Chapter 30

Reporting the Results of

Clinical Research
The culmination of the research process is the communication of results. This final stage
may be the most important part of the process in that only shared information can clar-
ify, amplify, and expand the professional body of knowledge. Research reports can be
developed in a variety of ways. The written article published in a refereed journal pro-
vides a permanent record of research that will be available to a large audience. Oral re-
ports and poster presentations at professional meetings serve to disseminate research
information in a timely fashion, although the audience is limited and the record of re-
s arch findings will be found only in abstract form. Students are usually required to
document their work inth form of a thesis or dissertation, but may be given the option
of writing the paper in the form of a journal article. The purpose of this chapter is to de-
scribe the process of preparing manuscripts for publication in scientific journals, poster
presentations, and oral reports.
THE JOURNAL ARTICLE
Selecting a Journal
The researcher should decide where the manuscript will be submitted before writing
the final paper. Not long ago, the choice of journals that were appropriate for publica-
tion in rehabilitation professions was limited; however, with the expansion of the scope
of practice, there has been a proliferation of publications serving specialized areas of
practice. The choices are numerous and selection of the appropriate one deserves care-
ful thought.
Some journals have a clearly defined focus with priorities explicitly stated. The fo-
cus is often stated in a journal's masth ad or instructions to authors. For example, the
583
584 PART V , COMMUNICATION
journal, Physical Therapy, "represents the science and practice of the profession and TABLE 30
serves as the archives of physical therapy knowledge." This journal also has stated a pri-
Section
ority, giving preference "to publishing articles that are oriented toward demonstrating
Abstract
clinical implications for the improvement of patient services. " When a journal' s focus is
not so obvious, the contents of several issues of that journal should be read to determine
if a particular study is consistent with the subject matter and type of research that the
journal t nds to publish. It is an unfort\mate waste of time, effort, and perhaps money
to make the wrong choice and to have a manuscript returned because it "is not suitable Introductic
for publication" in a particular journal. This is almost verbatim what the rejection letter
will say.
Another consideration in selecting a journal is the readership. The product of a re-
search project should reach the people who will best be able to use the information. If,
Methods
for example, a study documents the functional outcome of an orthopedic surgical pro-
cedure, the report should be in a journal that orthopedists read. If, on the other hand, the
study focuses on the postoperative physical or occupational therapy intervention, jour-
nals devoted to these professions will be more appropriate.
Every journal publishes instructions to authors which must be followed in the prepa-
Results
ration of a manuscript. Although the general format of a research report is fairly consis-
tent in medical and scientific writing, l each journal has its own particular rules about or-
ganization of a manuscript; preparation of tables, illustrations, or graphs; and method
Discussi on
of reference citation. Failure to follow the instructions is a reason for rejection; or, at (and Cor
least, the manuscript will be returned for corrections. This results in an unnecessary de-
lay i.n sharing research findings.
Structure and Content of the Written Research Report
The major sections of a research report are the introduction, methods, results, discus- References
sion, and conclusion, as shown in Table 30.1. The introduction and methods sections
serve the same purpose as in the project proposal; that is, they describe the rationale for
the study and the specific procedures used to collect the data (s e Chapter 29). Although ground tt
the content of these sections will be similar to the proposal, the author will have to do
provide 51
some serious editing to fit the journal article format. The "forward-looking" statements
will be an
must be changed to past tense because the project is now completed. The last three sec-
of the shu
tions of the article will be completely new. guiding q
Although there are no universal rules, generally manuscripts for journal articles
Methods
should not exceed 15 pages, typed and double-spaced. Journals have limited space, and
The meth
will not publish papers that are too long, unless they are especially important contribu-
studied, v.
tions to the literature. Many authors publish the results of large studies in two parts.
were assi
Introduction should b
The introduction can be drawn from the statement of purpose, the background and spe- quire a sta
cific aims included in the research proposal. As in the proposal, the introduction of an and that tl
article should provide a description of the research question and the context within The Ir
which the author intended to answer it. After reading the first one or two paragraphs of procedure
the introduction, the reader should have a clear understanding of the problem being dural flow
studied and why it is important. The literature review should reflect the relevant back- and weH k
--------------------------------------------
--------------------------
-----------------------------------
CHAPTER 30. REPORTING THE RESULTS OF CUNfCAL RESEARCH 585
TABLE 30.1 STRUCTURE OF A JOURNAL ARTICLE FOR REPORTING RESEARCH
Section Should contai n
Abstract Overview and purpose of the study
General description of methods
Highlights of results
Statement of significance of results
General conclusions
------- ---_.----
Introduction Statement of the problem
Clinical relevance
Revi ew of literature
Rationale and theoretical framework
Specific purpose and hypotheses (or guiding questions)
Methods Study design
Criteria for and methods of subject selection
Description and number of subjects
Measurement methods and data coll ection techniques
Data analysi s procedures
Results Narrative description of statistical outcomes
Tables and figures that summari ze findings
Statements to support or reject hypotheses
DiscussIon Interpretation of statistical outcomes
(and ConclusIons) Di scussion of cl inical significance of outcomes
Importance of the work
Compari son of results with work of others
How results support or conflict with theory
Critique of the study limitations and strengths
Suggestions for further study
References List of all references cited in the article
ground tha t is necessary to support the theoretical rationale for the study, and should
provide sufficient information for the reader to understand how the research question
will b answered. The introduction should end with a statement of the specific purpose
of the study, delineating the variables that were studied and the research hypotheses or
guiding questions that have been investigated in this study.
Methods
The methods section should begin by describing the subjects, including how many were
studied, what criteria were used to recruit them, how they were selected, and how they
were assigned to groups. Relevant characteristics of subjects, especially age and sex,
should be sununarized using means, ranges, and frequencies. Many journals now re-
quire a statement documenting that subjects read and signed an informed consent form
and that the project was approved by the appropriate committees.
The methods section continues with a description of equipment and data collection
procedures, presented in chronological order so that the reader can follow the proce-
dural flow of the project. If the measurement or treatment procedures are standardized
and well known, they can be described briefly and the author can refer the reader to the
586 PARTV. COMMUNICATION
original sources for a more detailed descrip tion. Operational definitions should be pro-
vided for all variables, with the intent that someone could replicate the data collection
procedures. Many researchers develop a written protocol that they use as a guide dur-
ing data collection to be sure that all procedures are followed properly. This protocol
can easily serve as an outline for this section of the paper.
Diagrams, photographs, and tables can clarify and simplify the presentation of
methods. For example, demographic information and special characteristics of subjects re
can be summarized in a table, and photographs of a unique procedural setup may make au
a lengthy verbal description wmecessary. stud. '
The methods section should end with a full description of the procedures used to T
reduce and analyze the data, including specific statistical procedures. If unique or new haye
statistical methods are used, they should be referenced. may
durir
impo
Results
thor
The results section should contain only a report of results, that is, a narrative description
alisti
of exactly what happened in order of importance relative to the specific aims or hy-
E
potheses of the study. In the course of the study, the researchers may have gained con-
arise
siderable amounts of information, but unless it relates specifically to the stated purpose
tors. _
of the project, such information should not be included in this section. If one simple hy-
searL:'
pothesis has been proposed, the results section may be stated in a few succinct sen-
auth
tences.
hons I
The outcomes of statistical tests must be included to demonstrate or support the
T
statement of results. Although the inclusion of calculated val ues, degrees of freedom,
kno"
and the significance level is important, the narrative portion of the results section
portal
should emphasize the variables of interest rather than just statistics. For example, in a
fecti\
study of gait comparing elderly and young women, the statement "The differences in
step length were significant, t =-3.13 (p < .01)," is not as meaningful to the reader as
Cond
liThe elderly women demonstrated a significantly shorter step length 'than the younger
The
group (t = -3. 13, P < .01)." When detailed statistical or descriptive information related
ings.
to the study variables is needed in the paper, it is usually easier and often clearer for the
the re
reader to refer to tables or graphs that summarize such information.
strat
Two major principles should guide the structure of the results section. One is that
tables and figures should not be redundant of the narrative; that is, if the author in
Abstr
cludes means in the body of the text, there is no need to repeat them in a table. The au-
Most
thor can refer the reader to the tables and figures for details and should only summarize
them
these details in the text. The reader should be able to understand the results without re-
the pl
ferring to the tables and should b able to understand the tables without referring to the
sumrr
text. Therefore, the tables and figures should complement but be independent of the
presa
text. Second, the author should not discuss resul ts in this section. Statements related to
straet
how this information could be applied to practice or interpretation of outcomes should
terns ~
be left to the discussion section.
their 1
TablE
Discussion
The discussion section is the heart of a research report. It reflects the researcher's inter- Table
pretation of the results in terms of the purpose of the study and the outside world . This plana
CHAPTER 30. REPORTING THE RESULTS OF CLINICAL RESEARCH 587
is the only part of the paper m w hich the author can express opinions. The author
should comment on the importance of the results, limitations of the study, suggestions
for future research, and clinical implications.
The commentary about the importance of results should not be a reiteration of the
results section, b ut should focus on alternative explanations of the observed outcomes,
emphasizing how they either support or refute previous work or clinical theories. All
results should be addressed, including those that were not statistically significant. The
author should provide perspectives on the applicability of results to practice or further
study.
The limitations of the study, including possible extraneous variables that could
have affected the outcomes, should be identified and explained. Some of these factors
may have been iden tified before the study began and others will have become evident
during the course of data collection or analysis. The author must consider the relative
importance of these lirrtitations to the interpretations of results. It is essential that the au-
thor delineates all major extran ous factors so that the reader can examine the results re-
alistically.
Every research endeavor leads to further questions. Sometimes, these questions
arise out of the expressed limitations of a study and the need to clarify extraneous fac-
tors. In clinical research, alternative methods exist for studying the same or similar re-
search questions and these may need to be examined. Given the results of a study, the
author may want to reconsider a particular theory and how it may be applied. Sugges-
tions for future research will develop from these ideas and should be expressed.
The immediate or potential applicability of results to clinical practice should be ac-
knowledged by authors. Their perspectives on the clinical relevance of studies are im
portant whether the research focus is primarily on theory, applied science, or clinical ef-
fectiveness.
Conclusion
The conclusion is a brief restatement of the purpose of the study and its principal find-
ings. It is often written in such a way that the author states the deductions made from
the results. Phrases like "the resul ts of this study indicate" and "this study demon-
strates" serve to link the summary of results and the meaning of those results.
Abstract
Most journals require an abstract of the report which the author usually prepares after
the manuscript is complete. The abstract summarizes the content of the article including
the purpose of the study, the number and type of subjects, the basic procedures used, a
summary of the results, and the maj or conclusion. The abstract must be concise. The
prescribed limit may be 100 words, occasionally less. Readers often refer first to the ab-
stract to decide whether to study the complete report. Many computerized retrieval sys-
tems store author-written abstracts. Therefore, they must be able to stand alone, despite
their brevity.
Tables and Graphs
Tables and graphs are frequen tly used in the results section of an article to facilitate ex-
planation of statistical findings and to provide visual explanations. To be effective, the
588 PARTV. OMMUNI ATION
tables and graphs must follow guidelines for the specific journal and general consider- is a s e r i e ~
ations for developing visual materials. The narrative portion of the paper will often pre- from sep.
sent general descriptions of findings, and the tables and figures will present the details. mental e\
In co
units of r
Ta bles
ships, or
The customary table has five components: the title, column headings (horizontally dis-
portant, t
played), row headings (vertically displayed), the "field" within which the data are
pression-
arranged by columns and rows, and footnotes. Most journals use a format whereby hor-
displays :
izontal lines can be drawn to frame the column headings and the bottom of the table,
The data
but no other lines (horizontal or vertical) are permitted. The well-constructed table of re-
treatmen
search resul ts will present numeric or descriptive data demonstrating the relationships
foll owing
between independent and dependent variables. The ti tle should identify those relation-
compare-
ships. For example, for a table presenting the effect of ultrasolmd on shoulder range of
range is ;:
motion, the title could read: "Pretest and Posttest Range of Motion Values .. .. " Whether
geration
data are oriented vertically or horizontally may depend on the size and format require-
In de
ment of the journal; however, logically, related numeric data should be presented in the
thor sho
columns, particularly when they will be swnmarized with totals or means and standard
alone an
deviations in the last row. The sequence of column headings should progress logically
search fin
from left to right based on the order of events. In the display of pretest and posttest data,
the pretest should come fi rst. The colwnn headings should specify what was measured
and the units of measurement such as "(degrees)." The source of column data must be
125
identified by the row headings, such as subjects by nwnber or code when individual
(j)
al 120
data points are displayed, or with labels, such as "control" and "experimental" when
~ 115
the table represents grouped swnmaries. Footnotes may be used to present p-values, to
:E.
explain abbreviations, or to cite references. A journal's instructions to authors may spec- 110
ify the style for sequentially labeling footnotes. Some may use small italic arabic letters
~ 105
(a,b, c). Others may use symbolic keys. For example, the American Medical Association
'0 100
<!)
style requires a common symbolic sequence: * (asterisk), t (dagger), t (double dagger),
Cl
lij 95
(section mark), II (parallels), <JI (paragraph symbol), and # (number sign).
a::
Specialized tables are constrlicted to present statistical test summaries. Many ex- 90
amples are presented in this text. A tabular presentation of a frequency distribution is
shown in Table 17.3. A typical analysis of variance table, call d a "source table," is
A
shown in Table 20.2.
Graphs
Graphs provide a visual demonstration of research results. Trends, relationships, and
comparisons may be presented more effectively and more concisely by constructing a
graph than by writing a detailed text. Graphs can be drawn in a number of ways. Fre-
quency data are commonly represented using a histogram or a frequency polygon. Fig-
ures 17.1 and 17.2 in this text are examples. In a histogram the bars are contiguous, and
in afrequency poLygon, the data points are connected by lines because these graphs dis-
play the distribution of a group of scores. A pie chart graphically can display the pro-
portional distribution of selected characteristics of a whole sample where the percent-
age of each characteristic is drawn to scale as a p iece of the whole pie. A bar graph, which
(j) 180
<!)
~ 160
Cl
<!)
:E. 140
c
~ 120
E 100
'0
~ 80
c
fP. 60-
B
~ 180
(/)
Q)
~ 160
01
(I)
:E. 140
c
.g 120
o
~ 100
Figure 30.1 Two bar graphs showing
o
shoul der abduction range of motion
~
c
t2.
80
60 --'--'--- ---'-
before and after treatme nt for two
groups, illustrating the effect of verti
Control Experimental Control Experimental cal axi s scaling. A. Scale from 90 to
Pretest Postlest 125 degrees, B. Scale from 60 to 180
8
degrees.
CHAPTER 30. REPORTING THE RESULTS OF CLINICAL RESEARCH 589
is a series of separate bars, may be used to show frequency or magnitude data derived
from separate samples, such as control versus experimental group values, or experi-
mental events, such as pretest and posttest val ues.
In constructing graphs, the author must pay careful attention to the scaling of the
units of measurement. Graphs are intended to represent meaningful trends, relation-
ships, or comparisons; therefore scales should be realistic and drawn to illustrate im-
portant, true differences in the data. They can, however, be drawn to present a false imc
pression-either exaggerating or diminishing real differences. For example, Figure 30.1
displays shoulder abduction range of motion before and after treatment intervention.
The data in both graphs are the same: a mean of 100 degrees for both groups before
treatment, 110 degrees for the control group and 120 degrees for the experimental group
following treatment. The magnitude of change appears to be greater in Figure 30.1A as
compared with Figure 30.1B. Especially considering that normal shoulder abd uction
range is somewhere between 160 and 180 degrees, Figure 30.1A seems to be an exag-
geration of the comparative effectiveness of the treatment intervention.
In deciding what content to present in narrative form or in tables or graphs, the au-
thor should consider a general m le that each element of the results section must stand
alone and each must contribute to the complete and accurate presentation of the re-
search findings.
1 2 5 , - - - - - - - - - - - - - ~ - - r - - - - - - - - - - - - - ~ - - ~
90 --'--'------'
A
Control Experimental Control Experi mental
Pretest Postlest
590 PARTV. COMMUNICATION
Converting Theses and Dissertations for Publication
though p
source of
Most theses and dissertations are written on the basis of a six-chapter format: statement
to questi
of the problem, review of the literature, methods, results, discussion, and conclusion.
Regal
Journal articles contain the same elements, but are honed carefully by authors to avoid
problem II
all but the essential content presented succinctly. The full document that is prepared to
documen
meet degree requirements is usually too long and overreferenc d to be acceptable as a
gether to (
journal article. The challenge for the student is to condense content considerably while
the auth 1
retaining substance and meaning.
nately, fOJ
This is not a simple underta.king; therefore, the student must consider seriously the
standabLe
decision and commibnent to proceed. The selection of the thesis or dissertation topic of-
author to
ten depends on the specific educational objectives of the student. The research project
pared, it
offers the student an opportunity to study in depth a particular, and perhaps very lim-
or the wri
ited, topic that will contribute to the overall purpose of the selected course of study. The
student should consider whether the outcome of the project will also offer the journal
Writing!
readers new and useful information or new insight and perspectives on the subject.
Only if the answer is affirmative, should the process of editing begin. The review of lit-
The proe
erature, presentation of methods and results, and discussion will require the most work.
organizati
The review of the literature in the full document is usually extremely lengthy. The
flecting th
student does not want to miss any citation even remotely related to the topic, and must
ary forma'
demonstrate to the faculty that indeed a complete search of the literature was made. The
elements;
author who writes solely for publication is obliged to make the same thorough search,
municatin
but must be much more selective, including in the manuscript only those references that
ficul t to to
provide necessary, contemporary information and explici tly relevant background for
tence stru
the work. Here is a sample statement that might be found in a thesis: "Electromyogra-
does not (
phy is the procedure of detecting and recording action potentials propagated along the goal 0
muscle membranes.8-10,12-16,18,20fl For publication, the number of references cited could be We
reduced to one comprehensive review article on electromyography. Even more impor-
problems
tantly, the entire statement can be omi tted as it reflects common knowledge and con-
erences fa
tributes nothing new to the background of a study.
Even the l
The author of every research paper is obliged to clearly and explicitly describe the
cially whe
method of study; however, a description is usually unnecessary in a
journal article, and can be very tedious for the reader. Often, minute details of the pro-
Active Vel
tocol are delineated in appendixes of a thesis. For the journal article, the content of ap-
Asentenci
pendixes must be explained in a few sentences.
sentences
Other appendixes may contain all the raw data gathered during the investigation.
point mo
Whereas the faculty advisor may need this information to guide the student or assess
ous. The fl
the work, journal readers do not need or want to see the raw data. Therefore, all the im-
Passi1
portant information contained in those appendixes must be synthesized and incorpo-
rated into the results section of the journal article.
The student turned journal author must carefully consider the emphasis of the dis-
Acti\'
cussion section. Two problems arise in preparing the discussion. First, perhaps because
of a lack of confidence, the student hesitates to firmly interpret results and accomplishes
nothing more than to reiterate the results. Second, implications of the findings and sug- Theemph
gestions for further study are often confined to a description of what went wrong. Al- the passiv
592 PARTV. COMMUNICATION
example. In addition, the active example is shorter by six words! Consider the following
examples as well :
Passive Increased tension throughout the upper extremity and neck is pro-
duced by c nstant pain in the wrist.
Active Constant pain in the wrist increases tension throughout the upper ex-
tremity and neck.
The focus is very different in these two sentences. If the author is addressing the poten-
tial for dysfunction at sites remote from the pathology, then the first (passive) example
may be best. If the author is developing a rationale for eliminating wrist pain, the active
example may be more appropriate.
Passive voice may be appropriate when the subject of the sentence is unimportant
or the object or action should be emphasized. For example, "Patients were randomly as-
signed ..." conveys an important action, and the subject (who assigned) may not be im-
portant.
Superfluous passive expressions, such as "it has been suggested ..." or "it is
thought that .. . " usually distract the reader because they dilute the strength of the mes-
sage. Who suggested? Who thought? In citing the work of others, authors should ac-
knowledge the "who," for example, "Jones and Brown suggested . . .." In discussing
present work, the authors might write "Our preliminary results indicate ...." Using ac-
tive voice in such cases is direct and dear.
One special case should be discussed- the use of first-person active voice. For
many years, authors went out of their way to avoid using first-person active voice with
the notion that to use it detracts from the "scientific," "objective" nature of research re-
ports. Now, the use of first person is acceptable in selected instances. When authors (re-
searchers) are emphasizing their own actions, experiences, assumptions, or opinions,
their wri ting may be more readable and indeed more accurate if they say "We think the
logical interpretation of this finding is ..." or "We found that this technique is ...." On
the other hand, ov ruse of "I" and "we" can be .intrusive, calling unnecessary attention
to the authors, especially when purely scientific information is being conveyed. Presen-
tation of techniques, procedures, and results requires attention t what was done and
how, not who. Therefore, it is stronger to say "The subjects were positioned prone dur-
ing treatment," rather than "I positioned the subjects prone."
Simplicity of Language
In conversation, we tend to use expressions and phrases that are spontaneous, but often
superfluous to the point we are making. Many such expressions will be found in the
early drafts of written work because of the natural effort to "speak" the text. Authors
must, however, remain cognizant of the need to be concise in scientific writing. Many of
the elements of creative writing that we learned in school, designed to create metaphors
and add color to our words, should be discarded for scientific writing. Many authors try
to use different words for the same concept to avoid being repeti tious; however, where
only one word will make the point, it is better to be repetitious than to be unclear or am-
biguous. Adjectives and adverbs are especially useless for describing scientific findings.
There is no need to say that an outcome is "very practical" or "extremely useful." It
would be sufficient to be practical or useful for clinical care.
TheuS<'
certainly m
structure, tI'
Here are a f4
In early dr,
"grouped t(
suit. " Carr
Bates hl
"readabilih
was origina
and the p e r ~
a reader' s 5{
1. Cho
2. Divi
mini
3. Di\;
in tr
4. Add
WOfl
5. Mul
If we take a
bles, the a\"t
total would
14 would b
cording to (
When a rna
graphs. Thi.:
in verbiage.
THE POSl
A poster pn
can be read
opportunit:
ference setti
CHAPTER 30. REPORTING THE RESULTS OF CLINICAL RESEARCH 593
The use of expressions should also be tempered for scientific reports. Although it is
certainly more interesting to read a paper that is written with variations in sentence
structure, the purpose of an article is to communicate findings, not to create poetry.
Here are a few examples of complex phrases that can usually be avoided:
in light of the fact that = because
with the exception of except
in spite of the fact that although
is designed to improve improves
E due to the fact that because
was found to have had
inunediately prior to before
In early drafts, there may be redundant phrases, such as "exactly identical" and
"grouped together," and unnecessary qualifiers, such as "blue in color" and "end re-
sult." Correcting these kinds of errors is easy, if the author is looking for them.
Bates has presented a summary of "formulas" that can be employed to evaluate the
"readability" of a manuscript. One of these formulas is Gunning's "Fog Index" which
was originally described in 1952. The Fog Index uses the average length of sentences
and the percentage of "difficult" words to calculate a number that Gunning equated to
a reader's school grade level. His formula is calculated as follows:
1. Choose a sample of 100 words or more.
2. Divide the number of words in the sample by the number of sentences to deter-
mine the average number of words in a sentence.
3. Divide the number of words of three or more syllables by the number of words
in the sample to find the percentage of difficult words.
4. Add the average number of words in a sentence to the percentage of difficult
words.
5. Multiply this total by 0.4 to obtain the Fog Index.
If we take a sample of 110 words, with 6 sentences and 18 words of three or more sylla-
bles, the average number of words per sentenc is 18, and 16% are difficult words. The
total would be 34 for a Fog Index of 13.6, rounded to 14. This sample with the score of
14 would be considered appropriate to the reading level of a college sophomore, ac-
cording to Gunning. No one would mathematically evaluate an entire research report!
When a manuscript seems tedious, however, the author might sample a few para-
graphs. This process may be useful in editing to ensure that the "message" is not buried
in verbiage.
THE POSTER PRESENTATION
A poster presentation is a report of research that is displayed on a large board so that it
can be read and viewed by large groups in a casual atmosphere. Posters afford a special
opportunity for researchers and their profeSSional colleagues to exchang ideas in con-
ference settings. Poster sessions are organized so that each poster is available for several
594 PART Y. COMMUNICATION
hours. Sessions may be somewhat formalized by asking researchers to present a brief
oral summary to an assembled group, with moderator who guides a discussion
around each poster in a symposium format. In another format, the open session, posters
are displayed in an exhibit hall where interested participants view the posters in a less
formal manner. In this case, the researcher is available to answer questions or engage in
discussion. A major advantage of the poster presentation is that interested members of
the audience can study the content and contemplate the implications of a study at a
comfortable pace. The researcher has an opportunity to clarify or amplify details of the
study. Observers' reactions or questions may be helpful in guiding future work and
stimulating new ideas.
Content and Layout
The poster should contain the major elements of the study in a clear, brief series of state-
ments including title, purpose, hypothesis or specific aims, method, results and discus-
sion, and conclusions. The poster should be selfexplanatory, but "telegraphic" in style;
that is, content should include key words and phrases and not necessarily complete sen-
tences. Tables, graphs, or photographs hould summarize and illustrate important find-
ings or unique aspects of the method. The most effective posters do not contain so much
written material that the observer gets lost, but should be complete enough to allow the
observer to understand the full intent of the study.
The conference sponsor will provide guidelines about the size and composition of
the board that will be available. The customary size is 4 ft high and 6 or 8 ft wide. The
composition is usually cork or particle board, so that thumb tacks can be used to hang
sections of the poster.
In preparing a poster, a scaled template should be drawn, showing the arrange-
ment of text and figures. The content elements can be moved about the template to find
the best arrangement for the logical fl ow of information. Ordinarily, the eye follows
from left to right as in reading. The introductory materials should be placed at the top printers pr
left and the conclusion at the bottom right. Methods and results should be displayed produced ~
prominently in the center. Figure 30.2 is a sample template for the arrangement of a available ir
poster.
Materials
THEORA
Many facilities employ or have contracts with medical illustrators who have the appro- Oral preser
priate materials and expertise to construct posters. Enlisting their help or consultation tradition ir
may be the most efficient way to create a poster; however, medical illustrations are usu- timely d i s ~
ally quite expensive. Fortunately, computer software and laser printers can readily cre- rect interch
ate text and graphics, so that mounting a poster can be greatly facilitated. The no
The effective poster should be legible and uncluttered with content presented in a difficult t
sharp contrast to its background. Text and figures can be mounted on colored poster oral report
board so that there is a contrasting border around each section. Letters for the title ideas areca
should be 2 in. high, headings should be at least 1 in. high, and text letters should be at opportuniti
least 0.5 in. high. The print should be bold with clear sharp edges. Sharp-contrast laser tion, which
CHAPTER 30. REPORTING THE RESULlS OF CLINICAL RESEARCH 595
(Institutional affiliation and logo)
TITLE
Authors
PURPOSE METHODS RESULTS
Figure legend
Table title
HYPOTHESIS II CONCLUSIONS I
Figure legend
Figure 30.2 A sample template for the arrangement of a poster presentation.
printers produce excellent images that can be photographically enlarged, or may be
produced in large enough font to display directly. Other kinds of lettering materials are
available in art supply stores.
THE ORAL PRESENTATION
Oral presentation of research findings in an open forum of colleagues is a time-honored
tradition in medicine and science. This avenue of communication offers immediate,
timely dissemination of new information. Like the poster presentation, it encourages di-
rect interchange of ideas and stimulates consideration of new directions in research.
The notion of oral reporting is particularly attractive to those who consider writing
a difficult task and speaking a much "freer ," more comfortable, process; however, the
oral report of research is not at all the same as conversational speaking. In conversation,
ideas are conveyed spontaneously, with facial expressions or gestures for emphasis and
opportunities to repeat or reconstruct a thought to clarify a point. In a formal presenta-
tion, which usually has a time limit of 10 or 15 minutes, each word and phrase must be
596 PART V COMMUNTCA nON
carefully chosen to convey the speaker's message correctly. The message is emphasized
and illustrated visually with slides or overhead transparencies. Unlike conversational
speaking, the oral presentation of research is highly structured. Thorough planning and
preparation including practice are required to ensure success.
Planning and Preparation
Most organizations sel ct individuals to present oral papers on the basis of written ab-
stracts submitted by the researchers. That written abstract can be the skeleton of the pre-
sentation because it contains the major elements of the research project. Indeed, the pre-
senter is obliged to adhere to the topic as written in the abstract.
Because content must be well organized and becaus of the customary time limits,
we suggest that the talk be written. From an initial draft, the speaker can adapt and re-
fine the talk. Key words and phrases can be manipulated to improve precision and em-
phasis. Logical sequencing and transitions from thought to thought can be refined.
Most organizations require that speakers stri ctly adhere to the prescribed time
limit. Therefore, even at this early stage, the text should be read aloud so the speaker be-
gins to develop a sense of timing. Practice should include using visual materials. The ex-
perienced presenter may know that eight pages of double-spaced text including refer-
ences to slides will be about a lO-minute talk. Each individual must acquire this sense of
timing, for which there is no common formula. If the talk is too lengthy, the presenter
must abbreviate the content. What can be eliminated? Is the background or introductory
material too extensive? Have any extraneous, albeit inter sting, sidelights been in-
cluded? Is the talk complicated by falsely fancy words or jargon?
Editing may continue until the final product is ready, but the major elements must
b in place early, so that the slides or overheads can be planned and prepared.
Visual Presentation
Visual aids are essential to the success of an oral presentation. Effective slides or over-
head transparencies emphasize and illustrate the content of the presentation and focus
the audience' s attention to important details. On th other hand, a presentation can be
destroyed by poorly constructed, overwhelming, or confusing slides. In this section, we
discuss a few important guidelines for planning and preparing slides. These guidelines
also apply to making overhead transparencies. As with pos ter presentations, slide
preparation can be facilitated by consulting a medical illustrator or photographer .
Reeder has compiled. an excenent manual for those who prepare their own materials.
4
A
useful handbook for presentations has been rrepared by the Commi ttee on Research of
the American Physical Therapy Association.
The type and number of slides to use should be determined by identifying the key
points of the written text. The most effective presentations use slides to accompany all
parts of the paper, so that the listener is guided through each section of the presentation.
Factors of production cost and the time allotted for the presentation may dictate how
slides are used. Four types of slides may be presented: words or phrases (text), pho-
tographs, graphs, and tables. Word slides are customarily used to present the ti tle of the
presentation, the statement of the purpose or objectives, important background mate-
rial, hypoth
conc1usioI15
setup or su
Word
characters p
tallest lett r
the number
usually diffi
if the word
fier, people
30.3A illus
mation to a
present rna
Byhighligh
it. In additi
The purpcj
the cont
weI/spa
not pre
This sli
A
Cia
Hig
FOCl
B
CHAPTER 30. REPORTING THE RESULTS OF CLINICAL RESEARCH 597
rial, hypotheses, description of subjects and study protocol, summary of results, and
conclusions. Photographs can illustrate aspects of the method such as the equipment
setup or subject activity. Graphs and tables are used to demonstrate the results.
Word slides must be legible and should contain no more than six lines of text or 45
characters per line.
4
The distance between Lines should be at least the height of the
tallest letter. The choice of uppercase or lowercase lettering and typeface depends on
the number of words and the spacing of phrases. Ornate, italic, and open typefaces are
usually difficult to read. One guideline for the size of print for proj ection suggests that
if the words and numbers on a slide can be read directly from a slide without a magni-
fier, people in the back of the room should be able to read them when projected.
4
Figure
30.3A illustrates a slide that contains too many words to be an effective source of infor-
mation to a large audience. Figure 30.3B shows how this information can be reduced to
present major points, which would then be discussed by the presenter in greater detail.
By highlighting each point, the listener can focus on each one as the presenter addresses
it In addition, the text is Larger and less cluttered so that the listener can read it quickly
The purpose of slides in an oral presentation is to clarify
the content. Words of the text should represent the main
points of Ihe commentary: highlighting the information.
To be effective, the text of slides should be uncluttered,
well spaced and in bold type. Words of the text should
not present the verbatim talk.
This slide is boring, tedious and difficult to read. It is so
distracting that the audIence will not concentrate on the
subject matter.
A
EFFECTIVE SLIDES
B
Clarify contents
Highlight important information
Focus attention of the audience
Figure 30.3 Illustration of slide content:
A. Overcrowded. B. Summarized.
598 PARTY. COMMUNICATION
and easily without being drawn away from the spoken material. The border of each oi
these "slides" is an example of a template drawnin proportion to a 34-mm slide.
The content of each slide and the verbal commentary must be synchronized. The
audience cannot take in two separate subjects at one time. Because many of us are "vi-
sual learo.ers," the presenter's remarks will be lost if the slide does not fit the talk. An
uncoordinated presentation is distracting and will be received negatively.
Graphs and tables must be simple and easily understood. The amount of informa-
tion included of course depends on how much is needed to present the results ade-
quately. When a study has generated a lot of data, the presenter may have to be selec-
tive in what to include in the presentation because listeners cannot absorb mounds of
data in such a short time span. Generally, three comparison lines, or six bars on a graph,
or four rows and columns in a table is a sensible limit. Legends, headings, and numbers
should be large enough to be read easily.
Colored slides improve contrast and soften the potential glare from the projection
screen in a darkened room. Most slides (except color photographs) are prepared in
black and white, and then can be converted to color using special film, filters, and pro-
cessing techniques. Color can be added to black and white slides using brush and dye
or felt-tipped pens. These manual techniques are less expensive, but are tricky to do
neatly. Recommended color combinations include whi te or orange on blue, black on
yellow, and orange or yellow on black.
4
Many computer programs are now available for
making slides. These programs provide an array of background colors and print styles,
as well as designs and patterns that can make slides more attractive. Researchers should
be wary of making slides too busy, so the background of the slide does not detract
from the information it is trying to convey.
Rehearsal
After the presentation is written and slides are keyed to the text, rehearsal can begin.
First, the presenter should go through the talk incorporating the slide presentation to be
sure that the slides are synchronized properly with the verbal commentary and to con-
firm the length of the talk. Then, presentation to the "home-town" audience is war-
ranted. Not only will staff members, fell ow students, and faculty comment on or make
suggestions for the presentation, but also they should be encouraged to ask questions,
which may indicate the kind of questions that will come up in discussion following the
formal conference presentation. Being well prepared for both the talk and the discus-
sion will inspire confidence and ensure a professional performan
C COMMENTARY
According to DeBakey, a written report of research findings should provide infor-
mation that is new, true, important, and comprehensible.
6
These criteria can be ap-
plied to poster and oral presentations, as well. ew treatment or measurement
techniques may have been developed and tested. Effectiveness of intervention
may have been demonstrated, reaffirmed, or refuted. The process of a study may
"r'.
time
ta O
edJtin",
rules a..
make a
-- Key "T
in_t:nu:
abstrac
REFER... -C
lnterna -
:iubmittea.
_ Staheli I T
3. Bates JD. ,
Reeder R(
_. CoIlUl1itre
Poster f>r,

i. Sheen AI'
Suggested
Robinson A:.
1982
Strunk \ ,
Zinsser \ :
of
The
"vi-
An
a-
ade-
_5elec-
of
ph,
~
on
aiin
-- pro-
.., dye
do
;; 'les,
uld
ct
CHAPTER 30. REPORTING THE RESULTS OF CUNICAL RESEARCH 599
have been valid and objective. The findings may have important implications for
clinical practice. But who will know if the report is poorly prepared? Sheen pre-
sented the point this way: "As a scientific author, you must write so that you are
understood or, perhaps more important, so that you are not misunderstood.,,7
The final step in the research process-to communicate the results-requires
time: time to plan, time to write, time to revise. Early drafts of reports and presen-
tations should be put away for awhile and then later reread with the intention of
edi ting. The editorial board of a journal and sponsors of a conference establish
rules and restrictions for the format and organization, but only the author can
make a presentation d ear, precise, and alive.
Key Terms -------------------------,
instructions to authors active voice
abstract passive voice
REFERENCES
1. International Conunittee of Medical Journal Editors: Uniform requirements for manuscripts
submitted to biomedical journals. Ann Intern Med 108:258, 1988
2. Stahe\i LT: Speaking and Writing/or the Physician. New York, Raven Press, 1986
3. Bates JD: Writing with Precision. Reston, V A, Acropolis Books Ltd., 1990
4. Reeder RC: Sourcebook o/Medical Communications. St. Louis, MO, CV Mosby, 1981
5. Committee on Research of the American Physical Therapy Association: Handbook for Oral and
Poster Presentations. Alexandria, V A, APT A, 1985
6. DeBakey L: The Scientific Journal. Editorial Policies and Practices. St. Louis, MO, CV Mosby, 1976
7. Sheen AP: Breathing Life into Medical Writing. A Ha ndbook. St. Louis, MO, CV Mosby, 1982
Suggested Additional Readings
Alley M: The Craft of Scientific Writing. Englewood Cliffs, NJ, Prentice-HaU, 1987
American Medical Association. Manual of Style, ed 8. Baltimore, Williams & Wilkins, 1989
Day RA: How to Write and Publish a Scientific Paper, ed 3. Phoenix, AZ, Oryx Press, 1988
Huth EJ: How to Write and Publish Papers in the Medical Sciences. Philadelphia, lSI Press, 1982
Robinson AM, Notter LE: Clinical Writing for Health Professionals. Bowie, MD, Robert J. Brady Co,
1982
Strunk W, White EB: The Elements o/StlJle, ed 3. New York, MacMillan, 1979
Zinsser W: On Writing Well, ed 3. New York, Harper & Row, 1988