This blog is based on an article written by Misty Bailey, MA, ELS(D), Kirsten Benson, EdD, and Anne Marie Weber‑Main, PhD, that was originally published in the AMWA Journal.
As a medical editor, your challenge is to use techniques that effectively balance the need for clarity with respect for the authors’ ideas. In other words, communication approaches need to empower authors while accomplishing the common goal of producing an easy‑to‑read piece of writing that clearly and effectively communicates the authors’ message and intent.
Some of the communication methods used by university writing center tutors can be effective in supporting the dialogue between medical editor and author. Below, we briefly describe some communication practices used by writing center tutors that we believe can apply to medical editors’ communication with authors.
Technique 1: Informational Support and Author Development
When tutors focus on an author’s development by explaining why changes are being suggested and offering to answer questions about editing recommendations/comments, they are offering what is called informational support.
Explain your recommendations
Medical editors can readily apply a tutoring approach in their work by taking the time to offer explanations for their recommendations.
In some instances, the reason for making a change might be based on a style guide or grammatical principle. In substantive editing (sometimes called macroediting or comprehensive editing), the reason for the suggested change might be framed in terms of its positive impact on readers, such as improving comprehension or influencing perceptions. This affirms the author’s expertise with regard to the content by acknowledging possible reader confusion and providing suggestions for revision.
Support the author’s authority over the text
Other ways to ensure the author retains ownership include reacting as a reader and, if an opportunity exists for in‑person contact, placing the document physically closer to the author. The idea that tutors should respect students’ authority over their own texts is a commonplace of writing center theory; demonstrating such respect in editing practice also leads to positive results. For example, among the many positive editor‑author experiences noted by one study of 449 authors, one was when editors understood authors’ authority over their own texts and represented reader needs and reader perspectives.
Practice paraphrasing to clarify understanding
Other ways that writing center tutors provide informational support and contribute to author development are by paraphrasing to clarify understanding and by “perception checking”—ie, admitting confusion, guessing the basic message, and asking for affirmation.
With regard to ownership of the text, perception checking is particularly important for medical editors who are not content experts. At times, edits might inadvertently change the meaning of the text, but by paraphrasing to clarify understanding, editors can advocate for the reader while maintaining rapport with the author and, importantly, demonstrate respect for the author’s knowledge of the discipline even while raising questions.
Promote satisfying, respectful author‑editor interactions
At the first author’s institution, a small group of medical editing clients (a mix of faculty, medical residents, postdoctoral associates, and graduate students) was asked to complete an anonymous online survey with 14 questions aimed at determining how specific editor techniques affected their satisfaction with author‑editor interactions. The questions were developed to guide personal editing practices and were based on several previous studies about tutor and tutee satisfaction with tutoring sessions.
Here is a sampling of the results.
- For the 26 respondents (51% response rate), the 2 communication techniques that were considered most important to authors’ satisfaction with editing interactions were “explaining why changes/suggestions are made” and “offering to answer questions about recommendations/ changes.” Both are forms of informational support.
- Nineteen of 26 respondents (73%) thought perception checking was “extremely important.”
- In another study that surveyed authors (predominantly technical writers) who had used the services of an editor, respondents reported that they were most likely to follow an editing suggestion when it was coupled with a “payoff statement”—a description of the way in which an edit would specifically benefit the reader and thus, the author.
One editing situation that is particularly well‑suited to the informational support technique is when authors seek assistance in responding to reviewers’ comments. Editors can provide support by editing for tone in responses and by offering another perspective if it seems the author may have misunderstood a reviewer’s question. Editors can also be a source of knowledge when a manuscript peer reviewer makes an erroneous comment about style or the mechanics of language. For example, an editor will be able to supply an author with specific evidence from style manuals or author instructions to include in a rebuttal.
Technique 2: Emotional Support and Author Trust
Writing center tutors are trained to provide writers with emotional support and to garner author trust in a variety of ways, such as by promoting “unconditional positive regard” in which the tutor does not approve or disapprove of the individual or his or her writing, but rather accepts the individual and is willing to help. Other techniques are actively and reflectively listening and granting validity to writer concerns, even those regarding motivation (or lack thereof), and offering support via empathy and encouragement. Reflecting a writer’s concern back to him or her and normalizing the concern, if appropriate, allows the tutor to acknowledge the writer’s experience without having to agree with it. Validating concerns in this way allows the writer to be heard and indicates a desire of the tutor to understand the writer’s perspective, thus helping build trust.
Like students working with tutors, authors working with editors also benefit from feeling nurtured and respected. Writing center tutor techniques, when applied effectively to the medical editor‑author dialogue, have great potential to increase the comfort level of both the editor and the author, as well as to make their relationship more productive.
In their article “Coaching Faculty to Publish,” Baldwin and Chandler recommend “validating and encouraging both the creator (author) and the creation (manuscript)” by acknowledging potential writing‑associated frustrations and celebrating events like submission and acceptance of a piece of writing with an email, phone call, or note to the author. They go further by discussing the editor’s role in commending progress and encouraging perseverance.
Tips for Creating an Encouraging, Helpful Relationship
The following list outlines some strategies for creating what Taylor calls a “helping relationship,” in which the editor projects an air of acceptance of the author and an eagerness to help.
- Take the time to understand the author’s meaning.
- Respond enthusiastically in a concerned way that shows “stronger concern for people than for things.”
- Provide a sense of acceptance of the author and convey a willingness to help. Do not give a message of approval or disapproval of the writing.
- Golden Rule: “There’s no room for sarcasm, superiority, aggression, or criticism.”
- Summarize to give the author a sense of progress.
- Assist in responding to reviewers.
Some of these techniques, especially avoiding judgmental criticism (different from critique), might be most effectively applied in face‑to‑face situations in which nonverbal communication is particularly important to the interaction. However, even within the constraints of written or electronic editing, helping relationships can be nurtured when editors take the time to go beyond simply fixing errors.
In our survey, 88% of author respondents (23 of 26) indicated that working with an editor who conveys empathy and responds enthusiastically was “extremely important” to them. Similarly, student comfort level with tutors was reported by Thompson and colleagues as correlating significantly with tutee satisfaction with the session. High satisfaction with their interactions with medical editors may encourage authors to become repeat clients.
Although writing is often a high‑priority activity (as with faculty expected to publish peer‑reviewed papers), writers who are also researchers, instructors, or practitioners often have low follow‑through when it comes to completing writing projects because other responsibilities are more immediately demanding.
Additional factors that can impede the writing process include the following:
- Authors’ anticipation of failure
- Embarrassment upon peer review
- Difficulty self‑motivating and staying focused
Thus, authors who feel they have a highly supportive teammate in the writing process—manifested in an editor—may feel more encouraged to make progress. When authors are able to focus on writing content and allow the medical editor to fine‑tune the text, writer output might increase, as was found in one study that compared the publication rates of 26 faculty members before, with, and without the use of writing coaches.
A limitation of our survey is the small sample of authors; therefore, the results should be interpreted with caution. Still, we believe that medical editors can effectively adapt the techniques of writing center tutors for use with authors. In light of evidence that supports a correlation between the use of these techniques and writer satisfaction, editors who apply these techniques might be more successful in advancing their careers through attracting, retaining, and influencing their clients.
The authors thank Sarina Manifold, LCSW, Veterinary Social Work, Veterinary Medical Center, University of Tennessee, for intellectual input on the practice of validation communication.