How can we write efficiently?















On this page you will find advice on overcoming a negative writing culture. some tips on giving positive feedback, five easy steps for getting around writer's block
and advice on how to turn pain into writing gain.
Overcoming a negative writing culture
One of the fascinating things about the way doctors and other health professionals organise their writing is how difficult they make it for each other.In other activities and in other walks of life, usually we are encouraged to be positive to people who are brave enough to have a go. But when it comes to putting things down in black and white, we are too quick to get out the red pencil.

For instance, as soon as the first author has finished the first draft of a scientific article, all the other co-authors try to show up his or her inadequacies as writer or researcher. When a journal is published, editors sit round pointing out all the spelling mistakes that have been missed.

And if someone writes well enough to get published in the national press, his or her colleagues will ignore any reference to the fact that important information has been disseminated, instead gleefully pointing out one or two omissions for which there probably wouldn’t have been room anyway.

Why does this happen? Partly, I think, for reasons of power – it is an excellent way of keeping people – particularly those younger and brighter than us - busy, occupied and therefore unthreatening.
 
But it also happens by default. This negative writing culture has been around for years and not enough people have sat down to work out whether there is a better way of doing this writing thing.

There is, and here are some suggestions.
  • Keep it all in perspective. The number of criticisms people can make about your writing is not a sensible measure of success. As the American humorist James Thurber famously wrote: ‘Don’t get it right, get it written’.
  • Negotiate before writing. Many of the difficulties that arise once the first draft has been written do so because all those involved still have to agree what it’s all about. With any major piece of writing, make sure that all those involved agree, preferably in writing, on what you are trying to say, to whom – and how you will judge your success.
  • Encourage balanced feedback. Try to encourage a culture in which those who are asked to comment on writing are expected to say what they think works – and what they think needs changing. They should not be encouraged to go through the text in nit-picking details – and any red pens used for this purpose should be destroyed.
  • Look for the positive. Anyone who writes will make mistakes, and we can always do it better. But the question to keep asking is this: has our writing achieved the goal we set out to achieve? All else is noise.
Unbalanced feedback: what the comments really mean
  • Didn't you learn grammar at school?
    What kind of school did you go to anyway?
  • Everyone know you can't start a sentence with And or But.
    My school was much better than yours.
  • I found it difficult to follow your arguments.
    Haven't you heard about paragraphs?
  • I'm not quite sure I understand your drift?
    I did brief you, didn't I?
  • You should write more concisely.
    This is too long.
  • I think you are being patronising.
    Goodness! You have written this in clear English. It could be dangerous.
One of the great mysteries in life is how people who speak simply and intelligibly face-to-face produce acres of gobbledegook as soon as they put pen to paper.
 
After running hundreds of courses on effective writing, I now feel that I know the answer. It's not so much the fault of the individual as the fault of the culture. And when it comes to the culture of medical writing, unfathomable prose seems to be particularly highly valued. A good way out is to build up a counter culture, and this means changing our habits and giving our colleagues useful feedback on their writing, not just criticism. Here are some tips.
  • Make sure you know what the writer is trying to achieve and who the audience is. Unless you understand this, your comments will be on matters of detail, not substance.
  • Be balanced. Don't just go through looking for errors and shortcomings. Tell the writer what he or she has done well.
  • Don't make endless minor changes. If someone is not very good at spelling, don't just circle the offending words; advise them to put their writing through a spell check.
  • Don't assume that what you were taught at school was correct. A common complaint is that writers have started a sentence with a 'But'. But look in any reference book and it will tell you that this is perfectly acceptable.
  • Don't use a red pen. This sends round all kinds of signals, and takes people back into the classroom. A pencil is a much softer option - amendments can easily be rubbed out.
  • Remember you are making changes, not necessarily corrections.
  • You are not the target audie ce. All your comments should be based not on the principle 'Do I like that?' but 'Is this right for the audience?'
  • Give yourself feedback. When you are finished ask the question: 'Have I helped the writer - or demoralised them?'

How experts view the writing process
  •  'Get up very early and get going at once, in fact work first and wash afterwards' - WH Auden
  • 'You can't wait for inspiration. You have to go after it with a club' - Jack London
  • 'Keep it simple. Be clear. Think of your reader, not yourself. Cheer up' - Roger Angell
  • 'Read over your compositions, and when you meet a passage which you think is particularly fine, strike it out' - Samuel Johnson
  • You will never be satisfied with what you do' - Fay Weldon
(From: Advice to writers, Jon Winokur (ed), London: Pavilion Books, 2000)
 

 Five tips for getting around writer's block
1. Make a drink
To write well you must be creative and critical - though not at the same time. If writer's block looms, the critical side has taken control. Remove yourself from the source of conflict - take a cool drink, a hot bath, or a wet and windy walk.
2. Be kind to yourself
Any piece of writing is judged on the final version, not on the first draft. You are not a failed human being if you do not get it right first time.
3. Go back to the beginning
It is almost impossible to complete a task well if you do not really know what that task is. Jot down on a scrap of paper what you are trying to write - one idea, as precise as possible. Also jot down for whom you are writing - and why. You will probably find a basic fault, such as writing the wrong piece, or for more than one audience.
4. Have another think:
Brainstorm. With your revised piece clearly in mind, spend five minutes writing down all the questions that you now need to answer. From this, work out a new plan.
5. Write again
Set aside about 20 minutes in a quiet place and, with your brief and plan to hand, start writing. Leave your detailed notes outside. Do not check details such as facts and spellings: you can do this later.
When you have finished this draft, put it on one side. When you come back to it you will certainly have to do some revision. But you will have completed the first draft - and will have unblocked the brain.

How experts view the writing process
  •  'Get up very early and get going at once, in fact work first and wash afterwards' - WH Auden
  • 'You can't wait for inspiration. You have to go after it with a club' - Jack London
  • 'Keep it simple. Be clear. Think of your reader, not yourself. Cheer up' - Roger Angell
  • 'Read over your compositions, and when you meet a passage which you think is particularly fine, strike it out' - Samuel Johnson
  • You will never be satisfied with what you do' - Fay Weldon
(From: Advice to writers, Jon Winokur (ed), London: Pavilion Books, 2000)
 
Turn pain into writing gain 
One of the most common things people say at the start of a course is that they want to take the pain - or the boredom - out of writing.
 
I can only give them bad news. Writing, like almost anything else, needs effort if is to be well done. So I can't solve that one.
 
What I can offer, however, are some tips for making the pain more useful, so that writing becomes tolerable and more effective.

1. Don't write too soon.
Many people rush to their pen or word processor, and set out on their writing journey without knowing where they are headed. This will almost certainly cause all kinds of problems as they use draft after draft to put their thoughts in order.
 
The secret is to get your thinking done first. Write down, on the back of an envelope or its electronic equivalent, exactly what you are trying to say (preferably in one sentence, with a verb), to whom, and why.
 
You will not need to block aside large amounts of time to do this: think in odd moments, like going to work or making the coffee. Don't worry if it takes time; this is the hardest part.

2. Don't put aside large amounts of time to write.
Writing is a risk-taking activity, so the more time you make available, the worse the worrying can be. The answer is simple: as soon as you are ready, start writing. Set aside 10 -15 minutes: don't go back, don't give up, and don't cross out.
 
You will almost certainly feel that you could have done better, but two important things will have happened. The first draft will now be written and (since you wrote it in one go) it will almost certainly have an easy-to-follow structure.

3. Don't fiddle uncontrollably with your drafts.
Now comes the hard work as you go through your first draft and make it fit for human consumption. Again, it is tempting to start fiddling too soon. But there is a way of approaching this systematically.
Print out your draft and, without getting involved in the detail, check whether you are still saying style.
 
4. Don't get it out of perspective.
There is more to life than writing. If you produce what you set out to produce, within the time limits you set yourself, then it is a job well done. After all, while writing can be terribly painful, having written is one of life's great joys.

What is a good writing style?
How can we get published in medical journals
How can we write effectively in the electronic age?