INTRODUCTION TO ACADEMIC WRITING IN MEDICINE JONATHAN MCFARLAND

INTRODUCTION TO ACADEMIC WRITING IN MEDICINE JONATHAN MCFARLAND HEAD OF ACADEMIC WRITING OFFICE 20 TH JUNE 2016

• “If there is a good will, there is a great way” ( William Shakespeare) • “In dreams begins responsibilities” (W. B. Yeats)

INDEX Research done – now what? Basic elements of a research article - Before writing - IMRa. D - Good writing Over to you - pair work Take home message References

THE FIRST SCIENTIFIC JOURMAL • Cover of the first volume of the “Philosophical transactions of the Royal Society” – the first scientific journal (1665)

CLINICAL PRACTICE ENGLISH IS THE KEY MEDICAL EDUCATION MEDICAL RESEARCH “…Medicine is like a tripod, standing on three legs. One leg is patient care, one is research, and one is education. ”

RESEARCH DONE – NOW WHAT?

• “In science the credit goes to the man who convinces the world, not to whom the idea first occurs”

“English is the language of the most widely read and quoted medical journals” John R. Benfield and Christine B. Feak, CHEST 2006

BASIC ELEMENTS OF A RESEARCH ARTICLE – BEFORE WRITING Choose a journal Think about your message Plan

EDITORIAL TRIAGE ( EG. BMJ) The BMJ uses the following questions: • Does the article have a clear message? • Is it original? • Is it important? • Is it true? • Is it relevant to readers? And, the answer to all these questions should be… YES

THE EDITOR LOOKS AT: 1. The covering letter – so, you need to sell yourself 2. The Title: • Be concise and informative • Entice the reader 3. The abstract is very important • Should be CLEAR, CONCISE and STANDALONE • It must reflect what is in the paper

IMRAD INTRODUCTION - Grab the readers’ attention Set the scene and tells a story Summarise the State of the Art - WHY – your research was needed ? - WHAT – was new ? - WHY – did it matter ?

• Use present tense for generalizations For example, “Repetitive strain injury is one of the commonest complications of writing a thesis” • Use past tense for specific findings For example, “Smith and Brown reported that the moon was made of blue cheese. ”

METHODS In many ways the most important part of paper Remember the “acid test” – repeatability Must state that your ethics committee approved, and informed consent was given Use the past tense

RESULTS • Here – the facts and nothing but the facts • The core of the paper

RESULTS Ordered around the Primary and Secondary outcomes State clearly and simply what you found, using words and numbers Put the main numbers into tables and figures Write all the results in the past tense Do not include references in this section

DISCUSSION What you found – begin by answering the question posed in the introduction Write discussion to anticipate the readers’ and reviewers’ questions

DISCUSSION: - SUGGESTED STRUCTURE Statement of principal findings Strengths and weaknesses of the study Connect your study to past studies Meaning of the study: possible mechanisms and implications for clinicians or policymakers Unanswered questions and future research

CAREFUL WITH TENSES • Mixture of past and present tenses • Use present for the answer • Use past for the results • But present for an established fact. For example, “Smith et al. found that X was associated with Y, but our results suggest that this is not the case. ”

GOOD WRITING

PLAN CLEAR MESSAGE

KNOW THE AUDIENCE • Who are the readers? • Aim your writing at them • What do your readers know about this topic and what do they want to know?

WHAT IS MY MAIN MESSAGE? • The READERS will be lost if there is no clear “take home” message

WHY WRITE ? ? • Publish their study to improve the care of patients • Improve their CV and job prospects. • Entertain readers with their witty remarks about the state of the health service

WHAT STYLE • Important to read the "Guidance to authors" and the “house style” of your chosen journal. • There are many styles but one of the most important is the Vancouver Style • Used by among others: BMJ, Lancet, JAMA, PLOS, etc

FOLLOW THE BASIC RULES OF WRITING

SIMPLE IS THE BEST "I would have written a shorter letter but I didn’t have the time”. * ( Blaise Pascal, French Mathematician and philosopher)

USE ACTIVE CONSTRUCTIONS • Passive voice – common in scientific writing • Considered impersonal • BUT it is always longer, more boring, so my advice is ("We did" rather than "It was done, " "We conclude that" rather than "It can be concluded that") USE THE ACTIVE

DO NOT SUFFOCATE THE VERBS • A verb is suffocated when it is turned into a noun and another verb added; eg • “ An analysis was made “ • This is unnecessary and pompous-sounding • “We analysed” is better

• Replace “It is not impossible that…. ” with “It is possible that……”

USE “WE” WHEN POSSIBLE Using “we” can help to create empathy But be careful not to make the presentation too personal Be direct when giving guidance ("You should do an electrocardiogram in patients with chest pain") Avoid using “I”

USE WORDS PRECISELY Use the precise word “Quantity” is vague- Did you “measure”, “count”, “estimate” or “calculate”? “regime” – system of government ”regimen” – system of therapy “dose” – amount given at one time ”dosage” – amount given per unit time Untidy use of language – confuses

“PROVING” WORDS ACCORDING TO STRENGTH • “Prove” is the strongest word we can use for scientific findings. • Here are some others in descending order of strength: • Show • Demonstrate • Indicate • Suggest • Imply

BE CAUTIOUS • Very little is IRREFUTABLE words are acceptable: • May be • Might be • Could be • Probably • Possibly in science, and “hedging”

PARALLEL STRUCTURES • “ Reading maketh a full man; conference a ready man; and writing an exact man. ” SIR FRANCIS BACON 1561 – 1626

“ The educational programme will encourage people to eat healthily, drink sensibly and exercise regularly. ”

TAKE HOME MESSAGE • MEDICAL EDUCATION • MEDICAL RESEARCH • CLINICAL PRACTICE RESEARCH IS FUNDAMENTAL and ENGLISH is the LANGUAGE ……

AND NOW It’s your turn!

examples of pompous language. • Can you suggest a better example ? now 2)There is an absence of there is no 3)Provided that if 4)A considerable proportion • And here are some 1)At this point in time many 5)In view of the fact that because 6)In addition also 7)Reached a conclusion concluded 8)Reveal show 9)Demonstrate show 10)Terminate end

CHANGE FROM PASSIVE TO ACTIVE The behaviour of the rats was monitored for 24 h by two technicians Two technicians monitored the behaviour of the rats for 24 h Our findings are compared with literature data in Table 3 compares our findings with literature data After noninvasive tests, the final diagnosis of a breast tumour is made by biopsy After noninvasive tests, biopsy confirms the diagnosis of a breast tumour The opinion held by Hunter et al. Is not shared by this author We do not share the opinion held by Hunter et al.

1)Make a decision decide 2)Come to the realization realize 3)Take into consideration consider 4)Make an estimate 5)Give an explanation of estimate explain 6)Make a presentation of present 7)Is indicative of indicates 8)Place an emphasis on emphasize 9)Come to a conclusion conclude 10)Undertake an investigation investigate

HUMOUR IS IMPORTANT BUT Be careful and Know the audience!!!

BUT REMEMBER ……. This is one of Rudyard Kipling's most famous quotations, and it is from a speech he made to the Royal College of Surgeons in London in 1923

THANKS FOR YOUR KIND ATTENTION mcfarland. jonathan@gmail. com http: //www. jonmcfarlandmedicalenglish. com

REFERENCES Mastering scientific and medical writing: A self help guide, Silvia M. Rogers, Springer, 2007 How to publish in Biomedicine: 500 tips for success, Jane Fraser, radcliffe, 2008 Medical writing: a prescription for clarity, Neville W. Goodman and Martin B. Edwards, 3 rd edition, 2003 Scientific writing: ewasy when you know how, Jennifer Peat, Elizabeth Elliott, Louise Baur and Victoria Keena, BMJ. 2 nd edition, 2003 Politics and the English Language, George Orwell The problem with writing, Albert. T, BMJ, 2002

• http: //www. plainenglish. co. uk/ • The title says is it all, Annesley. Thomas, Clinical Chemistry 56: 3, 357 -360 (2010) • How to write a research paper and get it published, Gavin Yarney, 2007, BMJ Learning • How to write effectively, Stuart Viegas, BMJ Learning • http: //www. icmje. org/about-icmje/ • Six Honest Serving Men for Medical Writers, Richard Asher, JAMA. 1969; 208(1): 83 -87 Developing Skills in scientific writing, John Giba, Esteve Foundation, 2013

SPECIAL THANKS