTRODUCTION

Research has shown that fostering reflective skills in health professional education can assist students to improve their clinical decision-making skills and enhance academic performance. 1,2 Furthermore, enhancing reflective writing within health education has been at the forefront of the published literature in recent years. 1,3-5 The ability to reflect on a deeper level is a desirable attribute for all health professionals. 5-11 Reflective capacity is regarded as a skill to enhance learning from previous knowledge and experience in order to improve future clinical practice and clinical reasoning 2,5,7,10,12 In particular, reflective writing can be used as a tool to enhance reflective capacity. 9,13

Furthermore, in the medical field, awareness of the patient and of the health professional’s own mental processes can be enhanced through the reflective-writing process. This can potentially improve clinical decision-making ability. 14 In many cases, academic performance in health professional education is an indicator of effective clinical decision-making skills. Therefore, fostering reflective-writing skills may be a skill associated with improvement in clinical decision-making skills and academic performance.

Scholars posit that developing reflective-writing capacity will foster deeper learning and reflective thinking, which may lead learners to make better informed judgments and increase their ability to make optimal clinical decisions. 1,5,8,9,15,16 Previous research has shown that using the skills of reflective writing improves academic and/or clinical performance 17,18 and is perceived by students as a valuable exercise to enhance reflective learning, thus potentially improving their performance of future clinical tasks. 3,19 Furthermore, reflective narratives used in medical education have been shown to improve clinical-reasoning skills by nurturing the skills of observation, analysis, and interpretation. 1,20 Thus, effective reflective-writing skills may be beneficial for educating the pharmacy student and are fundamental for developing not only the reflective practitioner, but may assist with clinical reasoning and academic performance.

Reflective writing may take the forms of reflective statements, essays, portfolios, journals, diaries, or blogs. 9 Evidence of support for the use of reflective writing in portfolios and journals in health professions are numerous. 14,21-30 These tools are used to foster students’ thinking to challenge their biases, assumptions, and firmly held beliefs. 14 Moreover, reflective-writing instruments in the form of statements have been used as an effective educational tool to assess medical and surgical resident learning in the medical curriculum. 31 As some have advocated, using tools of reflective writing and working towards becoming a reflective practitioner should be considered a core attribute for professional development. 1,7,18,20,25,32-34 Health professions are now insisting on students developing reflective-writing abilities to document continuing professional development and competencies. 1,35

Despite the importance placed on reflective-writing skill development in health professional education, some researchers report “tension” between what students will write as an honest reflection and what they will write if a grade is associated with the task. This was illustrated in a Belgian study that investigated the perceptions of 142 midwifery students toward completing reflective writing exercises during their clinical training sessions. While most respondents perceived the reflective writing exercises as an effective learning tool, others reported that they wrote reflections that they believed would gain them a better assessment score. 3 This was also illustrated in another qualitative study involving eight focus groups of second-year UK medical students, which reported similar issues regarding the “tension” caused by grading written reflections. 36 Nevertheless, students from both studies perceived the exercises as a valuable learning experience that could enhance their performance of future clinical tasks and facilitate deeper understanding and learning. 3,36 Similarly, a study introducing reflective-writing processes into an undergraduate pharmacy curriculum indicated that students perceived this type of learning as challenging. 19 However, the majority of the students did perceive this learning exercise as valuable and indicated that the skill of reflective practice would be beneficial for improvement in other essential skill development including counseling and clinical decision-making. 19

Therefore, it can be argued that effective reflective-writing skills can be used as a tool to promote deeper understanding and learning, and thereby enhance clinical decision-making skills and improve academic performance. Research suggests that reflective ability is not necessarily an inherent skill, but can be taught through various strategies, models, and guidelines. 37-44 Moreover, the development of reflective capacity has been described as necessary for experiential learning in the practice setting. 3 Thus, developing and evaluating this fundamental skill should be a consideration in undergraduate and graduate health professions educational programs, 9 and further scaffolding these skills in practice settings may benefit immediate and long-term reflective learning. 3,5,8,9,11,19

Although reflective practice activities may enhance clinical reasoning skills, 2,45 there is little published research investigating the effect of reflective-writing skills on particular types of assessments. The aim of this research was to explore the relationship between reflective writing and academic performance in a cohort of undergraduate pharmacy students.

The sampling frame for this research was 264 second-year undergraduate pharmacy students (92 male students, 172 female students) enrolled in a pharmacy practice course. The classroom or laboratory structure used in this course involved 10 groups of 26-27 students. Each group was facilitated by a practicing pharmacist clinical educator affiliated with the university. The pharmacy practice unit of study was an introductory unit that explored disease states and management options, including nonpharmacological recommendations. It focused on methods of delivering patient care to individual patients as well as to the wider community with an emphasis on primary care.

The data from this project were analyzed as part of a larger research project 5 in which approval for the study was sought and granted by the University of Sydney Human Research Ethics Committee. Approval for integrating reflective activities into curriculum was also received from the school’s Learning and Teaching Committee. As students were required as part of their regular course assessment to complete a reflective-writing task, all students in the second-year curriculum participated in this study.

In 2014, a reflective-writing module was introduced into a second-year undergraduate pharmacy curriculum as part of the Reflective Ability Clinical Assessment (RACA). 5 We have described the process of the integration of reflective practice activities into the curriculum, and the structure of the Reflective Ability Clinical Assessment (RACA) and its evaluation in more detail in our previous paper. 5 Briefly, The RACA aimed to enhance the reflective-thinking capacity of students and involved three components: a clinical scenario; a video podcast, and a reflective writing component. The RACA tasks required students to develop a role play, counsel another student, video tape the counseling session (for a maximum of five minutes), and then reflect on the experience through an introspective reflective-writing task. The reflective-writing task took the form of a reflective statement ( Appendix 1 ).

Students were assigned one of 10 health problems that could be treated with nonprescription medication or nonpharmacological advice. These health problems included heartburn, sunburn, impetigo, worms, scabies, insomnia, head lice, traveler’s diarrhea, chicken pox, and ticks. The students were then asked to research the problem (signs, symptoms, required referrals, advice), develop a typical clinical discussion/counseling session between a pharmacist and a patient, counsel (as the pseudo pharmacist) another student (serving as the pseudo patient) and write reflectively about the task. As part of the assignment, students were also encouraged to view and reflect on each other’s videos to enhance self- and peer-reflection ( Figure 1 ). The objective of the end-of-semester oral examination was to assess effective counseling and clinical decision-making skills.

Utilization of video podcasts to enhance reflective capacity (self and peer reflection) of pharmacy students. 5

While the video podcast task (which counted 8% of the course grade) provided students with the opportunity to reflect on their counseling and clinical competency skills and those of a peer, it did not involve clinical decision-making skills as the student had prior knowledge of the clinical scenario. The main purpose of the video podcast task was to provide an opportunity for counseling practice prior to the end-of-semester oral assessment. No limit was placed on the number of podcasts recorded before uploading the best one to the Blackboard Learning Management System (LMS). Thus, this activity provided an opportunity for students to counsel each other several times. The video podcast counseling task was submitted mid-semester, along with the reflective statement.

The reflective statement consisted of guided questions ( Appendix 1 ) 5 and was assessed by one external assessor to ensure grading consistency. The external assessor had expertise in the area of reflective writing and possessed extensive clinical pharmacy experience. The statements were assessed via a reflective rubric which was developed from Boud and colleagues’ 40 stages of reflection and Mezirow’s 46 categories of reflection. Elements of the rubric were also drawn from Wetmore and colleagues’ reflective rubric, used in dental education ( Table 1 ). 47 The reflective statement counted 7% of the student’s overall grade for the unit of study.

Reflective Rubric to Assess Reflective Writing in Pharmacy Education 11 , a

The oral assessment was a high-stakes examination completed at the end of the semester that accounted for 30% of the overall grade for the unit of study. Students were required to pass this assessment in order to pass the unit of study. While the topic area is provided earlier, the assessment does not provide students with prior knowledge of the case, patient background, signs and/or symptoms. In contrast to the video podcast assessment task, the oral assessment required the student to make appropriate clinical decisions based on gathering patient information during a five-minute timeframe.

After the oral assessment, all students from the cohort completed the end of semester written examination, which included both short-answer and multiple-choice questions (single best answer). This assessment accounted for 55% of the total grade for the unit of study.

S cores from all assessment and examination tasks were analyzed using SPSS, version 20 (IBM Corp., Armonk, NY, USA). Descriptive analyses were performed to provide an overview of the scores allocated for the four dependent variables (1) overall marks for the unit of study excluding the reflective statement scores; (2) written examination scores (including short answer and multiple-choice); (3) video podcasts score and (4) end of semester oral examination score. The predictor variable used the reflective-writing task scores. Simple regression procedures were employed to determine if reflective-writing skills predicted academic success in these different assessment formats. The reflective statement scores were excluded in the regression analyses, as these scores were used as a predictor variable. An adjusted overall score that excluded the reflective statement scores was used for this research. Significance was set at p <.05.

From a sample size of 264 undergraduate students enrolled in the Pharmacy Practice course, 259 (98%) students completed the video podcasts counseling activity and a reflective writing task. Two hundred fifty-eight (98%) students completed the written end-of-semester examination ( Table 2 ).

Descriptive Statistics: Scores for Different Formats of Assessment in a Second Year Undergraduate Pharmacy Curriculum

The results from simple regression analyses explaining 14% of its variance (R 2 = 0.14) with overall academic achievement are as follows:

• (i) Are reflective writing skills a predictor of academic success in the Overall Marks for one unit of study?

Reflective writing skills was found to be a predictor of academic success in the Overall marks for the Unit of Study, F(1,256)= 25.2, p <0.01

• (ii) Are reflective writing skills a predictor of academic success in the end of semester written examination?

Reflective writing skills was found to be a significant predictor of academic success in the end of semester written examination, F (1, 256) = 21.6 , p < 0.01

• (iii) Are reflective writing skills a predictor of academic success in the video counseling format of an assessment?

Reflective writing skills did not predict academic success in the video podcast counseling task, ( p= 0.08).

• (iv) Are reflective writing skills a predictor of academic success in the end of semester oral assessment?

Reflective writing skills was found to be a predictor of academic success in the end of semester Oral examination, F(1,257)= 8.5, p <0.01

In this study we examined the predictive relationship between reflective-writing skills and academic performance in four formats of assessment. The significant findings suggest that possessing reflective-writing skills is a predictor of academic success on the written examination and in the end-of-semester oral assessment. Interestingly, reflective-writing skills were not a predictor of academic success in the video podcast assessment task. There are two possible explanations for this. First, research has shown that reflective-writing skills may enhance decision-making skills. 48 Assessing the video podcast did not require the student to make any “on the spot” clinical decisions as the student had thoroughly researched the case prior to the counseling session. Conversely, the end-of-semester oral assessment did require students to demonstrate their clinical decision-making skills. Second, the video podcast assessment task was completed midsemester, prior to writing the reflective statement, and perhaps this contributed to the nonsignificant result, as reflection on that task was completed later. This study reported reflective writing had a stronger association with the written component compared to the oral assessment task. This may have been due to the fact that written skills were involved in completing the reflective task. In contrast, there were no written skills involved in completing the oral assessment.

These results, although significant, do not indicate a particularly strong effect size (14% of its variance with overall academic achievement). It is possible that the traditional assessment modalities that are employed in pharmacy education are by and large not directly assessing reflective skills. If educators wish to develop this skill in the health professions, we need to address this in our assessment practices. 11 Furthermore, the low effect size could be due to more specific details of the assessment strategies and to grades being allocated to content knowledge, written, and verbal communication skills compared to grades allocated specifically for reflective ability. The limitations of this study were that it involved only one course in an undergraduate curriculum at a single university and that it only involved pharmacy students.

This study advances understanding from previous research in the area of reflective learning of health professionals and the importance of considering the integration of reflective-writing skills into medical and other health professions educational curricula. Pharmacy students are not a homogenous group of future health professionals and this is also the case with the medical and other health professions. The use of reflective tools has been shown to improve decision-making skills. 45 Furthermore, it has been suggested that tools which encourage the reflective process allow for continuous evaluation of learning and development 48 as it encourages critiquing of practice, 49 thus developing the health professional into a reflective practitioner. 49 The findings from this study support the integration of reflective writing into health professional education.

Perhaps the greatest pedagogical challenge for educators of health professionals is how we can help them to write reflectively. Fostering students’ reflective writing skills may be one solution to further developing their critical-thinking and problem-solving skills so they will be able to make better informed clinical judgments. Reflective-writing skills are not necessarily inherent and therefore may be developed through inclusion in health care education programs. 20,38 For this to occur, a reflective framework or model may need to be further developed by health professional education systems to provide a springboard for fostering effective reflective writing. 9 Ideally these skills should develop over the course of the degree; therefore, time allocated within the curriculum to foster these skills may be a necessary consideration for educators. 9 Moreover, evaluating the effectiveness of such a fundamental skill through reflective rubrics may further enhance reflective capacity, particularly if reflective rubrics are provided to students prior to reflective-writing activities. 11 Also, well-designed reflective rubrics may assist in providing appropriate guidance for desired learning outcomes, such as enhanced reflective capacity. 11,50

Evidence from this study supports the notion that reflective-writing skills may be associated with improvement in pharmacy students’ clinical decision-making capacity and academic performance. It therefore stands to reason that further research into the effects of various reflective activities in other areas of health education, where effective clinical-reasoning ability is also an important attribute, should be considered.

CONCLUSIONS

This study suggests that developing reflective-writing skills in undergraduate pharmacy students may be associated with improved academic performance. As these results may be specific for one educational setting, namely, pharmacy, we must be mindful that these findings may not translate to other learning environments or health professions. However, as reflective activities and tools appear to embed several health educational programs worldwide, further research in how reflective writing impacts on academic performance measures in other health disciplines is recommended. If reflective writing encourages a broader thinking process, it stands to reason that all health professional education programs should consider this element across curricula and into clinical environments.

Appendix 1. Reflective Statement 5

The Differences Between Reaction Paper & Reflection Paper

Jennifer vanbaren, 27 jun 2018.

The differences between writing a reaction paper and a reflection paper may not, at first, be obvious; however, ignoring the variations in composition can make the difference between you getting an A on your essay or scrambling in a panic at semester’s end to make up for lost points due to not following directions. Both types of papers feature a student’s reaction, thoughts or feelings in regards to a poem, play, short story, book or film. The primary difference lays in the writer's approach in assessing and connecting to the literature or film at hand. While writing a reaction essay, the student first needs to use critical thinking skills to analyze the work being discussed. Next, the writer provides specific examples and and evidence to support the main points of the student's analysis. Conversely, a reflection paper revolves around the student's opinion and individual response while pointing out examples from the work and the writer's connection to the work based on personal experience.

Explore this article

• Reaction Paper
• Reflection Paper

Instructors often have students write reaction or reflection papers after reading and discussing a piece of literature in-depth. The literature or film, and their themes, may be studied throughout the semester along with emphasizing important details regarding the overall meaning. Both papers should be organized the same as any other essay; the writer needs to include an introduction that incorporates the thesis statement, or main point, of the essay as well as body paragraphs in which he supports his main points with evidence. Lastly, a concluding paragraph restates the main points and any final observations.

2 Reaction Paper

While writing a reaction essay, the student first needs to use critical thinking skills to analyze the work being discussed. Next, she should provide specific examples and evidence to support the main points of the student's analysis. The student may be given questions to answer as a starting point regarding her feelings about the work or topic as well as her assessment and evaluation. The reaction paper focuses more on the analysis of the work than personal opinion.

3 Reflection Paper

A reflection paper involves a student’s feelings, response and analysis of an experience using a more personal approach then its reaction paper counterpart. The goal when writing this type of essay is to present one's thoughts and responses to the literature, or film, being discussed. In this kind of essay, a student shares his personal opinions about the literature while also making connections between his life and background and the work he's reflecting upon. In contrast to the reaction essay, the reflection paper is more about a student's opinions while also highlighting relevant examples from the text or film to back up those opinions.

4 Assignment

Because the two types of papers are quite similar, a student's thorough understanding of the essay assignment and the writing process is imperative to composing effective reaction and reflection papers. In addition, details such as formatting (APA or MLA), word count and the inclusion of a works cited, or reference page, are significant; failure to follow the assignment instructions can result in an unnecessary lowering of the writer's grade.

• 1 St. Cloud State: Writing a Reflection or Response Essay
• 2 Monash University: Reflective Writing and Critical Incidents
• 3 Hunter College: The Writing Process -- Writing a Response or Reaction Paper

About the Author

Jennifer VanBaren started her professional online writing career in 2010. She taught college-level accounting, math and business classes for five years. Her writing highlights include publishing articles about music, business, gardening and home organization. She holds a Bachelor of Science in accounting and finance from St. Joseph's College in Rensselaer, Ind.

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Similarities Between Essays & Research Papers

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Reaction vs. Reflection Paper: What’s the Difference?

The purpose of writing a reaction or reflection paper is to provide a deeper and more meaningful understanding of a piece of literature, film, or artwork. As students, it is important to learn how to properly analyze and interpret material in order to gain a better overall understanding and appreciation of it. A reaction paper is a more personal and informal response to the material, while a reflection paper is a more formal and analytical reflection of the material. In this blog post, we will discuss the differences between a reaction paper and a reflection paper, and provide tips for how to write each. We will also discuss the importance of each and how they can be used to gain a better understanding of a given work of art.

ACADS EP.1: Difference between reflection paper and reaction paper

What is a reflection paper?

An essay that focuses on what the author learned from an experience is called a reflection paper. The experience could be completing a task, watching a video, or reading a book. Writers frequently discuss how an experience has altered their perspective on a subject. These essays also contain the authors’ descriptions of the events and their emotions.

What is a reaction paper?

A reaction paper, also known as a response paper, is an essay that expresses the writer’s opinions on a particular subject. These essays typically retain a formal tone while expressing the writer’s opinion and their agreement or disagreement with the concepts presented in a book, article, or film. When writing a reaction paper, authors can also evaluate the piece and provide proof to back up their assertions.

Reaction vs. reflection paper

The following are some key parallels and divergences between a reaction paper and a reflection paper:

Reaction and reflection papers tend to have similar uses. For instance, when they want students to respond to a piece of writing, a book, or a film, teachers and college professors frequently assign them. Students can develop analyses and incorporate evidence when using critical thinking, which is useful practice for writing lab reports and other essays. A reflection paper is typically assigned by a teacher when they want their students to respond to an experience. Students’ communication, teamwork, and organizational skills are frequently enhanced when they share what they learned from a lecture or internship.

Format and tone

Despite the fact that reaction and reflection papers include the writers’ opinions, they typically have a formal tone. These papers maintain their suitability for academic settings thanks to an academic tone and format. Teachers can specify the requirements for their assignments, but most students follow an MLA or AP style manual. Additionally, they employ academic vocabulary and sentence constructions that are less conversational than diary entries. Reaction and reflection papers can range in length and format, but they almost always have an introduction, a body, and a conclusion.

Summary of the work or experience

Writers frequently incorporate a summary of the published work or experience in both types of papers. They try to provide context because they are aware that the reader might not be familiar with their topic. For instance, a writer might briefly summarize a book’s major plot points at the start of their essay. The reader may find it simpler to comprehend the character analyses after reading this explanation. Good reaction and reflection papers frequently include objective summaries that give the reader context without the writer’s personal bias coming through.

The focus of reaction and reflection papers is the primary distinction. Reaction papers highlight the writer’s feelings following a book or video by including their first impressions. Additionally, they are able to evaluate various incidents and offer proof to back up their conclusions. For instance, a student may reference the author’s account of an event to support their claim that they are commenting on a phenomenon that actually exists.

In contrast, a reflection paper focuses more on how the experience or work altered the writer’s perspective. They frequently mention their previous viewpoint and how the subject opened their minds to new concepts. Some reflection papers highlight how the experience or work solidified their preexisting beliefs. For instance, a climate change article could support a student’s conviction that global warming is a real phenomenon. The student may mention this enduring belief in their reflection paper while also highlighting how the assignment exposed them to fresh strategies for tackling global warming.

How to write a reaction or reflection paper

Heres how to write a reaction or reflection paper:

1. Review the reference material

Consider reading the reference material in its entirety if you want to write a strong reaction or reflection paper. You can make sure you comprehend all of the key points by reading the entire book or by watching the entire video. You can also jot down important details to discuss later in notes. As you watch a movie or read a book, for instance, think about writing down any interesting details or queries you have. Try keeping track of your primary responsibilities and interactions with coworkers after each shift if you’re completing an internship.

2. Review your teachers requirements

Before writing your paper, consider reviewing your teachers requirements. You can verify details like word count, formatting type, and whether a reference or works cited page should be included. Knowing the requirements can help you structure your paper and prevent you from having to make revisions later in the writing process.

3. Create an outline

To create an outline, think about using your notes and your teachers’ expectations. Your notes, for instance, could point out three different ways the author introduces a certain theme. These three points can be broken up into paragraphs in your outline, and you can also indicate how long each section should be. Additionally, you can make a note of the quotes and details you want to use in each section.

4. Write an introduction with a thesis statement

The hook in the introduction of reaction and reflection papers entices readers to continue reading. In order to provide context for the reader, it might also include a brief summary of the work or experience. The conclusion of the introduction paragraph should include a thesis statement that sums up your position. If you’re writing a reaction paper, try to summarize your feelings about the work in your thesis statement. These details may also be in the thesis statements for reflection papers, but they usually place more emphasis on how the work or experience shaped your perspective.

5. Write body paragraphs

Writing the body paragraphs that you noted in your outline is the next step. An introduction to the main idea can be made in the topic sentence of each body paragraph. After the topic sentence, go into greater detail about how you analyzed the work or experience and provide evidence to back up your assertions. Although the teacher is typically familiar with the subject you are writing about, you can provide more context if necessary. For example, you can emphasize the main character’s stubbornness if you want to emphasize this quality to make your point.

6. Add a conclusion

Your paper’s conclusion paragraph restates your thesis statement and lists your key points. If you’re writing a reaction paper, you might want to focus on how the piece made you feel or your thoughts on the subject. Reflective essay conclusions could summarize what you learned and how you would persuade others to use your analyses to reevaluate their positions in the future.

Is reaction and reflection the same?

Reaction is largely driven by external stimuli. Contrarily, reflection is a higher-order executive function known as a metacognitive function that calls for awareness and control of one’s own thought process.

What is the difference between summary and reaction paper?

Refine and polish your summary by removing any repetitions or minor details and adding transitions to make the summary read smoothly. The Reaction is a text-based response where you express your opinions regarding the source text.

How do you write a reaction paper?

Write an informative summary of the material. Highlight the work’s main points and important supporting points to condense the content. Use direct quotations from the work to illustrate important ideas. Summarize the content to give the reader a broad understanding of all significant elements of the original work.

What is the purpose of the reaction paper?

In the classroom, reaction papers are frequently used as tools to help students think critically about texts and how they relate to one another or to a larger field of discourse. Research paper topics can also be found in reaction papers.

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Differences between Reflection Paper, Reaction Paper and Critical Reviews

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Q. What is the difference between an opinion paper and a research paper?

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Answered By: APUS Librarians Last Updated: Apr 14, 2017     Views: 109654

In an opinion paper , you will focus on a topic about which you have personal thoughts, beliefs, or feelings.  Your goal is to persuade your reader that your position on this topic is the best one. You won’t accomplish that goal with a rant or diatribe. Instead, you will need to support your claim with facts, statistics, real-life examples or published research studies. So, despite its name, an opinion paper will require some research .

The most common research paper assignment (particularly in undergraduate courses) is a lot like a literature review. You will conduct a thorough search for scholarly sources about your chosen topic, then carefully read and summarize them. But beyond simply describing the books and articles that you read, your goal is to participate in the scholarly “conversation” surrounding your topic. You can do that by:

• Organizing your paper by themes or trends that you discovered in the literature
• Identifying and explaining controversies surrounding your topic
• Pointing out strengths and weaknesses in the studies that you read
• Identifying aspects of the topic that need further research

Sometimes (more commonly in graduate courses), you will design your own study and write about it. While this kind of research paper includes a literature review section, it will also require you to describe your study’s methodology, data analysis and results. The graduate section of Writing@APUS offers advice for students working on original research papers.

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Reaction Paper vs Reflection Essay: Similarities and Differences

Table of contents, similarities, differences.

When it comes to academic writing, students often encounter various types of assignments that require critical thinking and analysis. Two common types of assignments that often confuse students are reaction papers and reflection essays. While they may seem similar at first glance, there are distinct differences between the two. In this article, we will explore the similarities and differences between reaction papers and reflection essays, providing valuable insights to help students understand and excel in these assignments.

Before diving into the differences, it is important to acknowledge the similarities between reaction papers and reflection essays. Both assignments require students to express their thoughts and opinions on a particular topic or piece of literature. They both involve critical thinking and analysis, allowing students to engage with the material and demonstrate their understanding.

Furthermore, both reaction papers and reflection essays provide an opportunity for students to showcase their ability to articulate their thoughts and support their arguments with evidence. In both cases, students are expected to provide a well-reasoned response to the material they have encountered.

While there are similarities, there are also key differences between reaction papers and reflection essays. These differences lie in their purpose, structure, and focus.

A reaction paper is typically a response to a specific reading or event. It requires students to critically analyze the material and provide their personal reaction or response. The purpose of a reaction paper is to demonstrate the student’s understanding of the material and their ability to engage with it on an intellectual and emotional level.

On the other hand, a reflection essay is more introspective in nature. It requires students to reflect on their own experiences, thoughts, and feelings, and connect them to the material they have encountered. The purpose of a reflection essay is to encourage self-reflection and personal growth, allowing students to explore their own beliefs and values in relation to the topic at hand.

When it comes to structure, reaction papers and reflection essays also differ. A reaction paper typically follows a more formal structure, similar to an essay. It includes an introduction, body paragraphs, and a conclusion. The introduction provides a brief overview of the material being reacted to, while the body paragraphs delve into the analysis and personal response. The conclusion summarizes the main points and offers a final thought or reflection.

On the other hand, a reflection essay is more flexible in terms of structure. It may not follow a strict essay format and can be more free-flowing. Reflection essays often incorporate personal anecdotes, experiences, and emotions, allowing for a more personal and subjective approach to the topic. While it still requires a clear introduction and conclusion, the body paragraphs may be more narrative in nature.

The focus of a reaction paper is primarily on the material being reacted to. Students are expected to analyze and critique the material, providing their own perspective and insights. The focus is on the external material and how it relates to the student’s own understanding and interpretation.

On the other hand, the focus of a reflection essay is primarily on the student’s own thoughts, experiences, and emotions. While the material being reflected upon is still important, the emphasis is on the student’s personal growth and self-reflection. Reflection essays allow students to explore their own beliefs, values, and biases, and how they have been shaped by the material.

To further illustrate the differences between reaction papers and reflection essays, let’s consider a hypothetical example:

Imagine a student is asked to read a novel and write a response. In a reaction paper, the student might analyze the themes, characters, and writing style of the novel, providing their own interpretation and critique. They might discuss how the novel impacted them emotionally and intellectually.

In a reflection essay, the student might reflect on how the novel resonated with their own experiences and beliefs. They might discuss how the novel challenged or reinforced their existing beliefs, and how it influenced their personal growth and understanding of the world.

While reaction papers and reflection essays share similarities in terms of critical thinking and analysis, they differ in purpose, structure, and focus. Reaction papers focus on analyzing and critiquing external material, while reflection essays emphasize personal growth and self-reflection. Understanding these differences can help students approach these assignments with clarity and confidence, enabling them to excel in their academic writing.

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Difference Between Essay And Reflection Paper

• 1 Introduction
• 2.1 1. Structure
• 2.2 2. Subject matter
• 2.3 3. Purpose
• 2.4 4. Intention
• 2.5 5. Outcome
• 3 Complete your homework by segmenting essays and reflection papers separately.

Introduction

The writing process may differ in various situations and depending on the criteria. Like in childhood, we learned that writing poetry and a story are totally different, and these differences showcase the distinct nature of various papers.

In this article, the discussion will be on essay papers and reflection papers. While many people think that essay papers are almost the same as reflection writing as both share a thinking process in writing. But the distinction is seen in the delivery of these two writing processes.

For instance, in a reflection paper, you will not need to be tidily ordered as it involves both the processes of thinking and learning simultaneously. But, on the other hand, essays have orders and formations as well. So, you need to be in order and then follow your thinking process to prepare an essay.

Where the essay depends on guidelines and structures, you can be a bit frank with reflective writing.

So, the approaches are different, and this is where students find it difficult and confusing to complete their assignments. In addition, when you are on a tight schedule, tension will try to harm your writing process.

Difference between essay and reflection paper

The difference is there, and it will be more clear to you if we tend to state every feature of these two types of the writing process in front of you. Here is what we are exactly going to do.

This article will allow you to understand the crucial difference between these two types of the writing process, and thus, as a student, you will find it easy to complete your homework. Time is money and managing your time is important as a student, especially when you are dealing with your deadline.

Let’s find out the distinctions between essay and reflection papers so that you can avoid confusion and complete your homework on time.

1. Structure

Essays are mostly properly structured and are in order. Tidily ordered essays are mostly considered good essays. Commonly, an essay starts with an introduction, and the majority of it goes to the body part (discussion), and then there is a clear conclusion to state the thinking process.

Moreover, the subject matter needs to be clearly defined in your essay structure.

In contrast, reflective writings are ill-structured, and the subject matter may diffuse. There is no particular structure to reflective writing. In a reflection paper, you start writing, and you continue to do it without following any particular segment.

However, there are various reflective models that you can follow to give a concise shape to your reflective structure.

2. Subject matter

Subject matter in a written paper may seem like you are selecting the topic, and depending on it, you go through the matter. But this is not all.

The subject matter that you will select should not be personal for an essay . The subject matter needs to be clearly defined and specified with the help of proper subject area research.

Moreover, you will need to have a concise idea about which particular subject you are going for and how much information you can gather to complete the writing.

In contrast, a reflection paper and its subject matter can be personal because you will need to experience it before you write it. So, it’s a continuous process that may need more time than an essay to complete.

Moreover, the ideas in reflective paper writing can be drawn from the perspective of the writer. Your forged reflection will be the key to defining the subject matter.

As we have already defined, the purpose of essay writing is mostly pre-determined. When you select a topic, you are likely to know what type of data you are undertaking and how you are going to end it.

So, there is always a concise plan ready to go before you start writing. In this way, the purpose of your writing an essay is also pre-determined, and therefore the reader mostly knows the results.

On the other hand, the only purpose of reflective writing is to deliver a process of learning through thinking and development. This is a continuous development process that considers the gradual delivery of a new understanding of the particular subject matter.

4. Intention

Intentions of writing can change the whole scenario of a paper. For instance, if your intention is to let the audience understand your view on environmental sustainability, then your writing approach and even the subject matter will be based on an experimental process.

On the other hand, if your intention is to be a representative of some process, then the writing approach will be different from the above.

In the case of essay writing, it generally represents the learning of a subject matter. On the other hand, the reflection essay delivers the underlying purpose of the subject matter. And here, you will get to learn new ideas with the development of understanding.

The outcome is set with an essay, whereas the outcome is not confirmed with a reflection paper.

This means that you will get to know what is there in an essay and what it is going to discuss so far in the whole paper.

But reflective papers are not confirmed with their outcomes. This is because it deals with a personal point of view. A writer can forge you to understand their view depending on their perspectives and experience throughout.

Over the course of experience, you will be able to discover new ideas and outcomes in the eyes of a writer.

Complete your homework by segmenting essays and reflection papers separately.

If you are confused, the above-mentioned steps will help you to understand the different writing approaches regarding essays and reflection papers. In this way, you will be able to complete your homework as quickly as possible.

If you do not have much time left to cover both assignments, you can simply ask to do my homework for me . Their expert writers know the distinctions and will deliver you quality writing within the deadline.

How Do Reflective Essays Differ From Analytical Essays?

How to write an essay with a thesis statement.

Teachers assign different types of essays, and you need to know the components of these essays to make sure you write an effective paper. Main types of essays include expository essays, narrative essays, descriptive essays and persuasive essays. An analytical essay falls under persuasive essays and teachers often refer to a narrative essay as a reflective essay. Understanding some of the differences between reflective and analytical works will help you strengthen your skills to write a strong, effective essay.

Topics make up the main difference between a reflective and analytical essay. In a reflective essay, you look at a personal story and tell your reader how that event, person or idea impacts your life. In an analytical essay, you look at a topic, such as a social issue or literary work, and evaluate the variety of angles that make up the subject of your essay.

In a reflective essay, you tell a personal story, so you rely on your memory and perception of events to relate the main idea of your essay. In an analytical essay, you rely on research to prove your perspective on the topic. This means, in your reflective essay, you do not typically cite sources or have a bibliography. However, when you write an analytical essay, you need to make sure that you use credible resources for information and cite any sources you quote or paraphrase. As well, your analytical essay needs a bibliography or “works cited” page to show the references you used to write the essay.

Point of View

In a reflective essay, use of first-person is most common, meaning you use “I” throughout the paper. For example, you may state, “The day I bought the car, I drove home happy.” In an analytical essay, you use a more formal style, typically a third person point of view. Using this, you may state, “After purchasing a car, drivers leave the car lot happy.”

The thesis statement, your main idea of the paper, goes in the introduction of your essay. For each type of essay, the thesis will have some differences. In a reflective essay, your thesis statement has a personal nature. For example, you may have the following thesis: “Every car I purchased in my 20s was a step up, and each one made me happier than the last.” The rest of your essay will give examples of this statement.

For an analytical essay, you write a thesis that gives your perspective on a topic. However, you should have a more formal sound and contain an arguable point. Your thesis may look something like this: “When young adults purchase vehicles without doing research, they do not always consider the long-term financial impact of the purchase.” The research you have on the topic will need to back up your statement.

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Research Paper and Article: What’s the Difference?

Research Papers and Articles are distinct types of academic writing, but they share many of the same qualities. This article seeks to elucidate the differences between a research paper and an article while also highlighting some common elements shared by both. It will be argued that although there is some overlap between these two forms of scholarly communication, research papers tend to have a more substantial emphasis on data collection and analysis than articles do. In addition, it will be demonstrated how each type has its own unique purpose in terms of disseminating information about particular topics or fields of study. Finally, best practices for utilizing either form for optimal results will be discussed as well as how researchers should go about selecting which one suits their needs best.

1. Introduction to Research Papers and Articles

2. the definition of a research paper, 3. distinguishing characteristics of a research paper, 4. the definition of an article, 5. distinguishing characteristics of an article, 6. understanding the difference between a research paper and an article, 7. conclusion.

What is a Research Paper?

A research paper is an extended written work that presents and supports a thesis, or argument. It delves into the details of existing knowledge on the topic, including both primary sources (directly related to the subject) and secondary sources (related information used as evidence). Research papers often involve analysis from an academic perspective—one backed up with facts, figures, personal opinions, and other forms of supporting material.

What are Research Articles?

Research articles are typically shorter pieces of writing than full-length research papers. They may focus on one specific aspect of the topic or contain some preliminary findings based upon their own original research efforts in order to present new ideas for further study. Unlike lengthy research papers which require extensive background reading before any meaningful conclusions can be drawn from them; many short form articles do not need this level of depth in order to provide interesting insights into a given field.

A research paper is an in-depth academic writing that requires the author to have a thorough knowledge of the subject at hand. It often contains research conducted by a student or group, and it is used to demonstrate their understanding of said topic. In most cases, this type of work will be written with data from primary sources such as interviews or surveys.

Structural Specifications

A research paper has a distinct structure that needs to be respected in order for it to pass the test of scholarly review. This includes having an introduction, body and conclusion sections, all organized logically. Additionally, there should also be headings and subheadings throughout the text. It is crucial that each section clearly states its purpose while also building on any previous points made – ultimately leading up to answering the initial question posed at the beginning of the paper.

Article vs Paper

Understanding the Different Kinds of Written Pieces In order to craft a comprehensive and thoughtful piece of writing, it is essential that one understands the difference between various forms of written pieces. The two main types are research papers and articles, which have distinct features separating them from one another.

• Research paper: A scholarly work typically required for completion of an undergraduate or graduate degree.
• Research article: A document containing original findings in a given field.

The primary difference between these two formats lies in their purpose. Research papers often delve into historical contexts as well as theoretical concepts; they may also serve as repositories for acquired data sets pertaining to current topics or events in academia.

On the other hand, research articles focus primarily on exploring new ideas within disciplines such as science and medicine. They tend to be more concise than longer form works such as dissertations; however, both draw heavily upon factual evidence presented through detailed analysis or empirical experimentation. In this way, each type serves its own unique purpose while providing critical information towards better understanding relevant topics across many subject areas.

While reading any text, it is important to know the distinguishing characteristics of the article. A research paper and a research article are both valuable works that help inform readers about various topics or issues; however, they differ in terms of purpose, structure and audience.

• Research Paper : The primary purpose of this type of work is to explain an issue through detailed analysis from a variety of perspectives. Research papers use long blocks of text which include arguments supported by evidence gathered from sources such as published books or journals. Additionally, they often have footnotes or citations embedded within them.
• Research Article : This type written work usually takes less time than a research paper due its smaller size (e.g., 2000-3000 words). It has clear objectives for writing up results regarding new methods/techniques developed for solving problems related to science/technology etc.; hence uses technical language rather than storytelling style like narrative pieces do.

The research paper and the research article can seem like similar documents, however there are key differences to consider when examining them.

• Research Paper:

Whereas a traditional research paper may explore multiple avenues regarding one particular field or area of study, an article will instead focus solely on one aspect at hand – which could range from discussing current trends surrounding technological advancements to summarizing literature review findings related to behavioral studies conducted over extended periods of time. As such, articles tend to have narrower scopes while papers allow authors greater leeway due to their lengthier formats and higher degree levels associated with them.

Final Reflection The research presented in this paper has revealed that technology can greatly improve the learning experience. Technology-enhanced instruction offers a range of advantages, including improved student engagement and an ability to tailor teaching to individual students’ needs. However, it is important for educators to recognize that there are challenges associated with introducing tech into the classroom. Properly assessing how best to incorporate new technologies requires time and resources from both instructors and institutions alike.

Technology-infused lessons have great potential for enhancing educational outcomes, but only when implemented thoughtfully and deliberately. Educators must take into account factors such as costs associated with implementing or maintaining technological solutions; technical support infrastructure; availability of professional development opportunities; contextual variables specific to their classrooms (e.g., access disparities); content knowledge related to using appropriate tools effectively in different subject areas; alignment between instruction objectives/assessments/technology use; sufficient instructional preparation strategies prior introduction of digital media components across multiple grade levels curriculum standards etc.. This will ensure greater success within the classroom environment via incorporating current technologies alongside traditional approaches found successful over many generations now past.

Overall, technology integration presents tremendous potential for improving teaching practices while also providing students better opportunities for reaching long term academic goals than ever before without utilizing advances available today–allowing them easier paths towards more diverse successes later on in life irrespective one’s location geographically speaking be they close by or further abroad . It remains up still though ultimately upon us all–educators at every level globally whether directly involved presently or seeking those who already working along these lines willing capable going above beyond expected norms from fellow colleagues–as well society entire–to help realize full capabilities modern age holds whenever possible each given chance arises come our way through innovation applied nowadays moving forward continually despite any odds imposed once beforehand against us never fully yielding nor wavering trying no matter what justifiably so deserves future we aim build far brighter much grander scale imaginable arguably could dream create surely intending construct sustaining legacy regardless anyone else’s opinion right wrong even if alone knows why worth taking doing ultimate efforts needed effectuating lasting impacts felt everyone concerned after gone leaving end impressions indelibly marked those remain serve testament integrity conviction carried out job done successfully accordance plan initially laid forth accurately faithfully followed adhere expectations set agreed assured kept fixed focus mind’s eye view foresight completing task moment arrives due date determined arrive consequently utmost importance placed assignments taken seriously ensuring relevant requirements meet met satisfactorily overall satisfactory rating received satisfaction ones entrusting project results depend deliverables supplied highly esteemed pleased finish thank you

In conclusion, it is clear that there are distinct differences between a research paper and an article. Research papers tend to be longer than articles and involve more in-depth analysis of the topic at hand. Articles typically focus on one specific aspect or point while research papers investigate several different perspectives within the given subject matter. Furthermore, both types of writing use evidence from sources to support their arguments but differ in terms of formatting requirements as well as content organization structure. It is important for authors to understand these distinctions when determining which type of written work best suits their needs.

The Effect of Mindfulness on Cognitive Reflection and Reasoning

• ORIGINAL PAPER
• Published: 08 June 2020
• Volume 11 , pages 2150–2160, ( 2020 )

Cite this article

• Stephanie T. Farrar   ORCID: orcid.org/0000-0003-2896-4496 1 ,
• Kielan Yarrow 1 &
• Katy Tapper 1  

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Cognitive decoupling (the ability to distinguish supposition from belief and run thought experiments) is considered one of the key mechanisms in mindfulness, cognitive reflection and reasoning. Therefore, the present study examined whether a brief mindfulness exercise that explicitly encourages cognitive decoupling can increase cognitive reflection and reasoning.

A total of 156 first- and second-year undergraduate students were randomly allocated to either a mindfulness or control condition, before listening to a 15-min audio recording. The mindfulness audio was a recording of the leaves on a stream exercise that focussed on how to dissociate from thoughts (decentring), whereas the control audio was a recording of a book prologue. Cognitive reflection and reasoning were measured through the expanded cognitive reflection test and a syllogistic reasoning test, both of which encourage an incorrect automatic response rather than a correct rational response. The five-facet mindfulness questionnaire-short form and the rational-experiential inventory were also administered as trait measures of mindfulness and thinking style (intuitive or rational), respectively.

The results showed no significant difference between the mindfulness and control conditions on either of the cognitive tests. However, there was a significant positive correlation between trait mindfulness and trait rationality ( r  = 0.56). Further analyses showed that the mindfulness subscales of observing, describing, detaching, and acting mindfully were all significant predictors of trait rationality.

Conclusions

Trait mindfulness and trait rationality are moderately associated, although more research is required to determine whether mindfulness training can increase cognitive reflection and reasoning.

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Data availability.

The data for the study is available from the first author on request.

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This study was funded by a Doctoral Research Scholarship awarded by City, University of London.

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Stephanie T. Farrar, Kielan Yarrow & Katy Tapper

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STF: designed and executed the study, performed part of the date analysis and wrote the first draft of the manuscript. KY: assisted with the data analysis, wrote part of the results and edited the final manuscript. KT: collaborated with the design of the study and edited the final manuscript. All authors approved the final version of the manuscript for submission.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the British Psychological Society and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval was granted by the Psychology Department Research Ethics Committee at City, University of London.

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Farrar, S.T., Yarrow, K. & Tapper, K. The Effect of Mindfulness on Cognitive Reflection and Reasoning. Mindfulness 11 , 2150–2160 (2020). https://doi.org/10.1007/s12671-020-01429-z

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What is the difference between reflection paper and a research paper?

The primary difference is that a research paper is strictly objective, while a reflection paper is somewhat subjective, since you're writing about your own personal thoughts, views and experiences.

Add your answer:

What is the difference between a reflection paper and a reaction paper?

Reaction PaperA reaction paper, also called a response paper, is designed to allow the student to share his feelings on a topic. The student answers several different questions in a reaction paper, including how she feels about the topic, if she agrees with it, if she identifies with it and her evaluation of the topic. After a brief description of the topic, a reaction paper contains the student's personal reaction to the topic or idea. It focuses primarily on how the student feels about the topic and whether the student agrees with the idea.Reflection PaperA reflection paper is similar; however, the student focuses on what he has learned rather than his feelings on the topic---although personal feelings are still a major component of a reflection paper. A reflection paper focuses on statements and feelings, answering questions including what the student thinks, sees and feels. It also explains the student's opinion and the main points of the topic. A reflection paper is a way for the student to reflect on the topic of the paper, sharing the ideas the student learned from the topic and his thoughts on the subject.Read more: The Differences Between Reaction Paper & Reflection Paper | eHow.com http://www.ehow.com/info_8524548_differences-reaction-paper-reflection-paper.html#ixzz1hz8puaj6

How do you write a reflection paper?

A "reflection" is a personal response.In education (academia), a written "reflection," is a personal response to an experience, a reading, or a specific question. What is wanted is that you demonstrate you understand whatever issue is at hand and that you can respond to it in writing by connecting it to your own observation, previous experience, or recent learning. Reflection papers are generally between 300-700 words.

What is the specific part of a subject that is dealt with in a research paper or in an essay?

What is a good 9th grade topic for a research paper.

the rise and fall of the roman empire

What are the steps in research method?

I think you are making research paper for first time when I was making firstly I am also confused that how to do then i search it through various websites and i got an excellent results of my search. view at source about steps of research method

What is the difference between informative paper and research based paper?

The difference between an informative paper and a research based paper is that a research based paper must cite the sources of information while an informational paper does not have to cite sources. An informational paper is also written in a simpler format than a research paper.

What is the difference between a report research paper and an argumentative paper?

The primary difference is that a report/research paper is written to inform someone about a topic. An argumentative paper is designed to convince someone to agree with a point of view.

What is the difference between a research paper and a report paper?

A Research Paper takes all of the information and then does something relevant and original with it. A report finds all the relevant material written or known about an issue and reports it back.

Difference between research paper and article?

Research can be said as activity which is specified much significance in scholastics. Be that as it may, research papers are not only these task papers composed by understudies as those composed by scholars and researchers and also published in different journals are additionally alluded to as research papers. Research article is a bit of composing that have original research thought with the pertinent data and discoveries. A research article is a composing or paper that advises individuals of a way breaking a finding or research with data to bolster the finding.

What is the formatting difference between a memo and an academic paper?

what is the difference between formatting a business document and a academic paper

What is the Difference between a normal paper and currency paper?

the main difference between currency paper and normal paper is that the currency paper is made up of cotton fibres and the normal paper is obtainde from trees

What is the difference between currency paper and a normal paper?

What is difference in photo paper plus glossy and photo paper glossy.

There is no difference between photo paper glossy and plus glossy. The main difference in photo paper can be seen between a matte finish and glossy finish.

What is the difference between a research article vs theoretical paper?

A research article is an article written based on the collection of many facts. Theoretical papers are ones written based on someone's educated opinions.

What is the difference between a business document format and an academic paper format?

What is the difference between an academic paper format and a business document format?

Example of reflection paper about cleaning?

A reflection paper is a paper that reflects on a personal stance or understanding of a subject. A reflection paper about cleaning would address your personal feelings and thoughts on cleaning, cleaning supplies, or the cleaning process.

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• Published: 15 April 2024

Age-specific nasal epithelial responses to SARS-CoV-2 infection

• Maximillian N. J. Woodall 1   na1 ,
• Ana-Maria Cujba 2   na1 ,
• Kaylee B. Worlock   ORCID: orcid.org/0000-0002-5656-7634 3   na1 ,
• Katie-Marie Case 1 ,
• Tereza Masonou 1 ,
• Masahiro Yoshida   ORCID: orcid.org/0000-0002-3521-5322 3 ,
• Krzysztof Polanski   ORCID: orcid.org/0000-0002-2586-9576 2 ,
• Ni Huang 2 ,
• Rik G. H. Lindeboom   ORCID: orcid.org/0000-0002-3660-504X 2 ,
• Lira Mamanova 2 ,
• Liam Bolt   ORCID: orcid.org/0000-0001-7293-0774 2 ,
• Laura Richardson   ORCID: orcid.org/0000-0002-8075-3816 2 ,
• Batuhan Cakir 2 ,
• Samuel Ellis 1 ,
• Machaela Palor   ORCID: orcid.org/0000-0003-4276-5346 1 ,
• Thomas Burgoyne   ORCID: orcid.org/0000-0002-8428-720X 4 , 5 ,
• Andreia Pinto   ORCID: orcid.org/0000-0002-0840-6844 5 ,
• Dale Moulding   ORCID: orcid.org/0000-0002-1431-7047 1 ,
• Timothy D. McHugh   ORCID: orcid.org/0000-0003-4658-8594 6 ,
• Aarash Saleh 7 ,
• Eliz Kilich   ORCID: orcid.org/0000-0003-0928-8293 3 , 8 ,
• Puja Mehta   ORCID: orcid.org/0000-0001-9459-9306 3 , 8 ,
• Chris O’Callaghan 1 ,
• Jie Zhou 9 ,
• Wendy Barclay   ORCID: orcid.org/0000-0002-6413-2454 9 ,
• Paolo DeCoppi   ORCID: orcid.org/0000-0002-1659-0207 1 , 10 ,
• Colin R. Butler 10 , 11 ,
• Mario Cortina-Borja 1 ,
• Heloise Vinette 1 ,
• Sunando Roy 1 ,
• Judith Breuer   ORCID: orcid.org/0000-0001-8246-0534 1 ,
• Rachel C. Chambers   ORCID: orcid.org/0000-0003-1370-9417 3 ,
• Wendy E. Heywood 1 ,
• Kevin Mills 1 ,
• Robert E. Hynds 11 , 12 ,
• Sarah A. Teichmann   ORCID: orcid.org/0000-0002-6294-6366 2 , 13   na2 ,
• Kerstin B. Meyer   ORCID: orcid.org/0000-0001-5906-1498 2   na2 ,
• Marko Z. Nikolić   ORCID: orcid.org/0000-0001-6304-6848 3 , 8   na2 &
• Claire M. Smith   ORCID: orcid.org/0000-0002-8913-0009 1   na2  

Nature Microbiology ( 2024 ) Cite this article

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Children infected with SARS-CoV-2 rarely progress to respiratory failure. However, the risk of mortality in infected people over 85 years of age remains high. Here we investigate differences in the cellular landscape and function of paediatric (<12 years), adult (30–50 years) and older adult (>70 years) ex vivo cultured nasal epithelial cells in response to infection with SARS-CoV-2. We show that cell tropism of SARS-CoV-2, and expression of ACE2 and TMPRSS2 in nasal epithelial cell subtypes, differ between age groups. While ciliated cells are viral replication centres across all age groups, a distinct goblet inflammatory subtype emerges in infected paediatric cultures and shows high expression of interferon-stimulated genes and incomplete viral replication. In contrast, older adult cultures infected with SARS-CoV-2 show a proportional increase in basaloid-like cells, which facilitate viral spread and are associated with altered epithelial repair pathways. We confirm age-specific induction of these cell types by integrating data from in vivo COVID-19 studies and validate that our in vitro model recapitulates early epithelial responses to SARS-CoV-2 infection.

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Helen Stölting, Laury Baillon, … Clare M. Lloyd

Delayed induction of type I and III interferons mediates nasal epithelial cell permissiveness to SARS-CoV-2

Catherine F. Hatton, Rachel A. Botting, … Christopher J. A. Duncan

SARS-CoV-2 infection induces the dedifferentiation of multiciliated cells and impairs mucociliary clearance

Rémy Robinot, Mathieu Hubert, … Lisa A. Chakrabarti

Despite effective vaccines, age remains the single greatest risk factor for COVID-19 mortality. Children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rarely develop severe disease 1 , while the mortality in infected people over 85 years is currently as high as 1 in 10 (ref. 2 ). Nasal epithelial cells (NECs) are the primary target of SARS-CoV-2 (refs. 3 , 4 ), and understanding their viral response is crucial as infection of upper airway cells can progress distally 5 , 6 , leading to diffuse alveolar injury with respiratory failure and long-term complications including lung fibrosis 7 .

Initially, it was thought that higher viral entry factor expression of angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) in adults could explain increased severity, but such differences between children and adults remain uncertain 8 , 9 . Children may alternatively be protected by a pre-activated antiviral state in the upper airways 9 , 10 , but this does not fully explain the increased risk with increasing age. In addition, most in vivo studies so far were unable to identify early cellular responses, since in almost all cases the exact time of infection was unknown, symptom onset was variable and research sampling usually occurred only a few days after testing positive for SARS-CoV-2 (ref. 9 ).

Here we investigated the effects of early SARS-CoV-2 infection on human NECs from healthy children (0–11 years), adults (30–50 years) and older adults (>70 years). NEC were cultured at an air-liquid interface (ALI) and either subjected to mock infection or infected with SARS-CoV-2 for up to 3 days. This setup was used to examine epithelial-intrinsic differences in function, viral replication, gene and protein expression. We reveal age-specific epithelial responses, independent of immune cells, with a strong interferon (IFN) response in infected paediatric goblet inflammatory cells, and the appearance of older adult basaloid-like cells that sustain viral replication and are associated with fibrotic signalling pathways.

Differences in the cellular landscape of NECs with age

We first investigated the cellular composition of NECs at different ages using single-cell RNA sequencing (scRNA-seq; Fig. 1a ). We analysed a dataset of 139,598 cells and identified 24 distinct epithelial cell types or states (Fig. 1b and Extended Data Fig. 1a–c ). These included basal (KRT5 hi ), secretory (SCGB1A1 hi , MUC5AC+) and ciliated (CCDC40+) cells (markers in Extended Data Fig. 1d ). Basal cells encompassed various subpopulations, such as basal, cycling basal, hillock, basal|EMT (associated with epithelial–mesenchymal transition (EMT)) and basaloid-like cells enriched in fibrotic lungs 11 . The second domain includes secretory, goblet and squamous cells, each expressing different secretory proteins and genes related to mucosal defence. The third domain comprised ciliated cells, which were further divided into two clusters on the basis of gene expression patterns associated with cilium organization. Comparison to published nasal COVID-19 datasets 9 , 12 confirmed the accuracy of our cell annotations including ionocytes and hillock cells (Extended Data Fig. 1e,f ).

a , Schematic of method and model used to study SARS-CoV-2 infection of paediatric (P, <12 years), adult (A, 30–50 years) and older adult (O, >70 years) nasal epithelial cells. b , UMAP visualization of annotated airway epithelial cells. Cell numbers per cell type are shown in parentheses. Dotted lines indicate the three principal cell domains these fall within: KRT5 high (KRT5 hi ), SCGB1A high (SCGB1A hi ) and ciliated/other. UMAP shows the entire single-cell sequencing (scRNA-seq) dataset, including SARS-CoV-2 and mock-infected NEC cultures across all three timepoints and ages ( n  = P3, A4, O4). c , Percentage of annotated airway epithelial cells with respect to age in baseline (non-infected) NEC cultures and following label transfer to an in vivo dataset of nasal brushings from age-matched donors from ref. 9 (data shown as a percentage cells in the three principal cell domains found in each age group). d , SARS-CoV-2 entry factor protein expression per culture type determined by Western blot. Comparisons of ACE2 and TMPRSS2 protein levels normalized to GAPDH were made using the Wilcoxon test. Individual values plotted for each participant, indicated by dots ( n  = P9, A7, O8). e , SARS-CoV-2 entry factor gene expression by scRNA-seq. SARS-CoV-2 entry factor gene expression per cell type calculated on the basis of absolute cell numbers, with the average expression of ACE2 and TMPRSS2 indicated by colour. Dot size corresponds to the number of cells expressing ACE2 and TMPRSS2 in respective age groups in the mock condition. f , SARS-CoV-2 RNA viral reads (grey dots, per cell; red dots, per donor) as determined by viral transcript counts (encoding for the full viral genome) per nucleotide per 500 cells (grey dots) or nucleotide per 500 cells per donor (red dots) within each age group. Pairwise comparisons between donors’ age groups were performed using two-sided Wilcoxon rank-sum tests; NS, not significant. g , SARS-CoV-2 viral reads were detected within the scRNA-seq dataset (Infected condition only) at 24 (top) and 72 h (bottom) post infection, shown by cell type and age groups, with dot size and colour indicative of the percentage of cells with detectable viral reads and average reads per cell, respectively. h , Representative maximum intensity z -projections of confocal images (left) of NEC cultures immunolabelled against cilia (cyan, tubulin), dsRNA (yellow) and basal cells (KRT5, white) with DAPI (blue) and phalloidin (magenta) to indicate the nucleus and actin filaments, respectively. Scale bar, 50 μm. Representation of dsRNA signal alone for each section is indicated in red adjacent to respective maximal projections, with the value of spread given on each panel. Summarized on the bar graph to the right (mean ± s.d.), subjected to one-way analysis of variance (ANOVA) with Tukey’s multiple comparisons test. Individual values are shown for each donor ( n  = P8, A5, O6). A representative orthogonal section is given (bottom right) to indicate location of dsRNA within infected NECs. i , j , Transmission electron micrographs of epithelial cell types infected with SARS-CoV-2, with selected areas of interest shown at a higher magnitude for each; i , ciliated cells (left), goblet cell (middle), transit (right) and j , ciliated 2 cell types. Panels show components of interest within each cell type, denoted by arrows: white arrows, SARS-CoV-2; green arrows, cilia; blue arrows, secretory mucin granules; viral particles false-coloured with red to aid visualization. k , SARS-CoV-2 protein abundance in apical fluid (extracellular) and cell lysates (intracellular) from SARS-CoV-2-infected NECs for 72 h p.i. as determined by mass spectrometry. Data are shown as mean abundance of protein (dot size) and mean fold change (FC) in protein abundance per donor from mock-infected NECs (colour, age group) ( n  = P5, A5, O5). l , Infectious viral titres in combined cell lysate and apical fluid of SARS-CoV-2 nasal epithelial cells from paediatric, adult and older adult donors as determined by plaque assays (mean ± s.d.). Two-way ANOVA with Tukey’s multiple comparisons test. Individual values are shown for each donor ( n  = P13, A8, O8). Lines in box and whisker plots ( d , f ) indicate median, interquartile range (IQR) and minimum to maximum of the distribution.

Source data

Interestingly, we observed age-related differences in cell-type proportions in healthy control cultures, with a higher abundance of basal/progenitor subtypes in adult versus paediatric cultures (Fig. 1c and Extended Data Fig. 1g ), mirroring an in vivo nasal epithelial dataset 9 (Extended Data Fig. 1e,f ). All age groups exhibited similar apical differentiation, mucus and tubulin expression (Extended Data Fig. 1h ), and ciliary activity (Extended Data Fig. 2a,b ). There was no substantial difference in ciliary beat frequency or cellular motility with age (Extended Data Fig. 2a,c ). However, NEC cultures from older adult donors were thicker (mean ± s.d. 40 ± 18 µm) than paediatric cultures (20 ± 10 µm; P  = 0.02) (Extended Data Fig. 2d ) with a distinct spiral morphology typical of NEC cultures (Extended Data Fig. 2e ), though this had no effect on the integrity of the epithelial barrier (Extended Data Fig. 2f ).

The most notable difference in paediatric cultures was an increase of goblet cell types, particularly the goblet 2 cells (Extended Data Fig. 1g ). This shift in cell state from secretory (higher in KRT5 ) to goblet (higher in BPIFA1) cells was not observed in adult and older adult cultures. Importantly, while the total protein levels of SARS-CoV-2 entry factors 13 did not vary with age (Fig. 1d ), paediatric cultures showed higher mRNA expression of TMPRSS2 and ACE2 in goblet cells (Fig. 1e ). In adult and older adult cultures, these markers were predominantly expressed in secretory and basal 2 cell types (Fig. 1e ), suggesting a shift in susceptibility to viral infection from goblet to secretory cell types with age. Other viral entry factors, BSG , CTSL , NRP1 , NRP2 and FURIN showed the same trend as ACE2 and TMPRSS2 (Extended Data Fig. 2g ).

Increased virus production in infected older adult NECs

To determine differences in viral replication between age groups, NEC cultures were infected with an early-lineage SARS-CoV-2 isolate (hCoV-19/England/2/2020; 4 × 10 4 plaque forming units (p.f.u.) per well (approximate multiplicity of infection (MOI) of 0.01 p.f.u. per cell)). Over a 5-day infection period, SARS-CoV-2 replication increased and then peaked at 72 h post infection (p.i.) (Extended Data Fig. 3a,b ); therefore, all subsequent investigations were completed before this timepoint. The total number of viral reads increased with time but did not differ between age groups (Fig. 1f ), with fewer cell types infected (showing >0 viral reads) in paediatric (3/24 cell types) versus adult and older adult cultures (7/24 and 11/24 cell types, respectively) at 24 h p.i. (Fig. 1g and Extended Data Fig. 3c–e ) and a wider range at 72 h p.i. in all age groups (Fig. 1g ). We also measured total viral spread (measured as %dsRNA+ signal coverage) by immunofluorescent analysis at 72 h p.i., which was greater in older adult (mean ± s.d. 16.1% ± 9.5) than in paediatric cultures (3.8% ± 3.1) (Fig. 1h and Supplementary Fig. 1 ). Overall, ciliated 2 and transit epi 2 cells had the highest proportion of viral reads (Fig. 1g ). Strikingly, goblet cell types appeared more infected in paediatric cultures, while adult and older adult cultures showed highest viral reads in secretory cell types (Fig. 1g and Extended Data Fig. 3c–e ). Cells expressing the highest viral reads displayed high ACE2 ( R 2  = 0.71) and TMPRSS2 ( R 2  = 0.57) expression (Extended Data Fig. 3f,g ). Transmission electron microscopy (TEM) demonstrated the presence of viral particles (red) in cells possessing both mucin-containing secretory granules and cilia (Fig. 1i,j , and Supplementary Figs. 2 and 3 ).

Key differences across the age groups were greater apical localization of the SARS-CoV-2 spike protein (Extended Data Fig. 3f ), greater abundance of intracellular and apical secreted SARS-CoV-2 proteins (Fig. 1k ) and higher levels of infectious particles in older adult than in with paediatric cultures, with a significant ( P  = 0.04) >800-fold higher titre in older adult (mean ± s.d. 1.64 × 10 7  ± 3.94 × 10 7  p.f.u. per well; n  = 8) than in paediatric cultures (1.71 × 10 4  ± 3.20 × 10 4  p.f.u. per well; n  = 13) at 72 h p.i. (Fig. 1l and Extended Data Fig. 4i ). These findings support the conclusion that SARS-CoV-2-infected older adult NECs translate more viral protein and generate more replication-competent viruses compared with paediatric cells.

SARS-CoV-2 infection induces age-specific effects

We next profiled the phenotypic effects of infection on epithelial cells, using live cell microscopy, immunofluorescence staining, proteomics and gene expression analysis, and compared these across the age groups.

Overall, we found that compared to uninfected cultures, SARS-CoV-2-infected adult ( P  < 0.05, n  = 5) and older adult ( P  < 0.001, n  = 7) cultures had decreased culture thickness (Fig. 2a,b and Extended Data Fig. 4a ) and epithelial integrity ( P  < 0.03, n  = 7; Fig. 2c ), with no change in adherens junction protein expression (Extended Data Fig. 4b ). This decrease in culture thickness was accompanied by an increase in basal cell mobilization ( P  < 0.03, n  = 7; Fig. 2d and Extended Data Fig. 4c,d ) and epithelial escape (cell protrusion) from the pseudostratified culture in older adult cultures (Fig. 2a,e ). Some protruded cells carried viral particles (Fig. 2f ) and expressed the SARS-CoV-2 spike protein (Fig. 2g ) and others were shown to completely detach from the pseudostratified epithelium on the apical surface of the culture (Fig. 2h and Extended Data Fig. 4e ). Ultrastructural changes such as endocytosis of cilia basal bodies and sloughing of ciliated cells were observed in all age groups (Supplementary Fig. 3 ). However, there was no significant loss of ciliated cells or changes in ciliary beat frequency (Extended Data Fig. 5a–c ), or entry factor protein expression within 72 h of infection (Extended Data Fig. 5d ).

a , Representative orthogonal views of the z -stacks showing the thickness (white dashed arrow) and morphology of fixed paediatric, adult and older adult mock- or SARS-CoV-2-infected NECs at 72 h p.i. Sections were immunolabelled against cilia (cyan, tubulin), F-actin (magenta, phalloidin), DAPI (blue), SARS-CoV-2 S protein (yellow) and cytokeratin 5 (white, KRT5+). Solid white arrows indicate cells protruding from the apical surface (as quantified further in e ). Scale bar, 50 μm. b , Epithelial thickness was further measured and quantified, and subjected to a two-way ANOVA with Sidak’s multiple comparison test ( n  = P9, A5, O7). c , Epithelial integrity, as measured by trans-epithelial electrical resistance (TEER) (Ω × cm 2 ) from 72 h p.i. mock- or SARS-CoV-2-infected NECs ( n  = P11, A4, O7), subjected to multiple paired t -tests. d , Quantification of non-basal KRT5+ cells (for example, KRT5+ cells above and not touching the basal membrane) as a measure of basal cell mobilization, with age and infection (mock vs infection). Calculated using a cross-section of fixed NECs at 72 h p.i. ( n  = P7, A5, O5), subjected to two-way ANOVA with Tukey’s multiple comparisons test. See Extended Data Fig. 4c,d for more details for analysis. e , Cell protrusion analysis, calculated by counting the number of nuclei (blue, indicated by white solid arrows in a ) above apical epithelial membrane (magenta) per section per donor. Data shown as mean ± s.d. ( n  = P7, A5, O6), subjected to one-way ANOVA with Tukey’s multiple comparisons test. f , Transmission electron micrograph of protruding epithelial cell type, heavily burdened with SARS-CoV-2 virions (red) at 72 h p.i. Scale bar, 2 μm. g , Representative images of immunofluorescence staining for cells that have escaped the pseudostratified position and reside above the apical membrane, as stained in a . Of note here: SARS-CoV-2 spike (yellow) and KRT5 (white). Image 3D-rendered (left) using Imaris (Bitplane) with Blend filter; scale bar, 60 µm. Scale bar for all other images: 5 µm, rendered in ImageJ in right bottom panel, showing a histogram of distance vs fluorescence intensity for DAPI, KRT5 and SARS-CoV-2 spike staining for a single Z -slice indicated by purple dotted line. h , Transmission electron micrograph of epithelial cell shedding (white arrows) at 72 h p.i. with SARS-CoV-2. i , j , UMAP representation of the results from Milo differential abundance (DA) testing (left plot) with nodes showing cell neighbourhoods and Beeswarm plot (right plot) showing the log(FC) observed when comparing SARS-CoV-2-infected versus mock conditions in paediatric i , and older adults j , with a significant enrichment of goblet 2 inflammatory cells and basaloid-like 2 cells, respectively, observed with infection. Beeswarm plot shows the distribution of log(fold change) across annotated cell clusters when comparing SARS versus mock groups, with cell types ranked on the basis of those with the highest fold change. Grey is non-significant, red is significantly increased, blue is significantly decreased at 10% FDR. k , UMAP visualization of annotated epithelial cells from lower and upper airways of 8 in vivo integrated single-cell datasets. Cell numbers per cell type are shown in parentheses. l , m , Graph comparing the frequency of ( l ) goblet inflammatory and ( m ) basaloid-like 2 cells normalized to the total number of cells per donor. Each dot represents the ratio of the number of cells multiplied by 1,000 to the total cells contributed from one donor and are coloured on the basis of age_status group. Healthy dataset n  = P49, A45, O46; COVID-19 dataset n  = P41, A58, O116. Statistical analysis was performed on the normalized proportions using zero-inflated Poisson models using the gamlss package in R. Boxplots show the median and IQR, plus the minimum and maximum value distribution. Note the large frequency of donors with zero incidence.

Using Milo 14 , we tested for differential cell state abundance following infection and whether this varied with age. In paediatric cultures, the most significant change was the emergence of goblet 2 inflammatory cells, which were not present in uninfected paediatric cultures (Fig. 2i and Extended Data Fig. 5e,f ). There was a decrease in basal, secretory and goblet cell populations, while the frequency of transit epi 2 and terminally differentiated goblet cells increased (that is, goblet 2 inflammatory) (Fig. 2i and Extended Data Fig. 6e,f ).

The goblet 2 inflammatory cell type is strongly associated with type I IFN signalling, with higher levels of CXCL10 , IFIT1 and IFIT3 markers than other goblet cell subtypes (Extended Data Fig. 1d ). While goblet inflammatory cells have previously been seen in vivo 9 , it is interesting that this inflammatory phenotype is epithelial cell-intrinsic and independent of immune cells that are not present in our cultures. We later (see next section) explore the impact of this on viral replication and spread.

The biggest and consistent change in infected older adult cultures was an increase in basal ( KRT5 hi ) cell populations, indicating an older adult-specific mobilization (proliferation) of progenitor cells following SARS-CoV-2 infection (Fig. 2j , adult dataset shown in Extended Data Fig. 5f,g ) and an expansion of basaloid-like 2 cells (Fig. 2j and Extended Data Fig. 5f ). These recently identified cells are characterized by markers associated with tissue injury and fibrosis ( ITGB6 , ITGB1 , ITGAV , ITGB8 , VIM , TGFB1 ) (Extended Data Fig. 1d ). In healthy epithelial tissue, including skin and lung, integrin beta 6 ( ITGB6 ) mRNA is virtually undetectable 15 , but its expression has been reported to be considerably upregulated during wound healing 16 , tumorigenesis and fibrosis 17 . The presence of these ITGB6 + cells is a major finding as they may be involved in the exacerbation of disease in older adults.

Pseudotime trajectory analysis suggested that goblet 2 inflammatory cells (Extended Data Fig. 2h ) and basaloid-like 1 cells (Extended Data Fig. 2j ) are terminal cell states, differentiating from goblet 2 PLAU+ (Extended Data Fig. 2i ) and Basal|EMT cells (Extended Data Fig. 2k ), respectively, with ciliated 1 cells seen as a third end state (Extended Data Fig. 5h )

In vivo patient validation of induced cell states

To confirm the existence of deregulated cell states in vivo, we performed an integration of 8 scRNA-seq datasets comprising 577,243 cells, spanning upper and lower airways from paediatric (0–18 years), adult (19–50 years), and older adults (51–90 years) that are either healthy or COVID-19 patients 9 , 10 , 12 , 18 , 19 , 20 , 21 , 22 (Fig. 2k and Extended Data Fig. 6a–c ). We identified common epithelial clusters by marker genes (Extended Data Fig. 6c ). Goblet inflammatory cells were induced in response to SARS-CoV-2 across all age groups, with the highest abundances in paediatric COVID-19 and older adult COVID-19 cohorts (Fig. 2l and Extended Data Fig. 6b ). We note that in the older adult COVID-19 cohort, a single donor (mild disease, early post-symptom samples) contributed 82% of all goblet inflammatory cells (Fig. 2l ). Thus, the induction of this cluster is most robust in the paediatric cohort. In the in vivo dataset, we also identified a basaloid-like 2 cell cluster enriched across all COVID-19 patients, which were most abundant in older adult COVID-19 patients across multiple donors (Fig. 2m and Extended Data Fig. 6c ), confirming our in vitro studies. Basaloid-like 2 cells also had the highest increase in fibrosis patients (both idiopathic pulmonary fibrosis and other pulmonary fibrosis), as previously reported 11 , 23 (Extended Data Fig. 6c ).

Stronger interferon response in paediatric cultures

As described, SARS-CoV-2 infection is associated with strong interferon responses, which were particularly apparent in paediatric goblet 2 inflammatory NECs but absent in mock-infected cultures and rare in infected older age groups (proportion of total goblet 2 inflammatory cells from NEC cultures: paediatric = 1,455/1,578, adult = 90/1,578, older adult = 33/1,578) (Extended Data Fig. 1g ). These cells exhibited high levels of interferon-stimulated genes (ISGs), associated with both type I and II interferon signalling (Fig. 3a,b and Extended Data Fig. 7a,b ), and were previously shown to reduce COVID-19 severity 10 , 24 . In addition, paediatric cultures-secreted proteins also showed an association with epithelial barrier and humoral immune response pathways (Extended Data Fig. 7c–e ).

a , UMAP visualization of expression of differentially expressed genes in goblet 2 inflammatory cells. Gene expression is shown in log1p scale. b , Scores of gene ontology (GO) term gene signatures for the terms: response to type 1 interferon ( GO:0035455 or GO:0034340 ) and type 2 interferon ( GO:0034341 ) across cell types. Scores were calculated with Scanpy as the average expression of the signature genes subtracted with the average expression of randomly selected genes from bins of corresponding expression values. Each dot is a cell. c , SARS-CoV-2 entry factor gene expression per cell type calculated on the basis of absolute cell numbers with the average expression of TMPRSS2 (top) and ACE2 (bottom) indicated by colour. Dot size corresponds to infected number of cells expressing TMPRSS2 and ACE2 in respective age groups in the mock (all timepoints) and SARS-CoV-2 (all timepoints) infected condition. d , Volcano plot showing differential gene expression between goblet 2 inflammatory and their precursor goblet 2 PLAU+ cells, with a total of 478 variables. Of note were several genes associated with an interferon response (for example, IFI6 , IFITM1 , IFIT1 , IFIT2 and ISG15 ) and SARS-CoV-2 viral replication (highlighted in red) which were significantly enriched within the paediatric goblet 2 inflammatory cells. The colours indicate the genes that have adjusted P values ≤0.05 (blue), a log 2 fold-change ≥1 or ≤−1 (green), or remain unchanged (grey). The dashed horizontal line signals statistical significance threshold (adjusted P values ≤0.05). Two vertical lines show the threshold of log 2 fold-change ≥0.5 and ≤−0.5. e , Visualization of MX1 protein-expressing cells. Maximum intensity projection images of immunofluorescence staining for F-actin (white, phalloidin), MX1 (green), SARS-CoV-2 S protein (red), with DAPI (blue) in composite image. An orthogonal view of the z -stacks is given in the bottom panel. Example given is a SARS-CoV-2-infected paediatric culture at 72 h p.i. Scale bar, 50 µm. f , Fold change in the gene expression in selected IFN genes across all cell types in SARS-CoV-2-infected NECs compared to mock infections in the single-cell datasets. Shown at each timepoint and broken down by age group. Where no expression was seen in the mock infection conditions, fold change was capped at 3 (red). Grey highlights genes that were absent in both conditions. g , Level (pg ml −1 ) of interferon protein (IFNA, IFNG and IFNL) within the apical supernatant between SARS-CoV-2 and mock-infected NECs. Two-way paired t -test. * P  = 0.05, ** P  < 0.01. ( n  = P9, O9). h , Representative immunofluorescence images of inflammatory goblet cell markers at 72 h p.i. with SARS-CoV-2. Maximum intensity projection images of immunofluorescence staining in fixed paediatric NECs. Red, DAPI; white, IFNL1; blue, BPIFA1; cyan, SARS-CoV-2 spike (S) protein. i , Higher magnification image of that shown in h with white IFNL1; blue, BPIFA1 (white arrows annotate inflammatory goblet cells). j , Co-localization plot for BPIFA1 and SARS-CoV-2 S protein.

The precursors of goblet inflammatory cells are goblet 2 PLAU+ cells (Extended Data Fig. 2i ) which expressed high levels of TMPRSS2 and ACE2 (Fig. 3c ), suggesting that the virus targeted these cells and induced the generation of goblet inflammatory cells, which again expressed high levels of entry receptors and could thus be the target for further infection. This is supported by high viral reads and high ISG expression specific to this subtype (Fig. 3d ). Coexpression of viral spike protein and the interferon-induced gene MX1 was confirmed at the protein level in our paediatric cultures (Fig. 3e ). Induction of interferon responsive genes appears to be at least partly autocrine since paediatric inflammatory cells transcribed IFNL1 , IFNL2 and IFNA1 genes (Fig. 3f and Extended Data Fig. 7c ). When comparing the ISG response across all cell types and ages, it is apparent that by 72 h p.i. paediatric cultures express more interferon genes (Fig. 3f ), a difference that was validated at the protein level (Fig. 3g ). Furthermore, immunofluorescence staining demonstrated the co-localization ( R 2  = 0.76) of IFNL1 with the goblet 2 inflammatory cell marker BPIFA1 (Fig. 3h,i ).

Goblet inflammatory cells may restrict viral replication

In paediatric cultures, despite high viral reads, the production of infectious virions is lower than in older adult cultures (Fig. 1l ). Examining the distribution of viral reads, we found that viral transcription in paediatric ciliated cells predominantly occurred towards the 3’ end, indicating active viral replication (Fig. 4a ). However, in paediatric goblet 2 inflammatory cells, viral reads were highest near the 5’ end, suggesting failed viral replication (Fig. 4a and Extended Data Fig. 8a–c ). It was concluded that this bias towards the 3’ end was not a technical artefact due to the introduction of the spike-in primer to increase the detection of viral reads, as SARS-CoV-2 reads were successfully amplified without biasing viral distribution (Extended Data Fig. 8d–f ). Moreover, using deep viral sequencing, we found that non-canonical subgenomic SARS-CoV-2 RNAs (sgRNA), particularly spike and ORF7a sgRNA, were more abundant ( P  = 0.042) in paediatric and adult samples than in older adult samples (Fig. 4b,c ). These non-canonical sgRNAs can result in defective viral genomes and have been associated with increased interferon production 25 . Paediatric cultures also exhibited more low-frequency and fixed mutations in viral genomes (Fig. 4d and Extended Data Fig. 8g ), particularly before the RNA-dependent RNA polymerase (RdRp) (that is, <16 kb; Fig. 4e ). These findings suggest that there is greater pressure on the virus to mutate in younger cultures, possibly due to the production of defective viral genomes by goblet 2 inflammatory cells (Fig. 4f ). In addition, ultrastructural observations revealed fewer viral particles in paediatric goblet cells than in heavily burdened neighbouring ciliated cells (Fig. 4g and Supplementary Fig. 2 ). Our findings indicate that paediatric goblet inflammatory cells may be responsible for the discrepancy between viral reads and infectious particles.

a , Coverage plot of viral reads aligned to SARS-CoV-2 genome from paediatric ciliated 2 (top) and goblet 2 inflammatory (middle) cells at 72 h p.i. Bottom panel shows the genomic organization of SARS-CoV-2 as drawn using Biorender.com . The sequencing depth was computed for each genomic position for each condition. b , Boxplot depicting the sgRPTL normalized counts for sgRNA abundances across age groups using unpaired t -test. c , The mean ± s.d. distribution of these sgRPTL counts across all genes in paediatric (green) and older adult (brown) NEC cultures, subjected to two-way ANOVA with Sidak’s multiple comparisons test ( n  = P5, O5). d , Left: frequency of genomic mutations observed in different regions of the SARS-CoV-2 genome. Right: the position and whether an amino acid change was generated from that mutation. Data were generated from 72 h p.i. with SARS-CoV-2 ( n  = P5, A5, O5). Bin size is 50 bases. Colour blocks indicate the start coordinates of annotated viral genes. e , Number of genomic mutations occurring <16 kb in genome, shown by age group. Data generated from n  = P5, A5, O5. f , Hypothesis of SARS-CoV-2-infected goblet 2 PLAU+ cells becoming protective goblet 2 inflammatory cells through increased interferon and defective viral genome production. Drawn using Biorender.com . g , Transmission electron micrographs of goblet cells at 72 h p.i. with SARS-CoV-2 at different magnifications. Scale bar, 2 μm. Viral particles are false-coloured in red and indicated with white arrows. Lines in box and whisker plots ( b , e ) indicate median, IQR and minimum to maximum of the distribution, with individual values for each cell ( b ) or NEC culture ( e ) shown.

Infected older adult cultures express pro-fibrotic and EMT markers

As discussed above, SARS-CoV-2 infection in older adult cultures led to an increase in basaloid-like 2 cells (Fig. 5a ) associated with a pro-fibrotic state and epithelial–mesenchymal transition (EMT), including expression of ITGB6 , VIM and KRT5 (Fig. 5b and Extended Data Fig. 1d ). Typically membrane bound proteins such as ITGB6, ITGAV and TMPRSS2, produced by these cells, were more abundant in the supernatant of infected cultures from older adults (Fig. 5c and Extended Data Fig. 9a ), possibly originating from shed cells or debris. Vimentin (VIM) was upregulated in cell lysates of SARS-CoV-2-infected older adult cultures compared with mock ( n  = 9; P  < 0.05) (Fig. 5d and Extended Data Fig. 9b ). Immunofluorescence microscopy revealed the co-localization of ITGB6 protein with SARS-CoV-2 S protein (Fig. 5e and Extended Data Fig. 9c,d ) and the formation of vimentin cages around the virus in some infected older adult cells (Fig. 5e and Extended Data Fig. 9e–g ) 26 . Rare instances of migrating basal cell types (defined by the presence of cytokeratin bundles) burdened with viral compartments were also observed, suggesting that KRT5+, ITGB6+ and VIM+ cells are permissive to SARS-CoV-2 infection (Fig. 5f and Extended Data Fig. 9h ).

a , Frequency of KRT5 hi basal airway epithelial cells in mock (black outline) and SARS-CoV-2-infected (red outline) conditions across all timepoints (4, 24 and 72 h p.i.) with respect to age. Data shown in ratio of cell numbers per 1,000 cells per age group within scRNA-seq dataset, where the colour of the bars indicates fold change (FC) from the matched cell compartment in the mock condition. b , UMAP visualization of expression of differentially expressed genes ( ITGB6 , KRT5 and Vimentin (VIM) ) in basaloid-like 2 cells. Gene expression is shown in log1p scale. c , Volcano plot of differentially expressed proteins in the apical secretome of mock- and SARS-CoV-2-infected cultures that were unique (highly expressed) in the older adult dataset. Blue highlights those that are highly expressed in mock compared with SARS-CoV-2 infection conditions and black are enriched with infection; of note: ITGAV, ITGB6 and TMPRSS2 in red. The red horizontal line signals statistical significance threshold (adjusted P values ≤0.05). Two vertical lines show the threshold of log 2 fold-change ≥0.5 and ≤−0.5. d , Analysis of vimentin protein levels by Western blot normalized to GAPDH ( n  = P5, A9, O9), subjected to multiple paired ratio t -test. e , Representative immunofluorescence images of basaloid-like 2 cell markers in older adults at 72 h p.i. with SARS-CoV-2. Maximum intensity projection images of immunofluorescence staining in fixed older adult NECs. Left: cyan, ITGB6; white, KRT5; yellow, SARS-CoV-2 spike protein; and composite with F-actin (magenta, phalloidin) and DAPI (blue). Right: green, vimentin; F-actin (grey, phalloidin); red, SARS-CoV-2 S protein; and composite with DAPI (blue). White arrows annotate the vimentin cage structure around SARS-CoV-2 S protein. f , Transmission electron micrograph of migrating basal KRT5+ epithelial cell in older adult cultures at 72 h p.i. with SARS-CoV-2 (white arrow). Cytokeratin bundles are indicated (grey arrows) and viral compartments (VC) containing viral particles false-coloured in red. Scale bars, 5 μm (left) and 0.5 μm (right). g , Hypothesis that infection of older adult cells leads to increased shedding of cells heavily burdened with viral particles, which may result in further spread of infection. Repair processes increase KRT5+ and ITGB6+ basaloid-like 2 cells, which are prioritized over the early antiviral responses from goblet 2 inflammatory cells, thereby elevating viral titre. Drawn using Biorender.com .

Although basaloid-like 2 cells showed low levels of viral transcription (Fig. 1g ), the most severely infected and damaged cells are probably shed into the secretome (as hypothesized in Fig. 5h ), leading to more ITGB6 protein (Fig. 5c ) and protruding cells (precursors of shed cells) in infected older adult cultures (Fig. 2e ).

ITGB6 expression in repair enhances viral replication

To investigate the role of basaloid-like 2 cells in SARS-CoV-2 pathogenesis, we performed gene set enrichment analysis (GSEA) and found that these cells are associated with extracellular matrix reorganization, wound response and migration processes (Fig. 6a ). Such processes may facilitate viral spread, metastasis and fibrogenic remodelling 27 , 28 , 29 . They also showed upregulation of alternative viral entry receptors CTSL , FURIN , NRP1 and NRP2 (Extended Data Fig. 10a ), suggesting their potential as targets for infection and spread.

a , GSEA indicating enriched gene ontology terms for basaloid-like 2 cells obtained using ShinyGo. b , Schematic to show the different wound healing assay protocols. c , Representative immunofluorescence images of basaloid-like 2 cell markers at 24 h post-wound NECs. Top: maximum intensity projection images (left to right): F-actin (grey, phalloidin); yellow, vimentin; and composite with DAPI (blue). Bottom (left to right): white, KRT5; cyan, ITGB6; and composite with F-actin (magenta, phalloidin) and DAPI (blue). Scale bar, 200 µm. Basaloid-like 2 cell markers mean fluorescence signal around wound area. Wound area shown by dotted red outline. d – f , Analysis of maximal intensity projections of fixed NECs without (−) and with (+) wounds at 24 h post wounding. d , KRT5+ (mean) signal ( n  = 9; P3, A3, O3). e , Vimentin+ (mean) signal ( n  = 5; P2, A1, O2). f , ITGB6+ % coverage ( n  = 10; P4, A4, O2), subjected to ratio paired t -test. Wound healing rate in NECs from different age groups with mock or SARS-CoV-2 infection. g , Percentage wound closure (healed) per hour (% h −1 ), subjected to two-way ANOVA with Sidak’s multiple comparisons test ( n  = P8, A5, O4). h , The difference in wound closure per hour between mock and SARS-CoV-2-infected cells from the same donor. Mean ± s.d. ( n  = P8, A5, O4), subjected to one-way ANOVA with Tukey’s multiple comparisons test. Age variable shown as shape (triangles, adults; circles, paediatric). i , dsRNA coverage for NECs irrespective of age group at 72 h p.i. Determined by percentage area covered with dsRNA signal (yellow) from maximum intensity projections of fixed NECs, subjected to ratio paired t -test ( n  = 5; P2, A1, O2). j , Representative immunofluorescent images from 72 h p.i. NECs with SARS-CoV-2 without (top) and with (bottom) wounding stained for dsRNA (yellow). Percentage area covered (right) with dsRNA+ signal from maximum intensity projections of fixed NECs using threshold analysis (red) in ImageJ, with the percentage coverage given at the bottom right of each image. k , Representative immunofluorescence images of basaloid-like 2 cell markers ITGB6 (cyan), KRT5 (white), dsRNA (yellow) and F-actin (magenta, phalloidin) in SARS-CoV-2-infected NECs. Maximum intensity projection images from wounded cultures after 24 h, shown both as maximal projections (top) and as an orthogonal view (bottom). KRT5 (white) is omitted from composite images, so that overlap of ITGB6 (cyan) and dsRNA (yellow) is apparent (white). l , Infectious viral titres at 72 h p.i. in combined cell lysate and apical fluid of SARS-CoV-2 nasal epithelial cells from non-wounded (−) and wounded (+) donors that were previously shown to propagate low levels of infectious particles (<10,000 p.f.u. per donor at 72 h p.i.). Infectious viral load in combined apical and cell lysates (p.f.u. per donor) were determined by plaque assays, with representative plaque assay wells shown (bottom). Subjected to paired t -test ( n  = 8; P6, A2).

To functionally observe these processes, we employed a wound healing assay (Fig. 6b ). This assay enabled us to stimulate epithelial repair pathways, resulting in the increased expression of basaloid-like 2 cell markers around the wound site including KRT5 protein (Fig. 6c,d and Extended Data Fig. 10b,c ) (mean signal ± s.d. 62.3 ± 8.40 to 94.3 ± 21.1; P  < 0.001, n  = 9), VIM (Fig. 6c,e and Extended Data Fig. 10d,e ) (mean signal ± s.d. 2,887 ± 1,378 to 14,088 ± 518; P  < 0.002, n  = 5) and ITGB6 (Fig. 6c,f and Extended Data Fig. 10f,g ) (%coverage ± s.d. 0.72 ± 0.05 to 8.13 ± 4.73; P  < 0.001, n  = 9). Although we found no difference in wound healing rate of uninfected cultures across ages (Extended Data Fig. 2c ), SARS-CoV-2-infected older adult cultures exhibited a faster ( P  = 0.01) wound healing rate (% h −1 , mean ± s.d. 8.01 ± 2.67% n  = 4) compared with infected paediatric cultures (3.67 ± 2.78%, n  = 8) (Fig. 6g,h and Extended Data Fig. 10h ), indicating greater cell motility and altered repair processes in the older adult. Stimulating wound repair also correlated with an increase in SARS-CoV-2 infection, as evidenced by a higher percentage of dsRNA-positive cells (indicative of replicating virus) in wounded cultures (mean ± s.d. 4.09 ± 3.61% to 9.69 ± 9.04%; P  = 0.03, n  = 5) (Fig. 6i,j and Extended Data Fig. 10i ), particularly around the site of the wound (Fig. 6k and Supplementary Fig. 1 ). Finally, cultures initially generating low infectious particle counts (<10,000 p.f.u. per donor at 72 h p.i.) showed increased viral particle production upon wounding ( P  = 0.006, n  = 8) (Fig. 6l ). These data suggest that basaloid-like 2 cells play a role in viral spread and their involvement in the wound healing process may contribute to SARS-CoV-2 infection and replication.

In our comprehensive study of SARS-CoV-2 infection in human NECs, we identified age-associated differences in COVID-19 pathogenesis. Key findings include the induction of a strong early interferon response in paediatric epithelial cultures infected by SARS-CoV-2, leading to incomplete viral replication. In contrast, NEC cultures derived from older adults produce more infectious viruses across various epithelial cell types when compared with paediatric cultures. Moreover, infected NECs from older adults exhibit increased cell shedding, thinning and leakiness, accompanied by the migration of basaloid-like 2 cells associated with wound repair. Interestingly, we showed that previous wounding of cultures resulted in an increased expression of basaloid-like 2 cell genes, promoting viral spread and ultimately augmenting infectious viral yield. Together, these findings contribute towards a deeper understanding of the age-specific nuances of the upper airway and the effects these may have on the pathogenic mechanism underlying SARS-CoV-2 infection across different ages.

Our in vitro model using primary NECs closely resembles SARS-CoV-2 infection in the human airway, the primary site of infection 30 . It confirms age-related changes in upper airway progenitor basal cell types reported previously 10 , 31 and allows for the detection of intrinsic age-related differences in epithelial cells without confounding variations in host immunity.

Notably, we observed a significant shift in the SCGB1A1 hi cell population, transitioning from goblet cells in paediatric cultures to secretory cells with age, with the latter expressing higher levels of SARS-CoV-2 entry factors (ACE2 and TMPRSS2). In paediatric cultures, goblet 2 cell types were a primary target of infection, while in older adult cultures, infected secretory cells accounted for the highest proportion of viral reads.

Through the integration of existing in vivo COVID-19 datasets, we confirmed the existence of both basaloid-like 2 and goblet inflammatory cells identified in vitro to be induced in an age-dependent response to infection. This validates the early epithelial response to SARS-CoV-2 in our in vitro model. However, we acknowledge differences between the in vitro models and patient responses. For example, basaloid-like 2 cells are far less abundant in vivo, as has been reported 32 , which may be due to the site of sampling, cell dissociation protocols or other technical factors 33 . On the other hand, viral and cellular dynamics can be timed more precisely in vitro, while the time interval from the initial infection to sampling is largely unknown for in vivo studies as they are estimated from symptom onset.

We found that fewer paediatric cell types contained viral reads compared with adult and older adult cultures. This is consistent with previous studies indicating that infection in paediatric cells is confined to a limited number of cells due to an early interferon response that limits viral spread 34 . We suggest that this effect is attributed to goblet 2 inflammatory epithelial cells, which decrease with age. These cells have the highest viral genome burden and the strongest interferon signature of all epithelial subtypes. Interestingly, our data suggest incomplete viral replication, increased subgenomic RNA and fewer infectious viruses in paediatric cultures, indicating more defective viral genomes, presumably due to the strong interferon response. Similar observations have been made in animal challenge experiments 35 and patient studies 36 , 37 , in which discrepancies between viral RNA and infectious viral load were also reported.

SARS-CoV-2 infection in older adult NECs led to epithelial damage and early signs of repair through cell migration and basal NEC proliferation. This was not observed in younger cultures. We also detected increases in ITGAV, ITGB6 and VIM proteins, which were attributed to the emergence of basaloid-like 2 cells. ITGB6 is expressed exclusively on epithelial cells but is virtually absent or expressed at very low levels in normal healthy adult epithelium 15 . It is highly upregulated in response to injury 38 and is associated with fibrotic lung disease and epithelial cancers 17 , 39 .

Integrins also modulate cytokine expression and activate TGF-β1, implicated in fibrosis and EMT 38 , a process with distinct pathological roles in wound healing, tissue regeneration and organ fibrosis and cancer 40 . We hypothesize that age-dependent reprogramming of infected NECs contributes to COVID-19 pathogenesis by prolonging disease and enhancing viral spread.

SARS-CoV-2, influenza and other respiratory infections have previously been linked to dysregulated epithelial repair processes and disease pathogenesis 41 , 42 , 43 . We hypothesize that SARS-CoV-2 infection in older adult NECs leads to the emergence of the basaloid-like 2 cell type and drives EMT repair pathways. Elderly cultures infected with SARS-CoV-2 exhibit flattened epithelial tissue, decreased resistance and increased cell shedding, indicating EMT activation 44 . Such functional changes facilitate disease progression and potentially enhance viral spread 45 , 46 . Ultrastructural and immunofluorescence studies confirm significant SARS-CoV-2 infection in shed cells in severe COVID-19 cases 47 . Elevated vimentin levels, an EMT and basaloid cell marker, are also present in these cultures. Our immunofluorescent assays reveal unique vimentin cage-like structures known to recruit viral components for assembly and egress 26 . In addition, the virus may directly interact with ITGB6, a component of caveolae involved in viral internalization 38 , 48 , 49 . In vitro studies suggest that the SARS-CoV-2 spike protein interacts with integrins 50 , 51 , potentially serving as a viral entry route in non-ACE2-expressing cells, thereby promoting infection in older adults. These findings integrate into our proposed model, where older adult cultures are more prone to induce basaloid-like 2 cells in infection, and these cells support both viral spread and disease progression.

In summary, we have shown that SARS-CoV-2 shows age-specific tropism in nasal epithelial cells, targeting goblet cells in children and secretory cells in older adults. Paediatric cells exhibit a strong antiviral response, resulting in limited viral replication. Older adult cells undergo shedding and more epithelial damage. Altered repair pathways and an increase in basaloid-like 2 cells associated with fibrosis markers contribute to greater viral spread in older adults. These findings provide insights into age-related COVID-19 pathogenesis and demonstrate how impaired repair processes enhance SARS-CoV-2 infection in older individuals.

Participants and ethics

Participants were recruited from five large hospital sites in London, the United Kingdom: the Great Ormond Street Hospital NHS Foundation Trust, the University College London Hospitals NHS Foundation Trust, the Royal Free London NHS Foundation Trust (the Royal Free Hospital and the Barnet Hospital) and the Whittington Health NHS Trust from March 2020 to February 2021. All participants provided written informed consent. Ethics approval was given through the Living Airway Biobank, administered through the UCL Great Ormond Street Institute of Child Health (REC reference: 19/NW/0171, IRAS project ID: 261511, Northwest Liverpool East Research Ethics Committee). Exclusion criteria for the cohort included current smokers, active haematological malignancies or cancer, known immunodeficiencies, sepsis from any cause and blood transfusions within 4 weeks, known bronchial asthma, diabetes, hay fever and other known chronic respiratory diseases such as cystic fibrosis, interstitial lung disease and chronic obstructive pulmonary disease. Nasal brushings were obtained by trained clinicians from healthy paediatric (0–11 years), adult (30–50 years) and older adult (≥70 years) donors who tested negative for SARS-CoV-2 (within 24–48 h of sampling) and reported no respiratory symptoms in the preceding 7 weeks. Brushings were taken from the inferior nasal concha zone using cytological brushes (Scientific Laboratory Supplies, CYT1050). All methods were performed following the relevant guidelines and regulations. Details of the study population are shown in Supplementary Table 1 .

Differentiated human nasal epithelial cell culture

Human nasal brushings were collected fresh for this study and immediately placed in a 15 ml sterile Falcon tube containing 4 ml of transport medium (αMEM supplemented with 1× penicillin/streptomycin (Gibco, 15070), 10 ng ml −1 gentamicin (Gibco, 15710) and 250 ng ml −1 amphotericin B (ThermoFisher, 10746254)) on ice. Four matched paediatric nasal brush samples were sent directly for scRNA-seq 9 . To minimize sample variation, all samples were processed within 24 h of collection and cultured to P1 as previously described 52 . Briefly, biopsies were co-cultured with 3T3-J2 fibroblasts and Rho-associated protein kinase inhibitor (Y-27632) in epithelial cell expansion medium consisting of a 3:1 ratio DMEM:F12 (Gibco, 21765), 1× penicillin/streptomycin and 5% FBS (Gibco; 10270) supplemented with 5 μM Y-27632 (Cambridge Bioscience, Y1000), 25 ng ml −1 hydrocortisone (Sigma, H0888), 0.125 ng ml −1 EGF (Sino Biological, 10605), 5 μg ml −1 insulin (Sigma, I6634), 0.1 nM cholera toxin (Sigma, C8052), 250 ng ml −1 amphotericin B (Gibco, 10746254) and 10 μg ml −1 gentamicin (Gibco, 15710).

Basal cells were separated from the co-culture flasks by differential sensitivity to trypsin and seeded onto collagen I-coated, semi-permeable membrane supports (Transwell, 0.4 µm pore size, Corning). Cells were submerged for 24–48 h in an epithelial cell expansion medium, after which the apical medium was removed, and the basolateral medium was exchanged for epithelial cell differentiation medium to generate ‘air–liquid interface’ (ALI) conditions. PneumaCult ALI medium (STEMCELL Technologies, 05001) was used for differentiation media following manufacturer instructions. Basolateral media were exchanged in all cultures three times a week and maintained at 37 °C and 5% CO 2 . ALI cultures were maintained in PneumaCult ALI medium for 4 weeks to produce differentiated NECs for all downstream experimentation.

Wound healing assay

Mechanical injury of NEC cultures was performed by aspiration in direct contact with the apical cell layer using a P200 sterile pipette tip, creating a wound with a diameter ranging from 750 to 1,500 μm. After wounding, the apical surface of the culture was washed with 200 μl PBS to remove cellular debris. The area of the wound was tracked with the aid of time-lapse microscopy with images taken every 60 min at ×4 magnification (Promon, AIS v.4.6.0.5.). The wound area was calculated each hour using ImageJ. The initial wound area was expressed as 100% to account for variability of wound size. Wounds were considered to be closed when the calculated area fell below 2%, the effective limit of detection due to image processing. Wound closure was calculated as follows: Wound closure (%) = 100 − ((Area/Initial Area) × 100). Wound closure (%) plotted as a function of time (h) was used to calculate the rate of wound closure (% h −1 ).

Virus propagation

The SARS-CoV-2 isolate hCoV-19/England/2/2020 obtained from Public Health England (PHE) was used in this study. For virus propagation, the African green monkey kidney cell line Vero E6 (ATCC: CVCL_0574 ; a kind gift from The Francis Crick Institute, London, United Kingdom and authenticated for use in this study) was used. Vero E6 cells were maintained in DMEM supplemented with 5% FCS and 1× penicillin/streptomycin. Cell media were replenished three times a week and maintained at 37 °C and 5% CO2. Vero E6 cells were infected with an MOI of 0.01 p.f.u. per cell in serum-free DMEM supplemented with 1% NEAA, 0.3% (w/v) BSA and 1× penicillin/streptomycin. A mock condition was conducted in parallel in which an equivalent volume of PBS++ was used instead of viral inoculum. The viral and mock-inoculated cell media were collected after 48 h, centrifuged at 10,000  g for 10 min to remove cellular debris and stored at −70 °C. The viral titre was determined by plaque assay (see below).

Viral infection of NEC cultures

After 28 days, NEC cultures were rinsed with sterile PBS++ and then infected with viral inoculum suspended in PBS++ (4.5 × 10 4  p.f.u. ml −1 , ~0.1 MOI) or an equivalent volume of mock inoculum suspended in PBS++ (mock infection) for 1 h on the apical compartment at 37 °C and 5% CO 2 . The virus inocula were then removed, and the NEC cultures were washed with sterile PBS++ and incubated for up to 72 h. This timepoint was chosen as maximum viral replication was observed at days 2–3 in our pilot studies (Extended Data Fig. 3a ).

Infectious viral load quantification by plaque assay

Vero E6 cells were grown to confluence on 24-well plates and then inoculated with serial dilutions of apical supernatant and cell lysates from infected cultures for 1 h at 37 °C and 5% CO 2 . The inoculum was replaced by an overlay medium supplemented with 1.2% (w/v) cellulose and incubated for 48 h at 37 °C and 5% CO 2 . Plates were fixed with 4% (w/v) paraformaldehyde for 30 min and overlay was aspirated from individual wells. Crystal violet staining was performed for a minimum of 20 min, and then plates were washed with water. The number of visible plaques was counted.

Viral copy number quantification

Viral gene quantification was performed on apical wash supernatants from experiments. Samples were lysed in AVL buffer (Qiagen) and stored at −80 °C until further processing. Viral RNA extractions were performed using a QIAamp viral RNA kit (Qiagen) following manufacturer instructions. Extracted RNA samples (5 μl) were quantified in one-step RT–qPCR using AgPath-ID one-step RT–PCR (Applied Biosystems) with the following cycle conditions: 45 °C for 10 min, 95 °C for 15 min, (95 °C for 15 s + 58 °C for 30 s) in a total of 45 cycles.

Cellular gene quantification was performed with cultured cells collected at the end of the experiments. Cells were lysed in RLT buffer (Qiagen) and extraction was performed using an RNeasy mini kit (Qiagen) following manufacturer instructions. Total RNA was converted into cDNA with qScript cDNA supermix (Quantabio) following manufacturer instructions. RT–qPCR was performed using Taq Man Fast Advanced Master mix with the following cycle conditions: 50 °C for 2 min, 95 °C for 10 min, 95 °C for 30 s and 60 °C for 1 min in a total of 45 cycles. The expression was normalized with GAPDH and then presented as 2 −(ΔCт) in arbitrary units.

SARS-CoV-2 genomic sequencing

Viral genome read coverage.

To visualize the viral read coverage along the viral genome, we used the 10X Genomics cellranger barcoded binary alignment map (BAM) files for every sample. We filtered the BAM files to only retain reads mapping to the viral genome using the bedtools intersect tool 52 . We converted the BAM files into sequence alignment map (SAM) files to filter out cells that were removed in our single-cell data pre-processing pipeline. The sequencing depth for each base position was calculated using samtools count. To characterize read distribution along the viral genome, we counted transcripts of 10 different open reading frames (ORFs): ORF1ab, Surface glycoprotein (S), ORF3a, Envelope protein (O), Membrane glycoprotein (M), ORF6, ORF7a, ORF8, Nucleocapsid phosphoprotein (N) and ORF10.

Detection of SARS-CoV-2 subgenomic RNAs

Subgenomic RNA analysis was conducted using Periscope 53 . Briefly, Periscope distinguished sgRNA reads on the basis of the 5′ leader sequences being directly upstream from each gene’s transcription. The sgRNA counts were then normalized into a measure termed sgRPTL, by dividing the sgRNA reads by the mean depth of the gene of interest and multiplying by 1,000.

Mass spectrometry

Paired mock- and SARS-CoV-2-infected airway surface fluids from groups of 10 paediatric, adult and older adult cultures were selected for this assay. For mass spectrometry, samples were inactivated with the KeyPro UV LED decontamination system (Phoseon Technology) before removal from the Biosafety level 3 laboratory (BSL3). Proteins were precipitated using ice-cold acetone. Protein pellets were resuspended in the digestion buffer as previously described and trypsin (Promega) digested to peptides 54 . Peptides were desalted by solid phase extraction (SPE) and separated by reverse phase chromatography on a NanoAquity LC system coupled to a SYNAPT G2-Si mass spectrometer (Waters) in a UDMSE positive ion electrospray ionization mode. Raw MS data were processed using Progenesis QI analysis software (Nonlinear Dynamics). Peptide identification was performed using the UniProt human reference proteome, with one missed cleavage and 1% peptide false discovery rate (FDR). Fixed modifications were set to carbamidomethylation of cysteines and dynamic modifications of oxidation of methionine.

Western blot

Samples were resolved on 4–15% Mini-PROTEAN TGX Precast Protein Gel (Bio-rad, 4561083) with high molecular mass standards of 10–250 kDa. Proteins were transferred to a Trans-Blot Turbo Mini 0.2 µm nitrocellulose membrane in a Trans-Blot Turbo Transfer System (Bio-rad, 1704150). Membranes were blocked in Odyssey blocking buffer overnight at 4 °C. Membranes were probed with primary antibodies described in Supplementary Table 2 , with dilutions prepared in Odyssey blocking buffer. Incubation with primary antibodies was performed at room temperature (r.t.) for 1 h. These included rabbit anti-ACE2 recognizing both long and short isoforms (Abcam, ab15348, 1:2,000) and rabbit anti-ACE2 specific for the long isoform (Abcam, ab108252, 1:2,000), rat anti-alpha-tubulin (Sigma-Aldrich, MAB1864, 1:2,000) and acetylated forms (Sigma-Aldrich, T6793, 1:2,000), mouse anti-SARS-CoV-2 spike glycoprotein (Abcam, ab273433, 1:2,000), rabbit anti-GAPDH (Abcam, ab9485, 1:3,000), rabbit anti-vimentin (Abcam, ab16700, 1:500) and rabbit anti-E-cadherin (Abcam, ab40772, 1:10,000). After three 15 min washes in PBS containing 0.1% Tween 20, the membranes were incubated with the appropriate IRDye secondary antibodies: goat anti-mouse (LI-COR, 926-68070, dilution 1:18,000) and goat anti-rabbit (LI-COR, 926-32211, dilution 1:18,000), both at room temperature for 1 h. The blots were then visualized using an Odyssey CLx imager and quantified using Image Studio Lite software

Cytokine assay

Apical supernatants were collected by washing the apical surface with 200 μl of PBS. These were snap frozen at −70 °C and inactivated with the KeyPro UV LED decontamination system (Phoseon Technology) in the CL3 laboratory before handling them in a CL2 laboratory. Cytokine and chemokine levels were assessed in 25 μl of supernatants using the multiplex BD CBA bead-based immunoassay kits including: IL6: A7, 558276; IL8 (CXCL8): A9, 558277; TNFα: C4, 560112; IFNγ: E7, 558269; IP10 (CXCL10): B5, 558280; IFNα: B8, 560379; and IL10: B7, 558274. Data were acquired using the BD LSRII flow cytometer and concentrations were obtained from a standard curve (provided with the kit). Analysis was performed using the FCAP software (v.3.0, BD Biosciences).

Immunofluorescence confocal microscopy

For immunofluorescence confocal imaging, NEC cultures were fixed using 4% (v/v) paraformaldehyde for 30 min, permeabilized with 0.2% Triton X-100 (Sigma) for 15 min and blocked using 5% goat serum (Sigma) in PBS for 1 h. The cultures were then incubated overnight at 4 °C with primary antibodies described in Supplementary Table 2 , with dilutions prepared in 5% goat serum in PBS with 0.1% Triton X-100. The primary antibodies used included rabbit anti-ACE2 (Abcam, ab15348, diluted 1:200), mouse anti-MUC5AC (Sigma-Aldrich, MAB2011, diluted 1:500), rat anti-alpha-tubulin (tyrosinated) (Sigma-Aldrich, MAB1864, diluted 1:100), mouse anti-alpha-tubulin (acetylated) (Sigma-Aldrich, T6793, diluted 1:100), mouse anti-SARS-CoV-2 spike glycoprotein (Abcam, ab273433, diluted 1:500), rabbit anti-GAPDH (Abcam, ab9485, diluted 1:250), mouse anti-dsRNA (Jena Bioscience, RNT-SCI-10010500, diluted 1:100), rabbit anti-MX1 (Abcam, ab207414, diluted 1:250), rabbit anti-cytokeratin 5 conjugated with Alexa Fluor 647 (Abcam, ab193895, diluted 1:100), rabbit anti-vimentin (Abcam, ab16700, diluted 1:1,000), rabbit anti-IL28+29 (Abcam, ab191426, diluted 1:100), goat anti-BPIFA1 (Abcam, EB11482, diluted 1:100) and rat anti-integrin beta 6 (Abcam, ab97588, diluted 1:100).

Following primary antibody incubation, cultures were washed and then incubated with secondary antibodies diluted in 1.25% goat serum in PBS with 0.1% Triton X-100 at r.t. for 1 h the following day. The secondary antibodies included donkey anti-mouse Alexa Fluor 647 (Jackson ImmunoResearch, 715-605-151, 1:600), donkey anti-rat Alexa Fluor 647 (Jackson ImmunoResearch, 712-605-153, 1:600), donkey anti-mouse Alexa Fluor 594 (Jackson ImmunoResearch, 715-585-151, 1:600), donkey anti-rat Alexa Fluor 594 (Jackson ImmunoResearch, 712-585-153, 1:600), donkey anti-mouse Cy3 (Jackson ImmunoResearch, 715-165-151, 1:600), donkey anti-rabbit Cy3 (Jackson ImmunoResearch, 711-165-152, 1:600), donkey anti-rat Alexa Fluor 488 (Jackson ImmunoResearch, 712-545-153, 1:600), donkey anti-rabbit Alexa Fluor 488 (Jackson ImmunoResearch, 711-545-152, 1:600), donkey anti-mouse Alexa Fluor 488 (Jackson ImmunoResearch, 715-545-151, 1:600) and donkey anti-goat Alexa Fluor 488 (Jackson ImmunoResearch, 705-545-147, 1:600).

After the secondary antibody incubation, cultures were stained with Alexa Fluor 555 phalloidin (ThermoFisher, A34055 , 4 μg ml −1 ) for 1 h and DAPI (Sigma, 2 μg ml −1 ) for 15 min at r.t. to visualize F-actin and nuclei, respectively. Samples were washed three times with PBS containing 0.1% Tween 20 after each incubation step.

Imaging was carried out using an LSM710 Zeiss confocal microscope, and the resulting images were analysed using Fiji/ImageJ v.2.1.0/153c54 for metrics including mean intensity, cell protrusion, culture thickness, % signal coverage, wound area and pseudocolouring 55 . Intensity profiles were generated using Nikon NIS-Elements analysis module, and three-dimensional (3D) renderings of immunofluorescence images were produced with Imaris software (Bitplane, Oxford Instruments; v.9.5/9.6).

Transmission electron microscopy

Cultured NECs that were either SARS-CoV-2-infected or non-infected were fixed with 4% paraformaldehyde and 2.5% glutaraldehyde in 0.05 M sodium cacodylate buffer at pH 7.4 and placed at 4 °C for at least 24 h. The samples were incubated in 1% aqueous osmium tetroxide for 1 h at r.t. before subsequent en bloc staining in undiluted UA-Zero (Agar Scientific) for 30 min at r.t. The samples were dehydrated using increasing concentrations of ethanol (50, 70, 90, 100%), followed by propylene oxide and a mixture of propylene oxide and araldite resin (1:1). The samples were embedded in araldite and left at 60 °C for 48 h. Ultrathin sections were acquired using a Reichert Ultracut E ultramicrotome and stained using Reynold’s lead citrate for 10 min at r.t. Images were taken on a JEOL 1400Plus TEM equipped with an Advanced Microscopy Technologies (AMT) XR16 charge-coupled device (CCD) camera and using the AMT Capture Engine software.

Sample preparation for single-cell RNA sequencing

Cultured NECs were processed using an adapted cold-active protease single-cell dissociation protocol 56 , as described below, based on a previously used protocol 9 to allow for a better comparison of matched samples included in both studies. In total, NECs derived from n  = 3 paediatric, 4 adult and 4 older adult donors were processed at 24, 48 and 72 h post infection (SARS-CoV-2 and mock) for scRNA-seq.

First, the transwell inserts, in which the NEC cultures were grown, were carefully transferred into a new 50 ml Falcon tube and any residual transport medium was carefully removed so as not to disturb the cell layer. Dissociation buffer (2 ml) was then added to each well, ensuring the cells were covered; 10 mg ml −1 protease from Bacillus licheniformis (Sigma-Aldrich, P5380) and 0.5 mM EDTA in HypoThermosol (STEMCELL Technologies, 07935). The cells were incubated on ice for 1 h. Every 5 min, cells were gently triturated using a sterile blunt needle, decreasing from a 21G to a 23G needle. Following dissociation, protease was inactivated by adding 400 µl of inactivation buffer (HBSS containing 2% BSA) and the cell suspension was transferred to a new 15 ml Falcon tube. The suspension was centrifuged at 400  g for 5 min at 4 °C and the supernatant was discarded. Cells were resuspended in 1 ml dithiothreitol wash (10 mM dithiothreitol in PBS) (ThermoFisher, R0861) and gently mixed until any remaining visible mucous appears to break down, or for ~2–4 min. The mixture was centrifuged at 400  g for 5 min at 4 °C and the supernatant was removed. The cells were resuspended in 1 ml of wash buffer (HBSS containing 1% BSA) and centrifuged once more under the same conditions. The single-cell suspension was then filtered through a 40 µm Flowmi cell strainer. Finally, the cells were centrifuged and resuspended in 30 µl of resuspension buffer (HBSS containing 0.05% BSA). Using trypan blue, total cell counts and viability were assessed. Cells (3,125) were then pooled together from the 4 biological replicates with corresponding conditions (for example, all mock viral treatments at 24 h) and the cell concentration was adjusted for 7,000 targeted cell recovery according to the 10x Chromium manual (between 700–1,000 cells per µl). The pools were then processed immediately for 10 × 5′ single-cell capture using the Chromium Next GEM Single Cell V(D)J reagent kit v.1.1 (Rev E Guide) or the Chromium Next GEM Single Cell 5′ V2 (Dual index) kit (Rev A guide). Each pool was run twice.

Of note, each sample was processed fresh for 5’ Next Gen single-cell RNA sequencing and thus pooled per timepoint when loading on the 10X chromium controller. Extra steps were taken where possible to balance sex, age as well as technical factors (that is, 10X chromium kit versions) within these sample pools. Furthermore, the downstream process of the sample pools, including library preparation and sequencing (see below) contained samples from the 4 h, 24 h and 72 h timepoints to mitigate additional technical effects. Timepoints can be seen to be well mixed within the single-cell dataset as visualized via a uniform manifold approximation and projection (UMAP) in Extended Data Fig. 1b .

For several samples (Supplementary Table 3 ), 1 µl viral RT oligo (either at 5 µM or 100 µM, PAGE) was spiked into the master mix (at step 1.2.b in the 10X guide, giving a final volume of 75 µl) to help with the detection of SARS-CoV-2 viral reads. The samples were then processed according to manufacturer instructions, with the viral cDNA separated from the gene expression libraries (GEX) by size selection during step 3.2. Here the supernatant was collected (159 µl) and transferred to a new PCR tube and incubated with 70 µl of SPRI beads (0.6× selection) at r.t. for 5 min. The SPRI beads were then washed according to the guide and the viral cDNA was eluted using 30 µl of EB buffer. Neither changes to the transcriptome were previously observed upon testing the addition of viral oligo 9 , nor were any significant changes observed with an increasing concentration upon comparison, outside of a small increase in the overall number of SARS-CoV-2 reads detected. The RT oligo sequence was as follows: 5′-AAGCAGTGGTATCAACGCAGAGTACTTACTCGTGTCCTGTCAACG-3′

Library generation and sequencing

The Chromium Next GEM Single Cell 5′ V2 kit (v.2.0 chemistry) was used for single-cell RNA-seq library construction. For all NEC culture samples, libraries were prepared according to manufacturer protocol (10X Genomics) using individual Chromium i7 sample indices. GEX libraries were pooled and sequenced on a NovaSeq 6000 S4 flow cell (paired-end, 150 bp reads), aiming for a minimum of 50,000 paired-end reads per cell for GEX libraries.

Single-cell RNA-seq data processing

Computational pipelines, processing and analysis.

The single-cell data were mapped to a GRCh38 ENSEMBL 93 derived reference, concatenated with 21 viral genomes (featuring SARS-CoV-2), of which the NCBI reference sequence IDs are: NC_007605.1 (EBV1), NC_009334.1 (EBV2), AF156963 (ERVWE1), AY101582 (ERVWE1), AY101583 (ERVWE1), AY101584 (ERVWE1), AY101585 (ERVWE1), AF072498 (HERV-W), AF127228 (HERV-W), AF127229 (HERV-W), AF331500 (HERV-W), NC_001664.4 (HHV-6A), NC_000898.1 (HHV-6B), NC_001806.2 (herpes simplex virus 1), NC_001798.2 (herpes simplex virus 2), NC_001498.1 (measles morbillivirus), NC_002200.1 (mumps rubulavirus), NC_001545.2 (rubella), NC_001348.1 (varicella zoster virus), NC_006273.2 (cytomegalovirus) and NC_045512.2 (SARS-CoV-2). When examining viral load per cell type, we first removed ambient RNA by SoupX 57 . The alignment, quantification and preliminary cell calling of NEC culture samples were performed using the STARsolo functionality of STAR v.2.7.3a, with the cell calling subsequently refined using the Cell Ranger v.3.0.2 version of EmptyDrops 58 . Initial doublets were called on a per-sample basis by computing Scrublet scores 59 for each cell, propagating them through an over-clustered manifold by replacing individual scores with per-cluster medians and identifying statistically significant values from the resulting distribution, replicating previous approaches 60 , 61 .

Quality control, normalization and clustering

Mixed genotype samples were demultiplexed using Souporcell 62 and reference genotypes. DNA from samples was extracted following manufacturer protocol (Qiagen, DNeasy blood and tissue kit 69504 and Qiagen Genomic DNA miniprep kit) and single nucleotide polymorphism (SNP) array-derived genotypes generated by Affymetrix UK Biobank Axiom Array kit by Cambridge Genomic Services (CGS). Cells that were identified as heterotypic doublets by Souporcell were discarded. Quality control was performed on SoupX-cleaned expression matrixes. Genes with fewer than 3 counts and cells with more than 30% mitochondrial reads were filtered out. Cells with a scrublet score >0.3 and adjusted P value < 0.8 were predicted as doublets and filtered out. Expression values were then normalized to a sum of 1 × 10 4 per cell and log-transformed with an added pseudocount of 1. Highly variable genes were selected using the scanpy.pp.highly_variable_genes() function in Scanpy. Principal component analysis (PCA) was performed and the top 30 principal components were selected as input for l. We performed graph-based batch integration with the bbknn method 63 using experimental pools and chemistry as batch covariate (encoded as ‘bbknn_batch’ in the object). Clustering was performed with the Leiden 64 algorithm on a k -nearest-neighbour graph of a PCA space derived from a log(counts per million/100 + 1) representation of highly variable genes, according to the Scanpy protocol 65 . Leiden clustering with a resolution of 1 was used to separate broad cell types (basal, goblet, secretory). For each broad cell type, clustering was then repeated, starting from highly variable gene discovery to achieve a higher resolution and a more accurate separation of refined cell types. Annotation was first performed automatically using a Celltypist 66 model built on the in vivo dataset of nasal airway brushes 9 , and then using manual inspection of each of the clusters and further manual annotation using known airway epithelial marker genes.

Developmental trajectory inference

Pseudotime inference was performed on the whole object or the basal/goblet compartment using Monocle 3 (refs. 67 , 68 ). Briefly, a cycling basal cell was chosen as a ‘root’ cell for the basal compartment, showing the highest combined expression of KRT5 , MKI67 and NUSAP1 genes. For the goblet compartment, a goblet 1 cell was chosen as a root, showing the highest combined expression of TFF3 , SERPINB3 , MUC5AC , MUC5B and AQP5 . Cells were grouped into different clusters using the group_cells() function, learning the principal graph using the learnGraph() function and ordering cells along the trajectory using the ordercells() function. A second pseudotime was inferred with Palantir (1.0.1) 69 . The cycling basal ‘root’ cell was determined as above and an unsupervised pseudotime inference was performed on a Scanpy-derived diffusion map. The five inferred endpoints were inspected and three were deemed to be very closely biologically related and replaced with a joint endpoint with the highest combined expression of OMG , PIFO and FOXJ1 . The pseudotime inference was repeated with the two remaining inferred endpoints and the marker derived one serving as the three terminal states.

Differential abundance analysis

To determine cell states that are enriched in the SARS-CoV-2 versus mock conditions for the different age groups, we used the Milo framework for differential abundance analysis using cell neighbourhoods 14 . Briefly, we computed k -nearest-neighbour graphs of cells in the whole dataset using the buildGraph() function, assigned cells to neighbourhoods using the makeNhoods() function and counted the number of cells belonging to each sample using the countCells() function. Each neighbourhood was assigned the original cluster labels using majority voting. To test for enrichment of cells in the SARS-CoV-2 condition versus the mock condition, we modelled the cell count in neighbourhoods as a negative binomial generalized linear model, using a log-linear model to model the effects of age and treatment on cell counts (logFC). We control for multiple testing using the weighted Benjamini–Hochberg correction as described in ref. 14 (spatialFDR correction). Neighbourhoods were considered enriched in SARS-CoV-2 vs mock if the spatialFDR < 0.1 and logFC > 0.

Expression signature analysis

To determine the enrichment of basaloid or interferon genes in the annotated clusters, we used the Scanpy function scanpy.tl.score_genes() to score the gene signature for each cell. The gene list for computing the basaloid score was composed of the EPCAM, CDH1, VIM, FN1, COL1A1, CDH2, TNC, VCAN, PCP4, CUX2, SPINK1, PRSS2, CPA6, CTSE, MMP7, MDK, GDF15, PTGS2, SLCO2A1, EPHB2, ITGB8, ITGAV, ITGB6, TGFB1, KCNN4, KCNQ5, KCNS3, CDKN1A, CDKN2A, CDKN2B, CCND1, CCND2, MDM2, HMGA2, PTCHD4 and OCIAD2 genes. The gene list for computing the IFN alpha score was composed of the ADAR, AXL, BST2, EIF2AK2, GAS6, GATA3, IFIT2, IFIT3, IFITM1, IFITM2, IFITM3, IFNAR1, IFNAR2, KLHL20, LAMP3, MX2, PDE12, PYHIN1, RO60, STAR and TPR genes and the gene list for computing the IFN gamma score was composed of the OAS3, OASL, OTOP1, PARP14, PARP9, PDE12, PIAS1, PML, PPARG, PRKCD, PTAFR, PTPN2, RAB20, RAB43, RAB7B, RPL13A, RPS6KB1, SHFL, SIRPA, SLC11A1, SLC26A6, SLC30A8, SNCA, SOCS1, SOCS3, SP100, STAR, STAT1, STX4, STX8, STXBP1, STXBP3, STXBP4, SUMO1, SYNCRIP, TDGF1, TLR2, TLR3, TLR4, TP53, TRIM21, TRIM22, TRIM25, TRIM26, TRIM31, TRIM34, TRIM38, TRIM5, TRIM62, TRIM68, TRIM8, TXK, UBD, VAMP3, VCAM1, VIM, VPS26B, WAS, WNT5A, XCL1, XCL2, ZYX genes, as used in ref. 9 .

Gene set enrichment analysis

Wilcoxon rank-sum test was performed to determine differentially expressed genes between clusters using the scanpy.tl.rank_genes_groups() function. Differentially expressed genes were further analysed using GSEA via ShinyGO 70 .

In vivo sub-analysis

Sex- and age-matched healthy adults and paediatric airway samples ( n  = 10 total) were subsetted from our previous dataset 9 for label transfer of the in vitro cell annotation using CellTypist as described above. Selected sample IDs from the in vivo dataset are shown in Supplementary Table 4 . These were selected to match the mean age and range, and sex of the current study as the sample collection and processing were conducted in parallel between studies.

In vivo integration

We performed integration of 8 single-cell datasets comprising 614,695 cells from upper and lower airways from healthy and COVID-19 patients from paediatric (0–18 years), adult (19–50 years) and older adult (51–90 years) samples 9 , 10 , 12 , 18 , 19 , 20 , 21 , 22 . Expression values were then normalized to a sum of 1 × 10 4 per cell and log-transformed with an added pseudocount of 1. Highly variable genes were selected using the Scanpy function scanpy.pp.highly_variable_genes(). PCA was performed and the top 30 principal components were selected as input for Harmony 71 to correct for batch effects between studies and compute a batch-corrected k -nearest-neighbour graph. The clustering was performed with the Leiden 64 algorithm on a k -nearest-neighbour graph of a PCA space derived from a log(counts per million/100 + 1) representation of highly variable genes, according to the Scanpy protocol 65 . Leiden clustering with a resolution of 1 was used to separate broad cell types (basal, goblet, secretory) and subclustering was used for more accurate separation of fine-grained cell types. Annotation was first performed automatically using a Celltypist 66 model built on the in vivo dataset of nasal airway brushes 9 , and then using manual inspection of each of the clusters and further manual annotation using known epithelial marker genes.

Statistical analysis on in vivo dataset

Due to the large proportions of zero counts, we fitted zero-inflated Poisson (ZIP) models to the counts of nasal epithelial cells including the natural logarithm of the total number of cells per donor as an offset in the models for both basaloid and gobletInFam cells. This allowed us to estimate both the incidence of nasal epithelial cells () and the probability of a donor being in the zero counts class () as functions of disease and age groups. We first included interaction terms between the disease and age groups in both the incidence and the zero counts parts of the models. Generalized additive models for location, scale and shape were fitted using the packages gamlss 72 and glmmTMB 73 (to include random effects on the probability of zero class by donor), both in the R language and environment for statistical computing (v.4.2.3) 74 . Using the Bayesian Information Criterion (BIC) as a goodness-of-fit statistic, we decided to include the main effects of disease in both the linear predictors for incidence and probability of belonging to the zero class after stratifying by age group.

Statistical analysis

Statistical analysis was performed using R or GraphPad Prism 9 and details of statistical tests used are indicated. Data distribution was assumed to be normal unless stated differently, and a Kruskal–Wallis test was used to test for normality using R. The determination of sample sizes was guided by those established in previous scRNA-seq and studies using ALI cultures 9 , 75 , rather than through the application of specific statistical methods. In total, NEC cultures generated from 11 participants were used to create our in vitro single-cell dataset, including 3 paediatric (<12 years), 4 adult (30–50 years) and 4 older adult (>70 years) donors. Additional statistical power here was provided by the experimental design, sampling from multiple timepoints (4, 24 and 72 h post SARS-CoV-2 infection), with the inclusion of matched mock-infected controls for each. Samples were also carefully pooled (see Methods) to help avoid batch effects and run across multiple lanes on the 10X controller. Together, this resulted in a total of 66 NEC samples processed for single-cell sequencing, with a total of 139,598 high-quality cells sequenced. Further validation of our in vitro single-cell data and our key observation was provided using an integrated in vivo single-cell dataset (using published patient datasets) and numerous experimental validation assays. Data collection and analysis were not performed blind to the conditions of the experiments. Representative images are displayed as examples for quantified data (1 n of the total n noted in their corresponding summary graphs) unless otherwise stated in the figure legend.

Reporting summary

Further information on research design is available in the Nature Portfolio Reporting Summary linked to this article.

Data availability

RNA-seq data are available in the European Genome-Phenome Archive (EGA) ( https://ega-archive.org/ ) under accession number EGAD00001015345 . The datasets from our study can be downloaded and explored interactively through a web portal ( https://covid19cellatlas.org , https://www.covid19cellatlas.org/ALI_COVID19/in-vitro/ , https://www.covid19cellatlas.org/ALI_COVID19/in-vivo/ ). Quality control metrics for our single-cell data are provided on the web portal page. All other data needed to evaluate the conclusions are available within the Article or its Supplementary Information . Viral sequences resulting from this study can be found on Genbank under the accession numbers PP346398 – PP346416 . Source image files for the main figures are available via Figshare at https://doi.org/10.6084/m9.figshare.25193618.v1 (ref. 76 ). Source image files for the extended figures are available via Figshare at https://doi.org/10.6084/m9.figshare.25194005.v1 (ref. 77 ). Source image files for supplementary data are available via Figshare at https://doi.org/10.6084/m9.figshare.25196396.v1 (ref. 78 ). Source data are provided with this paper.

Code availability

Custom code for the analysis performed in this study is publicly available via GitHub at https://github.com/Teichlab/ALI_COVID19 (ref. 79 ). Free data access to the single-cell objects used in this study is available at https://www.covid19cellatlas.org/ .

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Acknowledgements

This work was funded by a UKRI/BBSRC research grant (BB/V006738/1 awarded to C.M.S., M.Z.N., S.A.T., W.B., C.O., C.R.B., R.E.H.) and the NIHR Great Ormond Street Hospital Biomedical Research Centre. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. We acknowledge funding from Wellcome (WT211276/Z/18/Z and Sanger core grant WT206194 to S.A.T.). M.Z.N. and K.B.M. were funded by the Rosetrees Trust (M944) and Action Medical Research (GN2911). The project received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement 874656. M.Z.N. acknowledges funding from an MRC Clinician Scientist Fellowship (MR/W00111X/1) and the Rutherford Fund Fellowship allocated by the MRC UK Regenerative Medicine Platform 2 (MR/5005579/1). This project was made possible in part by grants 2017-174169 and 2019-202654 from the Chan Zuckerberg Foundation. C.M.S. was supported by grants from Animal Free Research UK (AFR19-20274), GOSH Children’s Charity (COVID_CSmith_017) and the Wellcome Trust (212516/Z/18/Z). Microscopy was performed at the Light Microscopy Core Facility, UCL GOS Institute of Child Health supported by the NIHR GOSH BRC award 17DD08. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. We acknowledge D. Sumanaweera (Wellcome Sanger Institute) for advice on some of the bioinformatic analysis and A. Ma (UCL GOS Institute of Child Health) for help with the analysis of NEC culture heights; Sanger IT and CellGenIT for help; Public Health England for providing the SARS-CoV-2 (hCoV-19/England/2/2020); and the Cell Services science technology platform (STP) at the Francis Crick Institute, London, UK for providing the African green monkey kidney cell line Vero E6 (ATCC: CVCL_0574 authenticated for use in this study).

Author information

These authors contributed equally: Maximillian Woodall, Ana-Maria Cujba, Kaylee B. Worlock.

These authors jointly supervised this work: Sarah A. Teichmann, Kerstin B. Meyer, Marko Z. Nikolić, Claire M. Smith.

Authors and Affiliations

Great Ormond Street UCL Institute of Child Health, London, UK

Maximillian N. J. Woodall, Katie-Marie Case, Tereza Masonou, Samuel Ellis, Machaela Palor, Dale Moulding, Chris O’Callaghan, Paolo DeCoppi, Mario Cortina-Borja, Heloise Vinette, Sunando Roy, Judith Breuer, Wendy E. Heywood, Kevin Mills & Claire M. Smith

Wellcome Sanger Institute, Cambridge, UK

Ana-Maria Cujba, Krzysztof Polanski, Ni Huang, Rik G. H. Lindeboom, Lira Mamanova, Liam Bolt, Laura Richardson, Batuhan Cakir, Sarah A. Teichmann & Kerstin B. Meyer

UCL Respiratory, Division of Medicine, University College London, London, UK

Kaylee B. Worlock, Masahiro Yoshida, Eliz Kilich, Puja Mehta, Rachel C. Chambers & Marko Z. Nikolić

UCL Institute of Ophthalmology, University College London, London, UK

Thomas Burgoyne

Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

Thomas Burgoyne & Andreia Pinto

UCL Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK

Timothy D. McHugh

Royal Free Hospital NHS Foundation Trust, London, UK

Aarash Saleh

University College London Hospitals NHS Foundation Trust, London, UK

Eliz Kilich, Puja Mehta & Marko Z. Nikolić

Department of Infectious Disease, Imperial College London, London, UK

Jie Zhou & Wendy Barclay

Great Ormond Street Hospital NHS Foundation Trust, London, UK

Paolo DeCoppi & Colin R. Butler

Epithelial Cell Biology in ENT Research (EpiCENTR) Group, Developmental Biology and Cancer Department, Great Ormond Street UCL Institute of Child Health, University College London, London, UK

Colin R. Butler & Robert E. Hynds

UCL Cancer Institute, University College London, London, UK

Robert E. Hynds

Theory of Condensed Matter, Cavendish Laboratory/Dept Physics, University of Cambridge, Cambridge, UK

Sarah A. Teichmann

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Contributions

M.N.J.W., A.-M.C., K.B.W., M.Y. and K.-M.C. designed the study, conducted experiments, analysed data and reviewed the manuscript. K.B.W. and M.Y. performed 10x and isolated DNA for genotyping. K.P., N.H. and R.G.H.L. assisted with computational analysis, including providing code for viral distribution analysis and customized dotplot functions. A.S., E.K., P.M., C.O., C.R.B., P.D.C. and M.Z.N. recruited patients and collected nasal brushings and clinical metadata. L.M., L.B. and L.R. prepared sequencing libraries and conducted the sequencing. A.P. and T.B. assisted with transmission electron microscopy image analysis and review of the manuscript. M.P. assisted with cell culture. S.E. assisted with the analysis of the TEM images and the addition of pseudocolour. T.M. assisted with flow cytometric bead assays and scRNA-seq data analysis and review of the manuscript. S.R. and J.B. assisted with viral genomic data analysis and review of the manuscript. W.E.H., H.V. and K.M. assisted with mass spectrometry data analysis and review of the manuscript. D.M. assisted with microscopy data acquisition and reviewed the manuscript. C.M.S., C.O., P.D.C. and C.R.B. provided support through ethics and patient recruitment. M.C.-B. provided statistical support. S.R. and J.B. oversaw viral genomics analysis and interpretation and review of the manuscript. J.Z. and W.B. facilitated the collection of preliminary data. T.D.M. provided support in setting up and training for all BSL3 work. B.C. facilitated data upload on COVID-19 portals. M.N.J.W., A.-M.C., K.B.W., K.B.M., M.Z.N. and C.M.S. wrote the manuscript. P.D.C., C.O., W.B., S.A.T., K.B.M., C.R.B., R.E.H., M.Z.N. and C.M.S. conceived and designed the study, oversaw the funding application and reviewed the manuscript. S.A.T., R.C.C., K.B.M, R.E.H, M.Z.N. and C.M.S. oversaw data analysis and interpretation, and the write-up of the manuscript.

Corresponding authors

Correspondence to Sarah A. Teichmann , Kerstin B. Meyer , Marko Z. Nikolić or Claire M. Smith .

Ethics declarations

Competing interests.

In the past three years, S.A.T. has received remuneration for Scientific Advisory Board Membership from Sanofi, GlaxoSmithKline, Foresite Labs and Qiagen. S.A.T. is a co-founder and holds equity in Transition Bio and Ensocell. Starting 8 January 2024, S.A.T. has been a part-time employee of GlaxoSmithKline. All other authors declare no competing interests.

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Nature Microbiology thanks Ivan Zanoni and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Extended data

Extended data fig. 1 paediatric nasal epithelial cells have less basal cell subtypes compared to adult and older adult nasal epithelial cells but display comparable differentiation markers and sars-cov-2 entry factor expression..

(a) Violin plot visualization of threshold for percentage of mitochondrial reads in scRNAseq dataset. (b) Uniform manifold approximation and projection (UMAP) visualizations showing good integration of donor IDs, donor pool, treatment, age group, time after infection, 10X Chromium kit version, sex, cell cycle phase and introduced spike-in primer after batch correction (see Methods for more details). (c) Boxplot indicating comparison of cell cycle phase states (G1, G2M, S) amongst the three age groups in mock/infected/combined (All) conditions. (d) Dot plot visualization showing marker genes for annotated airway epithelial cell types, with fraction of expressing cells and average expression within each cell type indicated by dot size and colour, respectively. Broad cell domains are colour coded; KRT5 hi (purple), SCGB1A1 hi (green) and ciliated/other (yellow). Logistic regression based label transfer using Celltypist for the data sets in (e) Yoshida et al. 9 and (f) Ziegler et al. 12 , with fraction of matched cells and average probability score indicated by dot size and colour, respectively (g) Numbers of annotated airway epithelial cells in respect to age (data shown in ratio of cell numbers/per 1000 cells in age dataset). (h) Representative maximum intensity z-projections of confocal images (left and central) and transmission electron micrographs (right panels) of NEC cultures differentiated at an air–liquid interface and immunolabeled against cilia (tubulin, green) and mucin (MUC5AC, red), with DAPI (blue) and phalloidin (grey) to indicate the nucleus and actin filaments, respectively. Scale bar 10-μm applies to all images in the row.

Extended Data Fig. 2 Physiological differences in paediatric, adult and older adult nasal epithelial NEC cultures.

Physiological comparison of paediatric (P), adult (A) and older adult (O) NEC cultures as measure by; (a) ciliary beat frequency (CBF)(Hz) (n = P6, A6, O7); (b) the percentage of +ve ɑ-tubulin staining coverage per 225 μm2 section (n = P6, A4, O5); (c) motility measured by percentage scratch closure over time (n = P8, A3, O8) and (d) culture thickness (n = P9, A5, O7). For ( a-d ) data was plotted as mean ± SD, subject to one-way ANOVA with Tukey’s multiple comparison test (e) Representative light microscope images of whole well scans of NEC cultures depicting the characteristic differences in culture morphology with age (P=Paed, A=Adult, E=Older adult). (f) Comparison of epithelial integrity via trans-epithelial electrical resistance (TEER) (Ω.cm 2 ). Mean ± SD (n = P12, A8, O8) plotted across the age groups using one-way ANOVA with Tukey’s correction. (g) Alternate SARS-CoV-2 entry factor gene expression per cell type calculated based upon absolute cell numbers with the average expression of BSG, CTSL, NRP1, NRP2 and FURIN indicated by colour. Dot size corresponds to the total number of cells expressing alternate viral entry genes in respective age groups in the mock condition. ( h ) Palantir inferred probabilities of cycling basal cells differentiating into basaloid-like 2 or goblet 2 inflammatory cells. (i) Boxplot showing the distribution of pseudotime within each cluster among goblet cell subtypes. (j) Palantir inferred probabilities of cycling basal cells differentiating into basaloid-like 2 cells. (k) Boxplot showing the distribution of pseudotime within each cluster among KRT5 hi cell subtypes. Lines in box and whisker plots i, j indicates median, interquartile range, and minimum to maximum of the distribution, with individual values for each cell shown.

Extended Data Fig. 3 Elderly cells replicate more infectious viruses with a greater distribution of viral reads across epithelial subtypes.

(a) Mean viral replication shown as pfu/ml per donor over a 5-day period (n = 35: P15, A10, O10). (b) Exemplar image of plaque assay used to determine infectious viral load. (c) UMAP of airway cells with detected SARS-CoV2 mRNA in each cell type in cultures mock and SARS-CoV-2 infected for all time points and ages combined (≥1 viral UMI per donor following filtering out ambient RNA). (d) Pie charts showing the fractions of annotated airway epithelial cells containing viral reads at 4 h, 24 h and 72 h p.i. in respect to age. (e) Numbers of annotated airway epithelial cells containing viral reads at 24 h and 72 h post infection (red) in respect to age with total number of cells in each subset (grey) (data shown as cell numbers/per 1000 cells in age dataset). (f) Representative orthogonal views of z-stacks from fixed paediatric (top), adult (middle) and older adult (bottom) NECs at 72 h p.i. with SARS-CoV-2. Sections were immunolabeled against F-actin (phalloidin, grey) DAPI (blue) and SARS-CoV-2 S protein (red). The scale bar represents 10 μm. (g) Linear regression analysis of viral reads vs ACE2 and TMPRSS2 expression per cell at 72 h post infection. Data represents all age groups combined (h) Linear regression analysis of viral reads vs ACE2 and TMPRSS2 expression per cell and grouped by cell domains (i) Linear regression of infectious viral titres in combined cell lysate and apical fluid of SARS-CoV-2 nasal epithelial cells from donors of different ages as determined by plaque assays (n = 29). Subject to Pearson correlation with SE shown for line error.

Extended Data Fig. 4 Minimal cytopathology following SARS-CoV-2 infection of NECs.

(a) Orthogonal views of the z-stacks showing the thickness and morphology from fixed paediatric, adult and older adult NECs from 3 separate donors at 72 h p.i. mock or SARS-CoV-2 infected NEC cultures. Sections were immunolabeled against cilia (tubulin, cyan), F-actin (phalloidin, magenta) DAPI (blue), SARS-CoV-2 S protein (yellow) and cytokeratin 5 (KRT5+, white). Scale bar = 50 µm. (b) Representative maximal intensity projections (top panels) and orthogonal z sections (bottom panels) of NECs stained for E-Cadherin at 72 h p.i. with mock or SARS-CoV-2 (scale bar 50 μm) and expression determined via Western blots and normalised to GAPDH. Data plotted as mean ± SD, subject to one-way ANOVA with Tukey’s multiple comparison test, with individual values shown (n = P5, A5, O5). (c) Representative orthogonal views of the z-stacks showing the localisation of KRT5+ve cells (white) from example NEC cultures (summary in Fig. 2d ). KRT5+ve cells above the horizontal yellow line are classified as non-basal -layer (not in contact with basement membrane), F-actin (phalloidin, magenta) stain references apical membrane and tight-junctions. Each section is 225 µm in width. (d) Maximal projections of the z-stacks showing the localisation of KRT5+ve cells (white) from above and below the horizontal yellow line (classified as non-basal -layer) from example air–liquid interface cultures at 72 h p.i. with mock or SARS-CoV-2 (scale bar 50 μm). (e) Transmission electron micrograph of epithelial cell shedding (white arrows) at 72 h p.i. with SARS-CoV-2 (scale bar 10 μm).

Extended Data Fig. 5 Cytopathology and changes in cell types.

(a) Cilia coverage for each age group at 72 h p.i. Mock and SARS-CoV-2. (left) Representative Immunofluorescent images from 72 h p.i. NECs with mock and SARS-CoV-2 condition stained for a-tubulin (cyan) (scale bar = 50 µm). Percentage area covered (right) with αTubulin+ve signal (cyan) from maximum intensity projections of fixed NECs using threshold analysis (red) in ImageJ. Summary of cilia coverage (right) (n = P5, A4, O5). Subject to one-way ANOVA with Tukey’s multiple comparison test. For 72 h p.i. (mock and SARS-CoV-2 conditions) NECs were compared between age groups, looking at average (b) cilia beat frequency (Hz) (n = P8, A8, O8); (c) α-Tubulin protein expression (n = P11, A8, O7) and (d) SARS-CoV-2 entry factor protein expression (ACE2, TMPRSS2 and short ACE2). Protein levels were determined via Western blot and normalised to GAPDH (n = P6-8, A5-9, O5-8). Data for b-d plotted as mean ± SD, with individual values shown. (e) Total numbers of annotated airway epithelial cells in all mock infected vs all SARS-CoV-2 infected datasets in respect to age (data shown in ratio of cell numbers/per 1000 cells in age dataset) (n = P3, A4, O4). (f) Dot plots showing the log-fold change in SARS-CoV-2 versus mock at different time points for all cell types in different age groups. Calculation based upon absolute cell numbers with the average fold-change indicated by colour. The dot size corresponds to the number of that cell type per 1000 cells from each condition. (g) Uniform manifold approximation and projection (UMAP) representation of the results from Milo differential abundance testing. Nodes are neighbourhoods, coloured by their log fold change when comparing SARS-CoV-2 infected versus mock conditions in adult samples. Non-significant DA neighbourhoods at FDR 10% are coloured grey and significant DA neighbourhoods at FDR 10% are coloured with increased log fold change in red and decreased log fold change in blue. Node sizes correspond to the number of cells in a neighbourhood. The layout of nodes is determined by the position of the neighbourhood index cell in the UMAP. (h) Palantir inferred pseudotime probabilities of cycling basal cells differentiating into ciliated 1, basaloid-like 2 or goblet 2 inflammatory cells.

Extended Data Fig. 6 Basaloid-like cells were predominantly found in COVID-19 older adult patients in vivo.

(a) Dot plot visualisation showing marker genes for annotated epithelial cell types in the integrated in vivo single cell dataset (Fig. 2k ), with fraction of expressing cells and average expression within each cell type indicated by dot size and colour, respectively. Normalised goblet inflammatory cells (b) and basaloid-like 2 cells (c) per total of 5000 cells per age group in all paediatric, adult, and older adult subgroups. PF = pulmonary fibrosis, IPF = idiopathic pulmonary fibrosis. (Healthy dataset n = P49, A45, O46; COVID19 dataset n = P41, A58, O116).

Extended Data Fig. 7 Paediatric goblet 2 inflammatory cells and viral truncation in response to IFN signalling.

(a) Gene Set Enrichment Analysis (GSEA) of HVGs from goblet inflammatory cells indicating enriched gene ontology terms using ShinyGo. (b) Correlation matrix of a subset of interferon genes expressed by all paediatric or older adult cells at 72 h post SARS-CoV-2 infection as determined using the function cor_pmat() in ggcorrplot and Pearson correlation method. (c) ISG gene expression in SARS-CoV-2 infected cultures (as log-fold change compared to mock) per cell type at 4 h, 24 and 72 h p.i. for paediatric and older adult datasets. Barplot indicates the number of cells at each time point. Grey = not detected (d) Volcano plot showing differential expressed proteins of the apical secretome between mock and SARS-CoV-2 infected cultures that were unique (highly expressed) in the paediatric cohort. Blue highlights those that are highly expressed in mock compared to SARS-CoV-2 infection conditions and black enriched with infection. (e) GSEA for expression of apical secretome genes of paediatric cells at 72 h p.i. with SARS-CoV-2 obtained using ShinyGo. The data in a,b,c relates the scRNAseq dataset (n = P3, A4, O4), whilst d and e uses data generated through the analysis of the collected apical secretome (n = P5, A5, O5).

Extended Data Fig. 8 Viral truncation in response to IFN signaling.

Coverage plots of viral reads aligned to SARS-CoV-2 genome in each cell type in (a) paediatric, (b) adult (c) and older adult infected NECs grouped across all time points. Coverage plots of viral reads aligned to SARS-CoV-2 genome for all cell types, shown by age group, both (d) with and (e) without spiked-in primer grouped across all timepoints (see methods for more details of primer) and at (f) 72 h p.i. time points. Viral reads for all coverage plots are shown in 100 nucleotide (nt) bins normalised per 5,000 cells. The data in a - f relates to the scRNA-seq dataset (n = P3, A4, O4). (g) Histogram displaying frequency and position of genomic mutations in SARS-CoV-2 consensus sequences from 72 h p.i. with SARS-CoV-2 (n = P5, A5, O5). Bin size is 1000 bases (left) and 50 bases (right). Colour blocks indicate the start coordinates of annotated viral genes.

Extended Data Fig. 9 Elderly basaloid-like 2 cells drive ITGB6 production and enhance viral pathogenesis.

(a) Abundance of ITGB6 protein in the apical secretome of mock or SARS-CoV-2 infected NECs at 72 h p.i. for each age group (n = P5, A5, O5). As detected using mass spectrometry and shown in boxplot depicting the median and IQR, plus the minimum and maximum value distribution analysed using paired t test. (b) Exemplar Western blot showing vimentin (vim) in the older adult sample 72 h p.i. with mock (-) or SARS-CoV-2 (+) and 72 h p.i. Vero E6 cells as control lysate (ctl). GAPDH is the loading control, E-Cadherin is also given for reference (n = P2, A1, O1). (c) Orthogonal views of the z-stacks showing the location of ITGB6 (green) and KRT5+ve cells (white) from exemplar air–liquid interface cultures, counterstained for F-actin (phalloidin, red) and cell nucleus (DAPI, blue). (d) Representative maximum intensity projections (left) and orthogonal sections (right) of immunofluorescence z-stacks of basaloid-like 2 cell markers ITGB6 (green), KRT5 (white), spike (magenta) counterstained for F-actin (phalloidin; red) and cell nucleus (DAPI, blue) in 72 h p.i. NECs (mock top, infected bottom). (e-g) Further, example immunofluorescence images of basaloid-like 2 cell markers in 72 h p.i. with SARS-CoV-2 in older adult NEC cultures. Markers and respective counterstain colour are indicated (n = O3). (h) Transmission electron micrograph of non-basal KRT5+ve epithelial cell (white arrow) location within an NEC culture at 72 h p.i. with SARS-CoV-2. Scale is on the right of the image. For panels c-h , representative images were selected from older adult NEC cultures (n = 3) 72 hours post-infection (p.i.) with SARS-CoV for each antibody panel.

Extended Data Fig. 10 Wound repair promotes SARS-CoV-2 viral replication.

(a) Dotplot visualisation showing viral entry genes for all cell types, with fraction of expressing cells and average expression within each cell type indicated by dot size and colour, respectively. Appended bar graphs indicate absolute cell numbers per cell type. Data generated using the entire scRNAseq dataset (n = P3, A4, O4). (b) Example immunofluorescence orthogonal sections of basaloid-like 2 cell markers in unwounded or wounded older adult NECs 24 h p.i. with mock or SARS-CoV-2 infection. F-actin (Phalloidin; red), KRT5 (white), ITGB6 (cyan) and DAPI (blue). (c) Mean ± SD KRT5 fluorescence signal (RFU) around wound area in different age groups. From maximal projections of fixed NECs without (-) and with (+) wounds, 24 h post wounding (n = P3, A3, O3) (n = 6). (d) Maximum intensity projection image of a NEC culture unwounded and 24 h post wound. F-actin (Phalloidin; white), Vimentin (VIM) (yellow) and DAPI (blue). (e) Mean ± SD Vimentin fluorescence signal (RFU) around wound area in different age groups. From maximal projections of fixed NECs without (-) and with (+) wounds, 24 h post wound (n = P2, A1, O2). (f) Example immunofluorescence orthogonal sections of basaloid-like 2 cell markers in non-wounded or wounded NECs 24 h p.i. with mock or SARS-CoV-2 infection from a paediatric and older adult donor. Stained for F-actin (Phalloidin; red), ITGB6 (green), SARS-CoV-2 Spike protein (magenta), KRT5 (white) and composite with DAPI (blue). (g) Mean ± SD ITGB6 fluorescence signal (RFU) around wound area in different age groups. From maximal projections of fixed NECs without (-) and with (+) wounds, 24 h post wounding (n = P3, A3-4, O3-2). (h) Example of wound healing images taken of NECs from different age groups and with mock or SARS-CoV-2 infection. Acquired by light microscopy over 24 hours. The scale bar (bottom right) represents 1 mm. (i) Representative immunofluorescence images from 72 h p.i. NECs with SARS-CoV-2 without (-) and with (+) wounding stained for ITGB6 (cyan) and dsRNA (yellow). Percentage area covered (right) with ITGB6+ve or dsRNA+ve signal from maximum intensity projections of fixed NECs using threshold analysis (red) in ImageJ, the percentage coverage is given at the bottom right of each image. For c,e,g the average values for each NEC donor are shown and are subject to a two-way ANOVA with Sidak’s multiple comparisons test. For panels b, d, f, g, i a minimum of 5 experiments (ranging from n = 5–10) were conducted for each antibody panel, from which representative images were selected.

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Woodall, M.N.J., Cujba, AM., Worlock, K.B. et al. Age-specific nasal epithelial responses to SARS-CoV-2 infection. Nat Microbiol (2024). https://doi.org/10.1038/s41564-024-01658-1

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Despite the fact that reaction and reflection papers include the writers’ opinions, they typically have a formal tone. These papers maintain their suitability for academic settings thanks to an academic tone and format. Teachers can specify the requirements for their assignments, but most students follow an MLA or AP style manual. Additionally, they employ academic vocabulary and sentence constructions that are less conversational than diary entries. Reaction and reflection papers can range in length and format, but they almost always have an introduction, a body, and a conclusion.

Summary of the work or experience

Writers frequently incorporate a summary of the published work or experience in both types of papers. They try to provide context because they are aware that the reader might not be familiar with their topic. For instance, a writer might briefly summarize a book’s major plot points at the start of their essay. The reader may find it simpler to comprehend the character analyses after reading this explanation. Good reaction and reflection papers frequently include objective summaries that give the reader context without the writer’s personal bias coming through.

The focus of reaction and reflection papers is the primary distinction. Reaction papers highlight the writer’s feelings following a book or video by including their first impressions. Additionally, they are able to evaluate various incidents and offer proof to back up their conclusions. For instance, a student may reference the author’s account of an event to support their claim that they are commenting on a phenomenon that actually exists.

In contrast, a reflection paper focuses more on how the experience or work altered the writer’s perspective. They frequently mention their previous viewpoint and how the subject opened their minds to new concepts. Some reflection papers highlight how the experience or work solidified their preexisting beliefs. For instance, a climate change article could support a student’s conviction that global warming is a real phenomenon. The student may mention this enduring belief in their reflection paper while also highlighting how the assignment exposed them to fresh strategies for tackling global warming.

How to write a reaction or reflection paper

Heres how to write a reaction or reflection paper:

1. Review the reference material

Consider reading the reference material in its entirety if you want to write a strong reaction or reflection paper. You can make sure you comprehend all of the key points by reading the entire book or by watching the entire video. You can also jot down important details to discuss later in notes. As you watch a movie or read a book, for instance, think about writing down any interesting details or queries you have. Try keeping track of your primary responsibilities and interactions with coworkers after each shift if you’re completing an internship.

2. Review your teachers requirements

Before writing your paper, consider reviewing your teachers requirements. You can verify details like word count, formatting type, and whether a reference or works cited page should be included. Knowing the requirements can help you structure your paper and prevent you from having to make revisions later in the writing process.

3. Create an outline

To create an outline, think about using your notes and your teachers’ expectations. Your notes, for instance, could point out three different ways the author introduces a certain theme. These three points can be broken up into paragraphs in your outline, and you can also indicate how long each section should be. Additionally, you can make a note of the quotes and details you want to use in each section.

4. Write an introduction with a thesis statement

The hook in the introduction of reaction and reflection papers entices readers to continue reading. In order to provide context for the reader, it might also include a brief summary of the work or experience. The conclusion of the introduction paragraph should include a thesis statement that sums up your position. If you’re writing a reaction paper, try to summarize your feelings about the work in your thesis statement. These details may also be in the thesis statements for reflection papers, but they usually place more emphasis on how the work or experience shaped your perspective.

5. Write body paragraphs

Writing the body paragraphs that you noted in your outline is the next step. An introduction to the main idea can be made in the topic sentence of each body paragraph. After the topic sentence, go into greater detail about how you analyzed the work or experience and provide evidence to back up your assertions. Although the teacher is typically familiar with the subject you are writing about, you can provide more context if necessary. For example, you can emphasize the main character’s stubbornness if you want to emphasize this quality to make your point.

6. Add a conclusion

Your paper’s conclusion paragraph restates your thesis statement and lists your key points. If you’re writing a reaction paper, you might want to focus on how the piece made you feel or your thoughts on the subject. Reflective essay conclusions could summarize what you learned and how you would persuade others to use your analyses to reevaluate their positions in the future.

ACADS EP.1: Difference between reflection paper and reaction paper

Is reaction and reflection the same?

Reaction is largely driven by external stimuli. Contrarily, reflection is a higher-order executive function known as a metacognitive function that calls for awareness and control of one’s own thought process.

What is the difference between summary and reaction paper?

Refine and polish your summary by removing any repetitions or minor details and adding transitions to make the summary read smoothly. The Reaction is a text-based response where you express your opinions regarding the source text.

How do you write a reaction paper?

Write an informative summary of the material. Highlight the work’s main points and important supporting points to condense the content. Use direct quotations from the work to illustrate important ideas. Summarize the content to give the reader a broad understanding of all significant elements of the original work.

What is the purpose of the reaction paper?

In the classroom, reaction papers are frequently used as tools to help students think critically about texts and how they relate to one another or to a larger field of discourse. Research paper topics can also be found in reaction papers.

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Facility for Rare Isotope Beams

At michigan state university, frib researchers lead team to merge nuclear physics experiments and astronomical observations to advance equation-of-state research, world-class particle-accelerator facilities and recent advances in neutron-star observation give physicists a new toolkit for describing nuclear interactions at a wide range of densities..

For most stars, neutron stars and black holes are their final resting places. When a supergiant star runs out of fuel, it expands and then rapidly collapses on itself. This act creates a neutron star—an object denser than our sun crammed into a space 13 to  18 miles wide. In such a heavily condensed stellar environment, most electrons combine with protons to make neutrons, resulting in a dense ball of matter consisting mainly of neutrons. Researchers try to understand the forces that control this process by creating dense matter in the laboratory through colliding neutron-rich nuclei and taking detailed measurements.

A research team—led by William Lynch and Betty Tsang at FRIB—is focused on learning about neutrons in dense environments. Lynch, Tsang, and their collaborators used 20 years of experimental data from accelerator facilities and neutron-star observations to understand how particles interact in nuclear matter under a wide range of densities and pressures. The team wanted to determine how the ratio of neutrons to protons influences nuclear forces in a system. The team recently published its findings in Nature Astronomy .

“In nuclear physics, we are often confined to studying small systems, but we know exactly what particles are in our nuclear systems. Stars provide us an unbelievable opportunity, because they are large systems where nuclear physics plays a vital role, but we do not know for sure what particles are in their interiors,” said Lynch, professor of nuclear physics at FRIB and in the Michigan State University (MSU) Department of Physics and Astronomy. “They are interesting because the density varies greatly within such large systems.  Nuclear forces play a dominant role within them, yet we know comparatively little about that role.” 

When a star with a mass that is 20-30 times that of the sun exhausts its fuel, it cools, collapses, and explodes in a supernova. After this explosion, only the matter in the deepest part of the star’s interior coalesces to form a neutron star. This neutron star has no fuel to burn and over time, it radiates its remaining heat into the surrounding space. Scientists expect that matter in the outer core of a cold neutron star is roughly similar to the matter in atomic nuclei but with three differences: neutron stars are much larger, they are denser in their interiors, and a larger fraction of their nucleons are neutrons. Deep within the inner core of a neutron star, the composition of neutron star matter remains a mystery. 

  “If experiments could provide more guidance about the forces that act in their interiors, we could make better predictions of their interior composition and of phase transitions within them. Neutron stars present a great research opportunity to combine these disciplines,” said Lynch.

Accelerator facilities like FRIB help physicists study how subatomic particles interact under exotic conditions that are more common in neutron stars. When researchers compare these experiments to neutron-star observations, they can calculate the equation of state (EOS) of particles interacting in low-temperature, dense environments. The EOS describes matter in specific conditions, and how its properties change with density. Solving EOS for a wide range of settings helps researchers understand the strong nuclear force’s effects within dense objects, like neutron stars, in the cosmos. It also helps us learn more about neutron stars as they cool.

“This is the first time that we pulled together such a wealth of experimental data to explain the equation of state under these conditions, and this is important,” said Tsang, professor of nuclear science at FRIB. “Previous efforts have used theory to explain the low-density and low-energy end of nuclear matter. We wanted to use all the data we had available to us from our previous experiences with accelerators to obtain a comprehensive equation of state.”   

Researchers seeking the EOS often calculate it at higher temperatures or lower densities. They then draw conclusions for the system across a wider range of conditions. However, physicists have come to understand in recent years that an EOS obtained from an experiment is only relevant for a specific range of densities. As a result, the team needed to pull together data from a variety of accelerator experiments that used different measurements of colliding nuclei to replace those assumptions with data. “In this work, we asked two questions,” said Lynch. “For a given measurement, what density does that measurement probe? After that, we asked what that measurement tells us about the equation of state at that density.”   

In its recent paper, the team combined its own experiments from accelerator facilities in the United States and Japan. It pulled together data from 12 different experimental constraints and three neutron-star observations. The researchers focused on determining the EOS for nuclear matter ranging from half to three times a nuclei’s saturation density—the density found at the core of all stable nuclei. By producing this comprehensive EOS, the team provided new benchmarks for the larger nuclear physics and astrophysics communities to more accurately model interactions of nuclear matter.

The team improved its measurements at intermediate densities that neutron star observations do not provide through experiments at the GSI Helmholtz Centre for Heavy Ion Research in Germany, the RIKEN Nishina Center for Accelerator-Based Science in Japan, and the National Superconducting Cyclotron Laboratory (FRIB’s predecessor). To enable key measurements discussed in this article, their experiments helped fund technical advances in data acquisition for active targets and time projection chambers that are being employed in many other experiments world-wide.   

In running these experiments at FRIB, Tsang and Lynch can continue to interact with MSU students who help advance the research with their own input and innovation. MSU operates FRIB as a scientific user facility for the U.S. Department of Energy Office of Science (DOE-SC), supporting the mission of the DOE-SC Office of Nuclear Physics. FRIB is the only accelerator-based user facility on a university campus as one of 28 DOE-SC user facilities .  Chun Yen Tsang, the first author on the Nature Astronomy  paper, was a graduate student under Betty Tsang during this research and is now a researcher working jointly at Brookhaven National Laboratory and Kent State University. 

“Projects like this one are essential for attracting the brightest students, which ultimately makes these discoveries possible, and provides a steady pipeline to the U.S. workforce in nuclear science,” Tsang said.

The proposed FRIB energy upgrade ( FRIB400 ), supported by the scientific user community in the 2023 Nuclear Science Advisory Committee Long Range Plan , will allow the team to probe at even higher densities in the years to come. FRIB400 will double the reach of FRIB along the neutron dripline into a region relevant for neutron-star crusts and to allow study of extreme, neutron-rich nuclei such as calcium-68. 

Eric Gedenk is a freelance science writer.

Michigan State University operates the Facility for Rare Isotope Beams (FRIB) as a user facility for the U.S. Department of Energy Office of Science (DOE-SC), supporting the mission of the DOE-SC Office of Nuclear Physics. Hosting what is designed to be the most powerful heavy-ion accelerator, FRIB enables scientists to make discoveries about the properties of rare isotopes in order to better understand the physics of nuclei, nuclear astrophysics, fundamental interactions, and applications for society, including in medicine, homeland security, and industry.

The U.S. Department of Energy Office of Science is the single largest supporter of basic research in the physical sciences in the United States and is working to address some of today’s most pressing challenges. For more information, visit energy.gov/science.

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Partisan divides over K-12 education in 8 charts

K-12 education is shaping up to be a key issue in the 2024 election cycle. Several prominent Republican leaders, including GOP presidential candidates, have sought to limit discussion of gender identity and race in schools , while the Biden administration has called for expanded protections for transgender students . The coronavirus pandemic also brought out partisan divides on many issues related to K-12 schools .

Today, the public is sharply divided along partisan lines on topics ranging from what should be taught in schools to how much influence parents should have over the curriculum. Here are eight charts that highlight partisan differences over K-12 education, based on recent surveys by Pew Research Center and external data.

Pew Research Center conducted this analysis to provide a snapshot of partisan divides in K-12 education in the run-up to the 2024 election. The analysis is based on data from various Center surveys and analyses conducted from 2021 to 2023, as well as survey data from Education Next, a research journal about education policy. Links to the methodology and questions for each survey or analysis can be found in the text of this analysis.

Most Democrats say K-12 schools are having a positive effect on the country , but a majority of Republicans say schools are having a negative effect, according to a Pew Research Center survey from October 2022. About seven-in-ten Democrats and Democratic-leaning independents (72%) said K-12 public schools were having a positive effect on the way things were going in the United States. About six-in-ten Republicans and GOP leaners (61%) said K-12 schools were having a negative effect.

About six-in-ten Democrats (62%) have a favorable opinion of the U.S. Department of Education , while a similar share of Republicans (65%) see it negatively, according to a March 2023 survey by the Center. Democrats and Republicans were more divided over the Department of Education than most of the other 15 federal departments and agencies the Center asked about.

In May 2023, after the survey was conducted, Republican lawmakers scrutinized the Department of Education’s priorities during a House Committee on Education and the Workforce hearing. The lawmakers pressed U.S. Secretary of Education Miguel Cardona on topics including transgender students’ participation in sports and how race-related concepts are taught in schools, while Democratic lawmakers focused on school shootings.

Partisan opinions of K-12 principals have become more divided. In a December 2021 Center survey, about three-quarters of Democrats (76%) expressed a great deal or fair amount of confidence in K-12 principals to act in the best interests of the public. A much smaller share of Republicans (52%) said the same. And nearly half of Republicans (47%) had not too much or no confidence at all in principals, compared with about a quarter of Democrats (24%).

This divide grew between April 2020 and December 2021. While confidence in K-12 principals declined significantly among people in both parties during that span, it fell by 27 percentage points among Republicans, compared with an 11-point decline among Democrats.

Democrats are much more likely than Republicans to say teachers’ unions are having a positive effect on schools. In a May 2022 survey by Education Next , 60% of Democrats said this, compared with 22% of Republicans. Meanwhile, 53% of Republicans and 17% of Democrats said that teachers’ unions were having a negative effect on schools. (In this survey, too, Democrats and Republicans include independents who lean toward each party.)

The 38-point difference between Democrats and Republicans on this question was the widest since Education Next first asked it in 2013. However, the gap has exceeded 30 points in four of the last five years for which data is available.

Republican and Democratic parents differ over how much influence they think governments, school boards and others should have on what K-12 schools teach. About half of Republican parents of K-12 students (52%) said in a fall 2022 Center survey that the federal government has too much influence on what their local public schools are teaching, compared with two-in-ten Democratic parents. Republican K-12 parents were also significantly more likely than their Democratic counterparts to say their state government (41% vs. 28%) and their local school board (30% vs. 17%) have too much influence.

On the other hand, more than four-in-ten Republican parents (44%) said parents themselves don’t have enough influence on what their local K-12 schools teach, compared with roughly a quarter of Democratic parents (23%). A larger share of Democratic parents – about a third (35%) – said teachers don’t have enough influence on what their local schools teach, compared with a quarter of Republican parents who held this view.

Republican and Democratic parents don’t agree on what their children should learn in school about certain topics. Take slavery, for example: While about nine-in-ten parents of K-12 students overall agreed in the fall 2022 survey that their children should learn about it in school, they differed by party over the specifics. About two-thirds of Republican K-12 parents said they would prefer that their children learn that slavery is part of American history but does not affect the position of Black people in American society today. On the other hand, 70% of Democratic parents said they would prefer for their children to learn that the legacy of slavery still affects the position of Black people in American society today.

Parents are also divided along partisan lines on the topics of gender identity, sex education and America’s position relative to other countries. Notably, 46% of Republican K-12 parents said their children should not learn about gender identity at all in school, compared with 28% of Democratic parents. Those shares were much larger than the shares of Republican and Democratic parents who said that their children should not learn about the other two topics in school.

Many Republican parents see a place for religion in public schools , whereas a majority of Democratic parents do not. About six-in-ten Republican parents of K-12 students (59%) said in the same survey that public school teachers should be allowed to lead students in Christian prayers, including 29% who said this should be the case even if prayers from other religions are not offered. In contrast, 63% of Democratic parents said that public school teachers should not be allowed to lead students in any type of prayers.

In June 2022, before the Center conducted the survey, the Supreme Court ruled in favor of a football coach at a public high school who had prayed with players at midfield after games. More recently, Texas lawmakers introduced several bills in the 2023 legislative session that would expand the role of religion in K-12 public schools in the state. Those proposals included a bill that would require the Ten Commandments to be displayed in every classroom, a bill that would allow schools to replace guidance counselors with chaplains, and a bill that would allow districts to mandate time during the school day for staff and students to pray and study religious materials.

Mentions of diversity, social-emotional learning and related topics in school mission statements are more common in Democratic areas than in Republican areas. K-12 mission statements from public schools in areas where the majority of residents voted Democratic in the 2020 general election are at least twice as likely as those in Republican-voting areas to include the words “diversity,” “equity” or “inclusion,” according to an April 2023 Pew Research Center analysis .

Also, about a third of mission statements in Democratic-voting areas (34%) use the word “social,” compared with a quarter of those in Republican-voting areas, and a similar gap exists for the word “emotional.” Like diversity, equity and inclusion, social-emotional learning is a contentious issue between Democrats and Republicans, even though most K-12 parents think it’s important for their children’s schools to teach these skills . Supporters argue that social-emotional learning helps address mental health needs and student well-being, but some critics consider it emotional manipulation and want it banned.

In contrast, there are broad similarities in school mission statements outside of these hot-button topics. Similar shares of mission statements in Democratic and Republican areas mention students’ future readiness, parent and community involvement, and providing a safe and healthy educational environment for students.

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About 1 in 4 U.S. teachers say their school went into a gun-related lockdown in the last school year

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