Technical Writing Essentials for Disease Surveillance Officers

1. Writing technical papers and reports Integrated Disease Surveillance Programme (IDSP) district surveillance officers (DSO) course

2. Preliminary questions to the group • Do you have to write technical reports? • If yes, what difficulties did you face? • What would you like to learn about technical writing? 2

3. Outline of the session • Types of reports • The six “S” of technical writing • Common errors to avoid 3

4. Audiences for which a district surveillance officer may need to write • Administrators • District health officials • State surveillance unit • Elected representatives 4 Reports

5. Types of report that a district surveillance officer may need to write • Initial “First information report” • Full outbreak investigation report • Rapid assessments • Scientific publications 5 Reports

6. General framework of an outbreak investigation report (1/2) 6 • Executive summary • Background • Territory, origin of the alert, time of occurrence, places, staff met • Methods used for the investigation • Epidemiological methods • Case definition • Case search methods, data collection • Analytical studies if any • Data analysis • Laboratory methods • Environmental investigations Reports

7. General framework of an outbreak investigation report (2/2) 7 • Major observations / results • Epidemiological results (population at risk, time, place and person characteristics) • Experience/expected outcome of affected, Pathogen involved, laboratory diagnosis • Environmental investigation results • Current status of transmission, control measures adopted/ initiated • Conclusion: Diagnosis, source, vehicles • Recommendations Reports

8. Annexes of an outbreak investigation report 8 • TIME: Epidemic curve • PLACE: Map • Spot map • Map of incidence by area • PERSON: Table of incidence by age and sex • Analytical study results if any • Relevant figures to illustrate the source / vehicle(s) Reports

9. The six “S” of technical writing • Simple • Short • Structured • Sequential • Strong • Specific 9 The six “S”

10. The six “S” of technical writing • Simple • Use simple words to explain what is meant • Explaining the concept to a lay person • Don’t use jargon technical or statistical jargon • Short • Structured • Sequential • Strong • Specific 10 The six “S”

11. Writing simply • Primary data on number of cases and death for two age groups (under five and above five) due to diseases / syndromes listed above are collected using a uniform format by all reporting units • Facilities report cases and deaths for 12 diseases among two age groups 11 The six “S”

12. The six “S” of technical writing • Simple • Short • < 10 pages, < 5 tables / figures • Use short sentences with one idea each • Split complex sentences • Cut unnecessary elements • Structured • Sequential • Strong • Specific 12 The six “S”

13. The summary • The audience of your report may be too busy to read it completely • Always add a summary of: • < one page • < 300 words • Structure your summary with subheadings "I'm sorry to write you a long letter. I had no time to write a shorter one” Mark Twain 13 The six “S”

14. The six “S” of technical writing • Simple • Short • Structured • Have headings, subheadings • Write under the high level outline • Follow the logic argument • Sequential • Strong • Specific 14 The six “S”

15. Using high-level outlines • Skeleton of the report in bullet points • Outline of various sections • Spell out all titles • Use outline format of word processors • Summarize each paragraph with a bullet point • List of tables and figures • Spell out titles • Reach consensus with contributors on the outline • Expand when the outline is strong and clear 15 The six “S”

16. The six “S” of technical writing • Simple • Short • Structured • Sequential • Take the reader by the hand step by steps • Start each sentence where the previous ended • Strong • Specific 16 The six “S”

17. Being sequential • The pipeline was repaired on 31 July. This was followed by a sharp decrease of incidence after one cholera incubation period. Moreover, cholera was isolated from stool specimens. • The first two sentences are sequential, not the third 17 The six “S”

18. The six “S” of technical writing • Simple • Short • Structured • Sequential • Strong • Use the verb as the centre of gravity • If the verb is weak, the sentence is weak • Specific 18 The six “S”

19. Using the right verbs • We conducted an investigation of the outbreak • We investigated the outbreak • We took a sample of the population • We sampled the population • We made an assessment of the situation • We assessed the situation 19 The six “S”

20. The six “S” of technical writing • Simple • Short • Structured • Sequential • Strong • Specific • Say clearly and exactly what you want to say • Do not paraphrase • Prefer numbers to qualifiers 20 The six “S”

21. Being specific • The village was very affected and the disease was severe • The attack rate was 13%, with a case fatality of 3% and 23% of case-patients hospitalized • Health workers are not aware of case definitions • Of 23 health workers interviewed, 35% could not quote the reporting criteria for measles 21 The six “S”

22. Avoid passive voice • Passive voice • Suggest lack of ownership in the process • Imprecise • OK if subject is unknown or irrelevant • Active voice • Reflects the responsibility taken • Precise • To use by default (use grammar checkers) 22 Common errors

23. Examples of passive and active voice use • Passive voice • A study was conducted • A sample was selected • Questionnaires were administered • Active voice • We conducted a study • We selected a sample • Field workers administered the questionnaires 23 Common errors

24. Avoid the wrong terms to document the level of evidence • Show (Leave it to music hall) • Indicate • Prove (Leave it to mathematicians) • Indicate • Reveal (Leave it to photographers) • Indicate (or suggest) • It appears (Leave it to crystal balls) • Spell out what data suggests that • Use suggest for indirect / partial evidence and indicate for clear / direct evidence 24 Common errors

25. Get rid of “should” • “Should” is passive and vague • Use the “find” function of word processors to hunt your “should” • Tuberculosis patients should be counselled • Use imperative • Counsel tuberculosis patients • Explain why it “should” be done • Counselling will decrease default rates • Do both • Counsel tuberculosis patients to decrease default rates 25 Common errors

26. Don’t be the bearer of bad news • Avoid general, undocumented, finger-pointing, negative statements: • The district medical officer has not even started programme implementation in this district • Prefer specific, documented, diplomatic opportunity statements: • Review of 6 out of 7 indicators indicated that the programme is still at an early phase in the district, allowing for some adjustments 26 Common errors

27. Say it well, say it once • The same information is displayed in duplicate • In two locations in the text • In two tables • In a table and in a graph • In the text as well as in the table or/and figure • The information needs to be presented only once, and in the place that is most appropriate to serve the point made 27 Common errors

28. Be technical, not anecdotal • Avoid reporting anecdotal events that do not contribute to the technical aspects of the report • The District Medical Officer and the Assistant Secretary of Health joined a team comprised of myself and three field workers to go to the site of the outbreak that could not be reached before three days because of rains • Focus on technical aspects • Because of logistical constraints the rapid response team initiated the investigation on 16 March 2003 • You could actually omit the logistical constraints as the reason does not really matter 28 Common errors

29. Be objective, not subjective • Subjectivity: The author is writing from the psychological perspective of the reader or writer • Subjective considerations (e.g., interests, surprises, shock) vary and are more likely due to backgrounds or transient feelings than from facts • Focus on the ideas that are relevant to the issues examined and on the consistency of hypothesis with available evidence • Objective statements 29 Common errors

30. Take home messages • Write for your audience, not for yourself • Place a six “S” checklist above your desk • Identify and eliminate your errors 30