In this editorial, we expand on our newly revised author guidelines to provide information essential to research dissemination (http://edmgr.ovid.com/anc/accounts/ifauth.htm). However, if you are wondering about the differences between research, quality improvement, and evidence-based practice manuscript preparation we encourage you to read "Preparing quality improvement, research, and evidence-based practice manuscripts" by Oermann and colleagues.1 There is a table in this article that is extremely helpful in comparing and contrasting the differences between these three different types of manuscripts and project designs.
ARE RESEARCH FINDINGS ALWAYS WORTHY OF PUBLICATION? YES!
For many of us, conducting research is about answering a question that is important to our clinical practice. We are driven by a desire to positively impact the lives of the infants and families we interact with daily. Yet with the answers to our questions in hand, we often lack the enthusiasm or experience to disseminate our findings to others. Research findings are rarely exactly what we expect which leads many of us to think that the work is not important enough to disseminate. However if you begin your research with a well-designed study, this assumption is far from the truth. Knowledge is built on the lessons learned from others about what works and does not work. Whether your findings are as expected, not as expected, or inconclusive, it is our ethical responsibility to disseminate our findings to advance the knowledge of the discipline. Conducting research is just not enough; for the research to have meaning and influence on the science and caregiving arena, it must be shared.
GETTING STARTED
Unlike other articles that require time to formulate an outline, you will likely already have your research manuscript outline completed from the prior work you completed in planning your research study. In addition, you may have a draft of many sections to the manuscript that were part of your Institutional Review Board (IRB) documents that you can use to begin to fill in the content of specific sections of a research manuscript. As you use content from research planning documents, make sure you change your verbs from future to past tense. In addition, if you have previously published parts of your study, you will need to make sure that you do not self-plagiarize your work. You will need to make this new manuscript unique, even if there are shared data and/or shared data points.
MANUSCRIPT SECTIONS
While some of the terms for the manuscript headings may differ (findings vs results), most journals use similar research manuscript sections and can be determined by reviewing the journal's author guidelines. Below we describe the content within each section using Advances in Neonatal Care's research format. Each section will occur in the order that it appears in the manuscript, but not necessarily in the order that it should be written.
Manuscript Title. The title of research manuscripts should convey the study design and problem to be addressed such as "Prevalence of Skin Breakdown During the First Week of Life in Extremely Low Birth Weight Infants," and "Nonpharmacological Interventions Following Surgical Procedures: A Prospective Observational Study." Always revisit any preliminary title at the completion of your article to make sure it describes your work. The title is very important as those searching the literature may not read or include your study in their review of the literature if the title does not seem to fit. This is also true of what you include in the abstract.
Abstract. While the abstract is typically the first part of any manuscript to be read, it should be the last thing you write, especially in a research article. Until you have written your entire manuscript, you cannot know the most important parts to include in the abstract. The abstract should include all of the major aspects of the study under similar headings in the manuscript structure, including background, purpose, methods, results, implications for practice and implications for research. Within the methods section of the abstract include a sentence describing the study design (eg, prospective descriptive, randomized control trial) and sample size. When writing your abstract, it is also important to stay within the word limit; for ANC the word limit is 250 words.
Background and Significance. The introductory material in a research manuscript provides information about the problem you are studying, seminal research to date, and the gap in the literature that your study addresses. The significant literature should be synthesized around the major findings rather than provided in a series of paragraphs describing the results of each study. In this synthesis the study designs and results are compared and contrasted to each other, and finally your study should be filling a gap not found in the previous literature. If you synthesize the literature regarding multiple outcomes of interest that are also part of your study findings, be sure to order them consistently across manuscript sections. The length of this introductory section varies depending on the study complexity and number of outcome variables explored, but typically this section should not be greater than 4 to 8 paragraphs. Often the introduction section may require modification after the results and discussion sections are completed. End this section with a clear purpose statement. If you have research hypotheses or questions they should be listed after your purpose statement.
Methods. The methods section provides the roadmap for how you conducted your study and is the area for which clarity of language is most important. You want to be concise, but complete enough in the description of your methods to allow others to replicate your study. Most authors begin their research manuscripts by writing the methods section because draft content can be pulled from other study documents and it is rewarding to have some content on the page. Begin your methods section with 1 to 2 sentences that describe your study design and measures and IRB approval. Next describe your study setting and sample, including inclusion and exclusion criteria. After the setting and sample section include a section that describes every measure or instrument used for data collection including the accuracy, sensitivity, reliability and/or validity. Order the content of the measures section to match order of the variables of interest in each research question or hypothesis. Next include a procedures section that details how the study participants were recruited and consented and how and when data were collected. End the methods section with your statistical analysis plan, including how you will evaluate each research question or hypothesis.
Results. Begin the results section with information about the sample's demographics and/or illness characteristics. These data are often best summarized in a paragraph, unless limited to a few variables such as age, race, and gender. When reporting summary statistics, provide a measure of central tendency (mean, mode) or percentage, the n, and range for each variable. Follow the sample information with the results for each research question or hypothesis in the same order that was used following the purpose statement. Include actual P values and statistical test parameters within the text as you describe your findings. In addition be sure to provide direction of your findings. For example, rather than stating "the infants' pain changed following the intervention," state "the infants' pain scores decreased significantly more in the intervention group (F2,91 = 5.38, p = .006) than the control group."
As feasible, use tables and figures to display your results, but do not include summary findings in both tables and figures. For example, pain scores following an intervention may be displayed as a figure that demonstrates how the pain scores decrease over time or as a table with the mean values at each data collection time point. In this situation a figure would tell a better story than mean values with 10 time points, however the actual means down to two decimal points might also be important for others who want to better understand the study findings. For situations where the actual values may be important to others, more detailed information can be submitted as supplemental digital content.
Other things to consider when reporting results are the need to include information about any outliers that were excluded from any analyses as well as any post hoc results. Do not report post hoc results as a priori. The results section is just for the results, take care NOT to include your interpretation of what the results mean in this section. Save the meaning behind your findings for the discussion section. Finally, if you had to stop or discontinue data collection based on preliminary analyses or adverse events be certain to provide the details.
Discussion. The discussion section should describe how your study findings compare to other studies, highlighting significant results. If you have unexpected or nonsignificant findings explain why you think this occurred and discuss any study limitations. You will also discuss the implications of your study findings for practice and future research. After you complete your discussion extract 2 to 3 bullets to place in the ANC box "What this study adds." The purpose of this box is to highlight for the reader the unique contribution of your study. Finally compose the content for the ANC "Summary Recommendations for Practice and Research" box. In this box you are asked to summarize your research problem in three areas: what we know, what needs to be studied, and what we can do today. The content for this box should be drawn from all of the current research, including your new results but not limited to only your results.
We hope you will continue to submit your neonatal research findings to ANC, but also consider summarizing clinical issues that are important to neonatal care. In our next issue we will highlight important issues to consider when writing a clinically oriented manuscript.
Debra Brandon PhD, RN, CNS, FAAN
Co-Editor; Advances in Neonatal Care
[email protected]
Jacqueline M. McGrath, PhD, RN, FNAP, FAAN
Co-Editor; Advances in Neonatal Care
[email protected]
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