Abstract
In designing and implementing a peer support writing group for junior researchers at our home institution, we saw an opportunity to advance the understanding of this intervention as a valuable tool for future physician-scientists. We, therefore, performed a scoping literature review of the available literature on peer support writing groups in clinical disciplines to learn what has been described about this topic. We paid specific attention to the characteristics, implementation, and impact of these groups on the academic development of medical/healthcare scientists. We performed a scoping literature review following the conceptual framework proposed by Arksey and O’Malley. We included studies describing the characteristics, implementation, and impact/effects of peer support writing groups in clinical disciplines. All the information extracted was summarized descriptively to chart the available literature on peer support writing groups in clinical disciplines. We identified a total of 369 articles, of which six were finally included. The absolute number of papers published increased considerably after the participation in the peer support writing groups. The subjective comments of the participating individuals highlighted the positive effects of these groups on the academic productivity of attendees. Available information shows a significant increase in the absolute number of publications and a positive perception between individuals participating in peer support writing groups. Stakeholders should implement this strategy in their home academic institutions.
Keywords: Medical writing, Academic success, Writing groups, Physician’s role, Academic performance
Introduction
One of the core missions of physicians is to provide care for patients through the appropriate application of current medical science. This mission can also be accomplished by advancing patient care through developing innovations and new therapies and testing them in research studies. Research results, however, are not meaningful and cannot be further implemented until they are shared with the medical community in the form of publications. Effective writing is an extremely important skill that physicians need to practice and develop [10].
Competent medical writing is essential for academic development and the progress of medical knowledge. However, many physicians struggle to translate the interpretation of research results into impactful manuscripts. Indeed, it has been observed that a text difficult to follow is one of the ten most common reasons for manuscript rejection [9]. Although it is well known that a well-written manuscript is more likely to attract readers and accumulate citations, there is often very little attention paid to specifically improving writing and communication skills.
In designing and implementing a peer support writing group for junior researchers at our home institution, we saw an opportunity to advance this skill set as a valuable tool for future physician-scientists. To learn what has been described about this topic, we performed a scoping literature review of the available literature on peer support writing groups in clinical disciplines. We paid specific attention to the characteristics, implementation, and impact of these groups on the academic development of academic researchers.
Materials and Methods
As a part of the implementation of a peer support writing group for physician-scientists at our home institution (Fundacion Valle del Lili University Hospital), we performed a scoping literature review following the conceptual framework proposed in the seminal paper by Arksey and O’Malley [1].
Research Questions
What has been described regarding the characteristics of peer support writing groups in academic medicine?
What are the benefits of implementing peer support writing groups on the academic development of physician-scientists?
Search Methods
For this scoping study, we performed a literature review using the MEDLINE database. A structured search was set-up using and combining terms and synonyms related to the intervention of interest (peer support writing groups). Keywords were as follows: “writing course,” “peer support writing group,” “peer writing group,” “collaborative writing group,” “writing group,” and “support writing development.”
Inclusion Criteria
We included studies describing the characteristics, implementation, and impact/effects of peer support writing groups in clinical disciplines. We excluded papers reporting on online writing courses without a specified “peer support” component and those that did not report information on the participants’ writing outcomes.
Study Selection and Data Collection
Two individuals (RMN, JER) independently examined the titles and abstracts identified in the search. Articles that appeared relevant were selected and downloaded for full-text review. Two researchers (RMN, JER) independently reviewed the full texts and selected the papers to be included in the scoping review based on the inclusion criteria.
Data collection was performed by two researchers independently (LEM and AG). For this purpose, we constructed a standardized data collection form, which consisted of an excel spreadsheet that the authors used to extract relevant information from the included studies. From each included study, the following data were extracted: title, authors, year of publication, journal, country of origin, research question/specific aims, characteristics of the peer support writing group (course structure), number of participants, the background of participants, publication outcomes (number of publications pre and post-intervention), follow-up time, and comments/opinions from the individuals who participated in the groups.
The data was extracted from all included studies. All the information extracted was summarized descriptively to chart the available literature on peer support writing groups in clinical disciplines.
Results
We identified a total of 369 articles from our search in MEDLINE. After reviewing titles and abstracts, 15 articles were considered eligible to be included in our report. After full text-review, six articles that fulfilled our inclusion criteria were included [2, 5–7, 13, 14] Figure 1 shows the PRISMA diagram for the selection of the studies.
Fig. 1.
PRISMA flow diagram for the selection of the studies
Studies included in this review were published between 2003 and 2016. All reports came from developed countries. Five studies were conducted in the USA (n = 3) [2, 5, 13] or Canada (n = 2) [6, 14] and one study in Australia [7].
An overview of the studies’ characteristics is shown in Table 1. All the studies addressed the following two objectives: (1) To describe the development and implementation of peer support writing groups in academic medicine, and (2) to assess the impact of these groups on the participants’ publication rates. In all the studies, the writing groups were involved in writing, but were not involved in data collection and analysis.
Table 1.
Characteristics of included studies
| Author | Objective | Discipline | Course structure | No. of participants | No. of pub pre-int | No. of pub post-int | Follow-up time | Conclusion from authors |
|---|---|---|---|---|---|---|---|---|
| Grzybowski 2003 | To describe the experiences and outcomes of a writing group. | Family medicine | Regular meetings at participants’ homes with the objectives of the following: (a) share ideas about collaborative research and/or writing projects; (b) assist individual faculty to complete unfinished work; (c) match journals appropriate for individual work; (d) provide peer support for faculty members. | 10 | 0.14 PPY | 0.6 PPY | 3 years | A peer support writing group for physicians in a Canadian department of family practice has led to successful scholarly publication. |
| Steinert 2008 | To combine a workshop with peer writing groups and to assess the impact and viability of this approach to increasing writing productivity on MedEd. | MedEd | Plenary session that focused on general principles of effective writing. After the plenary session, participants worked in small groups to (1) Identify innovations appropriate for publication, (2) review the process to write-up an innovation, and (3) develop a plan to prepare a manuscript. After the workshop, participants attended a series of three 2-h peer writing groups, over a 6-month period. | 24 | 9 pup in MedEd | 26 pup in MedEd | 5 years | A faculty development workshop and peer writing group can facilitate writing productivity and presentations of scholarly work in MedEd. |
| Sonnand 2011 | To systematically examine the results of a writing group developed in response to concerns of female junior faculty members about their ability to publish sufficiently for promotion. | Multiple | Writing group with meetings every 3 weeks for a 9-month period plus a curriculum focusing on how to write an impactful manuscript. | 48 female junior faculty | 1.5 PPY | 4.5 PPY | 4 years | A women’s writing group is an effective intervention for increasing publishing rates of female junior faculty. |
| Johnston 2014 | To examine the design and outcomes of a writing support group in a rural setting that was created with the goal of increased publication output. | NR | Creation of a writing support group + Daily every day for 30–60 min with a writing buddy. | NR | 0.5 PPY | 1.25 PPY | 6 months | Peer support groups could be a powerful tool to create and maintain regular writing practices and increase publication output. |
| Brandon 2015 | To examine the impact of the peer support Writer’s Circle on the members’ individual and collective publication productivity. | Radiology | Five clinical-track faculty in the radiology department decided to form a writing support group after sharing in informal conversations their struggles revising rejected manuscripts. | 5 | 10 previously rejected manuscripts | 4 = accepted; 5 = under review | 6 months | Peer support writing groups can facilitate the pooling of expertise and the exchange of recommended writing practices. Our peer-support group increased scholarly productivity and provided a collegial approach to academic writing. |
| Fleming 2016 | To evaluate the effectiveness of a research/writing group by quantifying scholarly activity from the participants in the group compared with a matched cohort of clinical faculty not participating in the group. | Pharmacy | The research writing group set monthly, 1-h meetings to discuss current scholarly activities with each member providing an assessment of their progress since the last meeting. | 6 | NR | During the year three of follow-up, the scholarly activity in the writing group was greater (pub = 13) than the comparison group (pub = 8) | 3 years | Participation in the group provided junior faculty the mentorship and support system needed to feel confident in their pursuit of scholarly activities; and therefore, they outpaced their counterparts in dissemination of their research. |
Pub, publications; PPY, publications per person per year; pre-int, pre-intervention; post-int, post-intervention; NR, not reported
Enrolled participants in these groups came from several clinical disciplines and their number ranged from 5 to 48. Three studies reported that their peer support groups were comprised of participants from individual departments: radiology [2], family medicine [6], and pharmacy [5]. One study reported a peer support group made up only of women [13]. In this study, participants were junior faculty from the departments of medicine, family medicine and community health, surgery, pediatrics and obstetrics, and gynecology. In one study, participants had different clinical backgrounds, with the common interest of increasing their research productivity in the field of medical education [14].
Three studies reported representative feedback from the individuals who participated in the peer support writing groups (Table 2). These comments highlighted the positive effects of this kind of group on the academic productivity of attendees. For example, in the study describing the writing group composed exclusively by females [13], one of the participants commented: “I credit the writing group with giving me the impetus to improve my publication records. I believe it was, in part due to the specific instruction and in part due to the enormous nurturing support that enabled me to go from one publication in the past years to 37 in the present.”
Table 2.
Representative comments from participants
| Author-year | Representative comments |
|---|---|
| Steinert 2008 | “The workshop signaled me to publish in medical education. The peer writing group pushed me to re-develop my Project in a much better way and I wish it to continue” |
| “The peer writing group helped me to learn that I just need to write my ideas down” | |
| Sonnand 2011 | “The course gave great practical tips to get past the block” |
| “My most frustrating, longest-lasting collaborative paper that I mentioned several times during the writing group was finally submitted and accepted…Thank you” | |
| Johnston 2014 | “As the weeks passed I was reading and writing with such regularity that I began to start in advance of our set times and was soon writing for an hour or more each day” |
| “Writing can be lonely, so knowing that others were doing the same thing at the same time gave me a sense of comradery and helped me make the commitment I needed to writing” |
All studies reported information related to the absolute number of papers published after the participation in the peer support writing groups. Three studies reported the outcome of interest in the form of publication per person per year (PPY). These studies reported a significant rise in the publication output in the post-intervention period (Table 1). In the study where participants were interested in increasing their publication rate in the field of medical education, the post-intervention publication output increased considerably from 9 to 26 papers published [14]. Another study compared the scholarly productivity of participants in the group and compared it with that of a matched cohort of non-participants [5]. In this study, the number of publications in the peer support group (n = 13) exceeded those of the comparison group (n = 8). The follow-up time for the collection of these “publication outcomes” was variable and ranged from 6 months to 5 years (Table 1).
Discussion
In this scoping review which mapped the available literature on the characteristics and benefits of peer support writing groups in clinical disciplines, we found six studies that reported the impact of these groups on the academic productivity of the participants, specifically reporting the number of manuscripts accepted for publication. There was a consistent finding that peer support writing groups had a positive impact on the pursuit of more productive scholarly activity, which was reflected by the increased number of publications in the post-intervention periods in all studies. Furthermore, we found that healthcare professionals involved in such groups perceived that the course/group did an excellent job in providing them with useful writing tools that resulted in an improvement in their writing skills.
Our review provides information to underpin the implementation of research writing groups in institutions interested in increasing their publication output and building their research profile. The fact that all the articles analyzed showed a considerable rise in the number of publications in the post-intervention period should be taken seriously by stakeholders from academic institutions. Encouraging and implementing peer support writing groups within academic/research programs may help in creating new writing habits that eventually would result in more and better scientific production.
Previous studies have shown that the ability to write clearly and follow a compelling narrative is paramount to increase the likelihood of publication in high-impact journals [8]. Also, it has been reported that difficulty in starting writing and limited writing skills are among the main barriers to publication [3]. In this sense, we found that, beyond increasing their publication output, individuals involved in peer support writing groups felt that they gained tools and skills to communicate better in writing which in turn could be one of the factors that led to publication success. This finding suggests that writing within groups may help in overcoming the pitfalls associated with manuscript drafting. Thus, we advise that medical schools and residency/fellowship programs create spaces where individuals can come to share their writing struggles in a safe, welcoming group environment.
Although we present peer support writing groups as a feasible and effective strategy to improve writing skills and publication output, other approaches have also been demonstrated to be useful in developing the practices leading to productive writing. Examples include brainstorming sessions [11], gamification [4], and online courses [12]. So far, there is no real certainty on which components or activities are more effective than others within these support groups to increase or encourage a robust culture of publication and reporting.
This review also revealed some important gaps in the literature. First, all studies came from developed nations, with a lack of representation of the experiences of researchers in low-to-middle income countries, who face unique challenges to scholarly success. In these settings, there is a definitive need for strategies aimed at increasing scholarly productivity. Second, from our synthesis, it is reasonable to posit that scientific writing is an area of clinical science that receives less focus if compared with other skills.
To reduce the gap with the more developed world, we recommend that institutions based in low-to-middle income countries design and implement peer support writing groups. These groups should be led and delivered by faculty members who have a strong scientific and medical background and expertise in medical research, writing, publishing and mentoring.
Limitations
Our scoping review is not without limitations. First, the majority of studies reported experiences with a low number of participants, which precluded us from performing any quantitative synthesis and limits the scope of our recommendations. Second, the variability in follow-up times across studies could affect the validity of our conclusions; however, all studies reported reliable follow-up information, and there was a consistent finding that peer support writing groups had a positive impact on publication outcomes. Another source of uncertainty is that the articles included in this review did not report information on other motivational factors for publishing, such as gaining professional promotion or obtaining research funding or economic incentives, which in turn may have a significant impact on publication success.
Finally, our findings may be further limited by the bibliographic search as we restricted the search strategy to one database (MEDLINE). Therefore, there is a potential for publication bias which in turn could impact the accuracy of our qualitative synthesis and our conclusions.
As little research has been done on the productive skill of writing in clinical disciplines, we believe our findings can be used by stakeholders interested in improving the writing skills of physician-scientists and advance the field of clinical research through an increased number of publications in their home institutions.
Conclusion
With high pressure to publish, peer-support writing groups have the potential to help students and professionals in academic medicine acquire communication tools and improve their writing skills to increase their publication success. Our review of available literature shows a significant increase in the absolute number of publications per person per year and a positive perception by participants of their ability to develop more robust manuscripts with higher likelihood of being accepted by journal editorial boards. Future research should focus on better understanding the most effective methodologies for building writing skills in these groups, ultimately leading to publication acceptance.
Acknowledgments
This article is dedicated to the memory of Daniela Rojas-Munoz, whose image is forever imprinted in the first author's mind.We would like to thank Dr. Lydia Maurer for proofreading assistance with this article. We acknowledge that only authors who made substantial intellectual contributions were listed as authors. RMN and FA conceived the idea. RMN and JER performed the literature search and selected the studies for inclusion. LEM and AG extracted the data. All authors provided input to the first draft during brainstorming sessions. All authors wrote the report, made critical revisions to the manuscript, and approved the final version for submission.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Research Involving Human Participants and/or Animals
Not applicable
Informed Consent
Not applicable
Footnotes
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Contributor Information
Ramiro Manzano-Nunez, Email: ramiro.manzano@fvl.org.co.
Fredy Ariza, Email: fredyariza@hotmail.com.
Javier E. Rengifo, Email: javier.rengifo@correounivalle.edu.co
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Gezzer Ortega, Email: gortega1@bwh.harvard.edu.
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