Health Sciences Writing Workshop
Frederick Reece
Director, English Language Center
Matthew Howell
Instructor, English Language Center
Clear writing is vital to science:
“Science moves forward in large measure because
people make their findings public, challenge or
confirm other people’s findings, have the occasional
cat-fight over how to interpret what’s been found,
and then build on that which turns out to be solid
and reproducible.”
Dale Hammerschmidt, MD
Writing Exercise (First Draft)
 Read Eating Brains: Cannibal Tribe
Evolved Resistance to Fatal Disease.
 Note the main ideas and most
important information in the article.
 Write a one paragraph summary /
abstract of the article under the
heading First Draft.
Style and Structure
Premises of Effective Communication:
 You have information worth sharing.
 Your audience has an interest in this
information.
 Your audience has a use for this information.
 Your are trying to convey this information as
clearly as possible.
Style and Structure
If your information is not useful and interesting
to your audience, then the style and
structure of your writing don’t really matter.
 Elegant style doesn’t compensate for
irrelevant, inconsequential, or ambiguous
information.
 Confusing or counterintuitive structure
makes reading, understanding, and
retention significantly more difficult.
Style
The best style is:
 Invisible
 Transparent
 Efficient: A conduit for information, not an
exhibition of “fancy” words and obscure
phrases
Style
By writing in a style that is:




Clear
Direct
Precise
Concise
You demonstrate respect for your reader.
Style
Good writing is clear:
What, exactly, do you want to say?
Use familiar words and phrases
The danger of the thesaurus: We all know
what “fix” means, right?
Style
Synonyms for “fix” (noun):
 adhere, adjust, aim, align, alter,
arrange, attach, cement, cleave, cling,
cohere, compose, concentrate,
conform, coordinate, corrupt, debug,
emasculate, fasten, focus, geld, glue,
harmonize, mend, modify, neuter, order,
overhaul, paste, regularize, repair,
solution, spay, suborn, target, unite. . .
Style
. . . prepare, heat, make, ready
Let’s not forget “fix” can be a noun. . .
synonyms: dilemma, mess, box, corner,
embarrassment, hole, plight,
predicament, quandary, scrape, spot,
hot water
(Furthermore, some synonyms of “fix”
can be antonyms of each other . . . )
Style
Good writing is direct:
 Explicit, not implied
 Active voice, not passive voice, unless
passive voice is clearly preferable.
Style
Implicit versus explicit:
“Patients such as yourself with both diabetes and
heart disease are often at increased risk for
myocardial infarction. As such, various lifestyle
changes on your part will not only lower
chances of morbidity, but have a positive effect
on your overall sense of well-being.”
“In order to reduce chances of a heart attack and
improve your quality of life, you need to adopt a
low-fat, low carbohydrate diet and lose at least 5
kilos.”
Style
Passive Voice versus Active Voice
Passive voice = be verb + past participle
“It could be observed that the patient’s fever
showed no sign of lessening after the first
course of treatment.” (bad use of passive
voice)
“There was no change in the patient’s fever
after the first course of treatment.” (preferred
use of active voice)
Style
And better yet:
“The patient’s fever remained
unchanged.” (clearer and more direct)
Style
Positive use of passive voice:
When the noun doing the action is unknown, or
when the action, or the noun receiving the
action, is more important than the actor.
“Someone broke the photocopier.”(The focus
is on “someone.”)
“The photocopier was broken.” (The focus is
on the photocopier being broken, not on who
did it.)
Style
Awkward Active Voice:
 “In the early stages, severe, persistent
headaches may indicate preeclampsia .”
(unduly emphasizes the headaches, creates
confusion regarding “in the early stages” . . .
of severe headaches?)
Preferable Passive Voice:
 “In the early stages, preeclampsia may be
indicated by severe, persistent headaches.”
Style
Conclusion: Generally, choose active
voice over passive voice, but use
passive when the action, or the thing
acted on is more important than the
actor, or when the actor is unknown:
“Labor can be induced after 37 weeks” . . .
rather than . . . “The physician may induce
labor if the patient is past 37 weeks.”
Style
Good writing is precise.
 Quantify when possible.
 Specify when possible.
 Divide information into separate
sentences as needed to facilitate
comprehension.
Style
“Since the earlier tuberculosis epidemics, New
York has become much more effective in
managing cases.” (vague)
“Since the 1992 tuberculosis epidemic, New York
has increased the proportion of patients
completing treatment to 90%, reducing
acquired drug resistance by 90%, and
documented a dramatic drop in the number of
cases.” (quantified and specific, but still
somewhat hard to follow)
Style
“Since the peak of the tuberculosis epidemic in
1992, New York City has increased the
proportion of patients who complete
treatment from 60% to more than 90% and
reduced the rate of acquired drug resistance
by more than 90%. A dramatic drop in cases
has been documented, from 3811 in 1992 to
651 in 2012.”
(quantified and specific, but also properly
divided into separate sentences)
Style
Good writing is concise.
 Use the number of words necessary to
convey relevant information, but no
more.
 In writing, more is only better if it
conveys more relevant, useful, and
interesting information. Even then,
respect the reader’s time and patience.
Style
Example:
“By undertaking a careful and detailed
examination of all of current studies, we may
easily conclude that many types of cancers
do not respond equally well to radiation.”
“Current evidence indicates that some cancers
are less responsive to radiation.”
Style: Grammar
Typical Sentence Structure: Subject + Verb +
Object
“ I ate the pizza.”
“I gave the pizza to my kids.”
“I gave my kids the pizza.”
Direct Object: the noun receiving the action
Indirect Object: the noun receiving the direct
object
Style: Grammar
“Doctor Uyar gave the patient
novocaine.” (correct)
“Doctor Uyar gave novocaine to the
patient.” (correct)
“Dr. Uyar administered the patient
novocaine.” (incorrect)
“Dr. Uyar administered novocaine to the
patient.” (correct)
Style: Grammar
Either construction may be used with
some verbs such as:
Give, offer, bring, pay, promise, send,
take, tell, hand, leave, sell, and a few
others.
However, for most verbs, the indirect
object must be proceeded by “to” or
“for.”
Style: Grammar
Subject – Verb Agreement:
Singular subject + verb (s or es)
The car runs well.
Plural subject (s or es) + verb
The cars run well.
Simple, in this case . . .
Style: Grammar
But when the subject is separated by
words or phrases from the verb:
One of the most common sites of
metastasized tumors (is/are) within the
marrow of the bone.
You must KNOW what the subject is.
Style: Grammar
Some grammatical errors in English can
be overlooked, but not this one:
“I enjoy golf is quite relaxing.”
In English, a noun can NEVER be a
subject and an object at the same time.
“I enjoy golf, which is quite relaxing.”
Style: Grammar
Why is there a comma after “golf”?
“I enjoy golf, which is quite relaxing.”
(non-restrictive clause; it provides extra
information about the noun)
“Of the sports which I’ve tried, the one which is
most relaxing is golf.” (restrictive clauses,
necessary to identify the particular noun(s) I
am talking about)
Style: Grammar
“The person who lives in the big house
on the corner is a doctor.” (restrictive)
“My friend Steve, who lives in the big
house on the corner, is a doctor.” (nonrestrictive)
“The person”: Which person?
“My friend Steve”: We know which person.
Style: Transitions
Transitional words and phrases:
 Provide logical connections between
ideas and information.
 Establish continuity (smooth flow)
between clauses, and between
paragraphs.
 Logical relationships: addition, cause
and effect, contrast, intensification, etc.
Style: Transitions
Lists of transitional (linking) words and
phrases can be found in books and on
the internet.
We will focus on some commonly
misused transitional devices:
“Moreover”: indicates addition, similar to
“additionally, furthermore, in addition.”
Style: Transitions
On the contrary: it does NOT indicate
contrast in the way that “although,”
“however, or “on the other hand” do.
On the contrary intensifies a previous
point, typically expressed in the form of
a negative statement.
“I’m not dying. On the contrary, I am in
excellent health.”
Style: Transitions
It is INCORRECT to say:
“I feel fine. On the contrary, I am in
excellent health.”
It is CORRECT to say:
“There is no evidence of coronary
damage; on the contrary, his
cardiogram showed no abnormalities of
any kind.”
Style: Transitions
“On the contrary” is similar to “in fact,”
or “as a matter of fact,” but it generally
follows a negative statement.
“On the contrary” emphasizes or
intensifies the previous statement.
Style: Transitions
“Despite” or “in spite of” both mean
“even though __________ is the case,”
“Despite his chronic pain, the patient
maintained an active lifestyle.”
Means . . .
“Even though his chronic pain existed, the
patient maintained an active lifestyle.”
Style: Transitions
“Despite the fact that” or “in spite of the
fact that” function like “even though,”
“although,” etc.
“Despite the fact that he was in chronic pain,
the patient maintained an active lifestyle.”
Means . . .
“Even though he had chronic pain, the patient
maintained an active lifestyle.”
Style: Word Choice
 Misused or overused words, by native
Turkish speakers:
 Aim
 Perfect
 Mention
Style: Word Choice
 Aim (noun): goal, objective, ambition,
aspiration, end, intention, object,
purpose, focus
 Aim (verb): attempt, intend, propose,
try, target
Style: Word Choice
Perfect:
flawless, that which could not be improved
upon, absolutely error-free
Perfect is not the same as excellent,
wonderful, outstanding, fantastic.
“Perfect” typically does not describe
anything that could even potentially be
improved upon.
Style: Word Choice
Mention:
a brief, often incidental reference or
statement; to refer to or speak about
briefly or incidentally
Any essential or significant point, idea, or
information communicated in any way
is NOT “mentioned.” It is examined,
discussed, argued, presented, etc.
Structure
The best structure is:
 Natural
• chronological
• logically sectioned
 Standardized
 An efficient conduit for information,
assisting the reader in comprehension
and retention.
Structure
IMRAD
The “IMRAD” structure is not an arbitrary
publication format but rather a direct
reflection of the process of scientific
discovery.
–International Committee of Medical Journal
Editors (over 1000 journals)
Structure
The IMRaD article
1.Title page
2.Abstract
3.Main Text
I –Introduction—Why did you do it?
M –Methods—How did you do it?
R –Results—What did you find?
D –Discussion—What might it mean?
Why is it important?
4.Acknowledgements
5.References
facilitates
modular
reading
Structure
Structure of an IMRaD article
Why did you study
this problem?
Start broad and narrow to
a specific question.
Study question
How did you do it?
Describe experiments done to
answer the question.
What did you find?
Describe results found that
answer the question.
Study answer
What might it mean?
Start with study answer and end
addressing broader implications.
Structure
IMRaD: Introduction
Purpose
 To interest your audience
 To describe why the study was performed
Content overview
 Provide sufficient baseline knowledge for readers to
understand your study (but don’t overdo it).
 Explain how your study differs from previous
publications.
 State the study question.
Structure
Introduction: content overview
General knowns/problems
Start with general
background information.
Specific knowns
Gaps in research
Questions and
approach
Move to specific details
about what is known and
unknown.
State the study question and
describe the experimental
approach.
KEEP IT SHORT
(500 words)
Structure
How to end the Introduction?
Link the unknown to the study purpose:
 Unknowns or what is inadequate
about previous research
 Study question/purpose
Signal the study question to the reader:
 “The purpose of this study was to…”
 “To determine whether…”
 “In this study, we examined whether...”
Describe how this
study is different from
previous studies.
Structure
IMRaD: Methods
Purpose
 To allow readers to interpret your results and evaluate
your conclusions
 To enable readers to replicate your findings
Content overview
 Include materials and methods, but not results.
 Provide enough experimental details and references
to enable a trained scientist to evaluate or repeat your
work.
 Identify where you obtained reagents and equipment
(manufacturer, city, state).
Structure
Methods: Overall structure
Arrange experimental details as protocols
described in separate subsections.
 Technical step-by-step procedure
 Explain the purpose of the protocol
Use a chronological order
 Begin with the study design and end with any
statistical analyses.
Structure
Common problems in the Methods
No explanation of the purpose of a method
 A purpose statement allows readers to jump
back and forth between results and their
corresponding methods.
 “To detect serum levels of protein X, we…”
No explanation of the purpose of a technique
 “We excluded patients who were febrile because
[the test] is known to give false positives in the
presence of an active infection.”
Structure
IMRaD: Results
Purpose
 To report the results of your experiments and answer
the research question posed in the Introduction
 To point the reader to the data shown in the figures
and tables
Content overview
 Report the results of the experiments described in the
Methods section.
 Report what happened during the study.
Structure
Results: Overall structure
Most to least important
 Give the main or most important findings first.
 Best for studies with a single main experiment or
focused study design
Chronological sometimes necessary
 Report results in the order in which the experiments
were done.
 Best for studies in which critical preliminary work is
performed prior to the main experiment or when the
results of one experiment determine the next
Structure
Common problem in the Results
Lack of meaningful descriptions of data
 Report “raw” data in tables and figures (when
possible).
 Summarize and interpret the data that is presented in
the tables and figures.
Just data
Mean tumor size was 2 cm in mice treated with
X and 4.2 cm in untreated mice.
Direction of change
Mean tumor size in mice decreased from 4.2 to
2 cm after treatment with X.
Direction and
proportion of change
Mean tumor size in mice decreased by half after
treatment with X (Figure 1).
Structure
IMRaD: Discussion
Purpose
 To provide an answer to your study question
 To show how your study advances knowledge
 To highlight the implications of your findings
Content overview
 Provide an answer to the study question.
 Compare and contrast your findings with existing
knowledge.
 Discuss the limitations of your study.
 Draw conclusions that follow from your findings.
Structure
Structure of the Discussion
Answer
Literature review
Answer the study question (cite
your key findings and other
supporting results as needed)
Interpret your findings in the
context of existing knowledge
and limitations of your study.
Limitations
Conclusions and Implications
End with general conclusions
and implications.
Structure
Discussion: First paragraph
Provide answer to the question posed in the Introduction.
Do not begin the Discussion with a second Introduction or
detailed repetition of results.
Support your answer with your results and data.
Support your answer with other’s results.
 Cite appropriate references.
Structure
Discussion: First paragraph
Start with the study answer.
You can briefly restate the study question or context.
 “The question addressed by the present study was whether
X is a cause of Y. The main finding of this study is that…”
 “Previous studies suggest that X is a common symptom of
Y disease. Our results show that X is only common in a
subset of…”
Structure
Discussion: Middle paragraphs
Difficult section to write
 Outline main points to improve flow
Organize from most to least important or according to the
science.
 Discuss possible explanations of your findings.
 Discuss your findings in the context of existing
knowledge.
 Discuss limitations and assumptions of the study.
Structure
Discussion: Last paragraph
Provide a one-paragraph concluding summary.
 Restate the answer to your study question.
 Discuss important implications of your study.
•Applications
•Recommendations
•Theoretical implications
•Speculations
•Future directions
 Provide a clear payoff to the reader.
Style and Structure: Summary
Good writing is transparent. It appears to
be effortless, but is the result of careful
preparation and attention. It is:
 Clear
 Direct
 Precise
 Concise
 Structured
Style and Structure: Summary




Proper grammar
Appropriate transitional devices
Appropriate word choices
Logical and chronological structure . . .
All contribute to the quality of your
writing.
Style Exercises
For each pair of sentences below, select the one that
better conveys the information.
“After reviewing the relevant data, it can be concluded
that many patients taking anti-inflammatory medications
have an increased likelihood of experiencing gastrointestinal problems such as internal hemorrhage.”
“The data indicate that long-term use of antiinflammatory drugs increases the likelihood of bowel
perforation or hemorrhage.”
Of the two sentences above, which one is better, and
why?
Style Exercises: Answer
After reviewing the relevant data, it can be
concluded that many patients taking antiinflammatory medications experience an
increased likelihood of undergoing gastrointestinal problems such as internal
hemorrhage. (Worse)
The data indicate that long-term use of antiinflammatory drugs increases the likelihood
of bowel perforation or hemorrhage. (Better)
Style Exercises
Which of the sentences below uses passive
voice, and which active voice?
“Lungs may be damaged by exposure to
airborne solvents.”
“Exposure to airborne solvents may
cause lung damage.”
What does each sentence focus on? Which
sentence is better, and why?
Style Exercises
Which of the sentences below uses passive
voice, and which active voice?
“A physician should administer heparin
to patients with venous thromboembolism.”
“Heparin should be administered to
patients with venous thromboembolism.”
What does each sentence focus on? Which
sentence is better, and why?
Style Exercises
Which sentence below is incorrect, and why?
“The paramedic administered cardiac massage to the
accident victim.”
“The paramedic administered the accident victim
cardiac massage.”
“The paramedic gave the accident victim cardiac
massage.”
“The paramedic gave cardiac massage to the accident
victim.”
Style Exercises
Which verb in the sentence below is
correct, and why?
“The results of a four-year study
conducted by the Mayo Clinic
(indicate/indicates) that caffeine
consumption has no causal relationship
with coronary illness.”
Style Exercises
Which sentence below is correctly
punctuated, and why?
“The physician administered a drug, which
dilates the blood vessels.”
“The physician administered hydralizine, which
dilates the blood vessels.”
Style Exercises
Which sentence below is correct, and
why?
I exercise often; however, my blood
pressure is still high.
I exercise often; on the contrary, my
blood pressure is still high.
Style Exercises
Which sentence below is correct, and
why?
There is no reason to suspect metastasis; on
the contrary, the tumor is highly localized.
There is no reason to suspect metastasis; on
the other hand, the tumor is highly localized.
Style Exercises
Which sentence below is correct, and
why?
“He is a perfect student; he only missed two
questions on his board exams.”
“He is an outstanding student; he only missed
two questions on his board exams.”
Style Exercises
Which sentence below is correct, and
why?
“This morning, I have mentioned several
characteristics of good writing.”
“This morning, I have discussed several
characteristics of good writing.”
Writing Exercise (Revised Draft)
 Exchange your first draft with someone
next to you.
 Check the writing for errors in style and
structure.
 Return the draft to its author.
Making an Abstract
 The following are the purposes of an
abstract.




Background info about the study/Why this study was done
What was done, and how
Most important findings and conclusions
Recommendations for future research
 Take the passage you wrote previously,
and using the above criteria, rewrite
your summary to function as the
abstract of a paper.
Model Abstract
 Compare your abstract with the
following model.

Mammalian prions, which are transmissible agents which cause lethal
neurodegenerative diseases, such as Kuru and Creutzfeldt-Jakob disease (CJD) are
composed of assemblies of misfolded cellular prion protein (PrP). A novel PrP variant,
V127, was under positive evolutionary selection during the epidemic of kuru-an
acquired prion disease epidemic of the Fore population in Papua New Guinea-and
appeared to provide strong protection against disease in the heterozygous state.
Here we have investigated the protective role of variant V127 and its interaction with
the common, worldwide M129V PrP polymorphism. We demonstrate that mice
gentically engineered to Express V127 and injected with infectious prions are
completely resistant to both kuru and classical Creutzfeldt-Jakob disease (CJD)
prions (which are closely similar) but can be infected with variant CJD prions, (a
human prion strain resulting from exposure to bovine spongiform encephalopathy
prions to which the Fore were not exposed.) Notably, mice expressing 2 copies of
V127 were completely resistant to all prion strains. Further study in transgenic mice
expressing different ratios of variants of PrP would assist in identifying the
mechansim by which V127 resists prion conversion and propagation.
Health Sciences Writing Workshop
Thank you for your attention.
Any Questions?