560180 research-article2014

APY0010.1177/1039856214560180Australasian PsychiatryBrakoulias et al.

Australasian

Psychiatry

Research

The rites of writing papers: steps to successful publishing for psychiatrists

Australasian Psychiatry 2015, Vol 23(1) 32­–36 © The Royal Australian and New Zealand College of Psychiatrists 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1039856214560180 apy.sagepub.com

Vlasios Brakoulias  Discipline of Psychiatry, The University of Sydney, Sydney Medical School, Penrith, NSW, Australia Matthew D Macfarlane  Graduate School of Medicine, University of Wollongong and Illawarra, Wollongong, NSW, Australia Jeffrey C Looi  Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra, ACT, Australia

Abstract Objective: To encourage psychiatrists to publish high-quality articles in peer-reviewed journals by demystifying the publishing process. Methods: This paper will describe the publishing process and outline key factors that ensure that publishing is an achievable goal for psychiatrists. Results: The publishing process can be long and often this is related to delays associated with obtaining reviewers and their comments. Negative reviewer comments often relate to grammatical and typographical errors, an insufficient literature review, failure to adequately discuss limitations and conclusions that are not adequately supported by the results. Authors who systematically respond to their paper’s reviewer comments are usually successful in having their papers accepted. Success in publishing is usually determined by a topic that appeals to the readership of a journal, a credible methodology and a paper that is well-written. Conclusions: Publishing is achievable for all psychiatrists providing they can write a paper that delivers a clear and concise message, are willing to address reviewer comments and that their paper is tailored to the readership of the journal. Keywords:  Publishing, writing, journal article, psychiatry

‘This is how you do it: you sit down at the keyboard and you put one word after another until it’s done. It’s that easy, and that hard.’ Neil Gaiman1 The words ‘publish or perish’ do not only apply to individuals striving to establish their academic career, but to the broader psychiatric community. Without the critical and scientific thinking involved in continuing education, research, writing and publication our profession soon loses its clinical credibility (see Figure 1). In general, psychiatrists are the most broadly trained of mental healthcare professionals. Psychiatrists are grounded in medical–scientific specialist training and often enriched with psychological, sociological, literary and philosophical education. There is a need for papers that arise from astute clinical observation. However, many clinicians lack the time and experience to write. A set of systematic guidelines can assist clinicians to start writing and publishing.2,3 We provide a description of the publishing process, and encourage psychiatrists to write. 32

The steps required to publish a paper Initially, as a potential author it is crucial to decide what to write about, why it is important and what audience you want to reach. Based upon these anchoring points, we suggest novice authors should begin with basic papers, such as but not limited to brief clinical update reviews, case reports, commentaries, letters, book reviews and, of course, research projects (such as the Scholarly Project for Royal Australian and New Zealand College of Psychiatrists (RANZCP) trainees). Journals have different topical foci, audiences and accepted ­article types that can then help guide where the paper should be submitted. Corresponding author: Vlasios Brakoulias, Nepean Hospital, Department of Psychiatry, The University of Sydney, Sydney Medical School – Nepean, Nepean Hospital, PO Box 63; Penrith, NSW 2751, Australia. Email: [email protected]

Brakoulias et al.

• • • • • • •

Communicating novel ideas, concepts and practices Improving standards of practice Providing education for trainees and established clinicians Encouraging critical thinking and debate Encouraging research and improved practices Improving teaching and training of Psychiatry for medical and interdisciplinary students and trainees Ensuring the future, credibility and professional status of Psychiatry

Figure 1.  Reasons to publish. The authors must secondly choose a journal in which to publish their work. This involves authors assessing where references in their literature review were published. Authors can ask more experienced colleagues which journal would be suitable for their work, after weighing the quality of a paper against the impact factor and prospective audience of a journal. Some authors email editors directly for advice. The increasing academic prestige of open access journals (where the author pays for publication, but the article is freely available) provides an alternative to publication in traditional journals.4 Authors must familiarise themselves with the scope of journals, documented in its instructions for authors. These are usually found in the initial or final pages of a journal or on the journal’s website. A paper on a topic that is not within the scope of the journal is unlikely to be published. Instructions for authors also describe the requirements for publication. These requirements can include the format that the paper should adopt, i.e. font size and style, paragraphs, spacing, the requirements with regard to titles, the structure of the abstract and the body of the paper, the number of keywords, the use of abbreviations, referencing style, tables, figures and word limits for abstracts, original papers, review papers, correspondence and more. Thoroughly reading the instructions for authors is an essential step in the process of publication. Having prepared the final version of the paper according to the instructions for authors, many authors ask for someone who is not familiar with their work to proofread it prior to submission; we suggest consulting a ‘scientific stranger’, i.e. a person who is familiar with the broad discipline of research (psychiatry), but not necessarily researching in your area. Proofreading reduces the risk of spelling and grammatical errors. Journals often recommend that authors whose primary language is other than English have their paper edited by a professional editing service. If the paper is significantly altered by this editing process, the editor should be acknowledged as a co-author to minimise the risk of ‘ghost-writing’. Even for prolific writers, proofreading can uncover poorly worded sentences and areas of the paper where concepts are not as clearly conveyed as originally assumed. Often the best approach for the author is to

reread the paper at least 1 week after it is originally ­written or last edited to pick up such errors. Structuring the paper appropriately is important in this stage – Figure 2 is adapted from Sterk and Rahbe’s5 recommendations and provides one recommended structure for scientific papers. Finally, in the process of preparing the manuscript, it is important to think of the audience of the journal and to read the paper from that perspective. The final step is the submission process. The submission process is usually electronic and tries to convey a simple step-by-step process, but sometimes reformatting and editing is needed even at this stage with particular requirements. Notification of a successful submission is usually sent automatically via email. It is recommended that a covering letter is uploaded with the manuscript, tables, figures, title page and consent forms (where necessary). A succinct covering letter can be very useful in highlighting the strengths of a paper to an editor and the reasons why the paper should be published in a particular journal. Most authors add to their letter that the paper is original and is not being considered elsewhere for publication. Some authors also include names of potential reviewers for their paper with email contact addresses. Occasionally, the submission process becomes complicated and challenging. In such situations it is always best to email the editorial assistant or the editor of the journal for assistance.

Common reasons for rejection and requests for revision ‘So the writer who breeds more words than he needs, is making a chore for the reader who reads.’ Dr Seuss6 The editor may conclude that the paper is not suitable for publication in the journal upon submission. Common reasons for rejection at this early stage include the paper being outside the scope of the journal, extensive spelling and grammatical errors or the paper being deemed as having inadequate significance or relevance to the journal’s readership. The editor or editorial assistant may also request for revisions to be made prior to the paper being sent out for review, typically because the author has not followed the instructions for authors, e.g.

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INTRODUCTION 1. General background regarding the topic 2. Specific papers relating to the topic 3. Gaps in the existing literature 4. Argument progressing to hypotheses 5. Hypotheses or aims of paper METHODS 1. Study design 2. Subjects (inclusion/exclusion criteria) 3. Ethics approval 4. Outcome measures and assessment tools 5. Statistical analysis RESULTS 1. Sample characteristics 2. Results of primary outcome measure 3. Results of secondary outcome measures *Choose wisely whether to present results in tables or text DISCUSSION 1. Discuss main result and implications 2. What is new or different from previous studies? 3. Strengths and weaknesses of study 4. How might the results be explained? 5. Clinical relevance and significance 6. Conclusion with suggestions for practice.

Figure 2.  A guide to the important components of the structure of a paper (adapted from Sterk and Rahbe, 2008).5

• • • • • • • • • • •

Conclusions are clearly stated Conclusions have value/significance Conclusions are supported by data/argument Analyses are appropriate to the research questions and the data Good discussion with the key issues addressed Paper makes good use of relevant literature Quality of writing Clarity of argument Relevance to clinical practice Paper acknowledges limitations where appropriate Quality of figures/tables

Figure 3.  Reviewer prompts for “Australasian Psychiatry”. exceeding the word count. Once the editor has invited reviewers for the paper, there is usually a 1–2 month period in which the paper is being reviewed. Outside this period, often at 3 months, it is recommended that the author contact the editor, unless correspondence has been received in the interim. Once the reviewer comments have been sent back to the author, the author must consider the comments very 34

carefully and discuss them with their co-authors. Reviewer comments can be confronting and it is important not to take them personally. Figure 3 provides an example of prompts used to assist reviewers in journal “Australasian Psychiatry” and it is worth keeping these in mind when reading the comments. Dispassionately assess each c­ omment and either rebut courteously and/ or amend accordingly. Mostly, authors end up responding in all of these ways and, as in clinical care, courtesy,

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Table 1.  Common reviewer comments Inadequate literature review: •  Reviewers often comment that papers have not presented an adequately comprehensive and prioritised literature review. •  Occasionally, reviewers provide references that they are aware of and that they believe are relevant to the paper. •  Authors should aim to demonstrate that they know the literature in the area very well and they should use the literature to effectively argue for the hypotheses of their study and the importance of their paper. Unclear objectives: •  The objectives of the paper are usually clearly stated in the abstract and towards the end of the introduction. •  Reviewers become critical of papers with unclear objectives and even more critical when the conclusions of the paper do no relate to the objectives. Inadequate description of methods: •  Reviewers commonly request details regarding recruitment and assessment. •  It is important for authors to include details regarding how the study was conducted accompanied by some description of the assessment tools used. •  Authors also occasionally forget to mention that they have obtained ethics approval for their project. •  Occasionally a reviewer might ask for details regarding the statistical analysis. •  Although it is important to describe the key methods of the statistical analysis, some more minor details might not be so relevant to all readers. In such situations it might be appropriate for the author to offer the statistical details in an appendix to the paper, which the editor may choose to only publish online. Tables and figures: •  It is important that tables and figures are easily interpreted. •  Tables and figures need to be clearly labelled and include definitions of all abbreviations. Limitations of the study: •  The most common theme among reviewer comments appears to relate to the limitations of a study. •  It is important that the authors give consideration to the limitations of their study and that they include a paragraph in the discussion section of their paper that discussed these. •  Limitations depend on the type of paper that is submitted, but can relate to sampling bias, sample size, the representativeness of a sample, assessment tools, objectivity in assessment and loss to follow-up. Conclusions are not justified by the results: •  Authors should take care ensuring that their conclusions are clear and that there is a clear and logical link between their objectives, results and their conclusions.

skill and knowledge are synergistic. Remember that reviewers have a range of experience and varying levels of commitment to the reviewing process. The editor may not agree with the reviewer comments and may be very well aware that the authors hold more expertise than the reviewer. Nonetheless, the reviewer is a potential reader and their comments need to be given serious consideration. Addressing the reviewers’ comments in a letter of response is essential. Successful authors list each reviewer’s comment in quotation marks and accompany each comment with a detailed response and an illustration of how the text in their paper has changed as a result of the comment. This systematic approach can be presented in text or bullet point form. Some authors also simplify the task further for the editor by presenting the response to reviewer comments in the form of a table, where the first column lists the reviewer comment, the second column lists the response and the third column illustrates how the text has changed with reference to

the page and line number. See Table 1 for common reviewer comments. It is important to note that most papers are accepted if the reviewer comments have been addressed and that most papers are rejected, either prior to being sent for review or after the first review.2,7 Even when a paper is rejected, it is worthwhile to revise the manuscript based on reviewers’ comments to date and re-submit either to the same or a different journal.

Characteristics of successful articles Successful articles tend to have short and ‘catchy’ titles. Some authors find it helpful to look at the titles in the journal to which they would like to submit and structure theirs in the same fashion. Themes may include clinical practice, research or new concepts, views, services or treatment approaches (often generating an element of controversy). Themes of successful papers often

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strike a good balance among high clinical and/or scientific merit, addressing a significant gap in the existing literature and, occasionally, applying or identifying a new approach to the field of research. In successful papers, these themes are well articulated and clearly presented in a concise manner, often with several figures or tables. Successful papers are focused and discuss the ­implications of their research for the reader and/or make valid, but parsimonious speculations based on their findings.

Conclusions Getting a high quality paper published in a peer-reviewed journal is more about nous and perseverance than it is about chance. In these aspects it is arguably the same skillset psychiatrists employ every day in service of their patients. Based upon our uniquely broad training and experience, psychiatrists do publish high quality papers in clinical psychiatry, medicine, neuroscience and cognate fields.

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Disclosure The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper. The first author V.B. is the Editor of “Australasian Psychiatry”. This article was blinded to reviewers and reviewers were chosen by his deputy Editor David Castle whose Editorial decisions were made independently.

References: 1. Goodreads Inc. Quotes about writing. https://www.goodreads.com/quotes/tag/ writing?page=2, (2014, accessed 13 August 2014). 2. Chernick V. Research: from concept to presentation. How to get your paper accepted for publication. Paediatr Respir Rev 2012; 13: 130–132. 3. Audisio RA, Stahel RA, Aapro MS, et al. Successful publishing: How to get your paper accepted. Surg Oncol 2009; 18: 350–356. 4. Hunt GE, Walter G and Malhi GS. ‘Open for business’: Do open-access psychiatry journals provide value for money? Aust N Z J Psychiatry 2013; 47: 407–411. 5. Sterk PS and Rahbe KF. The joy of writing a paper. Breathe 2008; 4: 225–232. 6. Goodreads Inc. Quotes about editing. http://www.goodreads.com/quotes/tag/editing, (2014, accessed 13 August 2014) 7. The Royal Australian and New Zealand College of Psychiatrists. Write-up and publication, research. https://www.ranzcp.org/Publications/Research/Research-in-Psychiatry/Writeup-and-publication.aspx (2014, accessed 3 August 2014).

The rites of writing papers: steps to successful publishing for psychiatrists.

To encourage psychiatrists to publish high-quality articles in peer-reviewed journals by demystifying the publishing process...
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