How to Write Like a Pro: Paper Sprints, Data, and Sparking Academic Productivity

John D. Cramer, MD; Nausheen Jamal, MD; Robin W. Lindsay, MD; and Michael J. Brenner, MD

Writing is hard. Taking an idea to fruition can be a lonely endeavor, littered with the skeletons of unfinished projects. We’ve seen many bright learners and faculty members spend hours, months, or years creating data sets without a clear vision of the final product. Others struggle endlessly before a blank screen, making little headway. 

There is a better way.

In this article we provide tips for otolaryngology colleagues on how to turn early forays in scholarship from desolate paths fraught with frustration to rich opportunities to cultivate relationships and shared success. We present strategies on paper sprints, quality improvement projects, and data collection within the workflow of routine clinic practice. 

What Is a Paper Sprint?

The paper sprint is a structured approach to rapidly develop and write projects. Sprints were initially developed by Google to help teams swiftly develop and prototype new products. Paper sprints were later adapted to academic medicine, in particular the University of Michigan School of Public Health Center for Evaluating Health Reform and Institute for Healthcare Policy and Innovation (sph.umich.edu/cehr/resources.html), and the approach has been used with great success by authors. Paper sprints bring collaborators together at the outset to develop an in-depth study plan. The structured paper sprint meeting not only breaks ground, but actually propels the project forward with a clear work plan.

All team members read the relevant literature prior to the paper sprint meeting and should be familiar with the data set, which allows shared input into study design. This approach is far more effective in building the product and relationship than merely having collaborators provide cosmetic changes just prior to manuscript submission. Setting expectations among collaborators around timelines and deliverables is critical. The keys to avoiding diversions that bog down research are having a focused study question, a clearly defined population, and a blueprint for the work product. 

Roles need to be carefully delineated. The data analyst should leave the sprint meeting ready to perform a goal-directed analysis and draft tables and figures. The lead writer will simultaneously draft the abstract, introduction, and methods sections. The team can then schedule a second meeting two to three weeks thereafter to review tables, figures, and text. Alternately, the team can reconvene for a two-hour writing sprint to rapidly develop a draft. Once a final version is drafted, the team submits the manuscript to a journal. 

How Can I Get Quality Improvement Work Published?

Quality improvement (QI) is a largely untapped reserve of academic productivity. Just as clinical research has gradually gained prominence on par with basic science research, QI has become a critical part of the academic landscape. QI is increasingly seen as a catalyst for improving the practice of medicine, and journals are vying for these articles. Ironically the majority of QI projects languish and are never submitted to an academic journal. This gap is a missed opportunity. QI projects afford valuable insights that can move our field forward. 

To be publishable QI projects need to define the problem, engage stakeholders, and utilize established QI methodology. The SQUIRE 2.0 guidelines are a framework for ensuring excellence in QI reporting. QI projects should define methods, interventions, and measurable outcomes. Aligning QI project plans with institutional QI priorities can dramatically increase the resources at the clinician investigator’s disposal. Furthermore, effective stakeholder engagement ensures that the multidisciplinary team can sustain successful interventions and meet QI educational requirements set out by the Accreditation Council for Graduate Medical Education. 

What Data Streams Can Be Generated from My Clinical Practice?

Clinical practice is a rich repository of opportunities for research and publication; however, fortune favors the prepared mind. The data incidentally collected in the electronic health record (EHR) tends to reflect the chaotic and unruly character of our clinical lives. Such data are often fraught with limitations that limit suitability for research. In contrast using structured tools in a planned, systemic manner can produce a standardized resource for academic pursuits. A variety of strategies can improve both the quality and quantity of data available for analysis.

Patient-reported outcomes (PROs) are low-lying fruit for otolaryngology researchers in any of our fields’ diverse subspecialties. In 2020, the AAO-HNS Outcomes Research and Evidence-Based Medicine Committee updated the listing of PROs relevant to otolaryngology-head and neck surgery, which are available to Academy members online (www.entnet.org/content/outcome-tools). PROs report health status directly from the patient, unfiltered by clinicians. The questions ask patients directly about their symptoms or perspectives. Many validated PROs already exist, and it is also possible to develop new PRO instruments that can be embedded in everyday clinical documentation. This approach builds a deep reservoir of information for either interventional or observational studies. Inviting patients to complete PRO instruments in the waiting room facilitates clinic flow, engages patients, and conveys commitment to their care.

Clinicians can also improve the quality of the data that they collect from their own clinical assessments. For example, EHRs often allow one to build customized fields for structured capture of data during the clinic. This approach can greatly facilitate data collection at later stages. For greater control of data, Research Electronic Database Capture (REDCap) is a particularly powerful tool that the authors have used for HIPAA-compliant studies. We have used this resource for applications ranging from analysis of the patient outcomes in rhinoplasty practice to benchmarking diverse outcomes for a global quality improvement collaborative that spans countries and continents.

How to Get Started

In summary, one need not accept isolation, long slogs, and unrewarded efforts that die quietly on a laptop as the “cost of doing business.” Instead start small, have a plan, and don’t go it alone. When it comes time to write, sit down and write something every day. Chip away at it. In 20-30 minutes you can write a paragraph. If you do this every day for two weeks, you will soon have a paper. The first draft does not have to be “good”—in fact it should be awful. Label the first draft a “bad draft” to make the quantum leap from nothing to something. For many writers the greatest hurdle is putting pen to paper. Some successful academics have even opted to dictate into a recorder during a commute to and from work and have it transcribed —a great way to create the bad draft. After submitting an abstract to a meeting, try to create a complete manuscript while the data set is fresh. Then reread and edit it before sending to collaborators who can help turn it into a polished final manuscript. Finally when the work is accepted, be sure to share the celebratory good cheer with collaborators! 

This topic was presented as a Panel Presentation at the AAO-HNSF 2020 Virtual Annual Meeting & OTO Experience.