Writing Recommendations In A Research Paper

The Report Body

Summary:

This resource is an updated version of Muriel Harris’s handbook Report Formats: a Self-instruction Module on Writing Skills for Engineers, written in 1981. The primary resources for the editing process were Paul Anderson’s Technical Communication: A Reader-Centered Approach (6th ed.) and the existing OWL PowerPoint presentation, HATS: A Design Procedure for Routine Business Documents.

Contributors:Elizabeth Cember, Alisha Heavilon, Mike Seip, Lei Shi, and Allen Brizee
Last Edited: 2013-03-12 08:44:40

The body of your report is a detailed discussion of your work for those readers who want to know in some depth and completeness what was done. The body of the report shows what was done, how it was done, what the results were, and what conclusions and recommendations can be drawn.

Introduction

The introduction states the problem and its significance, states the technical goals of the work, and usually contains background information that the reader needs to know in order to understand the report. Consider, as you begin your introduction, who your readers are and what background knowledge they have. For example, the information needed by someone educated in medicine could be very different from someone working in your own field of engineering.

The introduction might include any or all of the following.

  • Problems that gave rise to the investigation
  • The purpose of the assignment (what the writer was asked to do)
  • History or theory behind the investigation Literature on the subject
  • Methods of investigation

While academic reports often include extensive literature reviews, reports written in industry often have the literature review in an appendix.

Summary or background

This section gives the theory or previous work on which the experimental work is based if that information has not been included in the introduction.

Methods/procedures

This section describes the major pieces of equipment used and recaps the essential step of what was done. In scholarly articles, a complete account of the procedures is important. However, general readers of technical reports are not interested in a detailed methodology. This is another instance in which it is necessary to think about who will be using your document and tailor it according to their experience, needs, and situation.

A common mistake in reporting procedures is to use the present tense. This use of the present tense results in what is sometimes called “the cookbook approach” because the description sounds like a set of instructions. Avoid this and use the past tense in your “methods/procedures” sections.

Results

This section presents the data or the end product of the study, test, or project and includes tables and/or graphs and a brief interpretation of what the data show. When interpreting your data, be sure to consider your reader, what their situation is and how the data you have collected will pertain to them.

Discussion of results

This section explains what the results show, analyzes uncertainties, notes significant trends, compares results with theory, evaluates limitations or the chance for faulty interpretation, or discusses assumptions. The discussion section sometimes is a very important section of the report, and sometimes it is not appropriate at all, depending on your reader, situation, and purpose.

It is important to remember that when you are discussing the results, you must be specific. Avoid vague statements such as “the results were very promising.”

Conclusions

This section interprets the results and is a product of thinking about the implications of the results. Conclusions are often confused with results. A conclusion is a generalization about the problem that can reasonably be deduced from the results.

Be sure to spend some time thinking carefully about your conclusions. Avoid such obvious statements as “X doesn’t work well under difficult conditions.” Be sure to also consider how your conclusions will be received by your readers, and as well as by your shadow readers—those to whom the report is not addressed, but will still read and be influenced by your report.

Recommendations

The recommendations are the direction or actions that you think must be taken or additional work that is need to expand the knowledge obtained in your report. In this part of your report, it is essential to understand your reader. At this point you are asking the reader to think or do something about the information you have presented. In order to achieve your purposes and have your reader do what you want, consider how they will react to your recommendations and phrase your words in a way to best achieve your purposes.

Conclusions and recommendations do the following.

  • They answer the question, “So what?”
  • They stress the significance of the work
  • They take into account the ways others will be affected by your report
  • They offer the only opportunity in your report for you to express your opinions

What are the differences between Results, Conclusions, and Recommendations?

Assume that you were walking down the street, staring at the treetops, and stepped in a deep puddle while wearing expensive new shoes. What results, conclusions, and recommendations might you draw from this situation?

Some suggested answers follow.

  • Results: The shoes got soaking wet, the leather cracked as it dried, and the soles separated from the tops.
  • Conclusions: These shoes were not waterproof and not meant to be worn when walking in water. In addition, the high price of the shoes is not closely linked with durability.
  • Recommendations: In the future, the wearer of this type of shoe should watch out for puddles, not just treetops. When buying shoes, the wearer should determine the extent of the shoes’ waterproofing and/or any warranties on durability.

The aim of this study was to explore the range and nature of influences on safety in decision-making by ambulance service staff (paramedics). A qualitative approach was adopted using a range of complementary methods. The study has provided insights on the types of decisions that staff engage in on a day-to-day basis. It has also identified a range of system risk factors influencing decisions about patient care. Although this was a relatively small-scale exploratory study, confidence in the generalisability of the headline findings is enhanced by the high level of consistency in the findings, obtained using multiple methods, and the notable consensus among participants.

The seven predominant system influences identified should not be considered discrete but as overlapping and complementary issues. They also embody a range of subthemes that represent topics for future research and/or intervention.

The apparently high level of consistency across the participating trusts suggests that the issues identified may be generic and relevant to other ambulance service trusts.

In view of the remit of this study, aspects relating to system weaknesses and potential threats to patient safety dominate in the account of findings. However, it should be noted that respondent accounts also provided examples of systems that were said to be working well, for example specific care management pathways, local roles and ways of working and technological initiatives such as IBIS and the ePRF.

Implications for health care

The NHS system within which the ambulance service operates is characterised in our study as fragmented and inconsistent. For ambulance service staff the extent of variation across the geographical areas in which they work is problematic in terms of knowing what services are available and being able to access them. The lack of standardisation in practice guidelines, pathways and protocols across services and between areas makes it particularly challenging for staff to keep up to date with requirements in different parts of their own trust locations and when crossing trust boundaries. Although a degree of consistency across the network is likely to improve the situation, it is also desirable to have sufficient flexibility to accommodate the needs of specific local populations. There was some concern over the potential for further fragmentation with the increased number of CCGs.

Ambulance services are increasingly under pressure to focus on reducing conveyance rates to A&E; this arguably intensifies the need to ensure that crews are appropriately skilled to be able to make effective decisions over the need to convey or not to convey if associated risks to patients are to be minimised. Our findings highlight the challenges of developing staff and ensuring that their skills are utilised where they are most needed within the context of organisational resource constraints and operational demands. Decisions over non-conveyance to A&E are moderated by the availability of alternative care pathways and providers. There were widespread claims of local variability in this respect. Staff training and development, and access to alternatives to A&E, were identified as priorities for attention by workshop attendees.

One of the difficulties for ambulance services is that they operate as a 24/7 service within a wider urgent and emergency care network that, beyond A&E, operates a more restricted working day. The study findings identify this as problematic for two reasons. First, it fuels demand for ambulance service care as a route to timely treatment, when alternatives may involve delay. Second, it contributes to inappropriate conveyance to A&E because more appropriate options are unavailable or limited during out-of-hours periods. Ultimately, this restricts the scope for ensuring that patients are getting the right level of care at the right time and place. Study participants identified some patient populations as particularly poorly served in terms of alternatives to A&E (e.g. those with mental health issues, those at the end of life, older patients and those with chronic conditions).

The effectiveness of the paramedic role in facilitating access to appropriate care pathways hinges on relationships with other care providers (e.g. primary care, acute care, mental health care, community health care). An important element relates to the cultural profile of paramedics in the NHS, specifically, the extent to which other health professionals and care providers consider the clinical judgements/decisions made by paramedics as credible and actionable. Staff identified this as a barrier to access where the ambulance service is still viewed primarily as a transport service. Consideration could be given to ways of improving effective teamworking and communication across service and professional boundaries.

Although paramedics acknowledged the difficulties of telephone triage, they also identified how the limitations of this system impact on them. Over-triage at the initial call-handling stage places considerable demands on both staff and vehicle resources. A related concern is the limited information conveyed to crews following triage. Initial triage was suggested as an area that warrants attention to improve resource allocation.

The findings highlight the challenges faced by front-line ambulance service staff. It was apparent that the extent and nature of the demand for ambulance conveyance represents a notable source of strain and tension for individuals and at an organisational level. For example, there were widespread claims that meeting operational demands for ambulance services limits the time available for training and professional development, with this potentially representing a risk for patients and for staff. Staff perceptions of risk relating to patient safety extend to issues of secondary risk management, that is, personal and institutional liabilities, in particular risks associated with loss of professional registration. The belief that they are more likely to be blamed than supported by their organisation in the event of an incident was cited by staff as a source of additional anxiety when making more complex decisions. This perceived vulnerability can provoke excessively risk-averse decisions. These issues merit further attention to examine the workforce implication of service delivery changes, including how to ensure that staff are appropriately equipped and supported to deal effectively with the demands of their role.

Paramedics identified a degree of progress in relation to the profile of patient safety within their organisations but the apparent desire within trusts to prioritise safety improvement was felt to be constrained by service demands and available resources. Attempts to prioritise patient safety appear to focus on ensuring that formal systems are in place (e.g. reporting and communication). Concerns were expressed over how well these systems function to support improvement, for example how incident reports are responded to and whether lessons learned are communicated to ambulance staff within and between trusts. Consideration could be given to identifying ways of supporting ambulance service trusts to develop the safety culture within their organisation.

Service users attributed the increased demand for ambulance services to difficulties in identifying and accessing alternatives. They were receptive to non-conveyance options but felt that lack of awareness of staff roles and skills may cause concern when patients expect conveyance to A&E.

Recommendations for research

The workshop attendees identified a range of areas for attention in relation to intervention and research, which are provided in Chapter 6 (see Suggestions for potential interventions and research). The following recommendations for research are based on the study findings:

  1. Limited and variable access to services in the wider health and social care system is a significant barrier to reducing inappropriate conveyance to A&E. More research is needed to identify effective ways of improving the delivery of care across service boundaries, particularly for patients with limited options at present (e.g. those with mental health issues, those at the end of life and older patients). Research should address structural and attitudinal barriers and how these might be overcome.

  2. Ambulance services are increasingly focused on reducing conveyance to A&E and they need to ensure that there is an appropriately skilled workforce to minimise the potential risk. The evidence points to at least two issues: (1) training and skills and (2) the cultural profile of paramedics in the NHS, that is, whether others view their decisions as credible. Research could explore the impact of enhanced skills on patient care and on staff, for example the impact of increased training in urgent rather than emergency care. This would also need to address potential cultural barriers to the effective use of new skills.

  3. Research to explore the impact of different aspects of safety culture on ambulance service staff and the delivery of patient care (e.g. incident reporting, communication, teamworking, and training) could include comparisons across different staff groups and the identification of areas for improvement, as well as interventions that could potentially be tested.

  4. The increased breadth of decision-making by ambulance service crews with advanced skills includes more diagnostics; therefore, there is a need to look at the diagnostic process and potential causes of error in this environment.

  5. There is a need to explore whether there are efficient and safe ways of improving telephone triage decisions to reduce over-triage, particularly in relation to calls requiring an 8-minute response. This could include examining training and staffing levels, a higher level of clinician involvement or other forms of decision support.

  6. There is a need to explore public awareness of, attitudes towards, beliefs about and expectations of the ambulance service and the wider urgent and emergency care network and the scope for behaviour change interventions, for example communication of information about access to and use of services; empowering the public through equipping them with the skills to directly access the services that best meet their needs; and informing the public about the self-management of chronic conditions.

  7. A number of performance measures were identified engendering perverse motivations leading to suboptimal resource utilisation. An ongoing NIHR Programme Grant for Applied Research (RP-PG-0609–10195; ‘Pre-hospital Outcomes for Evidence-Based Evaluation’) aims to develop new ways of measuring ambulance service performance. It is important that evaluations of new performance metrics or other innovations (e.g. Make Ready ambulances, potential telehealth technologies or decision-support tools) address their potential impact on patient safety.

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