Teaching beyond manuscript writing
Teaching publication ethics, visual communication, clinical documentation or spoken medical English requires knowledge of the subject and methods suited to what participants need to practise.
Publication ethics through cases
In 2013, a collaboration among Japanese medical universities combined medical writing and publication ethics in short programmes for postgraduate students and faculty, addressing shortages of teaching staff, resources and time. The workshops had run annually since 2009; when ethics was added in 2011, the organisers introduced active participation through group workshops for postgraduates and problem-based learning for more experienced faculty. They recommended combined programmes because researchers with limited time, writing expertise or English skills may seek medical writing assistance and need to understand ethically acceptable practice.
Postgraduate exercises
The 2011 postgraduate programme used two two-hour evening sessions, each containing a 50-minute lecture and a 50-minute interactive workshop. Lectures covered the ICMJE Uniform Requirements and oral and poster presentation skills for doctors with little experience of English-language papers or international presentations. After a 30-minute introduction to authorship and peer review, small groups discussed short cases and presented answers to the same questions.
One guest-authorship case concerned a Chinese researcher writing a Chinese paper on cardiac bypass using data from a two-year US fellowship. Out of respect, she offered authorship to her US mentor, who could not read Chinese but understood the English abstract and had a general idea of the work. The exercise asked:
- What would the mentor do?
- Would accepting be appropriate if few colleagues would read the paper and the mentor did not intend to list it among his publications?
Participants also answered general questions:
- What is a guest author?
- What should a reviewer do if a paper is by a friend, or by someone they intensely dislike?
- Is the Uniform Requirements’ definition of authorship acceptable, and why or why not?
Faculty problem-based learning
The faculty programme used one four-hour evening session with two 50-minute lectures and two hours of problem-based learning. Advanced lectures addressed responding to reviewers and interpreting editors’ letters, using participants’ own correspondence collected beforehand to increase relevance and interest.
The ethics activity began with an introduction to the Committee on Publication Ethics (COPE), its flowcharts and misconduct, including the possibility that widely accepted practices may be unethical. Groups then worked through actual cases reported to COPE:
- Identify the key issue or problem.
- Find the appropriate COPE flowchart.
- Follow it and discuss the steps advised, then present the group’s conclusion.
A duplicate-publication exercise described a paper on a cohort with an unusual respiratory pathogen, accepted and published in journal A after the same authors had published a similar cohort study in US journal B a few months earlier. The papers concerned almost the same patients, differing by a few added patients and secondary outcome data but reaching the same conclusions; journal A’s editor called it duplication and the authors denied this because of the further data. Participants were asked to discuss the steps advised by the relevant COPE flowchart.
The organisers’ questionnaires asked whether the programmes were worthwhile, what participants learned and whether perceptions changed. Most responses were positive: postgraduates reported greater appreciation of both subjects and knowledge of authorship, peer review and conflicts of interest, while faculty reported learning to handle post-submission correspondence.
A different introductory format used an A-to-Z survey of bioethics, from autonomy through beneficence, consent and death to zygote, with definitions, history, controversies or questions at each letter. In that session, older participants revisited familiar milestones and younger participants gained an appreciation of the subject’s depth.
Visual communication through practice
A trainer of medical writers identified a gap between strong scientific language and a shared language of graphics; teaching visual literacy alongside scientific literacy was proposed as an important component of medical-writing education.
In 2024, a University of Miami visualisation teacher described courses with one month of lectures, discussion, principles, theory and reading followed by two months of project work with repeated feedback and explanations. He regarded visualisation, like writing, as a craft learned mainly through practice rather than through grammar alone.
For learners who doubt their creativity, his advice was to begin with bar graphs, line graphs, scatter plots and data maps, learning to design elementary forms well before emphasising creativity. Creativity can come later once the basics are grounded; artistic visualisation may prioritise it, while communication should emphasise efficiency and efficacy. He argued that anyone who can learn to write well can learn to design well and reported that all students who put in the effort learned to design attractive visualisations regardless of prior visual-design training. Most of his students were scientists, particularly data scientists, rather than journalists.
In 2024, his data-communication class was mandatory in the university’s data-science core and increasingly attended by biology students on their professors’ recommendation, although the university had no formal biology visualisation curriculum. A common curriculum or massive online course was suggested as a possible response to fragmented provision through individual workshops.
Another visual-communication trainer organised teaching from tricks and tactics, through software implementation, strategies, principles and design philosophy to the core idea; for a 15-minute session, he chose to teach the core idea.
Clinical documentation through authentic material
Teachers without healthcare experience may not understand clinical writing’s specialised style, and learners need exposure to authentic clinical material rather than assumptions about workplace language. Research on healthcare language needs found that teachers’ assumptions could be inaccurate and leave employees learning language unlike that used at work.
Social learning theory suggests that learning happens best through observation and exposure to content and context; authentic clinical examples provide role models, vocabulary and insight into language used for particular audiences. Teachers and clinical writers both benefit from seeing terminology and jargon in context.
Patient confidentiality, access to charts and the availability of placements can complicate workplace observation. A clinical-writing educator’s advice is to seek permission through a facility’s administrative channels and explain the goals; access for a few hours can be possible, with a confidentiality agreement and possible restrictions on notes and photographs. Where visits are unavailable, healthcare professionals can teach, demonstrate and coach as guests using examples of their own writing. Students can produce clinical writing for a health-professional guest and teacher to critique together in class or individually afterward.
Medical subject matter can exceed a language teacher’s expertise; being unprepared for clinical-language questions may undermine both the teacher’s self-perception and students’ perception of competence. Teachers may respond by avoidance or by risking incorrect answers, and without clinical knowledge may fail to recognise charting errors.
Clinical-writing teachers need intermediate-to-advanced English and competence in authentic healthcare language. Where experience is lacking, partnerships with healthcare professionals are more effective than a single consultation, while the internet offers authentic source material. Clinical-writing courses, workplace observation and short first-aid or resuscitation courses can provide exposure and opportunities to build a network of clinical-writing mentors.
Collaboration across disciplines can align writing exercises with other learning: for example, monthly meetings with nursing, anatomy, physiology or medicine teachers can establish what is taught when and provide collaborators to supply samples or review examples. Nursing and medical textbooks also provide documentation chapters and blank and completed charts that can serve as teaching templates.
Spoken medical English and teacher preparation
Medical writers can use their communication expertise to provide spoken-English training for health professionals who struggle to present, discuss or respond to criticism in international settings. Language-teaching knowledge, communication and listening skills are important, and learners benefit from speaking themselves rather than only hearing explanations. Familiarity with pharmaceutical language and culture can help teachers advise on content and tone.
A medical-English trainer’s guidance covers the following skills and preparation:
- Grammar and vocabulary: excellent English, knowledge of sentence structures and the ability to explain word order and tenses. Learners may know terminology but lack its grammatical scaffolding; teaching should emphasise short, direct spoken sentences rather than distracting adjectives and long clauses.
- The learner’s language and culture: bilingualism can help target common errors and false cognates. For example, French speakers may use “the characteristics of the patients” instead of “patient characteristics”, while French évolution means development and English evolution more often refers to Darwin’s theory. A logically constructed argument may need a more direct approach for an international audience.
- Pronunciation: teachers need to understand how stress, pauses and inflection give emphasis, retain attention and allow thought and comprehension, and how transferring native-language patterns can distract listeners. English emphasises key words over grammatical words, and examples of inflection include rising questions and falling statements.
- Presentation skills: clear language and instructions, suitable body language and voice control model the skills being taught. A confident teacher builds trust, and learners who look confident can appear more knowledgeable even when they do not feel confident.
- Medical knowledge: broad familiarity with medicine and specialties allows quick understanding of learners’ topics without spending excessive preparation time on the subject.
- Industry experience: knowledge of research, marketing, business development, good clinical research practice, graphics or writing can help with audience targeting, investor pitches, slides and written materials beyond language correction.
- Enthusiasm for teaching: enjoyment of working with people, listening, encouragement and enthusiasm help teachers identify needs and support learners facing shyness, low confidence or fear of public speaking.
- Training: practice and regular self-review improve teaching. A language-teaching qualification such as TEFL (Teaching English as a Foreign Language) or CELTA (Cambridge Certificate in Teaching English to Speakers of Other Languages) can provide teaching techniques, major grammar rules and issues specific to non-native speakers; books on teaching methods offer another route.