Main Body

Chapter 3. How do I effectively communicate my ideas?

Sandra Collins

Before moving on to editorial style in this chapter, I chose to focus first on writing style in the first two chapters (see the Introduction for a reminder of the difference). I have made this choice because of the logical flow of the writing process and because the content of your message is the most important element of your paper. Placing too much emphasis on editorial style early on can stifle your creativity, cause unnecessary anxiety, and restrict your freedom to make and learn from your mistakes. As Fowler and colleagues (2005) noted, “writing is not only, or even mainly, a matter of correctness” (p. 20).

Where editorial style becomes important is in the effective communication of the message you create to others. At this point, you have a draft of your paper, based on your work in Chapter 1 and Chapter 2. You have taken a break from your research to craft a thesis statement and to organize the ideas you have gathered under the various key points and sub-points in your argument. You also have a sense of the gaps you need to fill to support your argument. You can keep working on finding additional support in the scholarly literature as you begin to refine what you have already written.

In this chapter, I introduce some of the core elements of editorial style, drawing heavily on the APA Manual and other online resources designed to help you improve the quality of your writing. The techniques below are designed to add clarity, flow, and structure to your paper with a view to making it more meaningful to the reader. Some students decide to ignore APA formatting and forfeit that percentage of their grade; what they do not realize is that writing and editorial skills may also impact the remaining portion of their grade. Your ability to demonstrate critical thinking, to reflect the levels of learning targeted in the course assignment, and to clearly and effectively articulate an argument is directly related to the quality of the writing in your paper. If you have a great idea, but you are not able to articulate it clearly, your instructor likely will not get it!

You can use the links below to quickly access information on any of the topics covered:


Developing strong paragraphs

My focus in this chapter is on the revision phase of the writing process. I emphasize the importance of carefully examining both the content and structure of the paper to ensure that you meet the standards for graduate academic writing. You can now take your draft paper and begin to carefully revise it. Once you find enough information about a particular point, you may start refining your paragraphs.


Creating flow from your key point to sub-points

For some ideas about how to develop a good paragraph, see the Purdue University Online Writing Lab – On Paragraphs. Please also review the University of Toronto Writing Workshop – Paragraphs and pay attention to the importance of beginning each paragraph with one of the key points in your argument (referred to as a topic sentence). In your topic sentence, you describe the element of your overall argument that you plan to address in the paragraph. If you find yourself moving away from your key point, start a new paragraph! As a general rule of thumb, restrict your paragraphs to about half a page in length, with one key point per paragraph and a number of supporting or sub-points. The reader will likely lose focus on your key point if you run beyond one page per paragraph (see the APA Manual Section 3.08).

You can organize the sub-points in your paragraph in a number of ways (Fowler et al., 2005):

  • general to specific or specific to general;
  • chronologically, from most recent to oldest or vice versa;
  • simplest to most complex or most complex to simplest;
  • most important to least important or least important to most important; or
  • most familiar to least familiar or vice versa.

For more information about how to write effective paragraphs using some of these organizational strategies, see the University of Victoria Writer’s Guide – Developing and Ordering Paragraphs. In the examples in Figure 3.1 below, notice the difference in flow of the paragraphs when they are organized in different ways. The unorganized paragraph below is the least clear and meaningful!

Thesis statement: Navigating end-of-life care with patients or clients requires reflexivity and self-awareness as well as openness to the worldview and lived experiences of the patient or client.

General to specific:

Health care practitioners cannot respond effectively and ethically to patients or clients at the end of their lives without critical reflection on their own beliefs, values, and potential biases about life and death. [This is my key point for this paragraph.] Practitioners all hold attitudes, beliefs, or assumptions about health that can influence care for patients or clients. To a large degree, those elements of our worldview are shaped by the cultures in which we live, as well as by our own cultural identities (age, ability, socioeconomic status, religion, and so on). Many cultures embrace death as a natural part of the life cycle; others, particularly Western cultures, lean towards a collective phobia about death. Health care practitioners are more likely to allow their own beliefs and biases to surface when situations touch on heavy emotions or deeply ingrained beliefs, which often accompany end-of-life experience and choices. They must bring those perspectives into conscious awareness to avoid directly or indirectly imposing their values on patients or clients. The practice of reflexivity invites critical evaluation of their own reactions before, during, and after encounters with patients or clients to ensure that client needs and worldviews are prioritized in their care.


Many cultures embrace death as a natural part of the life cycle; others, particularly Western cultures, lean towards a collective phobia about death. Health care practitioners are more likely to allow their own beliefs and biases to surface when situations touch on heavy emotions or deeply ingrained beliefs, which often accompany end-of-life experience and choices. The practice of reflexivity invites critical evaluation of their own reactions before, during, and after encounters with patients or clients to ensure that client needs and worldviews are prioritized in their care. Health care practitioners cannot respond effectively and ethically to patients or clients at the end of their lives without critical reflection on their own beliefs, values, and potential biases about life and death. Practitioners all hold attitudes, beliefs, or assumptions about health that can influence care for patients or clients. They must bring those perspectives into conscious awareness to avoid directly or indirectly imposing their values on patients or clients. To a large degree, those elements of our worldview are shaped by the cultures in which we live, as well as by our own cultural identities (age, ability, socioeconomic status, religion, and so on).

Most familiar to least familiar:

Health care practitioners cannot respond effectively and ethically to patients or clients at the end of their lives without critical reflection on their own beliefs, values, and potential biases about life and death. The practice of reflexivity invites critical evaluation of their own reactions before, during, and after encounters with patients or clients to ensure that client needs and worldviews are prioritized in their care. Practitioners all hold attitudes, beliefs, or assumptions about health that can influence care for patients or clients. They must bring those perspectives into conscious awareness to avoid directly or indirectly imposing their values on patients or clients. Health care practitioners are more likely to allow their own beliefs and biases to surface when situations touch on heavy emotions or deeply ingrained beliefs, which often accompany end-of-life experience and choices. To a large degree, those elements of our worldview are shaped by the cultures in which we live, as well as by our own cultural identities (age, ability, socioeconomic status, religion, and so on). Many cultures embrace death as a natural part of the life cycle; others, particularly Western cultures, lean towards a collective phobia about death.

Figure 3.1. Ways to organize sub-points within a paragraph.

The type of organizational structure you chose does not matter; what matters is that you have a logical flow in your paragraph so that the reader understands your key point and sub-points.


Using transitional devices

Using transitional words will increase the logical flow of ideas within a particular paragraph (APA Manual Section 3.05). There are two types of transitional words.

Pronouns may be used to link one sentence to the content of another. Here are two examples:

  • Wiseman (2003) stated that it is important for health practitioners to be familiar with provincial health regulations. She noted that even the regulations pertaining to other health professions provide useful information.
  • Wiseman (2003) stated that provincial health regulations should be included in health disciplines training. They often provide useful information that can be applied across health professions.

In both examples above, you can tell which noun I am referencing in the previous sentence, and the pronoun I choose matches that noun (Wiseman . . . She . . . : health regulations. . . They . . . ). In the following example, it is unclear which noun from the first sentence is being referenced (Wiseman and colleagues or health regulations), so the meaning is blurred.

  • Wiseman and colleagues (2003) stated that it is important for health practitioners to be familiar with provincial health regulations. They often provide useful information.

Transitional words may also be used at the beginning of sentences to provide a link based on time, place, cause, purpose, and so on. Here is an example:

  • Wiseman (2003) stated that it is important for health practitioners to be familiar with provincial health regulations. In addition, some federal laws provide guidance in areas not covered under provincial legislation.

If you have trouble identifying new ways to say “In addition to,” or if you are not clear about which transitional word to use, review the tips on the following Web sites:

Exercise 1

Complete Exercise 1 to test your understanding of when to use transitional words to enhance meaningfulness in your paper. The Exercise 1 Feedback provides an idea of how the paragraph might be improved.


Writing with clarity and conciseness

Many graduate students struggle to write with precision. You may need to eliminate words that distract from your intended meaning and choose words that clearly communicate that meaning.

Conciseness or economy of expression. Many writers, even those who have been at it for a long time, find it challenging, sometimes almost impossible, to say things effectively, even when they specifically set out to do so, without using so many extra and unnecessary words. Did you catch my illustration of this point? As a result, their meaning becomes lost. Take a moment to read through Section 3.08 of the APA Manual for some tips on how to be more concise in your writing.

Precision and Clarity. Many writers also find it challenging to use language effectively to communicate exactly what they mean. Section 3.09 of the APA Manual introduces a number of strategies for increasing the precision of your writing. Here are some pitfalls that graduate students commonly encounter:

  • Vague pronouns. “Great writers create happy readers. They value precision and clarity.” It is unclear whether They refers to the writers or the readers.
  • Editorial we. “We should all be careful to write what we actually mean.” Who is the We in this sentence?
  • Jargon. “Alberta companies are engaged in redundancy elimination in response to right-sizing pressures.” There are more clear ways to say that layoffs are taking place. Professional jargon should also be avoided (or at least defined) because it may not be common knowledge for the reader.
  • Anthropomorphism. “The local charities in Victoria are doing a lot of Syrian refugees.” “The study argues that significant changes have occurred in nursing practice.” It is the members or boards of the charities (human beings) who are doing this work. Avoid attributing human characteristics or actions to organizations, animals, objects, or other inanimate subjects.

You may want to check out these additional resources:

Exercise 2

As a test of your understanding of these concepts, complete Exercise 2. Exercise 2 Feedback provides my suggested changes. You may find additional ways to improve this text.


Structuring skills

Using structuring skills is another way to enhance the meaning and flow of your paper. These skills are used predominantly to connect paragraphs or sections of your paper to one another.

If you have taken an interpersonal communications skills course, you have likely been introduced to a number of verbal skills that are designed to help you effectively and purposefully communicate your ideas and facilitate dialogue with others. A number of these same skills are very useful for creating a clear and logical flow of ideas in your written work.

The structuring skills in Table 3.1 are designed to increase the meaningfulness and logical flow of your paper. The person reading your paper should be able to see the logical sequence of arguments by simply reading the topic sentences (key points) of each paragraph and the structuring skills used throughout your paper.

Table 3.1. Structuring Skills for Enhancing Meaning and Flow




Overview An overview is a short statement at the beginning of a section or at a transition point within a paper that outlines the key points that are to follow. This helps the reader to understand the structure of the paper and develop realistic expectations as to what the paper will accomplish.

This section describes the conceptualization of human nature from a humanistic perspective.

I will now review the literature on feminist approaches to change, followed by a discussion of how these approaches differ from humanistic strategies.

Transition A transition is a short statement that signals a change in topic or direction in a paper. This review of the change process leads naturally to a discussion of how outcomes are measured within each model.
Summary Summaries include a statement or statements that review or pull together the essence of several paragraphs or sections of a paper. Summaries often occur at the end of a paper or at a transition point within the paper. Summaries encapsulate the arguments presented, rather than listing them again. They help the reader capture the bottom line and serve to wrap up a particular portion of a paper.

Each of the methods described above is based on the underlying assumption that human nature is basically good and that change is possible.

Based on the description of the change processes above, I conclude that feminist theorists most often place the locus of change at the systems level. This contrasts dramatically with the assumption of the primacy of self in the humanistic therapies described in the first section of the paper.

Summary + Transition In many cases, you will find it useful to combine these structuring skills. For example, placing a summary at the end of a section, followed by a transition or an overview of the next section, provides additional clarity and flow. Each of the techniques outlined in this section targeted change at the level of the individual client. The next section will focus on intervention strategies that expand the target of change to include systems (e.g., groups, organizations, or social systems).


Exercise 3

Complete Exercise 3 to apply these concepts to a sample text. The Exercise 3 Feedback provides one example of how structuring skills can improve the flow and meaningfulness of the text. Be sure that your responses provide a similar structure.

You should also avoid paragraphs that contain only one sentence, like this one, because they float in space without meaningful connection to your argument.

The sandwich technique

Think of each paragraph as a sandwich! You should be able to read the first and last sentence of each paragraph in your paper and understand the thesis and key arguments presented. If you cannot, then you need to include additional structuring skills. Check this out by reviewing only the structuring skills from Exercise 3.

You will notice that I have deliberately not used standard formats for the structuring skills (e.g., In this paragraph, I will discuss…). At the outset, you may find it easier to follow these formats, but you will discover that your paper is more enjoyable to read if you vary your style.


Using verbs effectively

Verbs are one element of a sentence that can either increase or decrease meaning. The APA Manual also specifies a number of editorial expectations for your use of verbs and verb tenses.

Using verbs that reflect the nature of your information source

In Chapter 1, the issue of intellectual honesty was introduced, and you were cautioned to treat the work of other writers respectfully. You must also carefully choose verbs that accurately reflect your information source (see APA Manual Section 1.13). When you are drawing on research studies to support your points, it is appropriate to simply list the sources after each of your assertions. Here is an example:

  • A significant correlation exists between self-esteem and self-efficacy (Brown & Woods, 2003; Frankel, 2005; Warrens et al., 2001).

However, in many cases, journal articles and other information sources reflect the opinions or hypotheses of the authors. In such cases, be careful to select verbs that indicate to the reader the nature of the original information.

  • Collins (2006) argued that writing skills have a dramatic effect on success in graduate education.
  • A number of authors speculated that globalization would soon require an expansion of professional ethics to address fundamental human rights at the international level (Martins & Perez, 2006; Pettifor, 2005).

Selecting verb tense

Students often struggle with verb tense in their papers. Read Sections 3.06 and 3.18 of the APA Manual. Table 3.2 contains suggestions about which verb tense to use in various parts of your paper. In most cases, you will not be reporting on your own research, so the procedures and results may not apply. You are also not expected to provide an abstract for most course assignments.

Table 3.2 Verb Tense and Elements of Your Paper

Section of Paper

Verb Tense



Abstract Past Refers to your study or paper as an event in the past (now completed) The study explored the differences in worldview between rural and urban teachers. Significant differences existed between those individuals who…
and and and
Present Refers to any conclusions or implications you draw in the present It is important to include a discussion of values and biases in teacher education programs.


Literature Review, and



Past Refers to an event, action, or circumstance at a specific time the past

Withrow (2006) noted that female participants tended to respond more frequently than male participants.

Participants completed a series of self-assessment questionnaires.

or or or
Present perfect Refers to an event, action, or circumstance that did not occur at a specific time the past or that started in the past and continues into the present

Several studies have indicated a link between self-esteem and early childhood social supports.

This methodology was effective in soliciting consistent response patterns from participants.

Results Past Results of your study occurred in the past Each group responded to the questionnaire within the timeframe provided.




Present Refers to your current thinking about the issues and invites others into that discussion

This study shows evidence of a connection between worldview and preferred intervention strategy.

Several implications arise from the differences in perceived well-being among these groups.

The purpose of selecting and consistently using specific verb tenses is to facilitate effective communication. In most cases, when you are reporting on published research, you will be speaking in the past tense, because these were arguments made by these individuals at a particular point in time. If you need further information about how to write in a particular verb tense, please see the Athabasca University English Grammar Handbook – Verbs. Follow the patterns outlined for various components of your paper. Switching verb tense within a paragraph or section will interrupt the flow of your paper and may reduce effective communication of your meaning to the reader. You also risk misrepresenting the nature of your information sources.


Sentence structure

The way you structure your sentences can have a dramatic effect on how well your paper reads. Remember, writing is about communicating meaning. Very simply, poor sentence structure can distract or confuse the reader, and your meaning may suddenly be lost. Composing a clear and meaningful sentence involves organizing the various components of your sentence properly.


Basic components of a sentence

If you are like most graduate students, it has probably been a long time since you have reviewed basic grammar rules. Even the parts of a sentence may no longer be easy for you to identify. Review the definitions in Table 3.3 to facilitate your understanding of sentence structure (adapted from Fowler et al., 2005, pp. 159-160).

Table 3.3. Basic Components of a Sentence




Nouns Person, place, thing George, the cat, lives in Alberta.

Substitutes for nouns, either personal or relative


He is a happy cat (personal).

George enjoys lounging on the window, which faces the street (relative).

Verbs Actions, occurrences, states of being He moves slowly (action). He has become less energetic over time (occurrence). However, he is content (state of being).
Adjectives Describe or modify nouns or pronouns
(quantity, quality, etc.)
He is a lazy cat and the only cat in the house.
Adverbs Describe or modify verbs, adjectives, other adverbs, or groups of words (where, when, how, etc.) Oddly, George moves even more slowly when a very plump spider quietly crawls down the wall.
Prepositions Connect nouns or pronouns to other components of a sentence Three baby spiders crawl along behind the plump spider.
Conjunctions Link words, phrases, or clauses:
  • Coordinating conjunctions link equally important elements
George wiggles and squirms, but he can not get his paws to move (coordinating).
  • Correlative conjunctions also link equally important elements
Neither his front paws nor his back paws budge.
  • Subordinating conjunctions link less important elements to the main element
George is very surprised because he is usually not this slow!
Modifiers A word or group of words that adds information about another word or phrase:
  • Adjectives or phrases that act as adjectives
Cats that suffer from such paralysis are rare (acts as an adjective).
  • Adverbs or phrases that act as adverbs
George is brave in every other situation (acts as an adverb).

You will have difficulty following the grammar rules in the APA Manual or other writing resources if you do not understand these basic elements of sentences. For further information, or for definitions of terms not appearing on this list, see the Athabasca University English Grammar Handbook – Basic Grammar: Parts of Speech.


Sentence fragments (incomplete sentences)

You may find yourself getting feedback that you are not writing in complete sentences. To create a sentence, you must include both a subject (a noun or pronoun) and a verb.

  • She cried.
  • The test was difficult.
  • It will be difficult to see the outcome.

The following are not sentences because they are missing either a subject or a verb.

  • Critical incident reports in many classical experiments. [no verb]
  • Running and hiding. [No subject]

When you start a sentence with a subordinating conjunction or a relative pronoun, you must ensure it is still a complete sentence. The following are not sentences even though they may contain a subject and a verb.

  • Because she cried.
  • In spite of the fact that the test was difficult.
  • Who found it difficult to see the outcome.

Exercise 4

Complete Exercise 4 to make sure you have a good understanding of how to structure a complete sentence and to ensure you have the vocabulary necessary to follow other guidelines for effective writing. Check your responses with Exercise 4 Feedback.

For more detailed information on sentence structure, see Athabasca University’s English Grammar Handbook- Sentences and Grammar. You may also want to review examples of how to correctly form more complex sentences through the Purdue University Online Writing Lab – Sentence Punctuation Patterns.

If you want further information on sentence fragments, please see the University of Calgary Writing Support Services – Identifying and Fixing Sentence Fragments.


Agreement between the subject and verb

Read Sections 3.19 of the APA Manual, then review Purdue University Online Writing Lab – Making Subjects and Verbs Agree. The basic principle is that both the subject and the verb must be either singular or plural. Where errors occur is typically in mistaking a noun (the subject) as either singular or plural. Table 3.4 summarizes some of the grammatical rules related to agreement between subject and verb.

Table 3.4. Principles for Subject-Verb Agreement



Subject and verb must agree – singular or plural The animals play well together.
The cat plays well by himself.
There are three dogs playing.
Watch out for plural nouns that may appear singular such as data or ethics The ethics of each member is what binds them together.
The data are consistent with other findings.
If subjects are connected by and, use the plural form The cat and dog play well together.
If subjects are connected by or or nor, link the verb to the closest subject Neither the dog nor the cats are happy.
Neither the cats nor the dog is happy.
Ignore phrases that add additional information (including, in addition to…) or qualify the subject (who, which…) The evidence of the crime together with the lack of alibi points to their guilt.
The response from all participants was similar.
The subject, which is singular, determines the verb format.
Collective nouns (family, group, pair…) are treated as singular if the verb refers to the individuals and plural if the verb refers to the group or collective The family head off in different directions.
The couple is welcomed warmly.
The group does not want to participate.
The collection of items are sorted into piles.
Treat words like each, every, any, or some as singular Any person is welcome.
Everyone is welcome.
The word none can be either singular or plural depending on the word that follows None of the events are open.
None of the news is good.


Agreement between pronouns and the nouns they replace

Read Section 3.20 of the APA Manual and Purdue University Online Writing Lab – Using Pronouns Clearly. There are several basic principles that you should follow to ensure congruence between nouns and pronouns, as outlined in Table 3.5.

Table 3.5. Principles for Noun-Pronoun Agreement



The pronoun and noun should agree in number The participants exhibited distress when they were exposed to the stimulus.
It was unclear whether the other woman or I was the first to hold up my hand. [Notice that the verb is singular]
The pronoun and noun must agree in gender (See the caveat below on gender neutral pronouns!) Each of the girls believes that she is the first to arrive. [Notice that the verb is singular]
Use neuter pronouns for animals and inanimate objects The scoring card was prepared in advance, and it was available to each observer.
The horse that we had planned to ride was missing.
If the pronoun is a subject, use who; if the pronoun is an object, use whom There are three people here who look like the suspect. [who is the subject of the verb look]
There are three people here whom the inspector identifies as potential suspects. [inspector is the subject and whom is the object of the verb identifies]
When a participle is used as a noun, make the pronoun possessive The results of the test are not useful because of their lowering of the mean.


Beyond APA: They as a singular pronoun

As with most disciplines, English grammar is rooted in Western worldviews that have traditionally treated gender as a binary concept: one is either male or female. Gender diversity (e.g., fluidity and complexity of gender identity) is now well recognized, both in health disciplines literature (American Counselling Association, 2014) and is reinforced by human rights legislation (United Nations Human Rights, n.d., 2014). This is resulting in a slow but critical transformation in language use. Take a moment to review the APA Style – The Use of Singular “They” in APA Style.

I believe that health practitioners should be taking responsibility for our deliberate use of language to support of cultural diversity and social justice. Here are a few tips for doing so:

  • Respect the gender identity of your subject (in the grammatical sense of the word). If that individual uses the pronouns he or she, then you should use them. If that person uses the pronoun they, then you should mirror their self-identification.
  • If the gender identity of the subject is unknown, then default to gender-neutral language wherever possible. You can often accomplish this by restructuring your sentence in a way that respects traditional rules of grammar.
  • Make a conscious statement about gender by defaulting to they or them rather than he/she or him/her. Here is an example: The patient I saw yesterday listed depression and anxiety as their presenting concerns. Note: you may need to educate your instructor about this choice.

Welcoming them, zim, em, hir. . .

As health care practitioners, we are bound by our codes of ethics to not only do no harm but also to place primacy on the emotional, psychological, social, and physical well being of our clients. Our choice of language can inadvertently cause harm to clients of nondominant sexual orientation or gender identity. It is our responsibility to raise our awareness of cultural diversity and to use inclusive and anti-discriminatory language in all of our written and verbal communications.

If you are unfamiliar with gender identity issues and the implications for language use, have a look at the following resources:


Appropriate placement of modifiers

Review the section on Components of a Sentence above to remind yourself of what modifiers that function like adverbs or adjectives look like. Without understanding what a modifier is, it is hard not to misplace them. Notice that the portion in italics is a dangling modifier because there is nothing in the sentence to hang it on. The word it does not specify whom the actor is. Restating the sentence in active voice helps resolve the problem: Without understanding what a modifier is, I find it hard not to misplace them.

Read Section 3.21 of the APA Manual and review Purdue University Online Writing Lab –  Dangling Modifiers and How to Correct Them. Table 3.6 summarizes the key principles for appropriate placement of modifiers.

Table 3.6. Principles for Appropriate Placement of Modifiers



Place the modifier as close as possible to the word you want it to refer to [to avoid a misplaced modifier] Without looking at the test results, the teacher instructed the students to complete the next section. [modifies teacher].
The teacher instructed the students to complete the next section, without looking at the test results. [modifies students]
Be sure there is a referent for the modifier in the sentence [to avoid a dangling modifier] The results of this study, in keeping with current research, link stress to lower self-esteem. [referent = results]
I am more confused than before, after looking at these examples! [referent = I – so it should be re-positioned]
Write in the active voice so that the modifiers have a referent within the sentence After traveling for several weeks, I finally saw the ocean come into view. [The referent ‘I’ is required to anchor the modifier – versus: “After traveling for several weeks, the ocean came into view.”]


Exercise 5

Complete Exercise 5 to test your understanding of how to properly structure your sentences. Review Exercise 5 Answers for corrections.


What’s the point?

Remember, the rationale for refining your writing is to communicate more effectively. Most instructors will not go searching for misplaced modifiers or lack of agreement between your nouns and pronouns. Instead, they will read a sentence and not be able to discern what you are trying to say. So, whether they point out the grammatical errors or not, your meaning has been lost and with it your success on the assignment!

If you require more in-depth writing support, I strongly recommend that you purchase the Fowler and colleagues (2005) handbook listed in the references. If you are an Athabasca University (AU) student, you can also take advantage of personal coaching and writing support through the AU Write Site.


Subordinate elements

Read Section 3.22 of the APA Manual, which describes the use of relative pronouns and subordinate conjunctions (see the Components of a Sentence) to introduce clauses or phrases that are subordinate to the main clause. Notice that, in the previous sentence, everything after which (a relative pronoun) could be removed, and you would still know what your instructions are! This is a subordinate element of the sentence. Tables 3.7 and 3.8 provide principles for effectively managing subordinate elements.

Table 3.7. Subordinate Elements Beginning With Relative Pronouns



Use that for restrictive clauses (essential to the meaning) The group that was given the placebo performed equally well.
Use which for non-restrictive clauses (not essential to the meaning) and enclose the clause in commas The group, which met in the foyer, formed a solid bond over the day.

Table 3.8. Subordinate Elements Beginning With Subordinate Conjunctions



Use while only to refer to something that happened at the same time as something else I tried to complete the exercises while I was writing my paper.
Use although, whereas, but, or and to imply comparison rather than while I tried to complete the exercises, although I was busy writing my paper.
Use since to refer to something that happened after something else Since finishing my paper, I have tried to complete the exercises.
Use because to infer cause and effect rather than since I was unable to complete the exercises because I was writing my paper.

Notice, that in some of the examples in Table 3.8, the content of the subordinate element is not essential to the meaning of the sentence, so it has be separated off with commas.


Parallel construction

It is important that separate parts of a sentence have a similar construction and for a similar pattern to be used to organize groups of words. Notice that the previous sentence would be easier to read if my pattern was consistent: It is important that separate parts of a sentence are constructed and that groups of words are organized using a similar pattern. Read Section 3.23 of the APA Manual and Purdue University Online Writing Lab – Parallel Structure. Next consider the general principles in Table 3.9.

Table 3.9. Principles to Support Parallel Construction


Correct Example

Incorrect Example

Keep sentence components (pronouns, verbs, propositions, etc.) in parallel form I struggle with composing papers and I hate editing my own work.
The outcomes were evidence that self-awareness is critical for short-term learning and that action is required for long-term change.
I struggle with composing papers and hate to edit my own work.
The outcomes were evidence that self-awareness is critical for short-term learning and action for long-term change.
Maintain the same verb tense There were people all over the park, bicycling, walking, and engaging in conversation. There were people all over the park, bicycling, walking, and engaged in conversation.
Maintain the same voice Three of the people were wearing jeans, and another person was sporting a suit. Three of the people were wearing jeans, and there was another person in a suit.
With pairs of coordinating conjunctions, place the first one close to the components it refers to The experienced groups focused both on the task and the timelines.
The experienced groups focused either on the task or on the timelines.
The experienced groups both focused on the task and the timelines. [incorrect if both refers to task and timeline]
The experienced groups either focused on the task or the timelines.


Exercise 6

Complete Exercise 6 to test your understanding of subordinate elements and parallel construction, then check your responses with Exercise 6 Answers.

For further information about common errors that impact the clarity and meaning of sentences, please see the AU English Language Handbook – Common Sentence Faults.



Correct spelling

Spelling something incorrectly is one way to lose marks on papers, and it is completely avoidable. The APA Manual recommends that you use Merriam-Webster’s Collegiate Dictionary as your primary resource. You can access it online quickly and easily. I have also compiled a list of commonly misspelled words in Table 3.10.

Table 3.10. Commonly Misspelled Words

Words that Often Confuse

Examples of Correct Use

affect versus effect

I have been trying to affect (verb) your writing skills. I hope my work will have the desired effect (noun).

I want to effect (verb) change in her affect (noun) by diffusing the situation.

principle versus principal High school principals emphasized that there are three core principles for school nursing programs. The principle reason for focusing on nursing was…
accept versus except It was difficult for her to accept that all she could do was to listen, except under very specific circumstances.
its versus it’s

It’s raining outside today and the dog is unhappy about wearing its raincoat.

[Avoiding contractions is an easy way to side-step this error.]

enquiry versus inquiry There will be an enquiry into the conduct of the team, and I have received an inquiry about my participation.
who’s versus whose Whose mess is this in the kitchen, and who’s responsible for cleaning it?
complement versus compliment She complimented me on my fairness when I divided the supplies and handed over her complement of them.
counsel versus council The program council asked her to attend a meeting to counsel them about the upcoming decision.
discreet versus discrete There were several discrete options before them; the challenge was selecting one that would enable them to be as discreet as possible about their role.
stationary versus stationery While she ran in to buy some stationery, he waited outside in the cold in the stationary car.
elicit versus illicit He spent a few hours trying to elicit enough information to know where to find the illicit drugs.
precedence versus precedents Other instructors have already set several precedents, but precedence is given to the one that best simplifies the process.
sleight versus slight His sleight of hand did not go unnoticed, although she gave only a slight turn of her head.
lead versus led The lead investigator led the raters through the assessment guidelines. He also took the lead in verifying inter-rater reliability.
prioritize (not priorize) It is important to prioritize your learning goals so that you see clear progress.

Avoiding Contractions

One of the ways to support accurate spelling is avoid using contracts such as it’s, who’s, and she’s or don’t, haven’t, didn’t. Review the links below for helpful advice on avoiding contractions:


Canadian spelling

It is important that Canadian spelling be used in all graduate papers at Canadian universities. Please note that the spelling checker in Word will flag Canadian spelling as an error (e.g., behaviour). Over time, you can build your own personalized dictionary of words you commonly use. The Oxford Dictionary Online provides the British (Canadian) spelling when you look up a word. You may also find the following online source of Canadian spelling useful if you want to double-check a word:

In Table 3.11, I have compiled a list of common words that require Canadian spelling. I have also identified general issues so you can watch for additional words that may fall into these categories.

Table 3.11. Canadian Spelling Guidelines and Examples



our versus or Behaviour, Colour, Endeavour, Favour, Rigour, Vigour
[Note: Rigorous, Vigorous]
re versus er Centre, Centred, Theatre
l versus ll Enrol, Model, Skilful
ll versus l Counselling, Counsellor, Fulfill, Modelling, Skilled
ze versus se Analyze, Capitalize, Organize, Optimize, Optimization, Organization, Recognize
ce versus se Advice, Defence, Offence (nouns)
se versus ce Advise, License (verbs)
sive versus cive Defensive, Offensive
oe versus e Manoeuvre
e versus oe Apnea, Fetus, Homeopathy
gue versus g Catalogue, Dialogue
g versus ge Judgment
ge versus g Acknowledgement
ned versus nt Leaned, Learned (verbs)
que versus ck Cheque (noun)
ck versus que Check (verb)

Note. I have drawn on the following sources to create this list: Barber (2004), Bond (2009), and Cornerstone Word Company (n.d.). Where there was disagreement, I referred to the Canadian Oxford Dictionary by Barber.


If you are quoting directly from a source that uses American or British spelling, do not change it to Canadian. Keep it exactly as it appears in the original text. The same applies to titles of articles, books, or journals in your reference list. You may also be encouraged by instructors and project supervisors to submit some of your writing for publication. When the time comes, check the location of the publisher of the journal to determine what spelling norms should be used.

Tech Tip

To check your spelling and grammar, select the “Spelling and Grammar” link under the “Review” menu in Microsoft Word. Either highlight the section of text you want to check or just set the cursor at the beginning of your paper and check the whole thing. Spelling errors are generally highlighted in red and grammatical errors are highlighted in green (although this may depend on your Word settings).

Please remember that computers are not perfect. Some things will be highlighted that are not errors and other errors will be missed. For example, the word “colour” would appear as an error here because I have used the Canadian spelling.

You can build your own customized dictionary by simply clicking on the “Add to dictionary” button on the spell check. Try it out! Highlight the word “colour,” open the spell checker and add the word to your dictionary. The red underline will disappear. Building a customized dictionary will reduce your editing time.

The “Review” menu also provides a dictionary and thesaurus for your use.



You may also lose marks on spelling through the misuse of hyphens. Read Section 4.13 of the APA Manual, which outlines several key principles for making decisions about hyphens.

Exercise 7

Complete Exercise 7 to test your understanding of these principles. Check your answers with Exercise 7 Feedback. Remember that it is better to insert a hyphen than to leave one out if the meaning of the sentence is unclear.

Tech Tip

Be sure that Microsoft Word has not been set to automatically hyphenate words at the end of sentences. The only hyphens in your paper should be ones you deliberately insert. To remove automatic hyphenation, go to “Page Layout,” then “Page Setup,” then “Hyphenation,” and then select “None.”



Now that you know how to structure a sentence well, it is important to select appropriate punctuation to support your intended meaning. Many graduate students encounter challenges with punctuation, in part because APA style is not observed in our day-to-day interactions. However, there are a few simple rules that can eliminate confusion. Read Sections 4.01 to 4.11 of the APA Manual and then review the punctuation summary tables below. These tables provide you with the more common punctuation rules.



Table 3.12. Appropriate Placement of Commas


Correct Example

Incorrect Example

Between items in a series Commas, periods, and dashes are different types of punctuation. [Remember to put the comma before and.] Each use of punctuation must be purposeful, and consistent.
To separate out non-essential elements of a sentence Different types of punctuation, even your use of periods, affect the pacing of your writing. [Notice that the sentence still makes sense without even your use of periods.] Sentences, that run on too long, require additional punctuation. [Notice that the meaning of the sentence changes without that run on too long, so remove the commas.]
To separate two independent clauses Students often misplace commas, or they fail to insert them at all. [Notice that either part of the sentence can stand alone as a complete sentence.] Most errors are a result of failing to proofread, or falling into old habits. [Notice that falling into old habits cannot stand alone as a complete sentence.]
Around the year in exact dates January 5, 2006, is an exact date, but January 2006 is not. January 5, 2006, is an exact date, but January, 2006 is not.
In large numbers The APA Manual could be renamed 1,001 not-so-simple rules. The APA Manual could be renamed 1001 not-so-simple rules.



Table 3.13. Appropriate Placement of Semicolons


Correct Example

Incorrect Example

Between independent clauses not joined by a conjunction An independent clause can function as a complete sentence; a dependent clause cannot stand alone as a complete sentence. [Notice that the semicolon could be replaced by a conjunction like but and that each part of the sentence is independent.] Some clauses cannot stand alone; without a subject and verb, for example. [Notice that without a subject and verb, for example cannot stand alone as a complete sentence.]
Between items in a series (if commas are already used) Clear punctuation provides structure, clarity, and cadence; directs the reader about when to pause; and indicates what information is essential or non-essential to the meaning. Unclear punctuation can confuse; leave the reader out of breath; and blur the meaning of sentences.



Table 3.14. Appropriate Placement of Colons


Correct Example

Incorrect Example

Between an independent clause and a phrase that describes, clarifies, or extends it

There are two punctuation marks that are used most frequently: periods and commas. [Notice that the first part could stand alone as a complete sentence.]


The two most common punctuation marks are: periods and commas. [The first part is not an independent clause – cannot stand alone – so a colon should not be inserted.]
Between an independent clause and a clause that describes, clarifies, or extends it There are two punctuation marks that are used most frequently: They are periods and commas. [Notice that if the second part could form a complete sentence, it starts with a capital letter.] There are two punctuation marks that are used most frequently: there are several others that are used less often. [A semicolon is more appropriate because the second clause does not complete the first; you could use a conjunction like and to join them.]
To indicate ratios / proportions The ratio of students who need no writing support is about 1:10. 1:10 students need no writing support. [One out of 10 students . . .]


Quotations marks

Table 3.15. Appropriate Placement of Double Quotation Marks


Correct Example

Incorrect Example

The first time you introduce a coined expression or ironic comment A coined expression like “grammar grudge” is different from a key term like sentence structure. [Key terms should appear in italics the first time they are used.] You could use quotations to indicate that you “love” grammar but not that you find punctuation “easier.” [The second usage does not reflect irony.]
To indicate the title of an article or chapter Collins and Arthur’s (2010) article, “A Framework for Enhancing Multicultural Counselling Competence” is worth a read. Collins, S., & Arthur, N. (2010). “A framework for enhancing multicultural counselling competence,” Canadian Journal of Counselling . . .
[Quotation marks should not be used in the reference list, unless they are used within the title.]
For verbatim instructions or test items

These should be treated like a normal quotation: “You will put the material in quotes, but probably won’t have a page number or other citation content.”

[Notice that the quotation marks belong outside of the final punctuation – e.g., .”]

The following instruction will exceed 40 words so requires block format:

“In this case, you do not need the quotations marks so they would be considered an APA error…”

[No quotations marks used for block quotes.]

Location of quotation marks Collins instructs to “Always place punctuation marks outside other punctuation marks.” This applies “even in the middle of a sentence”, which can commonly occur.

Single quotation marks should normally not be used in your paper. “One exception is to indicate ‘a quote within a quote,’ in which the inside quotation marks should be single, not double.”  Notice that, in both cases, the quotation marks follow the comma or period.

Overuse of double quotations marks puts you at risk of appearing to quote others when you are not. Use other strategies to place emphasis on particular words or phrases.



Table 3.16. Appropriate Placement of the Dash


Correct Example

Incorrect Example

To separate material that disrupts the flow of a sentence The dash – as demonstrated in this example – sets apart content that does not flow with the rest of the sentence. The dash – which you should use infrequently – can often be replaced by a non-restrictive clause. [the phrase which you should use infrequently would be better contained with commas.]



Table 3.17. Appropriate Placement of Parentheses


Correct Example

Incorrect Example

To separate material that is structurally independent This is a bit different from the dash because material in parentheses tends to be viewed as less important (see the previous table). Parenthetical material may be complete sentences. (In this case, you include the punctuation inside the parentheses.) [There is nothing to suggest that this is a secondary thought that requires parentheses.]
To contain abbreviations An abbreviation like Faculty of Health Disciplines (FHD) belongs in parentheses. However, if the referent is already in parentheses then use brackets for the abbreviation (Faculty of Health Disciplines (FHD), 2015). [Notice that this should be [FHD], 2015]
To introduce a list of items Additional examples are provided for (a) mathematical expressions, (b) formulas, (c) statistics, and (d) citations (See APA Manual 4.09). Instead of parentheses, brackets should be used for a) inserting material in a quotation and b) material already within parentheses [as noted above]. [Letters in the list should have double parentheses; as noted above should be in parentheses, not brackets.]



Table 3.18. Appropriate Placement of the Slash


Correct Example

Incorrect Example

For comparisons where a hyphen is used in the terms already The self-esteem/self-worth comparison indicated that… The depression/elation continuum is based on… [Use a hyphen for simple comparisons: depression-elation]
Only when clarity is not sacrificed

The instructor or course coordinator could answer your question about the test-retest/inter-rater reliability comparisons.

All of these rules apply to writing and/or editing. [The meaning of and/or is writing, editing, or both.]

The instructor/course coordinator could answer your questions. [The first use makes the sentence less clear. Is the instructor/course coordinator the same person or can either or both answer your question?]


Exercise 8

Complete Exercise 8 to test your understanding of punctuation, and then compare your responses to Exercise 8 Feedback.

If there are areas where you are still unclear, you may find it helpful to review the additional resources in Table 3.19.

Table 3.19. Additional punctuation resources



Punctuation overviews
Commas versus semicolons
Dashes versus parentheses
Plural possessive

Remember that if there are differences in editorial rules across resources, you should normally default to the APA Manual, except for the Canadian spelling noted above.


Word formatting

The APA Manual addresses a number of other editorial issues where the principles used are sometimes specific to the profession. As a result, you will find that various writing tutorials, which may target other audiences, introduce different rules. It is important to review the specific editorial guidelines that apply to writing in the health disciplines.



Read Sections 4.14 to 4.20 of the APA Manual for examples of when to capitalize the words in your paper. Review the capitalization checklist in Table 3.20 for a summary of these principles. Refer to this checklist if you are unsure of where to include capital letters.

Table 3.20. Capitalization Checklist


Examples: Capitalize

Examples: Do Not Capitalize

Titles of books or articles

In the APA Manual, you will find…

In the article by Adams, “Principles of Self-Awareness,” they described…

Titles of sections within a paper or other document In the Tables and Figures sections of the APA Manual some exceptions are noted. In the study process section that addresses hyphenation, I suggested…
Proper nouns (not adopted into common language) Parse would have a different perspective on nursing theory than Nightingale. A Likert scale would not be a good tool for assessing this. Terms like french fries are now part of the common language.
Titles of university departments or academic courses The Department of Nursing offers a course called Individual Case Management. However, the health studies division does not require this case management course.
Names of theories, models, approaches There are similarities between Ellis’ rational emotive theory and Beck’s cognitive therapy model. Cognitive-behavioural theory approaches human nature differently than psychoanalysis.
Specific numbered items There are several examples provided in Table 3.2 that reflect the outcomes of Test 3. If you look at column 3… I will address these issues on page 6.
Titles of tests The Canadian Registered Nurse Examination awaits those who want to license. The lesson post-test awaits those who want to write well.
Experimental groups or conditions Group A and Group C were both given pretests. Participants were exposed to either pretest or no pretest conditions.
Titles of Factors or Variables

Variable 1 (Gender) and Variable 3 (Age) had a significant effect on… (capitalized as part of a numbered series)

The Age x Weight x Sex variable was… (capitalized because terms are accompanied by multiplication sign)

Demographic variables included gender, province of residence, and age.



Understanding when to use an abbreviation begins with a few basic principles:

  • The purpose of an abbreviation is to increase clarity.
  • Abbreviations also save space and reduce redundancy when terms are long and complicated.
  • The meaning of the abbreviation must be clearly defined or commonly understood.
  • Do not use more than one abbreviation for the same term or concept.

These basic principles result in specific rules for abbreviation use in various contexts or professions. Review Sections 4.22 to 4.30 of the APA Manual for details on how to best use them in health disciplines writing. As a general test, ask yourself this question: “Does this abbreviation make my intended meaning more or less clear to my readers?”



Italics should be used carefully and infrequently in your papers. [I have use them more frequently in this e-book to point out examples because font colours may not appear on some devices.] The specific uses of italics, outlined in section 4.21 of the APA Manual, which are most likely to apply to your graduate papers, include

  • titles of books or periodicals,
  • first introduction of new or important concepts or terms,
  • words or phrases introduced as examples, or
  • words or phrases that would otherwise be misread.

Resist the urge to use italics for emphasis. Use other grammatical devices and structure your sentences clearly to communicate what you see as important.



Based on Sections 4.31 to 4.40 of the APA Manual, here are a few simple rules that you should remember for referring to numbers.

Table 3.21. Expressing numbers in figures or words

Express the following in figures
(e.g., 5)

Express the following in words
(e.g., five)

  • all numbers 10 and above
  • a combination of numbers less than and greater than 10 that occur in the same paragraph (as long as the numbers compare the same thing)
  • dates, times, ages, money
  • sample sizes
  • specific points in numbers series
  • all numbers between zero and nine
  • common fractions
  • numbers at the beginning of a sentence, title, or heading


Exercise 9

Complete Exercise 9 to test your understanding of these principles related to capitalization, abbreviations, italics, and numbers. Check your answers with Exercise 9 Feedback.



In Chapter 2, you spent a lot of time focusing on the forest, getting the big picture of what your paper would look like and how you would develop a logical and convincing argument for your reader. This chapter has honed in on the trees, many of the little details that can influence whether or not those great ideas you developed in Chapter 2 are accessible to the reader. The more you are able to fine-tune your writing in these areas, the more meaningful and straightforward your communication will be.

I expect that this lesson will be a challenge for many students. It was a challenge for me to ensure that I was providing correct examples and feedback on all exercises. However, some of you may experience more difficulty than others with basic written language skills. You may need to engage in further skill development before you can be successful in graduate school. Please search out the resources at your home university. If you are an AU student, take advantage of the resources provided through our Write Site.

Now is a good time to step back again from this detailed revision of your words, your sentences, and your individual paragraphs to reread your paper, looking again for overall flow and ease of understanding. Make sure that your thesis and arguments remain clear. You may want to use the checklist below to wrap up this part of your revision process. I have drawn some of these ideas from Fowler et al. (2005).

  • Have you structured each paragraph in a deliberate way to support the key point?
  • Have you structured the paper to make the flow of key points in the argument clear?
  • Have you made the relationship among various parts of the paper transparent?
  • Have you used appropriate transitional devices to support the flow of argument from one paragraph to another?
  • Have you written in a concise way, without extraneous words that distract from the meaning?
  • Is your writing precise and clear, without vague pronouns or jargon that may distract and confuse the reader?
  • Have you used appropriate structuring skills to link the various components of the argument (paragraphs) to one another?
  • Have you made the intention of the original author clear through the verbs you used?
  • Have you chosen consistent verb tense within various sections of the paper?
  • Does your selection of verb tense fit with the purpose of each section?
  • Does your sentence structure support clarity and precision of meaning?
  • Is there agreement between subjects and verbs, nouns and pronouns?
  • Have you carefully place modifiers close to the word that they relate to?
  • Have you cordoned off subordinate elements with commas so they do not dilute the main message of each sentence?
  • Are you using parallel construction, voice, and verb tense within each sentence?
  • Have you run a spelling and grammar check? Have you double checked for Canadian spelling or other words that are spelled correctly but used incorrectly?
  • Does your use of punctuation enhance the flow of meaning in your writing? Have you over or under used certain types of punctuation?
  • Does your formatting of individual words reflect the guidelines in the APA Manual?



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Chapter 3. How do I effectively communicate my ideas? Copyright © 2016 by Sandra Collins is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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