The Elements of Successful Written Communications

In this interview with OP, expert communicator Stephanie Roberson Barnard reveals the secrets to effective writing.

Our writing skills have suffered because “we’ve developed a second language of text shorthand,” write authors Stephanie Roberson Barnard and Deborah St. James in the preface to their new book Listen. Write. Present. (Yale University Press 2012). The authors note that while this is the case, healthcare employers demand more than ever print and electronic communication that is “clear, concise, well organized, thoughtful, compliant, and error free.” In such an environment, quality writing skills become an invaluable tool for the ophthalmic staff.

As an international speaker and communications consultant, Ms. Barnard has taught communication skills to thousands of professionals in health care and the pharmaceutical industry. In this interview with Ophthalmic Professional, Ms. Barnard discusses the importance of such skills and shares tips on how healthcare professionals, even those who have no formal training in writing, can sharpen these often-overlooked skills.

Ophthalmic Professional (OP): As a consultant for companies in science and medicine, what experiences led you to focus on communication skills?

Stephanie Roberson Barnard (SRB) I started as a contract communications trainer for Bayer Corporation, coaching healthcare professionals on communications skills. It was a value-added item that sales reps used. Of course, this program was eliminated after pharmaceutical companies adopted the PhRMA code. At that point, many companies had discovered my speaker series and first book, Writing, Speaking, and Communication Skills for Health Professionals (Yale University Press, 2011), so they contacted me to train their employees.

OP: Why are sharp communication skills so necessary not just for managers and those who regularly deal with the public, but for all who work in medical practices?

SRB: The staff of a medical practice sets the tone for the entire visit. The reality is that a patient sees the doctor for about 20% of the visit. The rest of the time the patient interacts with staff. If a receptionist, insurance clerk or nurse is a bad communicator, it could cost the practice a patient’s business.

When writing, the same rules apply. Often staff members are asked to send emails and letters that represent the practice. If this correspondence is badly written, it not only reflects poorly on the practice, it hinders comprehension. Translation: If you want people to read what you write, make it clear for them.

OP: In the environment of the doctor’s office, what do you see as the greatest challenge to effective written communications?

SRB: Lack of training. I have coached thousands of healthcare professionals from all educational levels. One thing they seem to have in common is no formal training in writing. We tend to take what our predecessor wrote and use it as a template for our documents, and this perpetuates bad writing.

OP: The constant floods of emails and texts have certainly resulted in faster communications, but have we sacrificed clarity or thoughtfulness?

SRB: Yes. Most people, even those of us who did not grow up with technology at our fingertips, expect fast responses to email and text messages.

OP: Is there a solution to managing this rush of communications?

SRB: No matter what you communicate or how you send the message, remember you don’t have to respond immediately. Take a few extra minutes to think about what you want to say and to proof your written comments before you send them. If you need more time, send a brief message explaining and offer a specific time when you will respond.

OP: For the person who is not the most skilled communicator, where do you recommend they start to improve their skills? Are there any shortcuts?

SRB: Of course, I’ll recommend that they read the grammar section of my new book. My co-author, Deborah St. James, who was an editor for over 35 years, wrote this section. I think it’s brilliant because it’s concise and includes the most common errors medical writers make.

Another tip: Designate a small notebook or Word file for your writing needs. For example, if you always get the words “dose” and “dosage” confused, write the correct usage in this notebook or document for quick reference later.

Last tip: I often check grammar and usage on the Chicago Manual of Style’s Website (www.chicago manualofstyle.org), even though I have a recent edition of the book on the shelf behind my desk.

OP: And finally, what do you believe are the keys to sharpening communication skills over the longterm?

SRB: Practice. This is one of the most important tips I give people. Think about professional athletes or “American Idol” contestants. What do they do almost every day? Practice. When you practice writing, communicating, or presenting, you set yourself up for success. For example, medical practice managers might want to organize a monthly meeting to discuss strategies for improving communications.

Presenting in the community is another great way to build your confidence and skill set. For example, offer to speak to elementary school students about glasses or give a talk at a civic club meeting on glaucoma. OP

An excerpt of the book “Listen. Write. Present.” begins on page 18.

Excerpt from Listen. Write. Present.

Yale University Press, 2012

Copyright 2012, Stephanie Roberson Barnard and Deborah St James

Write to Build Support for Your Ideas

Good writing can be very persuasive. First, others are more likely to read your document if it’s easy to understand, makes a logical argument, and uses correct grammar, punctuation, and language. Second, you can use benefit statements, sentence structure, and word choice to persuade your readers to support your idea. The following tips present specific ways to persuade others and negotiate a deal. You can use them in both speaking and writing. Remember this caveat: the audience is the most important consideration.

Organize your document in a logical manner. Most people tend to write in chronological order instead of priority order. For example, first this event happened, then we responded with this thing that didn’t work, so we changed course and tried something different, and finally we have this great result. Yet few of us are willing to wade through the details when we read if we can just flip ahead to the conclusion. Think about the order in which you read scholarly articles: title, abstract, conclusion, and, if the topic is worthy, introduction, methods, and results. You jump ahead to get to the punch line and go back to read the details if you need them. Your reader wants the same thing: easy access to the final point.

The Center for Plain Language Web site offers great advice for organizing your document to increase comprehension.⁶ We have expanded their ideas with practical comments below.

• Put the main message first. Think topic sentence. You learned in grammar school to put the topic of the paragraph at the beginning and so did your reader. Put it where the reader expects it.

• Divide your material into short sections. Think journalistic style. Everyone enjoys a mini break when reading, which is one of the reasons news stories have lots of short paragraphs.

• Group related ideas together. Think Venn diagram. When you can grab multiple concepts from various sources and experiences, and weave them together, you show your reader that you have a command of your topic and can incorporate critical thinking skills.

• Put material in an order that makes the best sense to the reader. Think logical, not chronological, order. Offer the conclusion first, and then capture the audience with your methods, examples, and supporting evidence.

• Use lots of headings. Think visual appeal. Headings naturally lead us to read the details below them.

Use benefit statements to give your points credence. Benefit statements offer the reader the WIIFM (What’s In It For Me?). An easy way to use benefit statements in your writing is to have a “you” focus. Another way to show the benefit is with an if/then statement.

For example:

If we reduce spending by 20%, then we can afford to hire another product manager.

Place the most important information at the end of the sentence in the stress position.⁷ Researchers agree that the end of the sentence is the stress position because it’s the last thing the reader (or listener) comprehends, and it sticks.

Example A:

The drug has significant side effects, but is highly effective.

Example B:

The drug is highly effective, but has significant side effects.

Presented with these two statements, more people say they would take the drug in Example A. Why? The emphasis is on effectiveness, not side effects.

Read your work aloud so you can hear how it sounds.

Use short sentences for important points. One sentence we use several times in this book is just one word: Practice. It has power because it’s short. Amid paragraphs of long sentences, the short one always stands out. As William Zinsser points out in his excellent book, On Writing Well, “Among good writers, it is the short sentence that predominates. And don’t tell me about Norman Mailer—he was a genius. If you want to write long sentences, be a genius.”⁸

Use repetition and transition to weave your paragraphs together. As readers, we look for visual cues that will aid in comprehension and retention.

For example:

In our section on dealing with difficult situations, we offer this tip:Follow up to make sure everyone is satisfied with your actions. If you’re not the person who can solve the problem, it might seem unnecessary to follow up. On the contrary, that’s exactly why you should follow up. Both the complainer (who may be a customer, colleague or boss) and your peers will see you as a problem solver. As we said earlier, this is the ultimate tag you want associated with your name.

Note the repetition

Notice how we strategically repeated the key phrase, follow up. This repetition led you into our main point: why you should follow up (also the benefit statement).

Note the transition

Notice how we wrote, As we said earlier, at the beginning of the last sentence. This transition ties the pieces of the book together and triggers you (the reader) to assimilate the new information into what you already know.

Choose persuasive words to make your points. Over the years, marketing experts have made lists with the most persuasive words in the English language. Nobody seems to know the original sources of these words, but common sense dictates that they must be persuasive. We chose words from a list developed by a group of education experts at the University of Maryland,⁹ which we have edited to suit you. Choose wisely from this list as your goal is to persuade readers, not scare, offend or threaten them into supporting your ideas. These words apply to both writing and speaking.

In support of

accurate advantage always/never best certain confident convenient definitely effective emphasize expect interesting most most important popular profitable should strongly recommend superior trustworthy worthwhile

Against

aggravate confusing damaging disadvantages displeased harmful inconsiderate inferior irritate offend ordeal provoke severe shameful shocking terrible unreliable unstable

6. Guidelines for creating plain language materials. Available at http://www.centerforplainlanguage.org/aboutpl/guidelines.html. Accessed May 24, 2010.

7. Gopen G, Swan J. The science of scientific writing. American Scientist. Available at http://www.americanscientist.org/issues/feature/the-science-of-scientific-writing/5. Accessed Jan. 29, 2009.

8. Zinsser W. On Writing Well. 7th ed. New York: Collins; 2006:71.

9. Fowler R, Hoffman N, Kolata D, Shah A. Building Learning with Technology website.

“Listen. Write. Present.” is available at booksellers including amazon.com.