Introduction
As students and practitioners, we need to be able to communicate effectively in writing. This is necessary to meet the requirements of professional practice not only in assessing, planning, implementing and evaluating care, but also in completing nursing and midwifery notes and in supporting and justifying changes in practice to managers and other multidisciplinary colleagues. In addition, you might want to write for publication in order to share good practice and innovative developments with a wider audience. Remember that there is probably no such thing as a born writer. The successful writer is the one who regards writing as a skill to be learned, refined and constantly improved.
Successful writing is about using ideas and information to say something in a clear, unambiguous way that others will understand. Many different types of writing are required in professional practice; for example, ‘academic’ style, report writing and protocol development. The focus of this chapter is on developing an academic style.
Academic style is important in the development of learning skills in two ways: (1) you will come across it in your reading; and (2) you will be learning to develop it yourself through your assessed pieces of coursework. Therefore, it is necessary to understand its ‘rules’. Academic writing in its purest form is cautious and tentative in approach and depends on argument supported by strong evidence. The aim is to be as exact as possible and to say only what can be justified. Academic writing is designed for a very critical reader who is interested only in whether the arguments make sense and not in appeals to the emotions.
Take something you have written recently, e.g. an assignment, a formal letter or minutes from a meeting. Read it through carefully and ‘mark’ it against the following criteria:
Take something you have written recently, e.g. an assignment, a formal letter or minutes from a meeting. Read it through carefully and ‘mark’ it against the following criteria:• Has all the relevant information been included?
• Does it make sense?
• Is it simple and to the point?
• Is it legible and easy to read?
Having marked it in this way, you should be able to begin to see where some of your strengths and weaknesses are, and where it might be useful to seek further help.
Developing an effective writing style
Academic style
In everyday language the word ‘academic’ is sometimes used in a pejorative way to describe things that have no practical purpose or are divorced from practice. In the context of education and writing, academic style means something very specific and relates to a set of rules about how to deal with information and evidence. Although the pieces of coursework you are required to produce on your programme will probably have a variety of formats – essays, case studies, reports, critical incident analyses, reflections on competency achievement in practice – the principles in terms of writing style are similar. For example, in most cases it is important to justify and support the points you want to make with material that you have read. This does not mean, however, that you should cite ten authors to back up statements such as ‘many women experience pain during childbirth’ or ‘maintaining patient/client dignity ought to be a high priority for nurses’. Make a clear distinction between what you know because you have read about it and what you know because of your own experience and reflections on those experiences. Being able to distinguish between different types of evidence is also important (see Chapter 8 for a further discussion about this).
It is vital to try to express yourself as clearly and as succinctly as possible by using short sentences and straightforward language.
Keep it simple. If you do not understand what you have written, it is unlikely that anyone else will.
Keep it simple. If you do not understand what you have written, it is unlikely that anyone else will.For example, consider this clear and straightforward introduction to an article by Roe et al. (2008):
Falls and falling are common occurrences with increasing age (Tinetti et al., 1998). Older people are particularly likely to fall, and this can result in severe cases in injury, fractures, hospitalization and premature death (Rawsky, 1998; Cryer and Patel, 2001). Other consequences are repeat falls, fear of falling, impaired mobility, loss of independence, social isolation and significant costs to individuals, their families and public services (Gryfe et al., 1977; Morse et al., 1987; O’Loughlin et al., 1993; Rawsky, 1998; Cryer and Patel, 2001; Tinetti, 2003). Awareness of the costs and implications of falls in recent years has made falls prevention an important policy internationally for health and social services to address supported by initiatives in the voluntary sector (DH, 2003, 2004; Todd and Skelton, 2004). There has been little research investigating the consequences of falls from the perspectives of older people and their families. In this paper, we report the findings from qualitative research investigating older people’s experiences of recent falls to analyse their understanding of these falls, and their autonomy. These findings could serve as the basis for service and practice development.
However clear and logical the argument, it is easy to get frustrated if you do not agree with what the author is saying. When reading, we are supposed to detach our thoughts from our feelings and put our own biases on one side to judge the validity of the author’s arguments by their strength and soundness alone. This is practically impossible, because if we were able to do this absolutely we would not have a position from which to think about, or to judge and criticize, what we read. Eventually, we may or may not decide that the author has a point but we need to give ourselves the chance to find out what is on offer and so must try not to reject opposing points of view too quickly. Instead, we should use our feelings constructively by writing down our criticisms point by point.
Learning from others
A valuable aid to developing your own writing ability is to look critically at the work of others. You may find it particularly helpful to read other students’ assignments and see what appears to work well and gets good marks. Similarly, when reading books and journal articles try to sort out why you prefer one author’s work to another. Critically judging other people’s writing in this way is a good way of increasing your understanding of what you are trying to aim for in your own writing.
Choose two journal articles that interest you. Read them thoroughly. Decide which is the better article and jot down the reasons why. You have probably picked the article that is well structured, clear and straightforward to read.
Choose two journal articles that interest you. Read them thoroughly. Decide which is the better article and jot down the reasons why. You have probably picked the article that is well structured, clear and straightforward to read.The subject
As a student, you may be given an essay title that specifies the subject you are to write about; for example, ‘The public health role of the midwife’. The title might even identify the claim you are to defend or attack; for example, ‘Time limits for the second stage of labour disempower women from achieving normal birth’. Alternatively, you may only be given broad guidelines; for example, ‘Write a 3000-word essay on a contemporary professional issue’. In this instance, your first task will be to identify the subject for your essay.
How might you go about identifying a subject?
How might you go about identifying a subject?Possible sources are:
■ Your own experience of practice: are there issues that interest or concern you?
■ Colleagues and managers: what are the current issues in your speciality, and in nursing and midwifery in general?
■ Professional and specialist journals: what subjects are being written about?
The evidence
Chapter 3, Chapter 4 and Chapter 5 looked at the practical aspects of gathering information about a subject. Having found your information, you then need to analyse it to see what evidence there is relating to your assignment. Although you might start with a strong hunch, or with views already well developed in one direction, it is important to keep an open mind and consider all the evidence, not just that which supports your point of view.
Structure
All written work should include an introduction where you set the context and outline the ‘map’ of what is to follow. This map should include what you are going to cover, why you have decided on this particular approach and how your argument will develop.
If you have been given a formal title for an assignment, such as ‘Discuss the evidence that distinguishes the differences between the responsibilities of a registered healthcare professional and a lay carer’. This title gives some clues about what the structure and content of your essay should be. The key words in this title are ‘discuss’, ‘evidence’, ‘ differences’, ‘responsibilities’, ‘registered healthcare professional’ and ‘lay carer’:
■ ‘Evidence’ indicates that you are expected to support your argument with research and other literature and not just provide your own unsupported opinion.
■ ‘Differences’ asks for you to concentrate on what is different between a ‘registered healthcare professional’ such as a midwife and a ‘lay carer’ such as a family member.
■ ‘Responsibilities’ highlights the area of difference which you need to focus on. So, for example, describing the different rates of pay for these two groups would not be relevant.
If, however, you have just been given a topic such as ‘institutionalization’ you will have to decide what you think the key points and issues are. For example, you might decide that you want to explore the effects of institutionalization on people with learning difficulties and put forward the case for community care in small group homes. First, you will need to define what institutionalization is. Then discuss the contribution of people such as Erving Goffman (1961) to our understanding of this concept, identify why people with learning difficulties might become institutionalized and consider the importance of small group homes integrated into the normal social life of local communities in preventing institutionalization.
You should outline the key themes and arguments in the main body of your assignment. So in our first example you might refer to the Nursing and Midwifery Council’s ‘The Code: Standards of conduct, performance and ethics for nurses and midwives’ (2008) and ‘Midwives rules and standards’ (2004), as well as to the various policies (e.g. drug administration polices) put forward by different healthcare organizations. Then you would outline the arguments from the literature and your own experience of the difference between the two groups. This should take several paragraphs.
Finally, you should write a conclusion that pulls together and summarizes the key points you have made. The conclusion to ‘Discuss the evidence that distinguishes the differences between the responsibilities of a registered healthcare professional and a lay carer’, could be as follows:
In this essay, I have used the literature and my own experience to show that the registered nurse’s responsibilities for the care of a sick child are different from those of a parent, even though some of the activities they undertake may be very similar. A key responsibility for the registered nurse is to make sure that their expertise in care giving and familiarity with healthcare organizations, systems and other professionals does not result in the parents feeling disempowered and undermined.
Each sentence in your assignment should lead logically on to the next and there should be clear signposts to your reader when you are changing subject or introducing a new point of view. Paragraphs are collectionsof sentences on a particular theme. When you change tack, it is time for a new paragraph.
Clarity is crucial. There is often a tendency for students to use very long phrases and complicated sentences in an attempt to emulate what they read in heavyweight journals and specialist books. However, ease of reading and simplicity are far more likely to impress.
Never assume anything. Your reader has not necessarily read the same sources as you and certainly does not know what is inside your head, so you need to explain all your ideas fully and give examples to illustrate the points you are making.
The UK government is committed to ensuring that all NHS staff are information technology (IT) literate and so the ability to word-process your work is essential. You should print on only one side of the paper and leave a generous space between the lines – dense text is very hard on the eyes. Mistakes in spelling, punctuation and grammar do not lose you marks as such but can get in the way of the readability of your work and stop it making sense to others. Use the support that technology gives you, such as spell- and grammar-checking functions, but do make sure that these are set appropriately for the country you are writing in (e.g. UK English). You might be able to get help if you experience any of the difficulties listed in the box below.
Reading
• Slower than usual reading speed
• Difficulties with reading comprehension and therefore with summarizing
• Problems decoding new scientific words
• Loses place in a series or in reading
Memory
• A ‘quick forgetter’ rather than ‘slow learner’
• Poor strategies for ‘rehearsal’ of information into long-term memory
• Difficulties memorizing facts and new terminology
Writing and spelling
• Handwriting problems
• Difficulties with listening and taking notes
• Difficulties in copying from the PowerPoint presentation
• Severe and persistent spelling problems
• Difficulties in getting ideas on paper, so that written work fails to adequately express student’s understanding, ideas or vocabulary
Learning
• Difficulties with organization, e.g. work, assignments, projects, university life, notes and files
• Trouble generalizing and applying new rules, seems to or reports ‘switching off’
• Problems working with background noise
• Short concentration span
• Needs to be told information more than once
Many organizations offer support to students with dyslexia and/or other learning difficulties. This can include providing access to staff with specific expertise in this area. If you are having difficulties, talk to your personal tutor, who will be able to put you in contact with the appropriate support. This confidential service should include supporting you through a formal assessment process and helping you to access specific equipment and funding to support your learning.
The following tips, hints and activities should help you develop and refine your academic style.
Compare the styles of argument and language used in the editorial columns of a range of newspapers; for example, the Daily Mail and The Guardian.
If you read something and find that you disagree with it, think about why this is. Do you think the author could have got the facts wrong? Or is the problem that the conclusion doesn’t follow from the arguments given?
• Read the work of others: this will help you identify good and bad writing styles.
• Reading helps improve vocabulary and grammar: share your work with other students and colleagues and get feedback.
• Practice makes perfect: writing short sections can help polish writing skills and boost your confidence.
Compare the styles of argument and language used in the editorial columns of a range of newspapers; for example, the Daily Mail and The Guardian. If you read something and find that you disagree with it, think about why this is. Do you think the author could have got the facts wrong? Or is the problem that the conclusion doesn’t follow from the arguments given?Developing an argument
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