As a practising clinician, there are scores of questions that arise in a working week that we would like to know the answer to. Equally, there are as many things in our practice that we have learned and applied, which would be advantageous to share with our peers. This resource is intended to simplify the apparently complex process of manuscript writing.
The issue you address should be common and simple.
Find a topic that has frustrated or confused you: ask the question ‘Why did it go wrong in this case?’, or ‘How should this be done in light of what we know?’, or ‘What did we not know?’. Answering this style of question points us to the existing research, and then allows us to summarise that if it is not well known (as a review) or to address it by collecting data (as an audit or a project).
Strive for clarity from the start.
The project should have a clear outcome parameter being assessed – studies with multiple outcomes and countless associations tend to confuse, and often conclude that future research is needed. Try to avoid too many hypotheses (but you must always have one).
Create a team.
One of the joys of research and publishing is working with colleagues who bring complementary abilities – rigour in data collection, a gift for analysis, mentorship, design ability (for source data collection and later presentations), authorship. Rarely are these gifts combined in one person, and most people are keen to work and get published once approached with a specific project. Being in a team also helps to develop the thick skin you may need when your paper is sent back with peer-reviewed comments! Once your team is assembled, decide on authorship early.
Read other papers.
Writing well is a talent, but like many talents, it is primarily gained by experience and practice (rather than being an innate gift). Learn the style of what makes some papers lively, clear and effective – then copy it in your own way.
Write your introduction with a structure.
With a simple question in mind, having a clear scaffolding to build on allows your findings to be easily understood. Try to avoid doing things by rote, rather, tailor your introduction towards the conclusion you found – set the reader up to understand easily. You are not writing for someone who has a complicated complaint to make, but to take the reader with you as you explain your point(s).
Present your methods and results with the goal of making your point.
Describe the population or problem you have studied and your intervention clearly – don’t rely on citing other publications since the reader is unlikely to read those. Be equally clear about the comparator being used (if any). The key outcome should be the first data presented. The italicised words spell out what is referred to as the PICO process, as a useful acronym reminder.
Your discussion should be honest and balanced.
Start by presenting your key finding as it relates to your hypothesis and first part of your results. Then elaborate any other conclusions you have reached. You should include complete (and not partial reflection) on how your findings agree and disagree with existing literature. You should also outline the limitations in study methodology and analysis, before using these as a springboard to briefly explain what the implications of the study are (in terms of direct practice and/or need for future study). Being transparent about shortcomings is the best way of getting reviewers to look favourably at the manuscript, rather than grudgingly being forced to add caveats.
Pay attention to your tables and figures.
Make sure these are absolutely accurate, that they complement rather than duplicate what is in the text, and that they are not too complicated. They should allow the reader to cut and paste them into a slide and present your findings with just the briefest of explanations.
Write the abstract last.
The abstract is critical, but it is much easier to write once you have completed your manuscript to ensure it is just a key distillation of the facts.
Follow carefully the instructions of the journal.
The manuscript will be declined before review if you do not follow the word length, figure resolution, number of references, journal style etc. Most publishers, for example ClinMed, have clear instructions for authors and can also be approached by email ahead of submission if further clarification is required.
Above all, these suggestions aim to encourage you to research and publish – it is not the daunting process that some may suggest. A summary of the above is to have clarity, confidence and humility.