PAME & Health RAB organize Workshops on Medical Writing, Medical Editing and Peer Review at QAMC Bahawalpur & SZMC Rahim Yar Khan

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PAME & Health RAB organize Workshops on
Medical Writing, Medical Editing and Peer Review
at QAMC Bahawalpur & SZMC Rahim Yar Khan

First such academic activity in medical institutions in
South Punjab arouses lot of interest among faculty members

From our correspondent

Bahawalpur & Rahim Yar Khan: Pakistan Association of Medical Editors (PAME) in collaboration with Health Research Advisory Board (Health RAB) an entity established by PharmEvo organized two days workshops on Medical Writing, Medical Editing and Peer Review at Quaid-e-Azam Medical College Bahawalpur on May 18th and 19th 2015. The same workshops were held at Sheikh Zayed Medical College Rahim Yar Khan on May 20th and 21st 2015.  These workshops were accredited for 1.5 Credit Hours each by University of Health Sciences (UHS) which is also keen to promote academic activities in these institutions. Mr. Shaukat Ali Jawaid Chief Editor of Pakistan Journal of Medical Sciences who is also Secretary General of Eastern Mediterranean Association of Medical Editors (EMAME) was the main facilitator while Prof. Javed Iqbal Head of the Dept. of Surgery and Director of Medical Education at QAMC was the co-facilitator at Bahawalpur and Prof. Tariq Mahmood Rehan Head of the Dept. of Surgery and Director of Medical Education at SZMC was co-facilitator at Rahim Yar Khan. Since this was the first such academic activity in these medical institutions in South Punjab, it aroused tremendous interest among the faculty members. 


Prof. Haroon Khursheed Pasha
Principal QAMC

There were thirty four participants in the workshop on Medical Writing and thirty five in Medical Editing, Peer Review at Bahawalpur while at SZMC Rahim Yar Khan, the number of participants in the workshop on Medical Writing were forty nine and twenty two in the workshop on Medical Editing and Peer Review. While on the first day it was interactive session but on second day the programme also included Hands on Training which was very much appreciated by the participants. The main objective of these workshops was to create awareness, sensitize and stimulate the participants in the art of medical writing and thus unearth the hidden talent in these institutions which is present in abundance. The participants in their feedback not only thanked PAME and Health RAB but also wished that such activities should be organized more frequently. 

 

Prof. Javed Iqbal 
Participating in the discussion

Introducing PAME, Mr. Shaukat Ali Jawaid said that this is a registered body medical editor of various biomedical journals published from Pakistan.  Dr.Fatema Jawad Chief Editor of JPMA is its current President and Dr.Jamshed Akhtar Editor of JCPSP is its General Secretary. Our main objective is to promote the art of medical writing and scientific publishing. As regards Health RAB, it has been established by PharmEvo with the main objective of promoting research culture in the country, helping authors and researchers. Since our objectives are similar, PAME has an understanding with Health RAB and we collaborate and cooperate with each other. Prof. A. G. Billoo an eminent paediatrician who retired as Prof. & Head of the Dept. of Paediatrics from Dow Medical College Karachi is its Patron while Prof. Abdul Basit an eminent Diabetologist and Director of  Baqai Institute of Diabetes and Endocrinology (BIDE) is its current President.

Publication Game

On the first day the important players in the Publication Game i.e. authors, reviewers, editors and their role and importance was discussed followed by different types of medical writing. Then the participants were encouraged to highlight the inhibitions and problems they face while starting medical writing so that a solution could be found to overcome these inhibitions. Case histories, original articles, Reviews, Case Reports,  Clinical Case series, Special communication, Brief Communications, Letters, Medical Books, Thesis, Dissertations, it was pointed out are all different forms of medical writing. One has to learn this art and develop a habit of reading which helps to overcome Writer’s Block.


Prof. Qazi Masroor Ali

Mr. Shaukat Ali Jawaid first gave the world overview, discussed the leading medical journals in different region as well as the top ten medical journals in the Eastern Mediterranean Region. He pointed out that it was heartening to note that out of the top ten medical journals in the Eastern Mediterranean Region, five were from Pakistan. He then gave figures of number of biomedical journals published by various countries in this region and said that Iran was on top with 347 medical journals. There are fifty seven medical universities in Iran and most of these journals are published by these medical universities and faculty members affiliated with different professional specialty organizations. These medical universities have lot of funds and they encourage faculty members by providing various incentives.

  

Prof. Munir Azhar

These medical universities also compete with each other for the top ranking based on the number of postgraduates produces and number of publications, research output. In order to encourage the facility members and promote research culture, those faculty members who publish more papers are honoured and rewarded at the annual Research Day which is celebrated by these medical universities annually. 

ICMJE, WAME, EMAME,
APAME and PAME

The participants were also introduced to various professional organizations of editors which are working to promote the art of medical writing, scientific publishing, Peer Review all over the world. They were informed about the background of the formation of International Committee of Medical Journal Editors (ICMJE). He also referred to the “ICMJE Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals” (“ICMJE Recommendations”(Revised in  2013) which are followed by most of the biomedical journals all over the world with slight modifications. ICMJE was founded in 1978 and it revised its guidelines after every couple of years.  ICMJE Guidelines on authorship was discussed in detail. It was also stated that now many journals demand contribution of each author in a manuscript to discourage the ménace of Gift Authorship. Details about World Association of Medical Editors (WAME), Eastern Mediterranean Association of Medical Editors (EMAME), Asia Pacific Association of Medical Editors (APAME) and Pakistan Association of Medical Editors (PAME) which was founded in 2010 were also provided. In addition the participants were also told about the various associations of medical editors functioning in different countries all working towards the promotion of discipline of medical journalism.

 

PAME in collaboration with Health RAB organized a workshop on Medical Editing, Peer Review at SZMC
Rahim Yar Khan on May 21, 2015. The group photograph taken on the occasion shows the workshop
participants with Prof. Athar Maqbool Principal SZMC, Prof. Tariq Mahmood Rehan Director
of Medical Education and the workshop facilitator Mr. Shaukat Ali Jawaid.

In the next presentation, the topics which were covered included how to write structured abstract, the difference between Summary of a Review article and structured abstract of an original article. It was also pointed out that latest ICMJE Guidelines state that Summary of Review article must give information about the databases searched for literature search and the time period for extracting this information. Then basic principles of medical writing were discussed. The participants were told that there is no place for vague statements in medical writing hence each and every statement must be properly referenced. The objective of writing a paper is to communicate some message hence every effort should be made to convey it simply, concisely and effectively.

This was followed by a presentation on How to write a scientific paper i.e. original article.  The important components of an original article, it was stated are structured abstract which usually consist of four headings i.e. objective, methods, results and conclusions with key words. The other components include Introduction, Methods or Methodology, Results, Discussion and conclusions followed by appropriate references.  It was discussed in detail how to write introduction, methods, results and discussion.  Once a study has been completed and one wishes to write the manuscript, one just has to answer few questions. Why this study was conducted will give the objective of the study and introduction. This section should also cover the information available on that particular topic and the knowledge gaps which still exist and then the objective of this study. Before starting any study, one has to do proper literature search using different key words and then one should be intelligent to sort out which of the important studies pertaining to the last few years can be used. How did you do it will provide the information needed to be covered in Methods section. It must give comprehensive accurate details of the method used so that others can replicate this study based on this information. If some method which is well known is used, one can just give its reference but otherwise methods section must ensure minute details i.e. how solution if used was prepared, what drug dose was used and how it was administered etc. If the method is a bit complicated, one can use a Flow Chart which is easy to comprehend the information. Inclusion and exclusion criteria, the statistical method used, ethics committee, Institutional Review Board approval of the study protocol will all be covered in the methods section. EC/IRB approval of the study, it was emphasized is extremely important and now most of the standard biomedical journals demand EC/IRB approval before processing and accepting the manuscript for publication. The authors have to provide a scanned or original copy of the approval letter and just mentioning the approval reference number was not enough. Authors were also asked to consult a statistician before starting the study to find out about the sample size and these statisticians are also very helpful in interpretation of results and data. Ideally, every medical institution, Mr.Shaukat Ali Jawaid stated must have a statistician on its faculty preferably in the department of medical education and they should help the authors.

 

PAME in collaboration with Health RAB organized a workshop on Medical Editing and Peer Review
at Quaid-e-Azam Medical College Bahawalpur on May 19th 2015. Picture taken on the
occasion
shows the workshop participants busy in Hands On training activity reviewing a manuscript.

What did you find will provide the information which has to come in Results section? The results can be supplemented with figures, tables if needed which must provide the information in stand alone position. Avoid duplication and repetition which is irritating for the Reviewer, Editor as well as readers.  Both positive and negative results are important and should be published. In the Discussion section, the information which needs to be covered includes what is the importance and relevance of the study, its strength and limitations, what information it has added to the medical literature. Compare your results with local, national, regional and international studies and if your results are different, try to find out the reason for that. Limitations of the study should be mentioned and ask for further research. Some journals demand a separate Para under a separate heading for conclusions while others accept a few sentences or last paragraph of the Discussion to cover the conclusions.  ICMJE guidelines say that while writing references one must list up to six authors and then write et al. Some journals also demand that DOI (Digital Object Identifier) should be added at the end of the references. For an original study, twelve to fifteen latest relevant references are considered good  enough while for Reviews the number of references usually allowed are up to forty and up to ten references in Case Reports, special, brief communications though some exceptions are there. Since there is lot of pressure on limited space available, every journal has fixed some limitations on the length of different kinds of manuscripts, number of tables and illustrations. One must carefully read and follow the instructions to authors before writing and submitting the paper. If the manuscript is rejected by one journal, one must modify and revise it to suit the requirements of the other journal before submitting it. One should not get disheartened with rejection as Editors and Reviewers have responsibility to ensure that only correct information  is passed on to the readers.  Improve the manuscript in the light of Reviewers comments and suggestions. Brevity is the art of medical writing. Lengthy manuscripts, it was stated not only take more time in processing but also increase the publication charges. Ensure complete submission and if the journal requires direct submission on their website, follow those instructions as they won’t process papers received by post or through e mail.

Medical Editing and Peer Review

On second day of the workshop at both the places, the programme started with copy editing. The participants were informed about the basic principles of editing with different examples. It was time and again emphasized that one has to be extremely careful in medical writing as careless attitude could lead to major blunders. Never use abbreviation in the title, in the text one can use the full word first followed by its abbreviation in bracket and then this abbreviation can be repeated in the text. Some authors also mention the details regarding various abbreviation used in the manuscript after the abstract. Definition of Peer Reviewer, different types of Peer Review i.e. single blind, double blind and Open Peer Review system were all discussed in detail. There are advantages and disadvantages of all these systems and it is up to the Editor and owners of the journal to decide which peer review system they are going to practice. However, open peer review system, it was stated, is currently considered the best and numerous studies have demonstrated that it does improve the quality of the Review. The editors must review the Reviewers reports before passing it on to the authors and if need be, the report can be rewritten, edited, modified to eliminate harsh comments if any. The reviewers are supposed to help the authors to improve the quality of their manuscript besides helping the Editors to take a final decision about the acceptance and rejection of a manuscript. Editors, it was further stated, were the final authority in this respect to accept or reject any manuscript because it is they who are eventually held responsible for what is published in their journal. The reviews are supposed to keep the manuscript confidential, never use it for their own advantage but if they need help and assistance from some other colleagues to review the manuscript, they can do that and do mention it in their report.  How to write the Reviewers Report which should be typed instead of hand written was also discussed in detail. One can sign or decide not to sing the report. Pakistan Journal of Medical Sciences, Mr. Shaukat Ali Jawaid stated is practicing Open Peer Review System for the last six years and it has worked very well. It was just about half a dozen cases when the Reviewers requested that their names should be kept anonymous, hence their request was accepted. Now even the authors can themselves suggest up to two or three potential reviewers for their study and if the Editors feel, they use these reviewers. Most journals send a detailed questionnaire along with the manuscript which is known as Reviewers Performa to the reviewers which helps them in reviewing these manuscripts and makes their job easy. The reviewers are also supposed to evaluate overall grading of the manuscript and recommend its early or routine publication.

 

A view of the participants in the workshop on Medical Writing held at SZMC Rahim Yar Khan.
The workshop organized by PAME in collaboration with Health RAB on May 20, 2015
was very
well attended by SZMC faculty members.

Hands on Training

In the next session, the participants at both the institutions i.e. Bahawalpur and Rahim Yar Khan on the second day of the Workshop were divided into different groups. They were given two different articles and asked them to go through them in detail based on the information they had been provided on both the days and then one representative from each group was asked to present their findings of Peer Review. This hand on activity was very much appreciated and enjoyed by the participants. Most of the presenters from different groups were able to find out the major deficiencies in the manuscripts provided to them for peer review. Later on Mr. Shaukat Ali Jawaid gave those details of the Peer Review Report, the major deficiencies found in these studies. Based on these findings, one of the manuscript regarding patients satisfaction about the quality of service provided at a tertiary healthcare facility was rejected since it had failed to cover numerous important parameters essential to evaluate the services in such a study. In the case of second manuscript which looked at the prevalence of Child Sexual Abuse in adolescents, the time and place of the study was missing in the abstract as well as in the main text. There were problems with the references as they were not in order i.e. 1, 2,3,4,5, and some of the references mentioned in the text did not tally with the list of references at the end.  There was no mention about the Ethics Committee approval of this study. The authors were advised to rectify these mistakes, revise and resubmit the manuscript for further processing.

Participants at both the institutions on every day were asked to give their feedback on the day’s programme and then this feedback was discussed with the participants the next day. Some of the points raised by the participants at Bahawalpur related to the unsatisfactory air-conditioning in the room, problems with the mike and sound system. Some felt that the number of participants should have been less. On the whole a vast majority of the participants appreciated the quality and standard of presentation, course contents and said that it will help them in medical writing while they also came to know about peer review system and how it is practiced by medical journals. Responding to this Prof. Javed Iqbal pointed out that a new audiovisual system has been tendered and hopefully it will be available in a month’s time. The number of participants was a bit more since it was first such activity organized in the institution and we wished to provide an opportunity to more people to get acquainted. Most of the participants wished that such workshops should be repeated on regular basis. On first day of the workshop at QAMC Bahawalpur, a meeting between the facilitator and some senior faculty members which included Prof. Haroon Khursheed Pasha Principal QAMC, Prof. Javed Iqbal, Prof. Qazi, Prof. Munir Azhar and others was also arranged at the dinner. Various options for further collaboration between QAMC and PAME and Health RAB were discussed in detail. Mr. Shaukat Ali Jawaid assured them that PAME/Health RAB will ensure that at least one such workshop is organized every year and if they feel, possibilities of more frequent meetings can also be looked into.  The registration fee, he said, has been intentionally kept just nominal i.e.  Rs.300/-  for each workshop just to encourage every one to participate.  Mr. Shaukat Ali Jawaid also announced that as a special gesture of goodwill towards QAMC/BV Hospital faculty, manuscripts accepted for publication in Pakistan Journal of Medical Sciences, the authors will get 50% discount in publication charges for two years. If some medical student prepares a write up and submits it for publication in the Students Corner, their publication charges will be waived off. He also offered to help them if QAMC wishes to start its own medical journal. Department of Medical Education at QAMC, it must be mentioned here has five qualified medical educationists and regularly organizes CME programmes. Prof. Javed Iqbal in his concluding remarks on the last day of the workshop also thanked Mr. Shaukat Ali Jawaid for sparing some of his time to visit QAMC to conduct these workshops which the participants found very informative and useful. It has stimulated them and they are expected to be better writers in the days to come.

 

Photograph shows from (L to R) Prof. Athar Maqbool Principal SZMC and Prof. Tariq Mahmood Rehan Director
Medical Education Department at SZMC and other faculty members participating
in the workshop on
Medical Editing and Peer Review organized by PAME in collaboration with Health RAB
at Rahim Yar Khan on May 22, 2015.

At SZMC Rahim Yar Khan, Prof. Tariq Mahmood Rehan the local focal person and co-facilitator hosted a lunch in honour of Mr.Shaukat Ali Jawaid on first day of the workshop. Principal of Sheikh Zayed Medical College Prof. Athar Maqbool personally attended both the Workshops and took keen interest. Speaking in the concluding session Mr.Shaukat Ali Jawaid thanked the faculty and Principal of SZMC in general and Prof. Tariq Mahmood Rehan in particular for the warm welcome and exceptional hospitality extended to him during his study.  “I am overwhelmed with the love and affection which I received from the moment I reached here”, he remarked. It has been a pleasure to visit QAMC/BV Hospital as well as SZMC in South Punjab. It provided me an opportunity to share my knowledge and experience with the participants while I have also learnt a lot from the feedback and interactive discussions with the participants. He further stated that he will try to visit SZMC at least once a year to organize such workshops. He also announced 50% discount in publication charges on all manuscripts received from faculty members of SZMC which are accepted for publication in Pakistan Journal of Medical Sciences for the next two years. On the whole time management was excellent at both the places.

A dinner meeting with senior faculty members of SZMC which was also attended by Prof.Athar Maqbool Principal, Prof. Tariq Mahmood Rehan Head of the Department of Surgery and Director Dept. of Medical Education was organized on May 20th 2015 and different important issues related to further collaboration and cooperation between PAME/Health RAB and SZMC were discussed. The Department of Medical Education at SZMC, it may be mentioned here is perhaps the most active throughout the province of Punjab. It is evident from the fact that during the first three months of 2015, it has organized eighteen CME activities which were accredited with 36 CME Credit Hours which is the maximum number of such programmes organized by any medical institution affiliated with the University of Health Sciences. It also reflects the abundance hidden talent here. Prof. Tariq Mahmood Rehan has built a team in the DME with the result that excellent arrangements were made here for the workshop on both days. The participants were very keen, were punctual which enabled the organizers to start the workshops in time.

They also actively participated in the interactive discussions.  While most of the participants were quite happy and appreciated the quality and contents of the workshop, a few felt that the seating arrangements on the first day were not satisfactory as the number of participants were more. They all wished that these kinds of workshops should be held more frequently and some Hand Outs, Reading material should also be provided to the participants. Hands on activity were very much appreciated. One of the participants in the feedback wrote that some irrelevant issues were also discussed while the facilitator also tried to impose his decision in certain cases. Responding to these observations Mr. Shaukat Ali Jawaid clarified that when some question is asked like that related to the PM&DC, one has to answer that. Furthermore it is important to inform the participants of different forms of Peer Review Systems and it was up to the individual journals and Editors to decide which is best suited to them.  However, since we in Pak J Med Sci practice Open Peer Review System, I did point it out but no one is under compulsion to follow that. Sheikh Zayed Medical College also publishes a Quarterly Medical Journal entitled “Journal of Sheikh Zayed Medical College (JSZMC) for the last five years. Dr. Syed Faiz ul Hassan Rizvi is the Editor while Dr. Ghulam Mustafa is the Assistant Editor of this Journal. Mr. Shaukat Ali Jawaid offered to help train one of the Editorial staff members of JSZMC in medical journal publishing. The candidate who should be selected by the Principal and Editor of the Journal can come to Karachi for a week and he will be shown and taught the whole process at Pakistan Journal of Medical Sciences. The selected candidate will also be provided a financial grant of Rs. 15,000/- by Pakistan Journal of Medical Sciences to meet some of the expenditures for boarding and lodging.

Prof. Athar Maqbool in his speech in the concluding session thanked PAME/Health Rab and the facilitator for conducting these workshops. Prof.Tariq Mahmood Rehan in his concluding remarks said that the presentations educated the participants about the existence and functioning of various associations of medical editors, it also gave them a world overview and the situation in the Eastern Mediterranean Region where Pakistan is located in particular.  It was quite informative and useful and hopefully it will help the participants to become better authors. The knowledge they have gained will improve the quality of their manuscripts.  He also thanked PAME, Health RAB and PharmEvo for organizing this academic activity at SZMC Rahim Yar Khan.