Scientific Writing

Kristin Messuri Writing Effective Paragraphs

Writing Effective Paragraphs

Kristin Messuri PhD

Abstract
Taking a methodical approach to constructing paragraphs can improve clarity
and organization in medical writing. This article describes a typical model for paragraph
structure, explains the significance of coherence and cohesion, and recommends revision
strategies.

Key words: writing, medical writing, medical manuscript, periodicals as topic

Almost all writers realize the need to group Paragraph Structure

sentences into paragraphs, yet many do not approach
this aspect of writing methodically. When asked how Authors must structure their paragraphs ef-
they determined paragraph structure, writers often re- fectively in order to develop their discussions and
veal that they did not have a strategy, indicate that the show the relationships between ideas. In general, in
paragraph divisions “just felt right,” or explain that they medical writing, a paragraph has three main compo-
began a new paragraph when the previous paragraph nents: a topic sentence, supporting sentences, and a
seemed too long. Some of these responses suggest concluding sentence. The topic sentence is usually
a nascent understanding of paragraphing (organizing the first sentence of the paragraph; it states the para-
sentences into a paragraph). A paragraph indicates graph’s central concept or argument. Often, a topic
that the sentences it contains are related and some- sentence introduces a new concept and/or transitions
how distinct from the other sentences in the text. Due from the previous concept by showing the relation-
to this function, paragraphs have been called “macro- ship between the two. Supporting sentences provide
punctuation”: they function as rhetorical signifiers that explanations, evidence, and other details related to
help an audience understand a text.1 the paragraph’s main concept. Paragraphs typical-
ly end with concluding sentences, which provide the
Thinking critically about how paragraphing af- reader with a sense of closure. A concluding sentence
fects the delivery of a message can help authors to may take many forms, including a brief summary of
enhance the clarity and organization of their writing. the paragraph’s information or a statement about the
Therefore, the remainder of this article will describe implications of that information. However, ending
paragraph structure, coherence, and cohesion, as paragraphs with transitions is usually not effective.
well as propose methods for revising paragraphs. Introducing a new concept in the final sentence of a
paragraph will likely confuse readers. Instead, this
transition should appear in the topic sentence of the
Corresponding author: Kristin Messuri, Ph.D.
Contact Information: [email protected]
next paragraph. Of course, this paragraph structure is
DOI: 10.12746/swrccc 2016.0415.209 not the only possibility; it is simply one common struc-
ture that is effective for most medical writing tasks.

86 The Southwest Respiratory and Critical Care Chronicles 2016;4(15)

Kristin Messuri Writing Effective Paragraphs

Paragraph divisions and length are determined sitions but may fail to adequately develop a central
by the concept developed in that paragraph. Writers idea, rendering the paragraph incomprehensible.
may create divisions between paragraphs for a num-
ber of reasons, including to address a new concept, to Conclusion: Revising Paragraphs
compare or contrast information, to introduce a count-
er-argument, or to give readers a chance to process As with most aspects of writing, paragraphs
information before moving on. Although there are no are best revised through a careful consideration of
strict guidelines for paragraph length, each paragraph audience. With a specific audience in mind, a writer
should be long enough to fully develop a concept but should evaluate how the content of each paragraph
not so long that readers become tired, bored, or con- develops the central argument of the paper. Try to
fused. Writing paragraphs of an effective length is, view the text from the perspective of a journal reader,
then, a matter of being considerate to the audience.2 a conference attendee, and so forth. Does each para-
graph provide new information that serves a specific
Paragraph Coherence and Cohesion purpose in the text? Or, do some paragraphs either
provide extraneous information or digress from the
Both coherence and cohesion are import- text’s main focus, signs that revisions are necessary?
ant qualities of effective paragraphs and texts. These
terms are sometimes used interchangeably, but for A writer should ensure that (1) each para-
the purposes of this article, coherence refers to the graph has one central idea and (2) those paragraphs
clarity and comprehensibility of a text or a unit of a appear in a logical order in keeping with the organiza-
text (such as a paragraph), whereas cohesion refers tional conventions of the genre (such as the IMRAD
to the sentence-level structures and words that foster model). One method discussed in a past article in
this sense of unity. Even when the overall organiza- this series is preparing a reverse outline by listing the
tion is predetermined, as in the common “introduc- central idea of each paragraph.4 This process helps
tion, methodology, results, and discussion” (IMRAD) a writer to determine whether each paragraph does,
model,3 writers develop coherence by clarifying the indeed, contain only one central idea. If a paragraph
relationships between sections and individual para- contains multiple concepts, the writer may need to
graphs as well as clearly communicating the meaning divide the paragraph or move or delete information.
of their ideas. In coherent medical writing, paragraphs Once the outline is prepared, the writer can evaluate
are ordered logically; each paragraph has one cen- whether the paragraphs (represented by their main
tral, well-developed concept; relationships between ideas) are in a logical order and whether they all sup-
ideas are adequately explained; and the language is port the main argument of the text. For example, are
appropriate for the audience. the paragraphs in the methods section divided log-
ically? Do they build on one another to explain how
Cohesion fosters coherence through the inclu- the research was conducted?
sion of transitions between ideas, as well as effec-
tive sentence structure and word choice. Cohesion is Another useful method is writing down the
sometimes called “flow”; it can be described as the text’s thesis or central argument followed by the top-
“glue” holding the paragraph together. In a cohesive ic sentence of each paragraph. The result is a rough
paragraph, signal words or transitions will connect outline that should progress logically through the
each sentence to the sentences before and after it. main ideas of the text. If the outline is difficult to un-
Moreover, key terms will be repeated and used con- derstand, topic sentences may need to be rewritten or
sistently. Note that it is possible for a paragraph to be paragraphs may need to be moved, deleted, or other-
cohesive, but not coherent. Ideas may be connected, wise revised.
but they may use language that is far too technical for
the audience, causing confusion. Or, each sentence Finally, the writer should evaluate each para-
may have effective language, explanations, and tran- graph for coherence and cohesion by examining the

The Southwest Respiratory and Critical Care Chronicles 2016;4(15) 87

Kristin Messuri Writing Effective Paragraphs

connections between ideas, syntax, and linguistic

choices.

Author Affiliations: Kristin Messuri is the Associate Director of

the University Writing Center at Texas Tech University / Texas
Tech University Health Sciences Center in Lubbock, TX
Submitted: 7/1/2016
Published electronically: 7/15/2016
Conflict of Interest Disclosures: None

References

1. Reeves A, Leventhal P. Paragraphing (part 1 of 2). Med Writ

2012; 21 (4): 298-304.
2. Taylor RB. Medical writing: a guide for clinicians, educators,
and researchers. 2nd ed. New York: Springer; 2012.
3. Sollaci LB, Pereira, MG. The introduction, methods, results,
and discussion (IMRAD) structure: a fifty-year survey. J Med
Libr Assoc 2004; 92 (3): 364-371.
4. Messuri K. Revision strategies. Southwest Respir Crit Care
Chron 2016; 4 (14): 46-48.

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