The message is not clear
One criticism I often see from reviewers is the manuscript does not
clearly articulate its contribution to advancing knowledge. A simple
statement of purpose is often not enough to convey that contribution to
the reader. The manuscript should provide the reader with information
about 1) context; i.e. what is the general issue and what is already
known about the topic that is being examined, 2) the knowledge gap; i.e.
what is not known about the topic, and 3) how the proposed study relates
to that knowledge gap. Such information is best presented in the
introduction. I have read introductions to manuscripts that list a
series of facts on a topic, but do not relate that information to the
knowledge gap or the purpose of the study. Listing “everything you
know” about a topic can be a distraction for the reader – one should
only provide information that is needed to understand why the study was
developed and executed or to follow the argument presented. Linking the
findings of the study back to that knowledge gap and relating those
findings to what is already known is also helpful in articulating the
contribution of the work to advancing knowledge. Reviewers of healthcare
research journals have come to expect the first paragraph of the
discussion section will present a review of the major findings of the
study. It is also common practice that subsequent paragraphs will be
used to contextualize the findings within the previous literature. I
will address what counts as a contribution in a later section.
How the material within the manuscript is organized also impacts how it
will be received by the reviewer (which again, impacts the probability
of success). There is little chance the manuscript will be published if
the reviewers and editor cannot follow the argument. I have too often
received manuscripts that (as discussed in the previous paragraph) have
no clear statement of purpose, offer substantial (and often distracting)
editorial content in the introduction, present some of the methods in
the results section, present information that is pertinent to the
analysis or important findings in the discussion section (or fail to
present that at all, as I will discuss in the next section), etc.
Conventional approaches to the organization of reporting empirical
research findings have primed experienced scientific audiences to expect
specific kinds of information in specific sections. Such conventions
also help orient the reader who may not have deep familiarity with some
aspects of the research. Misplaced information can confuse the reviewer
and may lead to a misinterpretation of the intended message. Anyone who
has a large volume of publications has experienced receiving a review
from someone who appears to completely miss the point of the manuscript.
Often that is a problem with how the information was presented and the
message communicated and not with some characteristic of the reviewer.
Clear communication of the message is often blurred by poor use of
language and grammar. When submitting a manuscript, the author is
confident that the writing is sufficient to communicate to the reader
the intended message. If not, why would the author be under any
impression that it is appropriate for publication?3 Proofreading
one’s own work to ensure the message is being conveyed in a clear manner
cannot be relied upon because the author is already familiar with what
the manuscript is about, as are the co-authors. In some cases, the
message is lost simply because the prose is poor. It may be that the
paper is full of jargon, several acronyms that are not intuitive, or
terms that are vague in meaning or are unfamiliar to the reader. In his
essay “How I write”, Bertrand Russell offers some simple advice,
acquired through his brother-in-law, on how to communicate effectively
in academic contexts. His maxims are: 1) “never use a long word if a
short word will do”, 2) “if you want to make a statement with a great
many qualifications, put some of the qualifications in separate
sentences”, and 3) “do not let the beginning of your sentence lead the
reader to an expectation which is contradicted by the end” [1;
p.65]. In many cases, the use of complex terms and nuanced language
cannot be avoided. However, the use of complicated language as an
affectation (i.e. using difficult language so as to give the impression
that you know what you are talking about) is unhelpful in getting a
point across to the editor and reviewers – making the reader work hard
to understand what the manuscript was written to communicate is
counterproductive.