Editing offices and writing centres for researchers
Researchers who need help writing in English can find it in writing centres and published resources, in salaried editing posts and offices inside research institutions, and in the editing services journals refer authors to. Where none of these reaches an author, the language is left to the author, the journal's editors and reviewers, and the author's colleagues. An editing office inside an institution has to be introduced to its users, scheduled, priced and evaluated, and it can teach writing as well as edit it.
Writing centres and published resources
The European Association of Science Editors' website carries much information for non-native writers of English, including many examples of false friends and of the traps that writers from common European languages fall into, so it might be useful to such writers.
The Writing Lab website, sponsored by the Hanyang University English Writing Center in Seoul, is designed to teach non-English-speaking Koreans to write scientific manuscripts. One reviewer judged it useful to medical communicators as well, because it holds a wealth of information on grammar, sentence structure and usage and step-by-step instructions for writing papers and submitting them to journals. It is the work of the centre's director, Adam Turner, who teaches graduate and undergraduate writing classes at the university. Its Biomedical & Life Sciences page covers the sections of the research article very comprehensively, setting out their structural components and what to include where, with examples of poor writing beside their better counterparts throughout. Under the same heading, its Tips on Medical Writing give advice on writing abstracts, case reports and grants, and on topics not often covered, such as writing effective titles and keywords, responding to reviewer comments and composing the submission letter. Besides tips on grammar, its Core Writing Skills page gives information on vocabulary building, sentence flow and transition words, links to other grammar and writing websites, and a section on using references correctly, avoiding plagiarism and rewriting passages in one's own words; a separate page covers presentation skills.
In 2005 J. Patrick Barron started www.ronbun.jp, a website on scientific publications and career development that by his account had become one of the largest in the world by 2014. He and his colleagues invested more than 5,000 hours in making more than 100 sixty-minute videos for it, and it also holds all the instructional materials on medical writing and scientific publications he produced over 40 years.
Science editors and editing offices in research institutions
Research units across the United States have recognised the value of a science editor's services to their researchers. In 2002 the Office of Research and Graduate Studies in the College of Veterinary Medicine at the University of Tennessee funded a position for a science editor to help faculty improve manuscripts and grant proposals and to serve as a technical or science writer for the college's research reports, the first position of its kind at the university's Knoxville campuses. In 2009, in an effort to add resources to become a "Top 25" research institution, the largest research office in the university system created its first proposal development team, hiring two editors to assist faculty in writing grant proposals. In 2011 St Jude Children's Research Hospital, the Mayo Clinic, several departments within Johns Hopkins University and the University of Texas MD Anderson Cancer Center all had science editors on staff; some of these programmes were fee-based, and others, including the University of Tennessee's, were free to authors because the editors were employed as full-time support staff. A peer community of academic research development professionals, the National Organization of Research Development Professionals, was established in 2010 with technical writing and editing as part of its scope, and by 2011 it already had 201 member institutions, including five Ivy League schools.
The Office of Grants and Scientific Publications at the University of Arkansas for Medical Sciences, a tertiary referral centre and Arkansas' only comprehensive academic health centre, had its origins when a clinician scientist there recognised the value of having a professional medical writer edit a previously unfunded grant application. The writer was hired full time and eventually became the office's first director. Two more editors and a budget specialist were soon hired because of high workload, and the office was officially established in 1995 as a university shared resource under the administrative oversight of the Vice Chancellor for Research. By 2012 it had a staff of seven and had helped hundreds of the university's faculty, fellows and residents obtain research funding and publications. The office is not unique among academic health care institutions and teaching hospitals, but similar shared resources remain uncommon: its own 2007 assessment of US medical school websites found 11 similar research resources among the 124 schools examined, excluding individual departments that may have hired a single science editor to help with grants and manuscripts. The office keeps current with changes at the NIH and with new funding opportunities through the NIH website and Grants.gov, and, because its staff are all AMWA members, through AMWA's email discussion groups, journal and meetings.
In 1975 Barron proposed a centre to enhance the flow of scientific information from Japan to the rest of the world by providing authors with full English-language medical writing, editing and translation support. When he suggested such a centre to Tokyo Medical University that year, his mentor replied that there was no money. In 1991 he founded the International Medical Communications Center at the university, the first of its kind in Japan, to provide those services to all clinical and academic departments and to educate medical and PhD students in English for medical purposes, scientific publications and publishing ethics. The centre became a full academic department in 2009, the only one in the country authorised to develop and offer master's and doctoral programmes in medical communications. The new Department of International Medical Communications created a standardised curriculum to globalise the teaching of English for medical purposes, whose website in 2014 contained 18 clinical modules, videos of physician–patient consultations, reading materials and self-assessment tests for medical students. South Korea and several European countries were then implementing or considering the programme under the European Union's sTANDEM, a standardised assessment system for English for medical purposes of which Tokyo Medical University was the only non-European partner. By his account, the number of manuscripts published each year by the university's authors rose from 18 in 1989 to nearly 300 in 2013, an increase more than four times the average of all other Japanese medical universities.
By Barron's later account, once the centre was established he brought the number of accepted full papers in impact-factor journals from 18 to almost 400 a year, with an acceptance rate close to 100%. That is one reason he believes a good communications centre is a must for every medical school, with editing a particularly important, but not the only, condition for enhancing the probability that papers are accepted. In his view, many senior medical school staff do not realise the tremendous financial benefits that competent writing and editorial staff can bring. He has tried to spread the idea of an international communications centre or department that can give in-house scientists in-house clerical support editors who, after some experience, know what the scientists need to do and gain experience of various journals and publishing techniques. He believes the Mayo Clinic would never have developed so much had it not started, from 1907, the equivalent of a communications and publication support system through the efforts of Maude Mellish Wilson, and that with increased communications come increased name value and a greater likelihood of successful grant applications. Old slides from the Mayo Clinic indicate a correlation between the numbers of papers published in given fields and institutional name recognition.
In 2012 a full-time post of medical editor and translator at a German university hospital was, to its holder's knowledge, the only one of its kind in Germany. Its holder began the move from bilingual assistant in the early 1990s. With several linguistic qualifications and a few years of working experience in England, she became personal assistant to the head of a department at a university hospital, where she read medical publications to learn the terminology. When a research paper that passed her desk showed a typical German grammar mistake in its title, the past tense used instead of the present perfect, she tactfully pointed it out to the author, was asked to correct the entire paper, and was soon editing most of the department's English publications and then papers from other departments. After ten years of editing and translating alongside the assistant job, she completed a Bachelor of Arts at the Open University, knowing she would stand little chance of being accepted at a university hospital without a degree. In 2006 she was offered a full-time position as medical editor and translator at the Centre for Clinical Trials in Regensburg. The centre supports clinicians and sponsors in the design, implementation, evaluation and publication of clinical research, and supports local researchers in non-commercial investigator-initiated trials, whose publications are usually written by the investigators themselves. Depending on the researcher's English, such a manuscript may be given to her for editing or for translation. For time and cost reasons she mainly edits research articles for publication in medical journals, with occasional full translations, and she has worked for many of the hospital's departments.
Language help through journals, reviewers and colleagues
For authors without access to such staff, many journals in 2011 included an online link to language editing services. Elsevier recommended a language editing service available through its own WebShop, Springer provided a link to an editing company in its "Manuscript Guidelines for Journal Authors", and Wiley-Blackwell offered eight different science editing company links in its online "Author Services" section. Editors' responses to authors about manuscripts under review often included a stock statement encouraging authors whose first language is not English to have their manuscripts reviewed by a primary English speaker, and the same notice appeared in some author instructions. The journal Veterinary Radiology and Ultrasound, for one, advised authors to seek help from experienced, English-speaking medical editors before submission when necessary, and emphasised that poorly written articles would be returned without review. The increasing visibility of science editing services for researchers, both inside their own organisations and through links from the journals they publish in, indicates that administrators and publishers recognise such services as important and useful for improving science communication.
Some authors may hope that a journal editor, peer reviewer or copyeditor will accept the responsibility of language revision. Journal editors and peer reviewers, however, do not have enough time to edit a manuscript's language substantially, and typically only the most prestigious journals are equipped with copyeditors who provide comprehensive language services. Manuscripts so poorly written that the message cannot be deciphered will often be sent back to the author, and some academic authors seek science editing services only after a journal's editor has rejected a manuscript for inadequate writing. Science editors often note that some reviewers who point out an author's poor English may be misjudging their own writing proficiency. In a study of peer reviewer feedback about language or writing, an experienced science editor deemed an average of 32% of the recommended changes incorrect, so not only does peer reviewers' lack of time limit their ability to help with language editing, but their level of writing skill may also limit the usefulness of their edits. The same applies to colleagues who are primary English speakers: an author will often ask such a colleague to review a manuscript before resubmission, and the amount of help received depends on the colleague's writing skill.
Introducing the service and working with investigators
The German hospital's editing and translation service met mixed reactions while it was being established, mainly because its editor was neither a native speaker nor a physician, but also because an official editing and translation service was generally unknown in German university hospitals. Some scientists tend to acknowledge the need for linguistic revision only when a medical journal's editor has rejected or returned their manuscript on linguistic grounds, and having one's manuscript corrected is a somewhat sensitive matter for every author, so the post required diplomatic as well as linguistic skills. To introduce the service the editor developed a short manual on how to write a scientific paper, including the most frequent sources of linguistic errors, particularly for German native speakers, and sent it to all hospital departments involved in conducting clinical trials. The manual led one department to request a four-hour course on scientific writing, for which she drew many examples from manuscripts she had corrected over the years. The course was well received and word got around, so that the service and the need for it became more and more accepted within the hospital.
One of the Arkansas office's goals is an investigator–editor relationship that facilitates mentoring by the editor and trust by the investigator, and it often begins with a face-to-face meeting. The investigator, and possibly other members of the research team, meet the office manager and the editor best suited, by expertise and availability, to the project; the overall deadline, including internal procedural requirements, is confirmed, and interim deadlines are set. The meeting also lets the editor discuss the investigator's research, and in this informal discussion key phrases and optimum wording can be identified for a specific application and intended audience. The enthusiasm a researcher shows while discussing the work can substantially help the editor emphasise its impact and significance, terms used to judge a grant's fundability at, for example, the US National Institutes of Health (NIH). Because grant applications and journal articles are formal scientific documents, many researchers mistakenly rely on very complicated language constructions or a slew of acronyms, and all excitement for the project is lost in technical language. A simple discussion with the investigator can tease out what he or she hopes to accomplish and let the editor invigorate the piece with the excitement that sparked the research.
An iterative editing process follows, in which the investigator addresses the editor's questions and concerns in subsequent drafts, and this seems to work best for most investigators and for the editing team. The office uses Microsoft Word's track changes and comments so that the investigator can see both where and why text has been moved, deleted or altered, and it typically sees three or more drafts of a grant proposal and two to three drafts of a manuscript before submission. Some investigators prefer to discuss the iterations face to face and others by email or telephone, and the office does its best to accommodate these preferences.
The office tries to schedule editing projects to allow substantive revisions and multiple iterations, preferably starting at least a month before the deadline, although this is not always possible. It still tries to accommodate requests that arrive just before a deadline by providing a more limited editorial service: with only four hours to work on a grant, it will offer to review the Specific Aims and provide feedback.
Fees, editing time and workload
In 2012 the Arkansas office billed at an hourly rate of $55, and for departments in the College of Medicine the Office of the Dean covered 75% of the total cost of a grant submission, substantially reducing the cost to the department. A typical grant application took approximately 40 hours of an editor's time from start to finish, time that represents substantive editing of very complex material, often with multiple iterations. The hours may vary considerably with the application guidelines, applications to the Department of Defense, for example, requiring an extensive amount of ancillary material besides the research plan, and with whether the principal investigator needs help with the English language or is new to grant writing. The shorter NIH applications and the typically short five-page foundation grants do not necessarily require less editing time. A manuscript may require only 10 to 20 hours, because most investigators are more accustomed to the guidelines and required style of manuscript writing, although depending on its length and other factors the time may easily be comparable to a grant application's. The number of grants and manuscripts the office edited per fiscal year from fiscal 2005 to fiscal 2012 shows an apparent drop in production from fiscal 2008 onward, which represents a greater emphasis on larger program project grant applications, still tallied as individual grants; the number of manuscripts remained fairly constant.
The office does not document how many investigators decline its services because of the fee schedule, but to help all faculty members it has developed a website with links to funding sources, grantsmanship resources, grant application guidelines and templates it developed for preparing a grant, as well as links to other shared resources on campus.
Teaching writing through editing, workshops and coaching
Using a general scientific jargon accessible only to an in-group is one of many bad habits that contribute to poor writing. These habits, which extend beyond language and style to practicalities such as time management, are transmitted from older to younger scientists: a senior scientist who throws together grant proposals at the last minute sets that example for mentees. In academia, the specialised language that defines an in-group and the bad habits passed down from senior to junior scientists form a culture of poor writing within a department or institution. Department leaders, senior investigators and mentors shape the culture by the extent to which they invest in and advocate for good scientific writing. Two scientific editors at an academic research institution hold that they are uniquely positioned to address poor writing as a problem of that culture. By editing faculty's manuscripts and grant proposals continuously they can change faculty's writing habits over time, workshops and seminars give direct instruction to a wider departmental audience, and by incorporating writing education into the everyday life of the department they seek to change its writing culture gradually from within.
The two editors, in the Department of Radiation Oncology at the University of Texas Southwestern Medical Center in Dallas, run programmes whose main goal is to teach academic writers to communicate ideas clearly, concisely and cohesively in research documents. That goal relies on the writers' awareness of and commitment to forming good writing habits, which can go well beyond mastering grammar, style and spelling. They expect faculty and trainees from other departments as well as their own to benefit from these strategies, which aim to instil good writing habits continuously and so change departmental writing cultures over time. Writing can only be improved, in their view, by forming good habits and practising continuously, so they interact with faculty and trainees as frequently and in as many contexts as possible, using a variety of strategies for writers with different experience, needs and language backgrounds and for documents at various stages of writing. Their primary strategy is didactic editing, which uses the editor's query to educate: didactic editors query not only to request clarification but to explain changes of grammar, style, structure and data presentation and show how they enhance overall clarity and cohesion, and they can link to resources, such as the AMA Manual of Style, that explain the rules, standards, conventions or best practices behind the changes. Didactic editing can target a specific issue in the writer's work, in context and at a level suited to the writer's position and experience, from postdoctoral fellow to associate professor. It is also cost-effective, because editors can practise it without developing additional programmes, which may be particularly important for editors whose departments do not support scientific writing education. Workshops and seminars give broader instruction on common document types such as grant proposals, scientific manuscripts, abstracts and posters, combining interactive lecture and discussion with hands-on writing exercises in seminars or guided revision of participants' own research documents in workshops. The hands-on components are at least as important as the didactic content, because improving writing requires forming habits and practising continuously more than mastering the content. One-on-one coaching supplements both: faculty or trainees meet the editors individually to discuss editorial suggestions on their documents or the content of a recent workshop or seminar, and some ask for help with research development and strategic planning for grant proposals, including identifying funding sources, writing or soliciting institutional letters of support, and setting timelines and checklists so that all grant components are completed on time. Faculty and trainees benefit from personalised attention, and the editors benefit from good working relationships, because those they coach are then more likely to attend a workshop, send documents for editing or recommend them to others.
Their Grantsmanship Education Program for junior and intermediate faculty coordinates the three strategies to instil new habits and change the way faculty develop and write grant proposals:
- Workshops on writing grants: interactive lectures on specific grant components and best practices for writing, such as active voice and parallel structure, with time in each session for participants to work on writing samples they prepare in advance and email afterwards for feedback.
- Didactic editing: continuous editing support throughout and after the workshop series to improve grant proposals, reinforce lecture content and instil good writing habits for future proposals.
- One-on-one coaching: a meeting with each participant after the series ends to gauge progress, offer suggestions for revision, help plan the next steps and solicit feedback to improve the next iteration of the series.
The Dallas editors find that both didactic editing and one-on-one coaching help investigators improve their writing, regardless of seniority or language background. In their experience didactic editing works especially well with investigators who send their manuscripts for multiple rounds of editing and engage in active discussion through comments, and they recommend in-person meetings for new investigators or those whose documents need substantive editing. They encourage junior faculty new to grant writing to develop a personalised editing plan that includes both one-on-one coaching and several rounds of didactic editing. They designed programmes for different academic levels by talking with mentors, division chiefs and directors of residency programmes. Because its workshop component distinguishes the grantsmanship series from other communication seminars, faculty with working drafts and concrete plans to submit a grant proposal benefit most from it, while those with no working drafts may learn useful information from the series' lecture component but will find more value in the interactive lecture-based seminars, where no working documents are needed. The seminars on manuscripts and on abstracts and posters are attended primarily by residents, postdoctoral fellows and instructors, but they would also suit mid-career and senior faculty as refreshers.
Because clear and concise writing takes continuous practice and commitment, they work to improve the effectiveness of all three strategies and overcome their difficulties. The success of didactic editing through tracked changes and queries depends on how much authors pay attention and how willing they are to accept the editor's suggestions, and because investigators' commitment to reading queries and checking edits varies considerably, they encourage forming and maintaining a relationship of trust as a first step. They often recommend multiple rounds of editing, both to ensure the document's quality and to create an ongoing conversation that encourages investigators to read comments more intently and remember the suggested changes. Although praising an investigator's work is not the editor's job, occasional compliments for well-written paragraphs and sentences can boost the author's confidence and give a welcome break from the tracked changes. Queries should be simple, to the point and written in a friendly, conversational, non-commanding tone.
Besides excellent content, useful exercises and effective organisation, successful writing workshops and seminars depend largely on the support of mentors and department leaders to promote active participation; for the Grantsmanship Education Program, division chiefs nominate or approve faculty to attend. Besides teaching workshops and seminars, editors should continuously encourage mentors to advocate for good writing and to model good habits. To overcome the practical difficulties of running workshops and seminars, the Dallas editors survey faculty for preferred days and time slots, ask mentors to help secure junior investigators' time to attend, especially for those with clinic duties, send reminders and calendar invitations, offer incentives such as refreshments, and collect grant and manuscript examples, especially funded proposals, by asking senior faculty to share their work.
Investigators have not pursued one-on-one coaching as actively as the editors hoped. One possible explanation is that many investigators who seek their help are non-native speakers of English and the language barrier can interfere with productive face-to-face discussion; the editors still encourage them to meet in person, and correspondence by email or through queries within documents could be a feasible alternative that also helps improve their writing. Another explanation is that some investigators find it difficult to set time aside during busy clinic times, and although incorporating coaching into the Grantsmanship Education Program has helped, setting up in-person meetings still requires time and patience, particularly with investigators who may not respond. Approaches to the problem include soliciting one-on-one sessions more proactively and seeking the help of mentors.
Besides substantive editing, the Arkansas office provides interactive workshops and lectures that instruct investigators in all aspects of grantsmanship and the peer-review process. It hoped to take portions of its workshop series on the road by submitting sessions as courses to upcoming scientific academy meetings, an idea workshop attendees at its institution suggested was worth pursuing. Its staff believe that the mentoring the office provides, whether through one-on-one interaction during an editing job or through the more formal instruction of its workshops, results in a more effective investigator–editor relationship that produces higher-quality documents and, ultimately, more funded grants and published manuscripts. They also believe that recognising the importance of this relationship during any editing job can be applied to others in scientific or medical communication.
The Centre for Clinical Trials belongs to a network of coordinating centres for clinical trials throughout Germany that offers training programmes for research personnel. English as the primary language of clinical research poses less of a problem to principal investigators than to study assistants, who may not have practised their English since their school days and for whom English communication and study-specific terminology, or an 80-page study protocol written in English, can be a major obstacle. In 2008 the centre's medical editor and translator was therefore asked to develop a job-specific two-hour English course for study assistants. The course covered study-specific medical English as well as introducing oneself at meetings, verbal and written communication and the typical problem areas for German native speakers, and it drew on the linguistic and cultural traps she had fallen into herself, particularly double meanings, false friends and a typical German straight-down-to-business attitude with no time for small talk. The need for improved English there too became increasingly acknowledged, and the two-hour course was extended into an interactive one-day tutorial.
Measuring an editing service's success
Evaluating the Arkansas office's success rate has proven elusive. It had numerous testimonies from those it had helped and encouraged investigators to provide only positive feedback to their department chairs and deans, but it had yet to develop a system that objectively scores successes and failures. Metrics to measure its success rate objectively in funding and publication were being developed, but in 2012 it relied on the positive feedback of the many investigators it had helped. Quality and productivity metrics used by other organisations that employ medical communicators, such as pharmaceutical and biotechnology companies, are not readily applicable to it, and a published evaluation of the effect of editing on manuscript acceptance time is difficult to translate to its work. This is primarily due to the nature of the grant and manuscript submission process at an academic health care centre. A grant application is likely to go through two submissions before it is funded, an investigator will often opt out of the office's services for the second submission, and a "failed" grant is commonly submitted to another organisation that then funds it; if the office is not involved, or the elapsed time to the final outcome is overly long, it may never know the outcome. A manuscript is typically submitted, reviewed, revised and then accepted with revisions, and a rejected manuscript may be resubmitted to another journal; if the office is not included in the process, it may not learn whether the manuscript was accepted. Unlike a pharmaceutical company, where one department oversees production of a type of regulatory document and another oversees publications, the university has no overarching organisation that oversees the manuscript submission enterprise, so the office depends on investigators to tell it of a successful publication, which, in part because of the elapsed time, is not always reliable.
When time allows, the office searches NIH RePORTER, a database updated weekly that lists the grants NIH has funded; it does not capture non-NIH submissions, but it has helped the office track down a large proportion of the grants it edited. It also searches PubMed to find whether a manuscript has been published in an indexed journal, with one caveat: multiple iterations of a manuscript may produce a substantially revised title, which can make the publications it edited difficult to identify, particularly if the full text is not readily available. The office holds that if the ultimate outcome is a successful grant application or publication and it worked on any version of it, the outcome should be counted among its successes. It was developing a database with unique identifiers, such as the investigator's email address and the assigned project number, rather than identifiers such as the grant title that are likely to change even before the first submission, linked to its own database so that it would have confirmation of a grant submission and be alerted when the application was rejected, scored or funded. It was also developing a customer survey in SurveyMonkey that automatically distributes a simple one-page questionnaire to investigators when one of its editors completes a grant or manuscript project and redistributes it on a six-month cycle to track the document's progress, and it hoped that the survey and the revamped database together would let it track success and failure rates and investigators' opinion of its editing more accurately.
Assessing the success of the Dallas editors' strategies is somewhat difficult, because investigators attend workshops or seminars and request editing or coaching voluntarily, so the editors may interact with individual authors only once, and they still need ways to measure the improvement of writers who work with them infrequently. Collecting data across the department is also difficult, because not all investigators use their services. At the programme level, they track participation in their editing services by recording the documents received for editing each week, and they assess satisfaction with workshops and seminars by surveys that identify the programmes' strengths and weaknesses. Feedback from the satisfaction surveys has been consistently positive and requests for editing have increased steadily over the three years of the programmes, which suggests progress in incorporating writing education into the life and culture of the department.