The American Medical Writers Association (AMWA) held its 69th annual conference in Dallas on 22–24 October 2009. Although many attendees came largely to complete workshops for AMWA certificates, there were also numerous other sessions, including some of particular interest to science editors.

Titled “Blazing the Trail” in keeping with its Texas setting, the conference emphasized changes and new ideas in medical communication. Accordingly, the keynote address, by Karen Woolley, CEO of ProScribe Medical Communications, framed points as ways in which attendees can all be pioneers. The address was titled “Getting Respect—Two Steps Forward and ?” and conveyed the following main point: Medical communicators must persuade the wider community of their “value and ethics”. Woolley said that she and other medical writers must “tell our side of the story” to skeptical editors and journalists. She also noted the importance of ensuring that authors worldwide understand journals’ ethical standards.

McGovern Address

Annette Flanagin, managing deputy editor of the Journal of the American Medical Association (JAMA) and a past CSE president, received the McGovern Medal, given for preeminent contributions to medical communication. Her acceptance address was titled “Publishing Research on Publishing: Valid and Useful or the Ultimate Oxymoron?” She presented a historical overview of research on scientific publishing and then summarized research in which she has participated.

Flanagin described research that she and her colleagues have done on authorship of scientific papers. They conducted a mail survey in 1996 and an online survey in 2008 asking authors about their experience with honorary and ghost authors. (An honorary author is a person who is listed on a paper as an author but who had minimal involvement in the study being reported. A ghost author is a person who deserves authorship but is not listed.) The percentage of honorary authors remained roughly the same over the 12-year period, but the prevalence of ghostwriting decreased somewhat.

Flanagin ended with a call for those involved in writing and editing to perform their own research.

Perspectives on Publication

Getting Published

The key to getting published is to have a manuscript that reports new information, bridges a gap in knowledge, or otherwise communicates something important, said William C Roberts, editor-in-chief of the American Journal of Cardiology, at the session “Getting Your Manuscript Published”. Roberts recommended choosing a target journal before starting to write. Speaker Christine F Wogan, program manager in the publications division at M D Anderson Cancer Center, recommended working with a statistician early in the writing process. Both speakers emphasized having a clear hypothesis and encouraged authors to focus on crafting the title and abstract because these are the two most widely read parts of manuscripts.

Wogan provided additional suggestions to help author’s editors to serve their constituencies: publisher, reader, and author. She said that author’s editors can supply more than surface-level copy-editing by critically evaluating papers (because author’s editors are often informal reviewers), improving papers’ persuasiveness, and checking for breaks in logic. Wogan encouraged author’s editors to familiarize themselves with the jargon used in their authors’ fields by reading some of the works cited in the paper being edited and reading papers from the journal being targeted. Author’s editors can also help authors to get published by helping them to craft appropriate responses to peer reviewers and write succinct, persuasive cover letters.

GPP and More

In the session “Publications Guidelines: GPP2, CONSORT, and You”, Tom Lang, of Tom Lang Communications, gave a brief history of the formal structure of scientific publications and listed some reasons that having a standardized structure is valuable. Yvonne Yarker, senior vice president at Scientific Connexions, gave a history of Good Publication Practice (GPP) guidelines, which are to be used for reporting industry-sponsored research. She related how GPP was inspired by discussion at a Council of Biology Editors retreat in 1998 (although the guidelines were not published until 2003). A revised and updated version, called GPP2, was created in response to increased news-media coverage and changes in various regulations. It has now appeared in the BMJ and can be accessed at www.gpp-guidelines.org/GPP2.pdf.

Not Only Impact Factor

Impact factor (a measure of the frequency with which a journal’s articles are cited) is only one journal characteristic to consider in choosing a journal for manuscript submission. That was the focus of the session “The Journal Selection Process: Getting Beyond the Impact Factor”. Speaker Daniel Donovan, senior vice president of Envision Pharma (a medical and scientific communication company), geared his presentation largely to corporate medical writers who work with authors to prepare manuscripts.

Donovan encouraged consideration of journal characteristics other than impact factor, such as time between manuscript submission and publication, frequency of publication, type of articles accepted (for example, original research or reviews), length of articles accepted, publication emphasis (for example, theoretical or clinical research), and target audience. He said medical writers should risk a “clash of egos” and steer authors toward journals most appropriate for their studies even if the journals are not the most prestigious. “Backup journals” should be considered in the event of rejection.

Donovan also spoke at length of the need for medical writers to be aware of an “anti–medical-writer policy at top medical journals”, reflected in such statements in journal author guidelines as “Manuscripts may not be prepared by outside parties or written by individuals with less than full status as authors.” He exhorted medical writers to enforce “disclosure” (for example, by demanding acknowledgment for participating in the writing of a medical manuscript), to be seen not as “ghostwriters” but as professionals who produce credible work.

Responding to Peer Review

Contrary to a common impression, peer review of manuscripts is not an adversarial process. By communicating clearly, everyone involved in the peer-review process—the journal editor, authors, and peer reviewers—can ensure that the common goal of excellence is met. Speakers Dorothy Pennachio, executive managing editor of Current Medical Research and Opinion, and Kevin S Holmes, manager of scientific publications, grants, and proposals in the Cardiovascular Devices Division of the University of Ottawa Heart Institute, presented that message at the session “How to Respond to Peer Reviewers’ Comments”. Their tips included the following:

• Respond completely and comprehensively to the points from peer reviewers: Ensure that every comment, positive or negative, is adequately addressed.
• Make it easy to identify revisions: Indicate sentences or phrases in the manuscript that have been revised by using software that tracks revisions or by highlighting changes. When referring to changes, if possible specify the exact location of the changes in the revised manuscript (line numbers work well). Always number the pages of the manuscript.
• Ensure that responses are polite: Abrasive comments are both juvenile and unprofessional. If you disagree with a reviewer’s comment, state your reasons. A polite response lets reviewers know that you respect their time and input.
• Finally, remember that the revised manuscript is the version that will be published. So, when responding to peer reviewers, put in the same level of effort that you put into writing the manuscript.

International Topics

English-as-a-Second-Language Ideas

Larenda Mielke (instructor, English Language Programs, Washington University) shared some “grammar tips for writing and teaching in a second language” in a session with the same name. She identified three kinds of frequent mistakes: the definite article “the”, the “-ing” form of verbs, and sentence structure. For example, she noted, we say “the Philippines” but not “the Indonesia” because of the presence or absence of the letter “s” at the end.

Mielke also provided some tips to use in writing a methods section, including using subordinate clauses to set the scene, using “-ing” phrases or clauses to indicate results, and using “by” phrases to add details. She emphasized the importance of repeating key terms, which make the writing easier to follow. She suggested repeating the key terms exactly and early in a sentence.

Near the end of the session, the participants received writing exercises in which they could apply the tips that had been provided.

Teaching International Authors

Many researchers who speak English as a second language have difficulty getting their work published in English-language journals. Speakers at the session “Teaching International Authors: Some Trailblazing Initiatives” summarized some efforts to help such authors.

Stephanie Deming, scientific editor at the University of Texas M D Anderson Cancer Center, described workshops and short courses that her institution gives to help international students and faculty with scientific writing. The instructors emphasize structure rather than the fine points of English, and they use examples to teach.

DONG Zheo, professor at Peking University Health Science Center, summarized achievements of the China Medical Board (CMB) Biomedical Writing and Editing Program. These achievements included helping to train Chinese faculty members to be medical editors and medical-writing teachers. ZHANG Jian, a graduate of the CMB program and lecturer at Peking University Health Science Center, described how medical writing is taught in China. She said that support from nativespeaking editors is needed.

Barbara Gastel, professor at Texas A&M University, introduced AuthorAID, an effort to help researchers in developing countries to write about and publish their work. Approaches used by AuthorAID include providing mentors, giving workshops, and offering online resources (at www.authoraid.info).

PR, Personal Essays, and More

Responding to PR Disasters

Even people not officially working in public relations sometimes face PR crises in their organizations. In “When Bad Things Happen at Good Places—PR Disasters and How to Respond”, Melanie Fridl Ross, of University of Florida Health Science Center News & Communications, and Barbara Snyder, director of scientific writing and editing at Procter & Gamble, shared their experiences with PR nightmares in their organizations. They also offered advice for those who find themselves in a similar position.

“Have a plan,” Ross advised. When a crisis does happen, she emphasized, it is important to move quickly. She said that the most important thing to remember in a crisis is to “tell the truth and tell it quick”. If you don’t, she said, people are not as likely to trust that you’re telling the whole truth later. Ross also said that it is important not only to apologize but to back up your words with actions to show that you’re committed to keeping the same thing from happening again.

Creative Nonfiction

The session “First Person Singular: Creative Nonfiction as an Outlet for Medical Writers” began by explaining what creative nonfiction is. Sue Russell, a medical writer at Thomas Jefferson University, said that creative nonfiction tells the “inner story”, or what a person is thinking or feeling about the events described. She went on to describe the genre (which includes memoirs, personal essays, profiles, and immersive journalism) as using some of the tools of fiction writers but at the same time trying to be truthful.

Online Surveys

Tracy E Bunting-Early, a freelance medical writer and consultant, presented a session titled “Online Surveys: Opportunities and Logistics”. The session included demonstration of a few of the many ways that online surveys, forms, and polls can be used. There are so many options, she said, that it is important to know, before choosing a survey company, what your goals are and what information you want to gather and from whom.

Although many of the issues are identical with those encountered in writing and distributing print surveys, a few are specific to the online format. For example, it is “difficult to control who’s responding” online, and some people might trick Web sites into allowing them to take a survey multiple times. In addition, online surveys might tend to receive responses from a younger demographic, and this could bias results.

Medical Writing Without a Medical Education

Scott Kober, medical writer at the Institute for Continuing Healthcare Education, focused the session “No Medical Degree? No Problem! Succeeding as a Medical Writer Without a Science Background” on career paths that people with backgrounds in English, journalism, or public health have followed to succeed as medical writers. Kober said that although many job announcements for medical writers state that a PhD or MD is required, this obstacle can be overcome by showing enough proof of competence in the field.

Having a liberal-arts background can provide advantages, Kober said, such as being used to deadlines and working with style guides, understanding the basic rules of grammar and sentence structure, and knowing how to work as part of a team in an office environment. For those with nonmedical backgrounds who wish to succeed in medical writing, Kober gave some tips: Learn the language of medicine, get some biomedical education, never turn down an opportunity, develop your sales pitch, and assume that you will be overwhelmed at some point.

Freelancing: Not Just the Writing

Brian Bass, president of Bass Advertising & Marketing, Inc, drew on his experience as a freelance in “Getting Down to Business: Nonwriting Issues for Freelances”. He provided the following tips:

• Maintain confidentiality. Doing so will keep you safe and keep your clients safe.
• Read contracts carefully. If you are uncomfortable with anything in a contract, consider asking the client rather than simply deleting the content that is of concern.
• Consult professionals. When starting your own company, consult financial professionals, such as an accountant, to design an appropriate financial management plan. Pay attention to protecting your assets.
• Buy insurance. Doing so can help to protect you and your family. In addition to health insurance and life insurance, consider long-term disability insurance and errors-and-omissions insurance. The former can keep money flowing into your account if you cannot work; the latter can protect you in the event of real or perceived mistakes.

Successful Mentoring

Michele Vivirito, medical writing director at Amgen Inc, spends about 20% of her time in mentoring newly hired writers. In the session “How to Mentor a Medical Writer”, she discussed a training program for new mentors at her company. She indicated that although mentoring is casual, it has proved to be a powerful tool for teaching new medical writers.

Vivirito contrasted mentoring and training. Whereas training is a one-way process, the mentor and his or her mentoree are supposed to develop a mutual flow. Also, whereas training focuses on a specific skill in need of development, mentoring focuses on personal and professional development of the mentoree. Finally, unlike training, mentoring is not time-bound; in some cases, Vivirito said, the relationship may continue indefinitely.

In keeping with principles of adult learning, a mentor should consider the need for immediacy of application and encourage the mentoree’s motivation and responsibility. The latter can be achieved by kindly challenging the mentoree to improve weakness in some critical part of the job. Other essential qualities of a good mentor that Vivirito noted were compassion, candor, creativity, and confidentiality. Even more important, she said, was to see mentorees as what they can become instead of what they are.

Other Sessions

Other sessions of interest to editors addressed topics ranging from punctuation to statistics to ethics.

The final event was a reception to segue into the 2010 AMWA annual conference, to be held in Milwaukee, Wisconsin, 11–13 November. For more information, please see www.AMWA.org.