Dissecting a Manuscript Series

Panel 4 Highlights: Discussion and Conclusion

Written by Brie Buchanan and Ria Tilve (Education Committee)

Panelists

Highlights

Dr. Michelle James is a board-certified pediatric hand surgeon and Chief of Orthopedics at Shriners Hospital for Children in Sacramento, CA. Dr. James specializes in caring for children with congenital hand malformations, neuromuscular conditions, and post-traumatic hand deformities. As a clinical researcher, she has published over 100 articles in peer-reviewed journals. She is also the associate deputy editor at JBJS.

Dr. Marc Swiontkowski is the Editor-in-Chief of JBJS, and is a Professor in the Department of Orthopaedic Surgery at the University of Minnesota. Over his career, he has served as president of the Orthopaedic Trauma Association, president of the Mid America Orthopaedic Association, and representative to the Board of Directors of the American Board of Orthopaedic Surgery. Dr. Swiontkowski also has a podcast called OrthoJoe. Definitely check that out if you haven’t already.

These panelists provided several tips in this one hour panel. Below are some highlighted advice/quotes from our panelists:

  • The purpose of the discussion is to place the study in context and tell readers how the findings inform clinical practice, along with providing potential directions for future studies.

  • The structure is far less rigid than other sections and it really depends on the study design! Some basic fundamentals include:

    • Results summary (a general overview, it is ok to include numbers)

    • How your findings fit into the context of other literature on the topic

    • Key differences between your findings/design compared to other literature

    • Limitations (essential!)

    • Future directions

  • It is ok to answer other questions but make sure to focus and reflect on the study’s original hypothesis.

  • Non-significant or null results can still be informative! Don’t be afraid to publish these if they have the potential to impact clinical practice or other research.

  • You can create a table if there is a large body of literature addressing the same topic.

  • Make sure to cite papers from all perspectives - avoid only citing papers that support your conclusions.

  • Write succinctly and generally aim to have no more than 5 paragraphs in the discussion.

  • Include future directions at the end to highlight what other research needs to be conducted to better inform clinical practice. Practice is informed by bodies of literature, not any single manuscript!

Common Mistakes:

  • Overstatement of findings, existing literature, and its impact on the field (using excessive adjectives, grandiose language). 

  • Using causative language when the study design cannot show causation. Medical students commonly use administrative databases like PearlDiver to conduct research, but it is impossible to determine causation with this type of design!

  • Misattributing citations - be sure to read through the papers you are citing fully to accurately convey their findings and use the most valuable references.

Overview

“Discussion and Conclusion” was the last panel hosted by the MSOS Education Committee as part of the research panel series “Dissecting a Manuscript”. The purpose of this panel was to gather advice from the JBJS panelists about writing the discussion section of a manuscript, including the purpose, key components, and organization of the section, through an in-depth analysis of 3 published manuscripts. We greatly appreciate all of the insight and advice shared by the panelists.