The Art of Writing and Getting PublishedMarch 29, 2014

Jennifer Campi, Senior Staff EditorAcademic Medicine

Types of Peer-Reviewed Manuscripts

• Research reports

• Systematic reviews

• Narrative (expert) reviews

• Scholarly articles

• Perspective articles

• Articles describing innovations

What makes a good abstract?

• Gives the reader an accurate idea of the article’s content (data, ideas, or both) but does not go into too much detail

o Includes year of studyo Includes number of participants and institutionso Does not overstate findings; includes key

limitations

• Is as substantive as possible within word limits (250 for Academic Medicine).

• Avoids providing too much background at expense of key information

When writing an abstract

• Remember it’s not an introduction—it provides a summary report of the article

• Remember that all information must match information (content and terms) in the main text

• Feel free to borrow language (phrases, sentences) from the article

• Ask yourself: “If someone saw only the abstract, would they have at least a fair, if not good, understanding of what my article is about and what its main message or finding is?”

Which is a better abstract – A or B?

Purpose: Non-teaching services (NTS) are becoming increasingly prevalent in teaching hospitals. This study was designed to determine if the presence of an NTS is associated with higher acuity and altered case mix on the teaching services.

Method: The authors explain when and how they carried out their study, the type of data sought, and where the data were obtained.

Results: The differences and similarities in patients’ illnesses and conditions between resident services and NTS are presented; a key limitation of the study is also discussed.

Conclusions: The authors summarize the differences between the patients on the two types of services and describe the type of research that is needed to assess the effects of these differences.

A

Purpose: Non-teaching services (NTS) are increasingly prevalent in teaching hospitals. This study was designed to determine if the presence of an NTS is associated with higher acuity and altered case mix on the teaching services.

 Method: The authors conducted a retrospective, cross-sectional analysis of all general medical admissions from January 1, 2005 to June 30, 2005 at two teaching hospitals. 6,907 inpatients were studied, of whom 1,976 (29%) were admitted to resident services and 4,931 (71%) to an NTS. Hospital billing databases were used to determine patient demographics, ICD-9 diagnoses, Charlson Comorbidity Index scores, and patient disposition.

Results: Compared with NTS patients, patients on resident services had higher median Charlson Comorbidity Index scores (3.0 vs. 2.0, P < .001), numbers of comorbidities (9.0 vs. 8.0, P <.001), and were more likely to require intensive care (15.5% vs. 7.6%, P < .001) and to die in the hospital (8.2% vs. 4.5%, P < .001). Patients on the resident services were more likely to have renal failure, respiratory failure, septicemia, and HIV. Residents were less likely to care for patients with primary diagnoses of chest pain, cellulitis, alcohol withdrawal, and sickle cell crisis. The differences in patients’ conditions between resident and non-teaching services were similar in the two hospitals and among patients who had not received intensive care. A key limitation of this study is that one of the hospitals temporarily closed for three months during the study.

 Conclusions: Patients on resident services may be more medically complex and more likely to have high-acuity diagnoses than patients on NTS.  How these differences affect residents’ education, residents’ career decisions, and practice styles deserves further study.

BWhich is a better abstract – A or B?

• A’s purpose is clearly stated

• The remaining sections of A do not reflect the content of the article

• A outlines the study, but provides little of the article’s important information.

• A’s “Results” has no results

• A’s “Conclusion” does not conclude anything

• B clearly reflects the content of the article

• B includes the year of the study (helps reader judge currency of study or place results within a historical context)

• B includes number of participants, number of institutions, relevant statistics

• B’s Conclusions are clearly stated but not over-stated

Which is a better abstract – A or B?

Despite the need for a robust primary care workforce, the number of students and residents choosing general internal medicine careers continues to decline. In this article, the authors describe their efforts at the University of California, Davis to bolster interest in internal medicine careers and improve the quality of care for medically underserved populations through a tailored third-year residency track developed in partnership with the Sacramento County Department of Health and Human Services. The Transforming Education and Community Health (TEACH) Program improves continuity of care between inpatient and outpatient settings, creates a new multi-disciplinary teaching clinic in the Sacramento County health system, and prepares residents to provide coordinated care for vulnerable populations. Since its inception in 2005, 25 residents have graduated from the TEACH Program. Compared to national rates, TEACH graduates are more likely to practice general internal medicine and to practice in medically underserved settings. TEACH residents report high job satisfaction and provide equal or higher quality diabetes care than that indicated by national benchmarks.

The authors provide an overview of the TEACH Program, including curriculum details (e.g., the program lasts 36 weeks; residents assume a first-contact role with patients), preliminary outcomes (e.g., a much higher percentage of graduates practice general internal medicine; TEACH residents are more satisfied with the practice of medicine and less negative about patient care issues), barriers to continued and expanded implementation (e.g., introducing a new program requires significant trade-offs in other aspects of the larger internal medicine program), and thoughts about the future of the program (e.g., funding remains threatened each year).

Is this a good abstract?

• This is a non-structured abstract

• The authors provide an overview of the TEACH Program

• They include key details

• They note barriers to continued and expanded implementation

• They discuss the future of the program (e.g., funding is threatened each year)

Is this a good abstract?

Effective titles

• Informative• Interesting• Represent the article• Define terms• Economy of words• Include key terms

Effective Titles

• Include key search terms• Avoid posing questions whenever possible

Broad termsHave First-Time Medical School Deans Been Serving Longer Than We Thought? A 50-Year Analysis

Revised to use key search termRetention Rates of First-Time Medical School Deans: A 50-Year Analysis

Effective Titles

• Capture the reader’s attention• Use an appropriate tone

Interesting but perhaps inappropriate“Don’t Kill Granny”: A Consensus on Geriatric Competencies for Graduating Medical Students

Revised for tone Keeping Granny Safe on July 1: A Consensus on Minimum Geriatrics Competencies for Graduating Medical Students

Effective Titles

• Sometimes break the rules!

Lacks specificity but is highly engaging and communicates a clear ideaIs There Hardening of the Heart During Medical School?

How do research reports differ from articles?

Research reports Articles

Present and test a hypothesis or pose a research question:What assumption will you test, or what research question will you answer?

Present and support a thesis:What are you going to tell the reader about or convince the reader of?

Structured abstract ≤250 words: Purpose, Method, Results, Conclusions

Non-structured abstract ≤ 250 words

Organized with a formal structure: Introduction, Method, Results, Discussion

Organized according to content – with topic headings

Includes quantitative and/or qualitative data

May or may not include data

Must base argument on dataMay be based on or express opinions, supported by facts, evidence, data

Does your study require ethical approval?

Questions about your study Do you need ethical approval?

Did you or any coauthors study, evaluate, or observe human participants?

YES

Did you or any coauthors have access to identifiable data?

YES

Did you or any coauthors survey people?

YES

Did you or any coauthors interview people?

YES

Authorship considerations• Many journals (including Academic Medicine) follow the

Uniform Guidelines for Biomedical Journals Requirements of the ICMJE for determining authorship.

• Requirements for authorship:1. Substantial contributions to conception and design, or

acquisition of data, or analysis and interpretation of data2. Drafting the article or revising it critically for important

intellectual content3. Final approval of the version to be published

• The group should jointly make decisions about authors and contributors before submitting the manuscript. All authors must approve any change made to the listed authors after the manuscript is submitted.

For Authors

Visit Academic Medicine’s For Authors page for resources on writing and submitting manuscripts and ethical issues as well as publication criteria for articles, research reports, and innovation reports.

Sample abstracts and papers

Academic Medicine’s writing workshop handbook contains guidelines for writing abstracts and sample manuscripts with annotations.

R

Collections include:

Diversity and Inclusion

Cultural Competency

Other Academic Medicine features

AM Last PageAM Cover ArtMedicine and the ArtsTeaching and Learning MomentsLetters to the Editor

…for more information visit:http://journals.lww.com/academicmedicine/Pages/InstructionsforAuthors.aspx#specialfeatures

Academic Medicine Peer-Review Resources An Interview with the Editors

David Sklar, MD, and Jan Carline, PhD

The (Re)View from the Other Side

Grace C. Huang, MD

Thoughts Upon Becoming a Journal Manuscript Reviewer

William A. Norcross, MD

Hints for Reviewing Articles

Rika Maeshiro, MD, MPH

The Hidden Mentor: The Role of the Peer Reviewer

Mark Cummings, PhD

For Reviewers materials on academicmedicine.org

PROCESSING A MANUSCRIPT

SUBSTANTIVE EDITING

INTERNAL REVIEW

EXTERNAL REVIEW

COPYEDITING

REVISION

SUBMISSION

ACCEPT decision

PROOFREADING

PUBLICATION

REJECT decision

Professional staff editors work closely with authors to make substantive edits that:• strengthen arguments• improve the

organization of ideas• improve the flow of

ideas• tighten prose