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Improving your Writing Grammar Tips

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What's Next?
By this point, you should have decided upon a research project or case study for your capstone project and should be deep into data
collection
Many medical professionals enjoy the research aspects of their professions. How do we improve the level of care to our patients?
How can reduce side effects of the treatment we deliver? How can we improve survival outcomes? How can I make this process more
stream-lined? All of these questions are answered through research! Though many enjoy learning the research outcome or result, far
less enjoy writing about it. This presentation is designed to IMPROVE your writing skills in the medical research setting. While this
presentation can set a good foundation in your capstone research writing, it might prove just as useful if not more useful in the editing
setting. In any event, read through the presentation prior to writing so you have these key concepts in mind. Then while sending to
other group members for editing, read through the presentation again and apply these concepts as you consider a stronger written
paper.
As data bombard the professional from every direction, the most user-friendly writing gets right to the point, supports its claims, and
achieves a transparent style that lets data shine. The strongest medical writing is:
Reader-based
Purposeful
Clear and concise
Correct
Streamlined
The strongest writing develops and stages, through multiple drafts and generous re-writing. While properly punctuated, grammatically
correct, and error-free writing is essential in the sciences, the writing must be tight and clear as well. The most experienced writers
know how rewriting develops these very qualities. Rewriting at the level of the sentence, at the level of the paragraph, and then again
at the level of the complete work takes correctness to the next level; rewriting make science more readable.
English is a "verby" language, and readers prefer active verbs to passive ones. Although English sentences come in a huge variety of
shapes, difficult technical vocabularies beg for syntactic clarity. In the age of estrogen-induced neurosynaptic plasticity, myocardial
infarction, and the vasoepididymostomy, less is more.

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Grammar Preference-Subject-Verb Pairing Subject-Verb Pairing

Compare the following. Each example is correct but which do you think most readers prefer?
A. The payment to which a healthcare provider is entitled should be made promptly so that in the event of a subsequent billing
dispute we, the health maintenance organization, may not be held in default of our billing contract by virtue of nonpayment to
participating providers.
B. Please pay healthcare providers promptly. Then if billing disputes arise, our organization cannot be held in default of our
contract for nonpayment.
Most readers choose B. Clarity often comes with fewer words
The subject verb pairing in the following three sentence shapes helps to clarify the sentences idea with straightforward syntax.
Rewriting at the level of the sentence focuses the writer's attention on subjects and verbs. It gives the writer an opportunity to listen
carefully for accurate expression and to choose economical phrasing. Remember a helpful rule of thumb: one good idea deserves
one good sentence. In the following slides, notice the highlighted subject phrase and underlined verb phrases.
"A" Assertion:
Think of simple assertion sentences as one part sentences with a subject + a main verb. Simple assertions define, put forth, and
clearly state.

  Clinicians treat patients.

  Clinicians meet, interview, assess, consider, diagnose, and treat all kinds of patients in a surprising variety of contexts these
days.

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Subject-Verb Pairing Subject-Verb Pairing

"B" SuBordinate: "C" Coordinate:

In two- part subordinate sentences, the main part of the idea (with its own subject + verb) is conditioned on or subordinate to the
other. Separate these unequal parts with a comma. Introductory phrases and subordinating words and phrases such as "although,"
"because," "when," "given that" (marked here with  ___  ) all signal subordination. Notice which part of each sentence can stand
alone; which cannot?
Although clinicians primarily treat patients, they also do research.
Two-part coordinate sentences compare or contrast; both halves of the sentence's idea are equal in importance. Both sides of the
sentence have a subject plus a verb, and writers tie them together either with a comma, a conjunction ("and," "but," "so"), or a
semicolon.
Clinicians treat, and patients get better.
Clinicians use different methods of treatment; patients improve at various rates.

When we overload our staffs with too much work, stress related symptoms start showing up in departments all across the
hospital.

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Tips for Rewriting Sentences Tips for Rewriting Sentences

Rewrite each sentence until you can easily identify its shape as an "A" simple assertion, "B" subordinate sentence, or "C" The following list gives a wide variety of active verbs especially useful for rewriting at the level of the sentence. Circle the 6 to
coordinate sentence. This process helps prevent wordiness, confusing syntax, and an array of punctuation errors. 12 that are most appropriate to your writing. Consider copying them down and posting them prominently near your desk, so
they will be at hand the next time you need them.
Circle main subjects and underline verb phrases to help you notice whether your sentence asserts, subordinates, or
coordinates. Consider breaking longer sentences into shorter ones and very in the sentence shapes you use.  
acted as consulted enacted interviewed processed screened
Rewrite important (or difficult) sentences in three new versions, and replace the original with the best of the three. This practice  
sharpens your sense of phrasing, and it shifts your attention from "fixing mistakes" to aiming for clarity.
Notice how these examples of streamlining the sentence shapes encourage use of stronger active verbs rather than passive  
administered controlled established invented produced secured
constructions.
   

advised coordinated evaluated learned proofread served  

 
allocated corrected examined lectured proposed set
 

 
analyzed corresponded executed led protected sold
 

arbitrated counseled expanded located provided solved  

 
argued created financed logged purchased specified
 

 
arranged delegated followed maintained raised stimulated
 

assembled delivered forcasted managed realized strengthened  

 
assisted demonstrated formulated manipulated received studied  

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assured designed forwarded marketed recommended summarized conducted drew up instituted planned revised  
  Rewriting
audited detected founded mediated recorded supplied   consolidated edited instructed prepared routed   Paragraphs
Writers develop the qualities of unity,
balanced developed generated monitored recruited taught constructed eliminated interpreted presented scheduled   coherence, and flow when they order their
sentences into thoughtfully focused
paragraphs.
built devised guided navigated reduced tested
Paragraph Flow:

Each paragraph must contain a few things: an introductory sentence, body content and a transition sentence and
calculated diagnosed hired negotiated referred trained
paragraphs must contain at a minimum, 3 sentences. See each section highlighted in the excerpt paragraph below.
The introductory sentence must provide an overall summary of the entire paragraph. The body content provides the
reader all of the information they need in this specific section. The transition sentence concludes the information in the
chaired directed identified obtained repaired translated paragraph while transitioning the reader into the next paragraph. (More about transitions in the next slide.)

If care is not taken to preserve the brachial plexus while treating cancer patients in the axilla, significant and debilitating damage can
chartered discovered implemented ordered reported updated occur. Radiation induced brachial plexopathy is the damage of nerves in the brachial plexus when treated with high doses of radiation.
The side effects of RIBP are incapacitating and include pain and weakness in the arm, shoulder and hand; paresthesias and even
paralysis in the most extreme cases.2 Radiation induced brachial plexopathy can severely affect the quality of life of a patient and the
coached dispensed improved organized represented upgraded damage is irreversible, therefore, treating the brachial plexus to below dose limitations is required. However, discrepancies between
the dose limitations of the brachial plexus exist indefinitely and vary depending on the literature.

collected disproved increased oversaw researched Significant literature has proposed dose limitations of the brachial plexus in head and neck cancer and breast cancer patients,
however, few articles have outlined brachial plexus neuropathy in apical lung cancer patients.3,4   The most respected literature
outlines 60-66 Gy as the dose constraint for the brachial plexus.5 In the case of apical lung cancer, the dose regimens often exceed
communicated distrubuted informed performed resolved   this dose constraint and physicians are faced with the difficulty of preserving the brachial plexus while curatively treating invasive
cells. In most cases, the solution occurs at the expense of prescription dose and tumor coverage.

completed documented inititated persuaded restored  

composed drafted installed photographed reviewed  

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Transitions and Coherence Order and Unity

Ideas hold together well when transitions signal the route from paragraph to paragraph. Transitions connect ideas, indicate
relationships, and keep the reader's mind moving in tandem with the writer's. Useful transitions include the following:
Addition : moreover, further, furthermore, besides, and likewise, also, nor too, again, in addition, equally important, next
Comparison: similarly, likewise, in like manner
Contrast : buy, yet, and yet, however, still, nevertheless, on the other hand, on the contrary, even so, notwithstanding, for all
that, in contrast, at the same time, although, otherwise, nonetheless
Place : here, beyond, nearby, opposite, adjacent to, on the opposite side
Result : hence, therefore, accordingly, consequently, thus, thereupon, as a result, then
Time: meanwhile, at length, soon, in a few days, in the meantime, afterward, later, now
Summary : to sum up, in conclusion, in brief, on the whole, in sum, in short, in other words, that is
Order:
Consider the order of your ideas by critically assessing your outline. Consider making small changes to your research
study to emphasize the strongest parts of your ideas as you lead the reader through your data.
Unity:
Reread your paragraphs sentence by sentence to ensure that every sentence contributes to the development of the
idea. If the idea expressed by a sentence is off the point, or better suited to another section, move it. If the sentence is
repetitious or irrelevant to development of the paragraph's main idea, simply exercise it. Repetition is one of the most
prevalent manuscript errors.

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Rewriting the Complete Piece Beginnings and Endings

At this point, nothing helps your writing more than putting it away for a time, then rereading it with fresh eyes. For many writers, One well-published biologist explained to a group of her postdoctoral fellows that a conclusion is inadequate until it has been written
rereading a piece from beginning to end helps test the organization and emphasis of the ideas. This is an appropriate time to consider in three different versions, then in a fourth that incorporates the best sentence from each of the previous three. If any part of your
additions that will make it easier for readers to skim your piece intelligently. piece deserves special writing attention, it is your opening words or your concluding ones.

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Proofread Common Problems

Better yet, make friends, brew strong coffee, and ask associates to proofread for you. Very few of us can identify obvious errors in our Long sentences
own work. Remember, associates need not be professional editors to help with proofreading. Consider giving a friend one or two Misplaced modifiers (phrases that confuse what or who is being described)
specific things to read for. Tips of professional copyeditors: Confusing: While eating lunch in the cafeteria, the CT scanner malfunctioned.
Clearer rewrite: While the technologist was eating lunch in the cafeteria, the CT scanner malfunctioned.
Enlarge the type on the computer screen (the change in font size often reveals previously invisible errors). Misused words
Read backward, sentence by sentence. This is one area that student struggle the most so read the examples below and keep it in the front of your mind when
Read out loud. reviewing your work.
Pay extra attention to names, dates, numbers, titles, and addresses. The patient was not toxic when she arrived (patients can't be toxic, their condition can be)
One study reported that the impact on PTV coverage was statistically significant. (the study can't report; a
researcher can report)
Please join Dr Schmidt, Dr Rossbery and myself in wishing this project the best (change myself to me)
Passive voice
Use the order: subject, verb, and object. Sentences with passive voice lead off with the object. We don't want passive
voice!
Generally, try to use the active voice whenever possible. Passive voice sentences often use more words, can be vague,
and can lead to a tangle of prepositional phrases.
In a sentence written in the active voice, the subject of sentence performs the action. In a sentence written in the
passive voice the subject receives the action.
Active voice: Dr. smith wrote the methods section.
Passive voice: The methods section was written by Dr. Smith.
Wordiness
Avoid using long words when simpler words will do
Instead of a limited number; use one
Instead of at this point in time; use now
Words ending in -ality, -ation, -ization, -ational, and so forth often make sentences more complex than they should be.
Instead of We made an application of; use we applied
Instead of Researchers made the determination; use Researchers determined

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Punctuation and Grammar Punctuation and Grammar Continued

Proper punctuation helps guide readers through sentences, paragraphs, and pages of what are often complicated ideas.
Colons
Commas Colons introduce long lists and series. A complete sentence must come before the colon.
Place commas after introductory phrases in subordinate sentences. These often include a verb or start with the words Example: Here is just a partial list of the basic science that the next century's physicians can be expected to
when, if, because, although, despite, since, or after. know: anatomy, physiology, organic chemistry, genetics, molecular biophysics, biochemistry, epidemiology, and
Example: As you requested, I included the patient's x-rays with the chart. biostatistics.

Semicolons Hyphens
Use a semicolon to connect two parts of a coordinate sentence; there should always be a subject verb pair on each side Hyphens join two or more words that serve as a single modifier before a noun. Do not use hyphens with modifying " -ly"
of the semicolon. adverbs.
Example: She graduated on Tuesday afternoon; she began work in the clinic Wednesday morning Example: He arrived at the ER with a self-inflicted gunshot wound.
Example: She was moderately obese.
When you use the words "however," "therefore," "moreover," or "consequently" to connect two parts of a coordinate sentence, put a
semicolon before and a comma after.

Example: We had no intention of purchasing the equipment; however, we wanted to know everything we could about what was
available.

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Punctuation and Grammar Continued Grammar and Spell Checks

Subject-Pronoun Agreement Grammar and spell checks on the computer are a boon to proofreaders everywhere: they are especially valuable in catching typos
such as transposed letters that authors easily miss in their own writing. Save your computerized proofreading tools, however, for
Pronouns must agree with their subjects. The word "each" like the word "someone" is singular and requires the use of "his" or when you have completed the draft and you will probably find them far less distracting than at earlier stages.
"her". One effective way to sidestep the problem is to make the subject plural.
Change: Each study particpant recorded their own data. Few standard programs include medical terms in their word lists. Keep a medical dictionary handy. New on-line writing resources are
To: Each study participant recorded his or her own data. Or Study participants recorded their own data. being developed regularly. Commercial programs such as Spellex (spellex.com) often offer quick spell checkers on their websites and
Change: Intensity Modulated Radiation Therapy (IMRT) improves dose conformity compared to standard three- they sell comprehensive medical, pharmaceutical, dental, and legal dictionaries on CD-ROM
dimensional treatments. These treatments take more time because the radiation therapists must wait for the gantry to be
set up at the appropriate angle.
To: Intensity Modulated Radiation Therapy (IMRT) improves dose conformity compared to standard three-dimensional
treatments but IMRT treatments take more time due to set up. (don't start sentences with "they", "these", etc. - be
specific to what you are referring to. In addition, this second sentence can be shortened if it's not necessary to provide
all the details for the paper.)

Subject-Verb Agreement

Verbs, too must agree with their subjects. Even if a phrase comes between a subject and verb, the verb needs to match its
main subject.
Change: The hip fracture, along with heart disease and pneumonia, are the top three threats to the health of America's
older adults.
To: The hip fracture joins heart disease and pneumonia as one of the top three threats to the health of America's older
adults.

Parellelism

The parts of a sentence that are parallel in meaning should be parallel in structure. In bulleted lists, it helps when writers
respect parallelism with each item. Start all phrases consistently with verbs, (or nouns) but don't mix them. In the example
below, "rewrite," and "use," satisfy conditions of parallelism as strong verbs.
Example: Medical writers need to -
rewrite regularly
use strong active voice

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Best Practice
1. Avoid long phrases or complicated sentences. Short, simple sentences are far more easily understood by your reader. In other
words, try not to posture but to communicate.
2. Use quotations sparingly; put ideas in your own words. Quotations are only used when it is necessary to convey precisely the
ideas of another researcher, for instance while conducting a critique of a paper.
3. Use past tense when writing your research report. (This is more important when editing for publication or when you are done
with your research)
4. Use an objective style, avoiding personal pronouns wherever possible.
5. Make sure you are writing to your audience; if the material is specialized or difficult, explain it clearly.
6. Make sure that you concise and clear; do not introduce issues and concepts, which are not strictly relevant to reporting your
investigation.

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