7 Writing the Research Paper

Writing in a formal, academic, and technical manner can prove a difficult transition for clinicians turned researchers; however, there are several ways to improve your professional writing skills.  This chapter should be considered a collection of tools to consider as you work to articulate and disseminate your research.

Guiding Principles

Although it is wise to identify a potential journal or like avenue as you begin to write up you research, this is not always feasible. For this reason, it is a good idea to have an adequate understanding of the general expectations of what is required of written research articles and manuscripts. Here are some things to keep in mind:

Consider the articles you read

As you begin to research potential research interests, pay close attention to the style of writing found in peer-reviewed and academic journals.  You will notice that the ‘tone’ of ‘voice’ is often formal and rarely uses the first-person narrative.  You will be expected to develop writing of this caliber in order to be published in a reputable peer-reviewed forum.  One of the most difficult concepts for novice researchers to understand is that professional or technical writing is very different from casual or conversational writing.  There is little room for anecdotes, opinions, or overly descriptive narratives.  Keep your writing succinct and focused.

Keep it simple, silly! (KISS)

Recall when you were first introduced to writing a paper in an early English Composition course.  It is likely that you were told that the key components of a paper are the introduction, body, and conclusion.  This is truly the foundational structure of any good paper.  Consider the following outline for your writing assignments:

Introduction

• Brief overview of the topic which identifies the gap of understanding about a particular topic that you hope to address (why is it important?)
• Statement of problem (what issue are you going to address?)
• Purpose statement/thesis statement (what is the objective of this paper?)

Body

Typically the body of the paper will be broken down into themes or elements outlined in the introduction.  Occasionally rather than themes or topics to be addressed, the ‘body’ of the paper will have specific components such as a literature review, methodology, data analysis, discussion, and/or recommendation section.  Each of these sections may have specific requirements within that section. Later in this chapter, you will be introduced to specific requirements of different types of research papers.

The body of any paper is the ‘meat and potatoes’ of the work.  That is, this is the section wherein you both present and explain your ideas in support of the purpose of the paper (described in the introduction).  The body of your paper, regardless of specific structure, is where the majority of your evidentiary base should be included.  That is, many of the statements you make in these sections will require substantiation from outside resources.  It is vital to include appropriate citations of all references used. To save yourself time, cite and reference correctly as you write. Doing so will help ensure that you stay organized as your work evolves.

Sections such as methods or data analyses, will not require as much substantiation and should be considered very ‘cut and dry’. That is, there will be little to no discussion or interpretation of the evidence here. Results sections, similarly, should be focused on the presentation of results specific to your investigation, including statistical analyses. When reporting results of your work consider the format and whether it makes sense to summarize results in a table, figure, or appendix. The appropriate method will depend on both the type and amount of information that you are trying to convey.

The discussion section is the point at which you should frame your results in the context of your interpretation of the existing literature and how your work addresses the gap in knowledge. You’ll work to substantiate your interpretation by utilizing references to present evidence to support your rational. Pay close attention to your approach as you discuss your results and the impact of your work. Be careful not to make declarative statements if your data does not support a cause-and-effect relationship. Additionally, be careful not to draw inference as a result of bias. That is, use caution in skewing the evidence to support your hypothesis.

Conclusion

The conclusion is exactly that.  This is your opportunity to wrap your thoughts up succinctly.  A good conclusion will remind the reader of the point or focus of the paper, reiterate the arguments outlined in the body as well as summarize any discussion or recommendations posed in those respective sections, and articulate what the content of the paper added to the knowledge base of the subject.  This is not a time to introduce new arguments, concepts, or evidence.  The reader should be able to finish the paper understanding the purpose of the paper, the main arguments, and the impact of the work on the subject.

References

References should be cited correctly in text as well as appropriately formatted at the end of each body of work. The format of your references will depend on the guidelines required of the intended journal or forum you’re submitting to. For example, papers written utilizing the American Psychological Association (APA) formatting standards will include reference pages which are organized on a separate page, titled ‘References’, and organized alphabetically by author surname. If you’re not quite sure of where you’ll be submitting your paper for publication, it may be best to write using APA format; because the references are listed in ascending alphabetical order, adding or removing references during the revision process will be minimally impactful on the designation of subsequent references. Altering your references can then be done once you identify a method of dissemination and review specific guidelines.

Formatting

Understanding how to present your work can be difficult. It’s one thing to plan and do the research; it’s quite another to put it down on paper in a logical and articulate way. As we discussed in chapters 1 and 2, planning is essential to the success of your research. Similarly, planning the layout of your manuscript will help ensure that you stay both organized and focused. Although most articles can be generalized as having an introduction, body, and conclusion; the specific components within each of those sections varies depending on the approach to research.

Original Research

Although many journals may outline specific requirements for how your manuscript or research paper is to be formatted, there are some generally acceptable formats. One of the most generalizable formats is referred to as IMRaD. IMRaD is an acronym and includes the following elements:

• Abstract
  • Most journals have specific word requirements for abstracts. However, abstracts should be a brief overview of the entire project such that if a reader were to only read the abstract, they would glean a good understanding of your research. Most abstracts are arranged to also follow the IMRaD format and amount of space spent on explaining each component can be estimated as:
    • Introduction- 25%
    • Methods- 25%
    • Results- 35%
    • Discussion/conclusion- 15%
• Introduction/Importance
  • Clearly state the focus for the work. Provide a brief overview of the issue and the gap in knowledge identified; including both a problem and purpose statement in the context of what is currently understood about the topic. This is where you ‘reel’ the reader in and also highlight the important themes which are consistently addressed in the existing literature.
• Methods
  • Describe both the general and specific approach taken in your work. This section is usually written with a very technical approach and includes sections such as:
    • General and specific approaches
    • Participant selection/randomization
    • Instrumentation/measurements utilized
    • Procedure
    • Analysis
• Results and
  • Here is where you report specific findings and outcomes of your work. There should be very little discussion in this section. Rather, you should present your results and comment, briefly, on how this may relate to the existing literature and state the bottom line. That is, what do these findings suggest. These succinct comments should frame the lens of the discussion section.
• Discussion
  • In the discussion section you can further elaborate on your interpretation, based in the evidence, of how your findings relate to what other researchers have found. You can discuss flaws in your work as well as suggestions for direction of future research. You should address each of the main points you presented in your introduction section(s).

QI Projects

When presenting your QI project; a systematic reporting tool, such as the SQUIRE method, is helpful to ensure that you appropriately present the information in a way that both adds to the understanding of the problem as well as a descriptive approach to solving the issue.

SQUIRE Method

Titling your QI project

• • Your title should indicate that the project addresses a specific initiative to improve healthcare.

1. Abstract
   • Provide enough information to help with searching and indexing of your work
   • Summarize all key findings in the format required by the publication. Typical sections include background (including statement of the problem), methods, intervention, results, and conclusion
2. Introduction (Why did you start?)
   • Include a description on the nature and significance of the problem
   • Review of available knowledge
     • Summary of what is currently understood about the problem
   • Rationale
     • Overview of framework, model, concepts and/or theory used to explain the problem. Include an assumptions, delimitations, or definitions used to both describe the problem as well as develop the intervention and why the intervention was intended to work.
   • Specific aims
     • Describe the purpose of the project

4. Methods (What did you do?)
   • Context
     • Describe the contextual elements relevant to both the problem and intervention (e.g. environmental factors contributing to the problem)
   • Intervention(s)
     • Describe the intervention in enough detail that it could be reasonably replicated
       • Include team-based approach, if applicable
     • Study of the Intervention
       • Describe the approach used to assess the impact of the intervention as well as what approach was used to evaluate/assess the intervention
     • Measures
       • What tools did you use to study both the process and intervention and why?
       • What tools are in place for ongoing assessment of efficacy of the project?
       • How is completeness and accuracy of the data measured?
     • Analysis
       • Describe the quantitative/qualitative methods used to draw inference from the data collected
     • Ethical Consideration
       • Describe how ethical considerations were addressed and whether the project was overseen by an Institutional Review Board (IRB)

5. Results (What did you find?)
   • Initial steps of intervention and evolution over time; including modifications to the intervention or project
   • Details of the process measures and outcome
6. Discussion (What does it mean?)
   • Summary
     • Key findings including relevance to the rational and specific aims
     • Strengths of the projects
   • Interpretation
     • Nature of the association between intervention and outcome
     • Comparison of the findings with those of other publications
     • Impact of the project
     • Reasons for differences between observed and anticipated outcomes; include contextual rationale
     • Costs and strategic implications
   • Limitations
     • Limits to the generalizability of the work
     • Factors that may have limited internal validity (e.g. confounding variables, bias, design)
     • Efforts made to minimize or adjust for limitations
   • Conclusion
     • Usefulness of the work
     • Sustainability
     • Potential for application to other contexts
     • Implications for practice and further study
     • Suggested next steps

7. Funding*
   • This section would be included if you received funding for the projects.

Narrative Reviews

As mentioned in chapter 2, development of either guidelines or protocols is an intensive process which often requires a systematic team approach to ensure that the scope and purpose of the work is as generalizable as possible. The best approach for the development of guidelines can be found by reviewing the World Health Organization handbook for guideline development.

Presenting a narrative review of a topic is an excellent way to contribute to the knowledge base on a particular subject as well as to provide framework for development of a protocol or guideline. The elements included in presentation of a narrative review are not all that different from those of traditional research studies; however, there are some notable differences. Here is a brief outline of what should be included in a quality narrative review, adapted from Green, Johnson, and Adams (2006) and Ferarri (2015):

1. Title
2. Structured Abstract
   1. Green, Jonhson, and Adams (2006) describe the components of a structured abstract in the context of a narrative review to include
      • Objective: State the purpose of the paper
      • Background: Describe why the paper is being written; include problem statement and/or research question
      • Methods: Include methods used to conduct the review; including those used to evaluate articles for inclusion into your work
      • Discussion: Frame the findings of the review in the context of the problem
      • Conclusion: State what new information your work contributes as a result of your review and synthesis
      • Key words: List MeSH terms and words that may help organize and/or locate your work
3. Introduction
   1. Clearly state the focus for the work. Provide a brief overview of the issue and the gap in knowledge identified; including both a problem and purpose statement
4. Methods
   1. Provide an overview of how information related to the review was located. This includes what terms were searched and where as well as why studies were included in your review. Delimiting your search is important to describe the scope of the review
5. Body
   1. Themes or constructs should be identified throughout the review of the literature and arranged in a way such that the discussion of the theme and the link to the evidence should directly address the purpose of your inquiry
   2.  Discussion
      1. What sets a review apart from an annotated bibliography is synthesis of the evidence around major points identified consistently throughout the research (i.e. themes). Both consensus and diverging approaches should be included in the discussion of the evidence. This should not be considered simply a comparison of the existing evidence, but should be framed through the lens of the author’s interpretation of that evidence.
6. Conclusion
   1. Tie back to the purpose as well as the major conclusions identified in the review. No new information should be discussed here, apart from suggestions for future research opportunities

References

An extremely important part of disseminating your work is ensuring that you have correctly attributed thoughts and content that you did not create. Depending on the nature of your research, discipline, or intended publication, the format by which you list your references or outline resources utilized may differ. Regardless of referencing formatting guidelines, it is imperative to keep your references organized as you draft different iterations of your work. For example, it may be easier to draft your work utilizing American Psychological Association (APA) formatting guidelines, which arrange references by author’s last name, in ascending alphabetical order, than in other formats which require that references be numbered in order of appearance in the text. As you add, delete, or rearrange references within the text of your manuscript, it may be both difficult and time consuming to constantly re-number each of your references. Note: Depending on the reference guidelines for your intended journal, you may be required to list the abbreviated names of journals. Finding this information can be difficult. Consider this resource for locating and identifying how best to list journal titles within a reference.

References

Green, B.N., Johnson, C.D., & Adams, A. (2006). Writing narrative literature reviews for peer-reviewed journals: Secrets of the trade. Journal of Chiropractic Medicine, 3(5), 101-117.

Ferrari, R. (2015). Writing narrative style literature reviews. The European Medical Writers Association, 24(4), 230-235. doi: 10.1179/2047480615Z.000000000329

SQUIRE. (2017). Explanation and elaboration of SQUIRE 2.0 guidelines. SQUIRE. http://www.squire-statement.org/index.cfm?fuseaction=Page.ViewPage&pageId=504

World Health Organization. (2020). WHO handbook for guideline development, 2nd Ed. World Health Organization. https://apps.who.int/iris/handle/10665/145714