Using a case report to teach junior doctors about medical publishing

Dear Sir,

Having peer-reviewed articles published in medical journals remains crucial for career advancement in many medical specialties. Despite this, the principles of academic writing and medical publishing are seldom formally taught at medical school, and only a minority of students will develop knowledge and skills in this area by writing up a research project that they have performed. A questionnaire survey of 10 Foundation Doctors confirmed that Junior Doctors lack knowledge and skills in this area; all understood the differences between case reports, reviews, and original research, but only 2/10 could correctly define the terms “author”, “peer review” and “impact factor”. On a 5-point Likert scale (1 = disagree, 5 = completely agree), only one doctor (who held a PhD) gave himself as 5 against the statement “I understand how to write, structure and submit papers for publication”, whereas the remainder rated themselves as 2 or 3.

Based on the above, a programme was designed to teach Junior Doctors the principles of medical publishing, and to help them develop academic writing skills. This consisted of a middle grade Senior House Officer (the first author, AM) supervising a Foundation Doctor who wrote a case report based on a clinical case. Three tutorials were held. At an introductory tutorial, the details of the case were given to the learner, and some readings on academic writing style and writing case reports were provided.

At the mid-point meeting, a draft of the case report was reviewed by AM, and scientific and clinical aspects of the case were discussed. Editorial suggestions were made by AM to the learner; these chiefly related to structure and format of the paper (e.g. including a cover page, the appropriate style for references), suggestions on writing style (e.g. using an active rather than passive voice, improving clarity) and correcting clinical misconceptions. The learner then redrafted the paper, and drafts were perfected via email correspondence. A final tutorial was held once the paper had been finalised. In this tutorial, possible journals to submit the paper to were considered and basic factors in journal selection were discussed, such as ensuring the journal accepted the type of manuscript for submission (case reports), selecting a journal likely to accept the manuscript, the convenience of submission method (online vs hard copy) and the concept of submitting to high-impact-factor journals first. This programme has been piloted with a Foundation Doctor and a Clinical Observer (an international medical graduate), and has produced two case reports, one of which has been submitted for peer review. Both participants’ writing skills clearly improved during the programme, as evidenced by the papers they produced, and simple verbal feedback indicated that their understanding of medical publishing (impact factors, journal types, etc.) had improved. By combining formal teaching on medical publishing with the experiential learning of writing a case report, this programme offers a simple method of providing Junior Doctors with the skills required to produce publications and, hence, enhance their career prospects.

Alisdair McNeill, Caroline K. E. Parkin & Umme Rubab

Freeman Hospital & Royal Victoria Infirmary Newcastle-upon-Tyne, UK [email protected]