Ready to write
Article Outline
Writing is not a mysterious process understood by only a select few. It is a skill you can learn. A simple analogy makes the process easier to grasp: the writing process is like the parts of the body—specifically the brain, heart, skeleton, intestines, and kidneys (Figure 1). In nursing school, we learned anatomy and physiology, and we use that knowledge at work every day. You also can put this knowledge into action as you write your article.
Figure 1.
Anatomy related to the writing process.
The Brain
The brain is the idea part of the article. In last month's article, you learned how to narrow a broad topic into one that can be covered well in an article and how to write a summary statement. To write an effective summary statement, you must identify and understand your target audience. Start by reading several issues of a journal that serves your target audience, and review the journal's author guidelines.
In addition, refer to your mind map to identify areas where you need more information, and formulate a plan to obtain it. Your main source will be a literature review, but consider other sources too (eg, books, reputable web sites, experts in the field).
The Heart
When your research is complete, you will have a better idea of how to organize the article. Just as the blood flows through the heart and the rest of the circulatory system, an article must have a flow to make it easy for the reader to follow. You may choose from several options for the flow of your article. The following strategies are presented for you to consider. You can use a single approach in your article or a combination of approaches.
Chronology.
You may choose to organize your material based on chronology. This is a frequent strategy for articles related to surgical procedures. This organization flows from preoperative, to intraoperative, and then to postoperative care.
Disease process.
The typical order for an article on a disease process is incidence, path physiology, clinical manifestations, diagnostic tests, treatment, and nursing care. Many continuing education articles are based on disease processes.
How to.
Quality improvement and clinical tips lend themselves to “how-to” articles. For example, how did you implement a new policy for on-call? How did you solve the problem of prolonged turnover time in your OR? Use the nursing process to organize a how-to article: write about your assessment of the problem, plan of action, implementation, and evaluation.
Case study.
You may use a case study to organize the entire article or a specific section. This technique is an excellent way to help readers apply information to practice. Using this method, you present a patient's history, assessment, diagnostic tests, treatment, nursing interventions, and outcomes.
IMRAD.
If you are presenting a quantitative research study, the traditional organization is referred to as IMRAD:
1
M H Oermann, Writing for Publication in Nursing (Philadelphia: Lippincott, 2002) 115–135.
Table 1. Research Paper Format:IMRAD1
An example of an article that uses the IMRAD structure is “Microbial flora on operating room telephones,”2 which appears in the March 2006 issue of the AORN Journal.
No matter what flow you choose, remember to move from simple to more complex ideas and information. For example, it would be better to present the case study of a patient with malignant hypothermia whose condition readily resolved before discussing a patient who experienced multiple complications.
Try to group information whenever possible by organizing it into easily digestible segments. For example, the author of a Journal article on addiction in nurses included a table comparing the signs and symptoms of alcoholism and drug addiction.3
The Skeleton
Just as the skeleton supports and holds the body together, an underlying plan (ie, an outline) must hold your chosen flow together. Think of your article as a story, with a beginning, middle, and end.
Beginning.
Your introduction sets the tone of the article and tells readers upfront what the article will be about. Think of it as the start of a book that draws the reader into the story that is being told. The introductory statement can be simple, such as, “Some superstitions maintain their hold over preoperative nurses even when research disputes their validity.”
Middle.
The middle is the main portion of the article. It is crucial that you keep your content outline and summary statement in front of you to avoid digressing from the topic. Paragraphs and subtopics help to maintain the flow. Note, for example, the subheads used in “The Heart” section of this article (ie, chronology, disease process, how to, case study, IMRAD).
Each paragraph usually begins with a sentence that reflects the content to follow. A sentence such as, “Three leadership styles are particularly effective during trauma-related OR procedures,” should be followed by a description of those three styles.
Use transitions to flow from one paragraph to another. A transition simply signals the reader that you are moving to another thought. Types of transitions include
End.
Your conclusion is the last chance you have to make your points to the reader. Focus again on what you want the reader to think, do, or feel. Make sure that you have not left any questions unanswered. Some options for endings include a summary of key points, a call to action, or suggested future directions for research.
The Intestines
The intestines can be thought of as the “guts” of the article. This is where the data and information (ie, the “nutrients”) of the article are made available. Most readers are probably like you—looking for information they can use either in their practice or to change their thinking. You can earn points with readers by involving them in the article. For example, show rather than tell your readers what is important. Anecdotes and case studies are excellent methods for illustrating your points. People like to read about people—both patients and nurses. For instance, if you want to show the effectiveness of a new surgical procedure, illustrate your positive statistics with a case study of someone who underwent the procedure and did well.
Another way to “show” is to use photographs, tables, or figures to help you accentuate the key points of your article. Visual elements provide interest and emphasis to your work and help your readers better understand your data or the points of your article. It is important that your visual elements are easy to understand, and do not simply repeat information from your text.
You also can involve readers by writing naturally and not struggling with awkward phrasing. Use language and examples that others can grasp easily. To guide your style and tone, review articles in the journal in which you would like your article to appear. Editors want an article that will resonate with readers. It is hard to achieve that if you write convoluted sentences that a reader has to puzzle over to understand. Remember, however, that your tone should be appropriate for the journal. The common advice to “write how you speak” is not completely accurate. You typically explain something to a co-worker in a more informal tone than would be appropriate in an article.
Kidneys
After you write the article, you must edit your work. Just as the kidneys filter out unnecessary electrolytes and toxins from the body, editing is used to filter and critically assess an article. When you edit, you look for sections bloated with words or sentences extraneous to your point. Be firm with yourself. Cutting and rewriting are hard, but it is one of the most important tasks you can do. Choose your words carefully. As Mark Twain said, “The difference between the right word and the almost right word is the difference between lightning and a lightning bug.”4
Two easy items to check are qualifiers and obvious statements. Watch for phrases such as “I believe … “or”very useful.” The first implies you are unsure of yourself or you may be injecting your opinion into a factual article. The second is simply “gilding the lily” (ie, adding unnecessary words that distract from your point). Examples of stating the obvious include, “The nursing shortage is serious,” or “Perioperative nurses play an important role in patient care.”
Next, ask others to review your article and comment on it. Choose both a typical reader and an expert in the field, and be sure to select reviewers who will be completely honest with you. Think of them as part of your team, not as critics. It often is helpful to ask someone unfamiliar with your topic to look over the article as well. This will give you many diverse points of view. You are not obligated to follow all the advice you receive, but do consider the rationale behind each suggestion. Remember, this is just the first stage of a complex editing process. Your article will undergo editing by the journal editors as well.
After making your revisions, you will have a completed draft of your article, and congratulate yourself on a job well done. In the next article of this series we will discuss how to write more effectively so that readers will enjoy your article and editors will be more likely to accept it for publication.
Notes
- . In: Writing for Publication in Nursing . Philadelphia: Lippincott; 2002;p. 115–135
- “Microbial flora on operating room telephones,” . AORN Journal . March 2006;83:607–626
- . “Substance abuse among nurses: Defining the issue,” . AORN Journal . October 2005;82:572–602
- “Lightning bug quotes,” Thinkexist.com http://en.thinkexist.com/quotes/with/keyword/lightning_bug/ (accessed 29 March 2006)
Editor's note: This is the third in a series of articles on writing for publication. The first article was printed in the March 2006 issue of the Journal.
PII: S0001-2092(06)60115-4
doi:10.1016/S0001-2092(06)60115-4
© 2006 AORN, Inc. Published by Elsevier Inc All rights reserved.