The observable characteristics and subsequent evolution of young stellar populations is dominated by their massive stars. As our understanding of those massive stars and the factors affecting their evolution improves, so our interpretation of distant, unresolved stellar systems can also advance. As observations increasingly probe the distant Universe, and the rare low metallicity starbursts nearby, so the opportunity arises for these two fields to complement one another, and lead to an improved conception of both stars and galaxies. Here we review the current state of the art in modelling of massive star dominated stellar populations, and discuss their applications and implications for interpreting the distant Universe. Our principle findin...