Writing Effectively and Navigating the Publication Process: Advice from the Editors of Academic Medicine

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On this episode of the Academic Medicine Podcast, our editors share their advice for authors submitting their scholarship for publication and describe what they look for when they’re reviewing submissions. Also included are resources to help authors write successfully and publish their work. This episode is meant for new authors and authors new to medical education and, while the advice comes from the editors of Academic Medicine, much of it also applies to other types of medical education scholarship, to scholarly publishing in other disciplines, and to submissions to other journals and publications.  

This episode is now available on Apple Podcasts, Spotify, and anywhere else podcasts are available.

A transcript is below.

Check out the resources discussed in this episode: 

Transcript

Toni Gallo:

Hi everyone. I’m Toni Gallo, a staff editor with Academic Medicine, and I have a different sort of episode for you today. I asked the journal’s editors the following questions: What advice do you have for authors submitting their medical education scholarship for publication? And, as an editor, what are you looking for when you’re reviewing a submission? In this week’s episode, I’ll be sharing the editor’s answers to these questions, which address preparing and writing up different parts of a manuscript, creating impactful tables and figures, and navigating the revisions process. This episode is really meant to be a resource for new authors and authors who are new to medical education as you write up your scholarly work and try to navigate the publication process. And while the advice I’m going to share with you comes from the editors of Academic Medicine, much of it really also applies to other types of medical education scholarship and to submissions to other journals and publications. At the end of today’s episode, I’ll also talk about some other resources that are available to help you write successfully and publish your work.

I want to start today with my own advice. When I talk to authors, oftentimes their first question is about how to best present the work they’ve done, especially when that work isn’t a straightforward study. If you’re in the same boat, before you even start writing, I recommend thinking about the main message you want to convey. That’s really going to help you decide what type of article is going to best showcase your work. Most journals have different article types and each one makes an important contribution to the field. You don’t have to publish a research report for your work to be valuable and move the field forward. It won’t serve you or your readers if you write up a research report about work that isn’t actually research, and often, that’s going to lead to a reject decision from the editors.

Here are a few examples. Are you describing the initial implementation of a novel program and reporting preliminary evaluation data? That would be an innovation report because your focus is on describing the components of a new program and how it was implemented. Or perhaps you want to describe a new framework that you and your coauthors have devised and you’re in the process of implementing. In this case, a scholarly article would be the right type of publication because your focus is on presenting the framework to readers and providing some early examples of how it might work in practice. It all comes down to the true focus of your work and how best to share that message with readers.

If you’re ever unsure about how to present your work, read some different article types in the journals you’re thinking of submitting to. That’ll give you an idea of the type of work that’s presented in each article type, and then you can see where your work might fit in.

Once you’ve decided how to present your work, it’s time to actually write your manuscript. For advice on how to do that. I want to turn to Colin West, one of Academic Medicine’s deputy editors and Jonathan Amiel, Laura Hirshfield, Gustavo Patino, and Dan Schumacher, all of whom are assistant editors with the journal. They shared what they look for when evaluating a manuscript, including how the authors position their work in the context of current scholarship on their topic, the rationale authors provide for their work and how that work moves the field forward, and the alignment of the purpose of the manuscript with the study design, as well as much more. Here’s what they had to say.

Colin West:

Hi, I’m Colin West, I am a deputy editor for Academic Medicine. I am also a professor of medicine, medical education, and biostatistics at Mayo Clinic in Rochester, Minnesota, with research focus areas on medical education quite broadly and health care professional wellbeing in particular. I’d like to offer 3 pieces of advice for authors submitting their medical education scholarship for publication from an editor’s perspective. First, I recommend discussing practical applications of your work to bridge the gap from theory to practice for your readers, without overstating your findings, of course. And this can be a tricky balance to walk but is really important to help readers understand why your work is relevant to medical education more broadly.

The second piece of advice is to be clear about your paper’s place in the field. What background literature does it build on and how does it advance knowledge? Again, this is about framing your work for your readers. And then finally, be thoughtful about limitations of your work. This is a key part of honest assessment of the contribution that your paper makes to the field and helps balance the innovative and exciting results with some notes of caution that are important for readers to understand and suggest that you as an author have maintained some sense of objectivity in presenting your work. Thank you very much and I hope these tips are helpful as people submit their work in scholarly publishing and to advance medical education at large.

Jonathan Amiel:

Hello, my name is Jonathan Amiel. I’m an assistant editor at Academic Medicine and a professor of psychiatry and senior associate dean for innovation in health professions education at Columbia University. When I read a submission to Academic Medicine, the first thing I do is try to understand how the work can help colleagues in the field make medical education better. That doesn’t mean a submission has to solve every problem we face, but it does mean that I have to understand why the author has invested time in it and how it can benefit our community. Then, if I’m hooked, the second thing I do is try to understand what small bite of the problem the authors took on and how rigorously they addressed it. I’m much more likely to advance a manuscript that takes a small bite of a problem and does a great job with it than with one that over promises and under delivers. Our work is complicated, so in my view, humility and discipline go a long way.

Laura Hirschfield:

Hi, I’m Laura Hirschfield, and I’m one of the new assistant editors for Academic Medicine. I’m an associate professor of medical education and sociology at the University of Illinois in Chicago. Some topics I’m interested in include qualitative methods, social theory, inequality, especially related to gender and race, and professional socialization. When I review a paper, the first thing I look for is whether or not the authors have engaged with the foundational papers and authors who do work on the topic they’ve written about. A lot of this work is often outside of medical education, so it’s really great to see authors who engage with key scholars from other disciplines and not just those within medical education. I’m also looking for papers that demonstrate clearly the link between their research question or topic and their research design. I love knowing why researchers made the scholarly choices they made and reading their clear arguments for why those choices were the correct ones.

Gustavo Patino:

Hello, my name is Gustavo Patino, and I’m a volunteer assistant editor at the journal. I’m also an associate professor of neuroscience at the Oakland University William Beaumont School of Medicine in Rochester, Michigan. I’ll mention 3 things that I look for when I’m reviewing a submission, and these are things where I commonly encounter authors having difficulty with their manuscripts. The first is, can they articulate very clearly what is the research question, and can they also tell us why is this a gap in the knowledge, how they come up with this idea, and why is it important that it be answered? For me, it’s also very useful when this is presented as a story, like this is the current landscape of our knowledge, but this is an area where we don’t have enough information and is causing these problems in our field.

The second thing is, are the research methods and the study design appropriate for answering that question that they have articulated? And finally, in the discussion section, are all the claims and the takeaway points that the authors have, are they consistent, both with their methods and the results that they have presented? Or are they bringing in new information that was not mentioned in any other section of the paper and it just comes out of the blue? Or are the claims that they’re making stretching the actual significance and implications of the results that they have? Thank you.

Dan Schumacher:

Hi, this is Dan Schumacher. I’m an assistant editor at Academic Medicine and I’m a full professor at Cincinnati Children’s Hospital Medical Center in the US. My medical education research focuses on what I would call patient-focused approaches to assessment. When I think about the advice that I would give to people that are submitting something to Academic Medicine, in terms of medical education and scholarship, I think there are 2 most important things that come to mind for me. First, I really like Lorelai Lingard’s idea of story, not study. The study is what you do, but for a paper, you don’t want to just simply report that study. You want to tell us the story about why it’s important and what you found and why what you found is important. Oftentimes, this means leaving out some of the details that are technical for how the study went about.

The other piece of advice that I would give is that I really like well-crafted research questions and methodologies or approaches that match them. And I think that sometimes this is not clear when people write. Maybe the research question is not entirely clear or maybe the way they’re going about answering that question is not entirely clear, and I really like to see clarity in those and for them to be very well linked to one another. That you have a clear question and that the methodologies that you’re choosing to answer that question truly do allow you to answer that question.

Toni Gallo:

For more on the importance of accurately and adequately describing your methodology and what information should be included in the method section of a research report is John Coverdale, one of the journal’s associate editors. Here’s his advice.

John Coverdale:

My name is John Coverdale. I’m an associate editor at Academic Medicine and also a tenured professor at Baylor College of Medicine. The question was “what’s important for authors to really focus on when writing their papers?” And I would suggest that the most important component of your writing is to do a good job with the methods. The methods are central to determining the validity of the research findings. Authors are responsible for providing sufficient information about the conduct of research that allows an accurate replication and an adequate judgment of the scientific merit of their work. From methods then will facilitate the critical appraisal of a study by readers and decision-making about whether to incorporate the findings into educational practice. It’s worth appreciating, actually, that research originates with an issue or a problem or a question, and authors should therefore explain the rationale of the study design, in relation to the research question or hypothesis, including how the design was appropriate to the question.

I guess in these days where there’s not much financial support for educational research, not all designs can be optimal, so it’s important to comment on the choice of design and its relative merits for that particular project. And then authors shall be attentive to how the methods are organized and communicated. So one way to order the methods is to describe the research design first, including the specific treatment of groups in an experimental study and data collection procedures. And that can be followed by a description of a sample and population from which the sample is drawn. And the outcome measures have to be described too, including the validity and reliability. And the data analysis procedures, including specific statistics used, conclude the methods. But there’s of course some flexibility in how those are organized. The limitations of the methods are normally identified in the discussion section, so that the results and conclusions can be understood in their light.

Now with qualitative research, the principles are the same. That is that authors should justify the appropriateness of the methods in relation to the specific research question. And it might help authors also to think about what problems may arise in undertaking the research and to plan to prevent or limit any major study design weaknesses. But again, my central key message is that it’s important to spend time on being thorough and comprehensive, as well as possible, in the writing of a methods because those are most important in enabling a judgment of the adequacy of the findings in relation to how well the methods answered the question.

Toni Gallo:

Turning to the visual elements of your manuscript, including the tables, figures, charts, lists, and appendices, is Mary Beth DeVilbiss, the journal’s managing editor.

Mary Beth DeVilbiss:

Hi, this is Mary Beth DeVilbiss, the managing editor of Academic Medicine, and I wanted to talk about what we look for in exhibits in a submission. And by exhibits I mean the visual elements of your submission, so tables, figures, charts. These can be a really great way to present information more clearly or concisely than you would be able to do with prose. That said, they should always be used judiciously and strategically. So we actually have a limit of 5 exhibits in a printed article, but regardless of the limits, there should always be a clear purpose and added value when you use an exhibit to communicate information in your submission.

So when we review an article, we look at whether the exhibits are enhancing or illuminating the text. They shouldn’t be used to repeat or replace the reporting that’s required in the text. There’s no need to repeat every data point between the text and the exhibits. But it’s a great way to add detail or add deeper understanding of your statistical calculations or perhaps visualize a model that’s maybe not clear by just writing it out in the text of your manuscript. Regardless, keep in mind that a good exhibit can be interpreted independent of the text. So there should be enough guiding information for the reader so that, if they look at this figure or table or list or appendix, they can get some valuable information from that, that they don’t need to read an extended method section to understand, for example.

Finally, color is allowed in our figures but should always be used intentionally. The best figures and tables are always simple and straightforward and don’t use elements just for the sake of using them, but every piece or every design choice has a purpose. And one quick reminder, anytime you reproduce or adapt a previously published figure or table, you should always seek permission from the original publisher and include documentation of that permission agreement with your submission. That really helps out with the documentation process on our end. So thanks, we look forward to seeing your submissions and especially the visual elements of these.

Toni Gallo:

For those of you interested in writing up innovations, here’s advice from Teresa Chan, another of the journal’s associate editors, on how to craft a successful innovation report.

Teresa Chan:

Hello, my name is Teresa Chan and I am an associate editor at Academic Medicine. And so I’m going to do my bit around what I think makes for a great innovation paper. Innovation reports are special, they’re kind of a first stab at a new way of doing things. And by new, I think it means that you have to be building on previous literature but then tweaking it in a novel way. Whether that means that you’re combining two things that haven’t been combined before, such as certain digital tools in a new environment, or it might be looking at a novel way of looking at an old problem and bringing in new conceptual frameworks and theories from other disciplines where they might have already tried and true answers but haven’t been migrated or translated into medical education.

I think at the end of the day, you have to do your literature research, and you have to know the grounding literature in other fields, and your own, when you’re doing something that’s innovative, so that you can show that you respect the work that has come before but are actually adding to the field by introducing new ideas in the form of your innovation.

And as our innovation report section highlights, you should outline your problem, aka the context and the conceptual framework from which you arose to solve the problem, and then you need to outline your approach, so that someone else could reproduce your innovation in their shop. And then you should actually provide some sort of reflective component to your report. So whether that’s evaluation and then a reflection about how you might have done differently or better by your learners in your particular innovation, or it might be looking at actually thinking through all the pitfalls and pearls that you have for how you made that implementation work. And while not all innovation reports will need outcomes, we certainly do look more favorably with regards to the kinds of innovation reports that have outcomes, that are beyond a Kirkpatrick 1 or 2 level, but start to look at changes in behavior or impact or apply a different and more novel program evaluation strategy for measuring outcomes. So hopefully this helps you get a better sense of what I’m looking for when we’re reviewing innovation reports. And good luck.

Toni Gallo:

Before you submit your manuscript for peer review, you should read through it 3 times–as an author, as a reviewer, and as a reader–according to Bridget O’Brien, the other deputy editor at Academic Medicine. Here’s how she described this practice.

Bridget O’Brien:

Hi, I am Bridget O’Brien, deputy editor at Academic Medicine. When I read a manuscript, I read it with no prior knowledge of the study, of the challenging decisions the authors made throughout the study, and of the rationale for all those decisions. And while this may seem obvious, I think it’s easy as an author to lose sight of the reader’s perspective. So my suggestion to authors is to read through your manuscript 3 times before submitting. The first time is the usual read through, as an author, making sure the argument flows and that essential details and key points are covered. The second time is from the perspective of a reviewer. So try to assume your typical stance of the reviewer and apply the manuscript review criteria you normally use to your own work. Take some notes.

And then the third time is as a reader. So imagine yourself perusing the table of contents of Academic Medicine. Would you flag your article as one to read? Would you read the abstract? Does it make you want to read more? As you read the article, what draws you in? What would you want to know more about? And where does your attention drift off? So then if you’ve done all 3 of those, review your notes and revise your manuscript accordingly. You might not be able to address all these points but give some thought to which ones are highest priority.

And of course, it’s also great to ask others to read your manuscript from these perspectives, before you submit. But by doing this yourself, you can gain additional insights about your own writing, about yourself as a reviewer, and about yourself as a reader of manuscripts. So thank you and I look forward to reading your work at Academic Medicine.

Toni Gallo:

Tony Artino, the journal’s assistant editor for Last Pages, shared his advice for responding to reviewer and editor comments and successfully navigating the revisions process.

Tony Artino:

Hello, my name’s Tony Artino, I am a professor at the George Washington School of Medicine and Health Sciences, and I’m also an assistant editor for Academic Medicine’s Last Page section. So we were asked to give some advice to paper writers to improve the odds of getting your scholarship published, and so I thought I would focus in a bit on the revision process. So if we’re lucky enough to get a revision, and really a revision request is a win, right? That’s what you’re looking for, a revise and resubmit. If you’re lucky enough to get that, there are 3 principles that I think are worth keeping in mind.

First principle is that revisions always result in a better paper. Now, this seems like a pretty strong statement, but I have to say, in my experience, it’s true. And keep in mind, I spend as much time as an author as I do as an editor and a reviewer. In all that time writing and reviewing papers, I’ve never really seen a paper that was not improved as a result of going through the peer review process. So revisions really do result in a better paper. And you can think about it this way … When do you want to get your paper peer reviewed? Before it’s published or after? And I would submit to you that you really want to get it critically reviewed before you send it out to the world. You want those problems to be identified early on so that you can fix them. You don’t want that to happen after it’s already been published, as a critical, fatal flaw can be embarrassing if it’s published. So that’s principle 1. Revisions always result in a better paper.

Principle 2 is that the editors and reviewers are always right. Now, again, pretty strong statement. In this case, this is less a statement of fact and more a way to orient yourself, as you consider the comments and suggested revisions provided by the editors and the reviewers. Sure, reviewers and editors are sometimes misinformed, sometimes they’re flat out wrong, but if they say to you that they didn’t understand something in your paper, odds are pretty good that the average reader won’t either. And keep in mind, most reviewers spend a lot more time with your paper than the average reader. So if somebody says, “This is unclear,” don’t argue with them. Clarify what it is you’re trying to say because the definition of something not being clear is somebody says, “Hey, this doesn’t make sense to me.” So take those reviewer comments seriously and then make the revisions.

And then last but not least is the idea that medical and health professions education is a very small world. Simply look at the mastheads of all the journals in our field, and you’ll see a lot of the same names. So you’re going to want to be gracious, kind, use good manners. The fact of the matter is, the editorial team, it’s a bit of a gatekeeping role, and so they have a bit of the power and you don’t. So you want to use good manners, you want to be kind and gracious and do all you can to improve the paper. We’re all on the same team in that regard, we’re trying to get the best scholarship published.

One thing related to this idea that it’s a small world is many times I’ve gotten a request to do a review from one journal, and then months later, I’ve gotten a request to review the same paper at a different journal. And again, that’s because it’s a small world and there’s a limited pool of reviewers. Now, if I get asked to do a review of the same paper, the first thing I do is look at the original review, and then I look at the paper and see if the author has made any of the revisions I made initially. And if they don’t, if it’s the same paper, I just resubmit my initial review and say, “Hey, I’ve already reviewed this paper, here it is. The authors didn’t make any changes.” So if you get a rejection or a revision, you really do want to take the time to make the revisions to make your paper better.

That’s all I have. Three principles for doing a revise and resubmit. Those principles are revisions always result in a better paper, the editors and the reviewers are always right, and health professions and medical education is a small, small world. So good luck and happy writing.

Toni Gallo:

Now that you’ve heard from the journal’s editors, I want to share some other resources that are available to help you write effectively and navigate the publication process successfully. I’ll include the links to all these resources in the show notes for today’s episode. First, the Fostering Scholarship in Medical Education collection that’s available on aamc.org. There are resources for getting started, writing up and submitting your work, as well as professional development opportunities and resources for reviewers. If you’re just getting started in publishing or you’re looking for a refresher, this is a great place to start. It’s not overwhelming, but it has a lot of good information.

One of the resources in that collection is the Conducting Research in Health Professions Education eBook, and it’s made up of 40 last pages or one-page infographics, exploring every stage of medical education research, from writing in a compelling way, to selecting the conceptual framework underlying your work, to writing a research question, choosing a methodology and data analysis strategy, and responding to reviewer comments. It even includes suggestions for promoting your work once it’s been published. And while the focus of this eBook is research, a number of these infographics apply to lots of other types of scholarship too.

I also recommend reading the Writer’s Craft section in the journal Perspectives on Medical Education. These articles offer simple tips to help you improve your writing, and they’re meant to be accessible and instructive, and they cover everything from grammar to writing persuasively to giving feedback on others’ writing.

Another resource that’s worth checking out is the review criteria for research manuscripts, which includes guidelines for reviewing each section of a manuscript. And what I find really helpful is the one-page checklist that includes everything a reviewer should look for in each section of a manuscript. Even though this checklist is geared towards reviewers, it’s useful for you as an author to know what reviewers are looking for as they evaluate your manuscript, so you can be sure you’ve included the right information. And this publication also has a section on describing innovations like MedEdPORTAL publications. We didn’t talk about MedEdPORTAL today, but that might be another journal where you look to publish your education and teaching scholarship.

The last resource I want to mention is a monthly webinar series that’s starting in January. My colleagues and I are hosting this series, and we’ll have sessions on publishing in both Academic Medicine and MedEdPORTAL, understanding and using inclusive language, tips for good writing, building and working with a diverse author team, and much more. Each session is going to also include time for Q & A with the editors of both Academic Medicine and MedEdPORTAL. These webinars will be the last Friday of every month at 1:00 PM Eastern Time. Registration information is available now on academicmedicine.org.

With that, I hope these free resources and the advice from our editorial team are helpful as you prepare and submit your work and navigate the publication process. If you have other questions for the editors or suggestions for resources you’d like to see, please tweet us @AcadMedJournal. Remember too to visit academicmedicine.org to find some of the resources that I mentioned here, as well as others from the journal. You can also access the latest articles and our archive dating back to 1926, as well as additional content including free eBooks and article collections. Subscribe to Academic Medicine through the subscription services link under the Journal Info tab or visit shop.lww.com and enter Academic Medicine in the search bar. Be sure to subscribe to this podcast, anywhere podcasts are available. Leave us a rating and a review when you do, let us know how we’re doing. Thanks so much for listening. Good luck with your submissions. I look forward to seeing your work published in Academic Medicine.