Writing the Summary
IF A PICTURE IS WORTH A THOUSAND WORDS, A GOOD STORY IS WORTH MANY COLUMNS OF STATISTICS. STORIES PRESENT IDEAS, CONFLICTS, AND SOMETIMES, RESOLUTION. THEY HAVE DEPTH AND DIMENSION, DRAMA AND EMOTION, MAKING THEM MORE MEMORABLE THAN DATA ALONE.53
DECISION MAKERS RARELY USE A REGRESSION COEFFICIENT TO HELP THEM SOLVE A PARTICULAR PROBLEM. RATHER, OVER LONG PERIODS OF TIME, IDEAS ENLIGHTEN DECISION MAKERS ABOUT A PARTICULAR ISSUE AND HOW TO HANDLE IT.6
Research in the form of "ideas," not "data," is what most influences managerial and policy decision-making.6,54 Of course, these ideas or take-home messages are best considered a starting point for a discussion with policy makers and managers rather than a cookbook remedy. Summaries are intended to augment collaboration between researchers and decision makers, not replace it altogether. This section provides tips for writing an easy-to-read research summary that gets to the point for policy and decision makers.
Proposed objective
Students should be able to write actionable, evidence-based messages using lively prose and meaningful statistics.
Knowing the audience
One of the underlying points of the "exchange model" of knowledge transfer is that it requires a relationship between those who generate research knowledge and those who may use it. For those involved in these relationships, the "getting-to-know-one-another" stage is often an ongoing one. For those about to undertake a Mythbuster, some will already have established these sorts of relationships. For others, this activity will inspire the first encounter with an audience or audiences. In any case, before considering the best ways to start or convey a summary, it is wise to ask "What is the essence of the story I am trying to tell?"55 Similarly, one should aim to write and edit a summary with the readers' needs and habits in mind.55 These points touch on two of the important questions that arise in the discussion of dissemination in section six. These two questions are (1) what is the message I wish to share? and (2) who is the audience to which this summary is targeted? Asking these questions at this stage will help one develop a plan that can guide the writing process. In terms of addressing these questions, please refer to From research to practice: A knowledge transfer planning guide for appropriate direction, as this guide already provides valuable insights.22
Writing actionable, research-based messages
The research evidence strongly recommends transferring actionable messages from a body of research knowledge, not simply presenting a single research report or the results of a single study.6 These statements should be as active as possible and limit the number of lengthy qualifiers (such as methodological and technical details) that are typical of full research reports. Caveats are important, but the research summary need not (and cannot hope to) present all of the minutiae of every piece of research. Instead, the research summary must extract clear, simple and active main messages or key implications from research results, while directing readers to the full research reports for more specific details.
Getting to the point
Policy and decision makers will want to know why the subject you are writing about matters or should matter to them. It's essential to tell the readers quickly what the story is about and why they should keep reading. If you bury the point, you risk losing readers.
As is the case in journalism, a summary will become less reliable when "events are inflated for sensation, neglected, stereotyped, or disproportionately portrayed as negative" too.56 Don't leave out important details and caveats for the sake of getting to the point. Writing and rewriting will help synthesize the text, so always allow plenty of time to edit.
Taking time to edit the title of a Mythbuster is especially important. In the news media, the headline and lead are often written by an editor, not the reporter who covered the story. For that reason, the headline can sometimes appear disjointed from the rest of the story. As a research summary evolves and gains precision, so too must the title. Often the title and subheadings of a Mythbuster undergo several iterations before they are finalized.
Being economical but lively with words
Summaries, like news articles, will suffer from passive verbs, run-on sentences, mixed metaphors and clichés. In particular, "readers notice sloppy writing and they don't forgive."55 To ensure every idea flows logically into the next, it is best to use simple declarative sentences, each sticking to one idea. This kind of writing is easier to understand and will better hold the readers' attention.55
When there is only a limited or fixed amount of space and text to work with (say, two pages or roughly 800-1,000 words), it may be best to use strategies that tell your reader a lot, but with few words. For example, it may help to organize and present information in charts, tables, bulleted lists or other graphics. Another technique is to pull out catchy pieces of text that are representative of the section.
Keep in mind that two pages can feel long if tables or graphs are used inappropriately or the text is written passively and without the appropriate amount of detail. To keep the summary short and sweet, writers should aim to use conversational styles.
Using storytelling and narrative to demonstrate a summary's focus
FEW PARTS OF THE HUMAN WORLD ARE BETTER SUITED TO STORYTELLING THAN HEALTHCARE.57
The historian and health policy commentator Dan Fox famously commented, "The plural of anecdote is policy."58 In a Mythbuster, an anecdote can be a powerful tool for introducing an issue and inspiring action. However, a Mythbuster must also go beyond anecdotal evidence to providing necessary details from the relevant body of research evidence. A 2006 issue of Evidence Boost — a series of research summaries highlighting evidence-informed healthcare management and policy options — began with the story of Jean Sauvé, a 72-year-old widower with diabetes and high blood pressure who is on several medications.59 Introducing Mr. Sauvé allowed CHSRF to paint a picture of the "revolving door syndrome" of hospital care, which is a particular problem for Canada's vulnerable populations who have ongoing but non-urgent medical needs.59 Not every Mythbuster topic will lend itself to the use of narrative. For those that do, anecdote can be a commanding tool for piquing the readers' interest and inviting them to read the research evidence.
In Once upon a time... The use and abuse of storytelling and anecdote in the health sector, the author explains the appeal of anecdotes in healthcare: "the narrative is so appealing because it is familiar and thus comfortable, like an old pair of slippers."57 The news media in particular are well-known for their reliance on anecdotal evidence, which is often considered "the lowest rung of the evidentiary ladder in science."60 While this may be true, narratives remain an influential means for sharing information, as Mullen58 explains:
Terms such as "evidence-based" and "data-driven" are the coin of the policy world today, and "the anecdote" as evidence is as much demeaned in policy circles as it is in clinical medicine. Yet, important as the arguments are for the use of quantitative science to inform clinical and policy decisions, the anecdote — the report of life events from an unabashedly subjective vantage point — remains a powerful tool for focusing the human mind.
When it comes to news reporting on research, Seale61 says "[s]ome degree of simplification must be necessary if the dramatic oppositions that are the core device of story telling are to be created" (p. 514).
In Stephen Denning's work on effective storytelling, he describes the power of telling stories to transfer knowledge. While Denning's work is written for a business audience, its lessons are equally relevant to anyone interested in being more effective at sharing knowledge and inspiring action. According to his work, the key to effective storytelling is choosing the right story for one's purpose. Among the objectives of the stories Denning discusses are those intended to spark action or share knowledge.62,63
| OBJECTIVE | THE STORY SHOULD: | THE STORYTELLER WILL NEED TO: |
| Spark action | Describe a successful change | Avoid excessive detail |
| Share knowledge | Focus on mistakes, how they were
corrected and why the solution worked | Solicit alternative solutions |
There are a number of other helpful resources on effective storytelling, narrative and personal essay:
- In The story of knowledge: Writing stories that guide organisations into the future, the authors build on CHSRFal knowledge developed by Denning and others, proposing that well-written stories can be a motivator for organizational change.64
- In Made to stick: Why some ideas survive and others die, the authors discuss how to nurture ideas so that they are understood, remembered and have a lasting impact by changing the target audience's opinions and behaviour.65 The authors adopt the "stickiness" language from Malcolm Gladwell's book, The Tipping Point. As a complement to Gladwell's work,65 they propose six principles of sticky ideas: simplicity, unexpectedness, concreteness, credibility, emotions and stories.
Making numbers meaningful
NUMBERS CAN'T "TALK," BUT THEY CAN TELL YOU AS MUCH AS YOUR HUMAN SOURCES CAN. BUT JUST LIKE WITH HUMAN SOURCES, YOU HAVE TO ASK!66
To the untrained eye, meta-analyses, effect sizes and odds ratios may be meaningless. It is the writer's job to interpret such statistics for policy and decision makers. These days, many resources exist for beginners and advanced writers:
- In Statistics every writer should know: A simple guide to understanding basic statistics, for journalists and other writers who might not know math, the author provides an overview of some of the basic concepts in statistics that every writer should know.66
- In Drugs in the news: How well do Canadian newspapers report the good, the bad and the ugly of new prescription drugs?, the authors provide examples of the difference between absolute and relative risk.67 In Risky business: Making sense of estimates of risk David Streiner provides further insights.68
- The Hayward Group Inc. has developed a helpful What is . . . ? series. This series answers such questions as "What is a Number Needed to Treat?" "What is cost-effectiveness?" and "What is meta-analysis?"69
- A number of helpful resources exist for making sense of numerical results from meta-analyses and systematic reviews.70,71,72
Avoiding interjecting personal bias
This resource has already addressed the possibility of interjecting one's personal bias in a research summary. To be an effective Mythbuster, the myth and the evidence debunking it must stand independent of the writer's personal convictions. In the writing stage, it is important to continue to challenge one's own thinking by asking: "Am I missing or misrepresenting any of the research evidence in an attempt to make it more accessible?"