Clear, Simple, Precise, Meaningful: A Quick Guide to Writing for Publication

Everything should be made as simple as possible. But not simpler.

-Albert Einstein.

Compare and contrast these words: kind, helpful, invaluable; rejection, disappointment, frustration. The first set are ones we are (hopefully) used to hearing as palliative care clinicians, gaining some satisfaction from caring for people toward the end of their lives. The second set, sadly, are those we often hear as palliative care researchers and writers, when (yet again) the article we have carefully crafted has been declined for publication. Unfortunately, I do not have a cure to help you cope with the disappointment of rejection, but perhaps, some of the guidance given here might help mean you are more likely to have your article accepted for publication. Remember though that many journals are only able to accept a small proportion of articles submitted, and that even the most eminent of researchers experience rejection.

The areas that I consider essential in writing for publication are outlined in Box 1. This depicts the eight central questions that should guide your writing, with four key principles wrapped around, and underpinning these questions.

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Box 1

Key principles of writing for publication

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The first key principle is that your writing is underpinned by robust science. Planning to write for publication starts early, with the way that you design and conduct your study. You sow the seeds of writing success when you apply for research funding, write a study protocol, and make choices during your research. If the research design is not the strongest possible for the question posed and well executed, your chances of an impactful publication diminish.

The second key principle is to write for a general audience, so that “naïve humans” understand the paper.[1] You are the expert in your field of research, but your audience are not, and you need to write with them in mind. I started this editorial with a quote attributed to Albert Einstein. Another, also attributed to him, is that “If you can't explain it simply, you don't understand it well enough.” Remember, in palliative care, your audience may be general clinicians and policy-makers, not experts in palliative medicine or methodologists. If you want your research read, and its findings implemented in practice, then you must write for this audience. Remember too, that your audience may not work in your context, culture, or country. Explain key terms; ensure your work is understandable for an international audience. Readers are interested in research in other settings, but only if their needs are considered. Remember this in the title, papers with country names in the title are less well cited, as they appear relevant only to people from that setting.[23]

The third key principle is to write using clear, elegant, and plain language. You do not demonstrate your worth as a researcher through complex technical language. You need to eliminate abbreviations, avoid jargon, and carefully reflect on sentence and paragraph construction and order. Consider the logical flow of the argumentation and the information the reader requires to make sense of your paper as they read. Be prepared to edit your work ruthlessly. Sharing early drafts with others, especially those who do not understand your field, can be helpful.

The fourth key principle is iterating the story. Papers should have a clear, central message, and be focused on one topic. This does not mean writing multiple publications from a single study. Rather, it means carefully determining and distilling the essence of the research into a core message, the “big idea,” that is obvious to the reader throughout the paper. Make this focus apparent, starting with the title, reflected in the abstract, and threaded through the sections of the paper. Findings can be reflected in a title, remember many readers skim titles and abstracts to decide what to read, and you want yours to be attractive and informative.

The key elements of the paper should answer the eight central questions posed in Box 1. Address the first three questions in a background or introductory section. Avoid simply stating a problem. While problems can be important starting points, it is important to present what research in this area has already been done, what is yet to be known, and why knowing this is important. The last question is critical but frequently overlooked. There are many areas of palliative care that could be studied, but the focus should be on those that both can be studied, and which are important to study. This section is where you start to articulate the “big idea” of the paper and engage the readers' interest.

The next three questions focus on presenting the excellence of the research. A clear research question (or aim, objective, or hypothesis, as relevant to the chosen design) is important in focusing attention. A personal plea is to separately and clearly state the question at the start of methods or design sections. Frequently, questions are implied or vaguely stated as an aim at the conclusion of the background section. Many guidelines on the content of these sections exist, relevant to designs such as trials (the CONSORT statements),[4] qualitative research (COREQ or similar),[5] or reviews (such as PRISMA or ENTREQ).[67] Please use them. Find them at the EQUATOR network site (https://www.equator-network.org/).

The final two questions focus on findings and their importance. Again, remember to iterate the story. This does not mean only presenting certain findings. It does mean clear presentation of findings, using good figures and well-structured tables appropriately. Do not repeat data between tables and narrative, but use words to enable the reader to see what is important. Do not over analyze limited data, do not overclaim, do not speculate, and carefully explain both the strengths and limitations of the study. A structured discussion can be helpful.[8]

Writing is a skill, like any other, that has to be learned. Sadly, we can sometimes learn from those who believe they demonstrate their importance through overly complex, jargon-laden writing. Rather, learn from those who are excellent communicators, who are able to engage their audience and enable them to understand complex concepts and why they matter. I hope that the next email you open from a publisher is one saying “yes” to publication of your work. This is the first step to your work making a difference to patients and families, who we must never forget are the reason we conduct our research.