Non-feature Articles for InnovAiT

Case reports

Case Reports are an excellent way to share an interesting case with fellow trainees. The word limit is 800 words and typically includes a brief synopsis of the scenario that should include the clinical context in which the case was encountered (e.g. hospital, general practice, community paediatrics etc.). You can download a pro forma from our website www.oxfordjournals.org/our_journals/innovait.case_studies.html.

When thinking about the case that you are writing up, try and answer the question, ‘Why is this relevant to GP trainees?’ For example, if it is an incredibly rare condition, try to highlight how it can be diagnosed in the community rather than giving technical details of a rare genetic test. Perhaps there was a missed diagnosis that you feel other trainees could benefit from learning about. Or perhaps it is a common condition where the social circumstances made it particularly challenging.

Patient confidentiality is paramount. Where possible, obtain patient consent. This is essential if using ‘real’ details such as the correct name, age or occupation. If it is impossible to obtain consent, then you must ensure that all identifying details are removed from the article and that the patient is disguised, e.g. by changing the age/occupation/location.

We usually consider publishing two high-quality images with case reports. All photographs should be of the highest quality possible as reproduction reduces the quality. Resolution—figures should be supplied at a minimum resolution of 300 dpi. Most figure file formats are acceptable, although TIFF is preferable. If you have taken photos of the patient, please ensure that you have obtained written consent. Alternatively, we have access to a number of library images and may be able to find an appropriate image to match your case history.

Book reviews

Book reviews should be 800 words in length. You can download a pro forma from our website (http://www.oxfordjournals.org/our_journals/innovait.for_authors/bookreviews.html?). We ask reviewers to grade the book that they are reviewing out of four stars. We consider book reviews on a range of subjects, from clinical guides to classical texts that illuminate something important about the role of GPs or dealing with particular medical conditions.

For example, if you've spent a wonderful year studying anthropology for an intercalated BSc, you might want to suggest a book for GP trainees to give them a feel for the subject. Or perhaps you want to review Sherlock Holmes and his power of observation relating to general practice? Or perhaps some of those classic medical texts that are often referred to as essential for GP training, such as The Inner Consultation or The Doctor, His Patient And The Illness: it would be great to hear what a current trainee thinks of this work.

For newer texts, please email us suggestions if you would like to review the book, including the publisher's details. We will contact the publisher to try to ensure that you are sent a free copy. We also ask that you declare an interest if you are personally connected to the publisher or the author. If you want your friend's book to be reviewed, please email us the suggestion and we can consider commissioning someone appropriate to review it without prejudice.

When writing a review, it is important to try to give a balanced view of the book. If you think that this book is the best thing since Shakespeare (if indeed you like Shakespeare), try to come up with some constructive criticism: why might some GP trainees not like this? What might make it even better? Conversely, try and tease out the strengths of a book that you dislike. It is helpful to backup your points by quoting from the text. The more specific that you can be, the better your review is likely to become.

Fillers

Filler is a broad term that we use to cover a wide range of articles that are typically between 400 and 800 words in length. They include articles such as reports from conferences, reflections from an excellent teaching experience, reviews of art exhibitions relevant to GP trainees or an interesting anecdote from the history of medicine. We are also keen to hear reports back from exciting initiatives on different training schemes, e.g. successful steps taken to ensure that all trainees receive protected GP training time while doing their A&E posts.

We welcome articles from overseas trainees, typically short articles about some aspect of training in another country that may be of interest to readers. If English is not your first language, then it is advisable to ask someone else who is fluent to read through your article first.

Unlike more traditional scientific journals, InnovAiT is keen to hear a little bit about the people writing the articles. For example, if you are writing about a conference you attended, it would be good to know why you chose the conference, perhaps letting readers know a little bit about where you work and how it relates to your current point in training. Such details are particularly important if you are going to write about an interesting time that you have had away from medicine, e.g. doing volunteer work.

Audit

Audit is an important part of modern clinical care. It is a way of ensuring that standards are maintained and provides a platform for discussions within practices that might lead to further work locally. For the old MRCGP examination, it used to be compulsory for GP trainees to complete an audit but this is no longer the case. Nevertheless, trainees can find audit very useful, both in terms of engaging with their practice team and experiencing the reality of bringing about change within the clinical environment.

Audits are often challenging to complete, and one of the most common difficulties we encounter at InnovAiT are trainees who have tried to write up something that is over ambitious. There are a number of strategies for producing a good audit but the main advice is to think clearly about the audit design. As Jim Henson, creator of the Muppets, said, ‘Simple is good’;.

Background —why did you choose this subject, what was the clinical need, why might other trainees be interested?

Standard —what is your standard? This is a crucial question. Audit is comparing care within your clinical environment against an agreed standard. For example, does everyone who receives a prescription for Viagra at your practice meet the requirements for National Health Service (NHS) prescriptions? The standard would be: ‘all NHS prescriptions for Viagra should meet the inclusion criteria as specified in the British National Formulary’. There may be areas of care for which there are no national guidelines and you have to devise a standard. For example, although potentially harder to measure, you might agree having discussed it with your colleagues that ‘90% of repeat prescriptions should be returned to reception within 48 hours’.

Design — How are you going to collect the data?

Audit results —What did your work reveal? Consider using appropriate tables or graphs to display your results.

Intervention —What are you going to do to make a change? Why did you choose this method?

Re-audit results —Has your intervention made a difference? Many trainees find that it is hard to complete this part of the audit cycle. It makes for a more high-quality piece of work if you are able to do this. The whole purpose of the audit cycle is to try and demonstrate effective change. You need not wait 12 months to re-audit. For example, if you are looking at repeat prescriptions, it might be adequate to re-audit in 2 months time. Or perhaps you could ask your trainer what the previous trainee did and complete the second cycle if it has not been done. If you keep the design of the audit simple, the second cycle should be relatively easy to complete.

Discussion —This is arguably the most important part of the audit for InnovAiT submissions. It may be that your audit was a disaster, and you were unable to demonstrate any change, or perhaps findings in the re-audit were actually worse. … This does not matter, as long as you are able to reflect upon the process. What was challenging about the process? How could you have made it better? Perhaps prescribing behaviour within the team was too entrenched or perhaps people did not really agree with the standards being set. There are hundreds of aspects that you can reflect upon. Did you actually enjoy doing the audit? Or was it something that you felt you were doing for other people's benefit. If you were to repeat the whole process, what would you do differently? The discussion should refer explicitly to the clinical need you refer to at the start of the article.

Research

What is the difference between research and audit? Research aims to derive generalizable new knowledge. Audit aims to compare current practice against preset criteria. Although this sounds simple, it is easy to design an audit that goes one step further than comparison against preset criteria and strays into the territory of research. Guidance on what is research and what is audit can be obtained from the National Research Ethics Service at the following web address: www.nres.npsa.nhs.uk/applications/guidance/research-guidance.

Why is it important to distinguish between research and audit? From the perspective of InnovAiT, we do not publish original research except in special circumstances [for example, publishing prize winning entries from the Royal College of General Practitioners (RCGP) Roche Awards]. Even under those circumstances, in accordance with General Medical Council (GMC) regulations and guidance from the International Committee of Journal Editors, we are unable to publish any research on human participants (not just patients) that does not have prior authorization from an approved ethics committee.

Letters

You may have noticed that from time to time we publish letters that readers have sent us about articles that have appeared in InnovAiT. We like to publish these if we think that they would add further information for our readers. We try to obtain a response from the author of the original article to publish alongside your letter if this is relevant.

If you want to write InnovAiT a letter for publication, then please email your letter to our editorial office (innovait.editorialoffice@oup.com). Remember to keep your letter short (no more than 200 words) and to the point.

And finally …

For all the articles mentioned above, the stylistic directions for InnovAiT articles remain, e.g. referencing, trying to engage the reader, etc. More information can be found at www.oxfordjournals.org/our_journals/innovait.for_authors/index.html. However, for non-feature articles, there is no need to explicitly refer to the curriculum in the text.

If you are unsure whether your article is appropriate, or you have a suggestion for an article, please email us directly at innovait.edjunior@oup.com. We are always keen to hear new ideas for this section. It also often helps to touch base before committing to writing something. It may be the case that someone has already written a case report on Lyme disease or has been commissioned to write a report on the conference you are attending.

All articles go out for peer review, and all articles tend to require a degree of editing before being accepted—and even then there may be some last minute changes at the proof stage. This is common to all medical publishing and it is important to be aware of this at the start.

We look forward to hearing from you.