Delving into the critical components of the discussion section

Abstract

A quick outline of any general manuscript often includes an introduction in which the purpose or multiple aims are outlined. Following the introduction is the background section where it is expected that the authors would explore the comparative literature and identify where the gap exists in knowledge information. The methodology and results sections follow. Then the most critical segment of any manuscript, the discussion section, is revealed. This can be the most creative section to a manuscript, and for some, the most difficult to write. The discussion segment of any manuscript requires more thought and effort than any other manuscript component.1 As a writing consultant, I have found that writing the discussion section can be the most challenging task, for most authors, novice or otherwise. The most demanding aspect of framing a discussion section is deciding which aspects of the study are the most critical.1 The discussion section addresses the significant findings and must ensure that the manuscript's purpose has been fully accomplished.2-5 If within the initial paragraphs of the discussion it is unclear to the reader or reviewer, what the key outcomes or findings are, the purpose is then left unfulfilled, and the direction of the discussion can be further misdirected. The purpose of this manuscript is to outline for the reader the critical components needed to successfully complete the discussion section within any manuscript. Watson states that the discussion section is the heart of the entire manuscript.6 It pulls together the purpose, methods, the key results and then interprets the relevance of the key findings for the reader. One way to successfully accomplish this is to restate the purpose of the study within the first two sentences of the opening paragraph within the discussion. Then, the key findings follow which will likely complete the stated purpose of the manuscript. For any discussion section, it is helpful to build on what has already been presented in the existing literature within the background section of the manuscript.7 The background section identifies where the gap is within the literature justifying the writing and research of the present manuscript. One way in which to enhance the writing of the discussion section for novice writers (and a likely indicator of success), is to follow the style or components outlined within other published works.8 Commonly noted errors within the discussion section include the following: (a) repeating the results section over again, (b) addressing findings which were almost significant and then discussing those findings as if they were critical, and (c) documenting conclusions without supporting evidence or clear results, that is, overplaying the significance of the findings.8 Additional errors can include: the significance of the results not being fully discussed or supported, presenting unsupported conclusions, or having study limitations being inadequately covered.8 Within the discussion section, authors must not overreach and presume causality based on findings of association alone.1, 9 This is often a critical mistake within the discussion section. The main function of the discussion section is to pull together the total manuscript. What makes the discussion section so pivotal are the multiple functions it accomplishes for the manuscript. The key functions of the discussion section are: (a) to complete the purpose of the manuscript, (b) to identify and explore the impact of the key findings, and (c) to bridge the gap in the literature. The discussion answers the question of whether the purpose of the manuscript was fulfilled. Most editors will look for this so as to know whether the stated, original purpose and intent was or was not completed appropriately. In addition, significant findings must be identified and explained early on within the discussion. The discussion provides critical meaning as to why the manuscript was initially developed or proposed. Restating the purpose of the manuscript and providing a summation of the key findings are helpful within the first few paragraphs of the discussion section. Putting the key findings and results into perspective for the reader is critical. Most analyses or results sections primarily display or identify data elements. However, they do not alert the reader to the significant or critical effect of the findings which is one of the key functions of the discussion. In addition, the impact of the key findings must be identified in order to assist the reader in knowing how to utilize the findings going forward. The impact of the key findings must fill the gap in the existing literature so as to present new knowledge or dispute prior findings. No other manuscript section is as vital as the discussion section which encompasses multiple functions to move the manuscript to its desired end. For the complete development of the discussion section, four critical components are essential. The first is the presentation and full description of the key findings, that is, highlights, outcomes or key observations. As with any manuscript, the key findings and outcomes must be fully explained and interpreted for the reader. These findings represent the key interpretation of the results or analysis section of the manuscript and often come early on in the discussion. The full significance of the findings must be explained while avoiding discussion of non-significant findings. As noted in Table 1, there are key phrases to use when developing topic sentences within the initial section of the discussion. This study examines or evaluates The findings of this study indicate The results may be further explained by The findings of this study support Future research will need to focus on Findings were consistent with the current literature relative to Future research can offer more insight into One challenge worth noting is One particularly interesting finding was There are a number of key study findings Overall, the most robust findings include This study provides further evidence of This national survey reveals the following This study highlights To understand how to bridge the gap within the literature, the strengths of this study can be used to These findings raised a number of questions Study findings support past work from other authors regarding This analysis has uncovered further Another recent study on this subject proposed the following Areas for improvement in clinical practice include Results from this study are I agreement with previous studies supporting the need to These results demonstrate It is recommended that Minimal data are available regarding this topic, thus making this study The purpose of this study was to The principal aims of this study were Findings confirm Another implication worth noting is The second component is contrasting of the key findings with the comparative literature and related studies. This component is a must have for most editors and reviewers. Often, within a manuscript, authors will initiate a background section where a literature review or related studies is performed. These data can then be used as a guide for the comparative literature content that follows within the discussion section. Alternatively, authors can also choose to cite significant studies with which to compare and contrast with the findings separately within the discussion section without a pre-existing background section. However, having a background section can be useful to orient the reader and fully inform them of current studies on the topic of interest. This comparing and contrasting of findings with the literature provide the reader with a much clearer perspective on what impact the findings will have on the research literature at-large. The third component includes the inferences for research, education, practice and policy, as applicable. These explain the authors' familiarity with the applications of the findings. It is not enough to simply present findings alone. The author or authors must suggest how such findings can affect future research, practice, educational endeavors or major policy changes. Authors must ask themselves a series of questions: How can the immediate findings affect tomorrow's practices or best practices? What future studies can be envisioned based on the findings from this study? Can these findings affect national and international policy recommendations? What recommendations can be put forth that can be relevant and spark new areas of research inquiry? The last component, which often follows the discussion, is that of strengths and limitations of the manuscript. This is often a stand alone section which follows the discussion (although often grouped as part of the discussion components). It provides the reader with a much clearer perspective on how biased the findings might be and presents the strengths and limitations of the methodology subsections specifically. Strengths and limitations of a manuscript often relate to the following examples: missing data, recall bias, diversity of participants as to race/gender and sample size. Although the discussion section starts with presentation of findings, it includes many other content details supporting the essential components and allowing for full development of the discussion section. As previously noted, restating the purpose in the beginning of the discussion section (prior to noting the key findings) sets the stage for the rest of the critical items and content details to follow which are part of the discussion section. The authors must inform the reader if the new findings are consistent or inconsistent with past research from other authors and why. Authors need to as the question, Does this work build on the work of others or dispute the work of others in this field of study? Key phrases to utilize within this sub-section might include: these findings support past work from other authors regarding the following or using the phrase, as results from this study are in agreement with previous studies which support the following conclusions. All such starter sentences provide the author with the opportunity to expound on such comparisons. Lessons learned and then noting what worked and what didn't work are additional sub-content items within the discussion section. These two components often build off of the study and lessen the mistakes for others with similar research efforts. Authors can identify trends going forward as well as the challenges that lie ahead. If a model or paradigm was developed, how might other authors be able to utilize this and additionally, what suggestions can be made toward future research efforts? Other sub-content areas include recommendations and strategies to propose to implement study findings. In other words, what innovations might be suggested based on key findings, and what implications do they have going forward? What impact might policy decisions have on practices endorsed by professional organizations? What specific research studies can the authors propose that can jump start new research studies that build off the current findings from this study? This can assist future authors in delving deeper into research inquiry around this topic. The idea generated from one study can exponentially assist to create new research interests. It is critical for authors to address future directions for this research and what the key take home message is for the reader. Barriers and facilitators are sub-content categorical descriptors that can often assist authors in dividing up content findings in the discussion section and help to categorize content for the reader. Barriers and facilitators are meant to enhance how authors explain what helped and what did not while performing a study. These descriptors provide a more indepth perspective or framework for the study. Often, these details can be useful to a future researcher contemplating the same topic of inquiry. As a checklist to completing the discussion section, authors must ask critical, at large questions to ensure that all comments have been fully completed. Table 2 provides key questions which authors can use to identify the completeness of the discussion section. Was the purpose completely fulfilled Did the discussion section tie the paper together for the reader Were the relevance of the findings explained in full Were the new findings discussed relative to the comparative literature What lessons can others learn from this study What model or paradigm was demonstrated from this study, if any What specific recommendations can be drawn from the findings What are the trends and challenges ahead What value or usefulness can be taken from study findings relative to national or professional trends What specific inferences or strategies exist for practice, research or policy changes What were the barriers and facilitators, if applicable How do findings affect the state of clinical practice or science What worked in this study and what didn't work Is there a key take home message Was the gap in the literature fulfilled from the study findings What are the future directives proposed from this body of research Finally, after reading the discussion section, many editors will revisit the purpose to see if it has been fully met and completed and if the findings added new information to the existing literature or disputed prior findings. This provides a final snapshot that the study did what it set out to accomplish originally in its stated purpose. The discussion section can be divided into sub-sections and sub-content areas which are easily identifiable and workable for all authors. Noting the key functions and components of the discussion section and addressing specific, critical content details will fully complete this most vital section of any manuscript. By breaking down content by sections and having key phrases to use and questions to ask, authors can be more successful in fully completing the discussion section for most manuscript types. The author declares no conflicts of interest. Diane J. Angelini: Currently, Writing Consultant and Clinical Professor in the College of Nursing at the Medical University of South Carolina in Charleston, South Carolina. Co-Founder and Perinatal Editor Emeritus for the Journal of Perinatal and Neonatal Nursing and Professor Emerita of OB-GYN (Clinical) at the Warren Alpert Medical School of Brown University. Data sharing is not applicable to this article as no new data were created or analyzed in this study.