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08_How to write 'Discussion' Section — Transcript

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0:00hello everyone following the session on
0:03results
0:04today we will be seeing how to write a
0:06discussion section so by now you are
0:09already familiar with the imrd structure
0:12i for introduction m for methods r for
0:15results and d for discussion so today's
0:19session is going to be on the discussion
0:22section of a manuscript where you are
0:24going to say what it all means or in
0:27other words you are going to be saying
0:30how all that you found comes together
0:33the objectives for this session will be
0:36as follows
0:37at the end of this session the
0:38participant must be able to
0:41explain the importance of a discussion
0:44section
0:45he or she should be able to list the
0:47components of the discussion section he
0:50or she should be able to construct an
0:52argument through the discussion section
0:55and finally also be able to list the
0:57strengths and limitation of their study
1:01so let us first look at the importance
1:04of the discussion section
1:06now this is the section that is going to
1:08give you all the meaning to your article
1:11from your study findings it is in this
1:14place where you are going to be
1:15explaining the meaning of the results so
1:18i would like to reiterate a point that
1:20was made in the results session also
1:23that when you are describing the results
1:25you just describe you do not interpret
1:28so the place for interpretation is the
1:30discussion section where you describe
1:32the meaning of all your results
1:35the next reason why discussion section
1:38is important is that it is here that you
1:41will be discussing what your study
1:43findings mean in your study context what
1:47are the implications of what you have
1:49found in your study
1:52the next importance is because
1:54this is the place where your original
1:57opinions and your original
1:59interpretations as a researcher come
2:02into play and you exercise your
2:05skill and knowledge as a researcher to
2:08apply your interpretations on your study
2:11findings and you put it out there in the
2:13discussion for the reader to read
2:16the next reason why the discussion
2:18section is important will be it is here
2:21you say
2:22how
2:23your study findings hold in the context
2:26of existing evidence is it an agreement
2:29is it in disagreement is it a new
2:31finding in the context of existing
2:34literature
2:35and it is also here that you describe
2:38what your study findings mean in the
2:40context of the strengths and limitations
2:43of your own study
2:45the next step would be to recommend for
2:49policy and practice now this is the very
2:51purpose why all of us enter into
2:54research you start with the research
2:57question because you think that the
2:59answer to this question is going to
3:01influence policy or practice so it is in
3:04the discussion section that you put out
3:06your recommendations for policy and
3:09practice based on your study findings
3:12now let us go through this diagram which
3:14you all are very familiar with the life
3:17cycle of a research and we will see
3:20where exactly the discussion section
3:22fits in
3:23well this is where it fits in from
3:26drawing conclusions from your study
3:28findings and formulating recommendations
3:31and involving the program or the
3:34practice
3:35that you are seeking to influence based
3:37on your research study
3:40so here if you closely observe
3:43there are two sets of processes that are
3:45happening in parallel now let us say
3:48when you lay out your study objectives
3:51you want to be your conclusions from
3:53your study to be answering these
3:55objectives so these are two processes
3:57that happen in parallel the other one is
4:00when you chart out your analysis plan
4:03for your study which we described in the
4:05methods section
4:06here
4:07when you are doing your analysis of your
4:09study it is supposed to meet what you
4:11proposed in the analysis section so the
4:14objectives and the conclusion need to be
4:16in parallel or they should meet each
4:18other's purpose and your analysis plan
4:21and the actual data analysis section are
4:24also two sections that run in parallel
4:26now let me try to describe this to you
4:29with an example now i've taken the
4:31example from the paper that is uh cited
4:33below where we've seen the trends in
4:35tobacco consumption between 1985 and
4:382016. now here if you see in the
4:42objectives it has been clearly written
4:45that the authors want to assess the
4:47impact of fcdc or the framework
4:49convention for tobacco control now one
4:52would expect that the conclusion of this
4:55article or the major finding from this
4:57article should be answering this major
4:59objective
5:01then the planning of the analysis again
5:04here the authors have listed that they
5:06would be seeing the relative percentage
5:09decline between 1985 and 2016 in the
5:13consumption of tobacco now let us see
5:16whether these this objective and this
5:18analysis plan was followed in parallel
5:22through the other two sections namely
5:24conclusion and data analysis so if you
5:27look at the conclusions that the authors
5:29have drawn you can see that they have
5:32said that following the implementation
5:34of fctc they were able to observe a
5:37certain decline in the consumption of
5:40tobacco now you can clearly see how the
5:43conclusion is written in a way that it
5:46answers the major objective spelled out
5:48by the researcher similarly if you see
5:51how they have analyzed the data in sync
5:53with their analysis
5:55plan they have formulated a hypothesis
5:58that following fctc they expect a
6:02decline in the consumption of tobacco
6:04and that they have done by looking at
6:07the relative percentage in decline in
6:09tobacco consumption between the uh years
6:121985 and
6:142016. so following that this would be
6:18the outline of the discussion section in
6:21other words these are the components of
6:24the discussion section you would start
6:27out with summary of findings where you
6:30say what was found in not more than two
6:32to three lines and without delving again
6:35into talking about the quantitative
6:36details in your results
6:39this would be followed by making your
6:41key points now
6:43however elaborate your research might be
6:45you could come up with two or three key
6:48points around which you want to center
6:50your discussion or these are the key
6:53points that you want the reader to focus
6:55on so you make these points one by one
6:58and center your discussion around it now
7:01i would like to reiterate what i said
7:03about building an argument around a
7:06certain key point where you talk about
7:08what it means in the study context what
7:11it means in the context of exit existing
7:14literature the next step would be where
7:17you discuss the strengths and
7:18limitations of your study and how they
7:21are likely to or not likely to influence
7:23the validity of your findings the last
7:27step would be where you leave the reader
7:29with recommendations for clinical
7:31practice or recommendations for the
7:33program implementation so we would now
7:36see the second objective of today's
7:39session which would be how to construct
7:41an argument through your discussion
7:43section so here i would say you take a
7:46particular study finding and build it
7:48through your discussion section we've
7:50already seen how you have narrowed down
7:53to two or three key findings that you
7:56want to discuss in your discussion
7:58section how do you go through it you put
8:00out your tables and figures read through
8:02the text of your results if you've
8:04already written it and narrow down to
8:06those two or three key findings then
8:10what you do is you take each of those
8:12findings and develop them through the
8:14discussion section here you could
8:16discuss first what each study finding
8:19means then you could discuss it in the
8:22light of existing literature and in the
8:25light of the strengths and limitations
8:27of your study design and finally say
8:31what it means in the larger context of
8:34things so this is how you generally
8:36construct an argument around a single
8:39study finding in your discussion section
8:42so
8:43in a discussion section you look at
8:45describing and interpreting while the
8:48describing part is majorly done by the
8:50result section the interpretation is
8:53strictly restricted to the discussion
8:55section so here you interpret and
8:58analyze your study findings you look at
9:02the context you look at the meanings you
9:05look at the understanding you register
9:07your observation and you talk about
9:10relative information
9:12now let us see what description and
9:14interpretation mean so in the context of
9:17neurophysiology if i show you this
9:20picture what would you say maybe when
9:23you observe it you would say that this
9:25is a picture of concentric circles which
9:27are in different color but your visual
9:30zone in your cortex is going to
9:31interpret it and put the information out
9:34that this is a target now this is how
9:38description and interpretation work in
9:40neurophysiology if you take clinical
9:43practice now let us say you were reading
9:45an x-ray you could say that you found
9:48opacities you found a system at
9:50systematized low bar opacity but then
9:53your interpretation would be that this
9:55is a consolidation probably a lower
9:58pneumonia
10:00now taking this further let us see how
10:02description and interpretation work in
10:05the context of manuscript writing
10:08you follow the sequence and you take the
10:10thread that you left in the results
10:12section and take it forward you describe
10:15the result you describe the study
10:17finding in the results section and you
10:20take it forward in the discussion
10:22section by interpretation a gentle
10:25reminder again to keep these two stages
10:28separate
10:29so description in a manuscript in the
10:32results section usually follows the
10:35sequence of general to specific simple
10:38to complex so you would be having your
10:41descriptive statistics first then your
10:44analytical statistics and stop there in
10:47the results section it was also
10:49mentioned in the results section that
10:50you do not use adjectives or qualifiers
10:53in the results section so when you come
10:56to the discussion section now here i
10:58will show it to you with an example
11:00where what is the describing part that
11:02you do in the manuscript and what is it
11:05the interpretation that you base on this
11:08description now if you see here this
11:10data is from the same paper that i
11:12referred to earlier in this session so
11:15here the author says there was a
11:17reduction in smoked tobacco use after
11:20the year 2000 but the reduction in
11:23smokeless tobacco use was registered
11:25much after 2009. now how does the author
11:29follow this up in the discussion section
11:31the author says that following the
11:33ratification of fctc by india which
11:36happened in the year 2004 there were a
11:38slew of legal measures which were mostly
11:41centered around smoked tobacco the
11:44measures to curtail smokeless tobacco
11:46use came into four much after and this
11:50the author says could be the reason why
11:53the trends in smoke tobacco and
11:55smokeless tobacco are different and the
11:58smokeless tobacco use registers a
12:01decline much later in fact nine years
12:03after the decline registered in smoked
12:06tobacco use there is also another
12:09finding which the author describes in
12:11the results section the author says that
12:14there is a delayed peak in smokeless
12:16tobacco use in females and also the
12:20females
12:21who were analyzed in the study did not
12:24register a product switch in other words
12:27the author says they did not switch over
12:30from smoked to smokeless tobacco now
12:33this is a finding that is just described
12:35in the results section what the author
12:37follows up with in the discussion
12:39section is the probable reason why this
12:43occurs so the author here details how
12:46the smoked tobacco use is also
12:48registering a delayed peak among females
12:51compared to males and also says that
12:54this could be the reason why the product
12:57switch from smoke to smokeless tobacco
12:59is not yet registered in the females as
13:02of now but could be something that could
13:04happen in the future
13:07so you could carefully observe that the
13:09language that one uses in the results
13:11section and the discussion section is
13:14quite different and i would also like to
13:17remind you that the author brings in his
13:20or her original interpretations in fact
13:23this is a coming-of-age experience for a
13:26researcher where it is one thing to see
13:28the data analysis sheet and just present
13:31the results but it is one step further
13:33to go forth and interpret what these
13:37findings could actually mean and where
13:40they actually come from
13:43so the next point that i would like to
13:45bring to you is all this interpretation
13:48happens in the light of the initial
13:50hypothesis that you have in mind for
13:53example in the smokeless tobacco paper
13:55that we were just uh discussing
13:58the author had stated a probable
14:00hypothesis in mind that fctc
14:03ratification or implementation of fctc
14:06could have led to a decline in tobacco
14:09use irrespective of forms so
14:12any study that you are writing up it is
14:14essential that you have an initial
14:16hypothesis in mind so that all your
14:20interpretations can harp back to this
14:22initial hypothesis and you could discuss
14:24on whether your findings are
14:27refuting it or whether your findings are
14:29confirming the initial hypothesis that
14:32you came up with so please remember data
14:34are always interpreted in the light of
14:37the initial questions and hypothesis
14:39that you came up with okay so we will
14:42come to the next learning objective
14:44where after constructing the discussion
14:47section you are now going to see whether
14:50it bridges efficiently the objectives
14:53and the conclusion so let us say that
14:56one end of the bridge is the objectives
14:58and the other end is the conclusion
15:00which we've already seen are two
15:02parallel processes that are happening
15:04here so the discussion should be a
15:07logical connector between these two ends
15:10and the reader should be able to make
15:12the con connect instantly
15:14so
15:15the you have the results the facts and
15:18the figures in your hand and you have
15:21the recommendations at the other end
15:23where you're going to be making
15:24recommendations for change in a practice
15:27or guidelines or policy you have the
15:30conclusion where the points are made
15:33based on the evidence that you have
15:34generated and right in between there you
15:38have your discussion section which
15:40bridges these two ends
15:43so the first paragraph of your
15:45discussion which is one end of the
15:47bridge so it is here that you briefly
15:50summarize your findings the two or three
15:53points that you have finalized for
15:55discussion in your article you summarize
15:59it there and you announce you sensitize
16:02the reader about what he or she should
16:04be expecting while reading your
16:06discussion section that the reader
16:09should be ready for interpretation and
16:12arguments centered around these key
16:15findings now what you do not do in this
16:17first paragraph is you do not go into
16:20in-depth interpretation you do not
16:22repeat all the results again and you do
16:25not
16:26you know you do not dive straight away
16:28into discussion in the first paragraph
16:30the first paragraph is the place where
16:32you
16:32briefly summarize your study findings in
16:36two to three lines without giving any
16:38specific quantitative details now the
16:40other end of the bridge or the last
16:43paragraph of the discussion is the place
16:45where you come towards your conclusion
16:48so it is here that you summarize your
16:50conclusion points all said and done
16:52you've discussed you've pondered over it
16:54you've reflected upon evidence that is
16:56available and the last paragraph is
16:59where you are heading towards a
17:00conclusion so the reader you are
17:02preparing the reader for the final
17:04verdict from you as the researcher about
17:07the research question that you have post
17:10so it is here you come up with
17:13the conclusion
17:15which will be followed by the
17:17recommendations again based on your
17:19conclusion please remember that the
17:21conclusion should entirely draw from
17:24your study findings and should not be
17:27some general points that you are trying
17:29to make the conclusion should be
17:31entirely grounded in your objectives and
17:34your study findings now what you avoid
17:37here in the last paragraph of your
17:39discussion is going on to you know give
17:42generalized recommendations which are
17:44not linked to your conclusions or
17:48those that are not in sync with your
17:50objectives so i hope you are able to see
17:51the link here you have the objectives at
17:54one hand your conclusions that are
17:56answering these objectives based on your
17:59study findings alone and recommendations
18:02which you propose
18:04in sync with the conclusions that you
18:07have come up with now what is left is
18:09the body of the discussion alone so here
18:12start from the results themselves take
18:14each of them one at a time and bridge
18:18them with your logical argument centered
18:21around each of the results you review
18:23the causes and consequences of your
18:26finding and you interpret the findings
18:29and what could be their implication for
18:32your study findings and for the larger
18:34context
18:35what you should avoid here and
18:38this is a temptation that most of us
18:40have when we are early researchers is to
18:42just limit your discussion to comparing
18:45it with existing literature your
18:47discussion simply cannot flow like i
18:49found this they found that i found this
18:51but they did not find this so this is
18:53not how your discussion flows this is
18:55not why i come to read your discussion i
18:58come to read your
18:59discussion to understand what you think
19:02what you
19:03reflect upon your own study findings and
19:06what you come up with originally so let
19:09us see how you deal with an unexpected
19:12finding in your research paper now you
19:15would agree with me that though you have
19:17an initial hypothesis in place not all
19:20your study findings need to confirm that
19:23in a very explicit or in a very
19:25affirmative manner you could have data
19:28and information that do not immediately
19:31align with your initial hypothesis now i
19:34would like to give the example of the
19:35tobacco paper that we were just
19:37discussing
19:38now here if you see the initial
19:40hypothesis of the author was that
19:43tobacco use was going to register a
19:45decline following the implementation of
19:48fctc now here what the authors have
19:50found was that while smoke tobacco
19:53followed this
19:54hypothesis and registered a decline
19:57after implementation of fctc smokeless
20:00tobacco decline
20:02took some time it it lagged behind that
20:05of smoked tobacco and additional finding
20:08was that
20:09smokeless tobacco use actually briefly
20:12registered an increase now the authors
20:14reflect upon it so in the discussion
20:17section we can see that the authors look
20:19at existing literature and report that
20:22in a particular study most smokeless
20:25tobacco users had been former smokers
20:28now this could mean that the apparent
20:30increase was because of smoked tobacco
20:33users switching over to smokeless
20:35tobacco another finding from literature
20:38that they found to probably align with
20:41this hypothesis was that
20:43people were more aware about the hazards
20:46of smoke tobacco when compared to those
20:48of smokeless tobacco use now this led
20:52the authors to put for the hypothesis
20:54that it is possible that a product
20:56switch was briefly happening people were
20:58briefly switching over from smoked
21:00tobacco to smokeless tobacco because of
21:04you know their perception that probably
21:06this is a less hazardous substance that
21:08is
21:09that could be used so whenever you come
21:12across start your study results which do
21:14not align with your initial hypothesis
21:17you need not immediately panic
21:20i would first check the coding if i
21:23would see
21:24whether my data is coded correctly and
21:27whether my results are correct whether
21:28my data is robust and once that is clear
21:31i would go into actually analyzing and
21:34interpreting in my mind what the study
21:36finding could mean and then look into
21:39available literature to see what else is
21:41there to support or refute what i am
21:44coming up with
21:46always consider alternate hypothesis it
21:49is the feature of any good researcher do
21:51not be dogmatic and stuck to your
21:54initial hypothesis but also free to
21:56explore what your information could add
22:00to modify that hypothesis or generate
22:03new hypothesis
22:05now
22:05we will move on to the next section on
22:07under the discussion section itself
22:09which is the strengths of your study now
22:11there is no need to be very humble about
22:14yourself you could actually go forth and
22:16list the strengths of your study because
22:18it adds to the credibility of your study
22:21you could say that this is the first
22:24such study coming up from your
22:26geographical location or you could talk
22:28about a novel methodology or a novel
22:31tool or a novel statistical analysis
22:34that you have employed in your study you
22:36could talk about a large data set a
22:39large representative sample that had
22:42that had been used in your uh study you
22:44could talk about the data quality or the
22:47data validation techniques that you have
22:50used in your study these are some of the
22:52strengths that you could list out there
22:54for the reader to be more sure of the
22:56research findings that you were
22:58reporting
22:59now having talked about strengths it is
23:01also equally important to report your
23:04limitations now here what we generally
23:06recommend is be transparent
23:09be forthright in reporting the
23:11limitations of your study but do not
23:13leave it just there please also comment
23:16on whether the limitation of your study
23:19is likely to influence the validity of
23:21your findings or not likely to influence
23:24the validity of your findings now this
23:26is very important you could say that
23:28your study suffered from a certain
23:30limitation but you have overcome that by
23:33employing a certain statistical
23:35technique or you have overcome that by
23:37some other method you need to report
23:39that in your study or if you say that
23:42despite your best efforts certain
23:44limitations persisted in your study you
23:46need to say how they are
23:48likely to affect the validity of your
23:51study findings you could also put forth
23:54recommendations for future studies to
23:56overcome these limitations that your
23:58study came up with
24:01now the last paragraph of your
24:02discussion will be where you put forth
24:04your conclusions and recommendations
24:07about conclusions i've already said
24:09please
24:10base them only on your study findings
24:13remember if a reader is going to quickly
24:15read the conclusion section of your
24:17article alone he or she should get the
24:19key take home points that you have come
24:21up from your research articles and they
24:24should be based on your study findings
24:27they need to answer the objectives that
24:29you put forth in the first place
24:31remember
24:32writing that there is need for more
24:35studies in this area is not a conclusion
24:37point you cannot conclude from your
24:39research that you need more research
24:42i finally leave you with these take home
24:44messages about the discussion section
24:47you have seen the structure of the
24:49discussion section wherein you started
24:51on one end with the summarizing the
24:53results without delving into
24:55quantitative details then you followed
24:58with interpreting each of the key
25:00findings in the light of existing
25:02literature and by putting forth your own
25:05original interpretations of these
25:08findings then you explained what are the
25:11implications of these study findings in
25:13your study settings and in a larger
25:16context if applicable you then you
25:19followed it with the strengths and
25:21limitations of your study and finally
25:24ended up with the conclusion where you
25:27gave those two or three take home
25:28messages from your study
25:31you then followed it up with the
25:33recommendations where you made specific
25:35recommendations based on the one two or
25:38three conclusions that your study has
25:41come up with
25:42thank you and good luck with your
25:44writing

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