Open Access

Writing letters to the editor: A workshop [Version 2]

Yuki Kataoka[1], Miho Kimachi[2], Junji Kumasawa[3], Sayaka Shimizu[2]

Institution: 1. Hyogo Prefectural Amagasaki General Medical Center, 2. School of Public Health in the Graduate School of Medicine, Kyoto University, 3. Sakai City Medical Center
Corresponding Author: Dr Yuki Kataoka ([email protected])
Categories: Research in Health Professions Education
Published Date: 07/08/2018
Keywords: letter to the editor; continuing medical education

Author Revision Notes

We appreciate the reviewers for the constructive suggestions. In accordance with the comments, we have revised the manuscript.

>What exactly were the criteria followed while carrying out the critical analysis?
We intended to criticize the methods including confounding and bias.

>To which journals did the authors submit their letters to the editor?
Participants selected articles from the view of their area of expertise and closing date of submission.
We have added a sentence.

>What criteria were followed while writing the letter? How many groups were created each year?
Sorry for insufficient presentation. We have added all citations in supplement 2.

>Why did the two groups miss the deadline for submission of the letter? I did not exactly understand what the authors meant by the deadline for submitting the letter?

Each journal has deadline for submitting letters to original articles. In usual the duration is four weeks.

>Even the description of the curriculum in the first year of the workshops is vague and just mentioned as clinical research. It would have been more useful to the readers to see what is involved in the first year.

Sorry for insufficient presentation. We have added the detail of curriculum in supplement 1.


Critical appraisal of current literature is important when embarking on a new clinical study (Laidlaw 2012). Several workshops teach critical appraisal as step 3 of evidence-based medicine. However, few workshops address critical appraisal in anticipation of implementing a clinical study, much less, how to deliver the results of the critique to the original author is not described.

We presented a two-day workshop on how to write a letter to the editor as part of a two-year distance-learning program to acquire the skills necessary to conduct clinical studies.

Participants were recruited online, and the inclusion criteria comprised medical doctors with at least four years of clinical experience who had never learned how to do clinical research.

During the first year, they watched a three-hour movie about clinical research and then submitted homework every month. Thereafter, group feedback was given for one hour each month between May and November via online conferences, and they participated in a two-day workshop review in July. The detail of curriculum is described in supplement 1.

Another 8-hour, two-part workshop proceeded during December. Before the first day, students in groups of 3 or 4 selected a full original article to critique. They selected articles from the view of their area of expertise and closing date of submission.

The first half comprised a lecture about confounding, bias, and how to write a letter to the editor. Each group was provided with a facilitator who had at least one year of clinical research experience. The second half comprised presentations about their critical appraisals and suggestions for the article.

Three workshops proceeded in 2015, 2016, and 2017. A total of 38 participants in nine groups wrote 13 letters about articles, of which 11 were accepted. All citations are shown in supplement 2.

Generally, the workshop was well received, and the students were satisfied. However, two groups could not achieve acceptance. One group cannot submit final manuscript before the date in 2015 because of time shortage. We held a flipped lecture about how to write a letter to the editor before the workshop and gave two hours to write one. One group missed the reply from the journal and missed the deadline in 2016 because of their unfamiliarity with English e-mail. We will limit the journal choices and inform the students of the actual reply.

To our knowledge, this is the first attempt to teach the skills required to write a letter to the editor. We plan to improve the workshop to support clinicians who embark on clinical research projects.

Take Home Messages

After the two-day workshop, medical doctors who participated acquired skills to write a "letter to the editor".

Notes On Contributors

Yuki Kataoka is a Medical Head of the Department of Respiratory Medicine at the Hyogo Prefectural Amagasaki General Medical Center.

Miho Kimachi is a Program-specific Assistant Professor of the Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University.

Junji Kumasawa is an Assistant Head Physician of the Department of Critical Care Medicine, Sakai City Medical Center.

Sayaka Shimizu is a Program-specific Assistant Professor of the Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University.


We would like to thank P Ravi Shankar and Sateesh Babu Arja for their constructive comments.


Laidlaw, A., Aiton, J., Struthers, J. and Guild, S. (2012) ‘Developing research skills in medical students: AMEE Guide No. 69’, Medical Teacher, 34(9), pp. 754–771. https://doi.org/10.3109/0142159X.2012.704438




There are no conflicts of interest.
This has been published under Creative Commons "CC BY-SA 4.0" (https://creativecommons.org/licenses/by-sa/4.0/)

Ethics Statement

This program was not reviewed by an institutional review board, but we followed the Declaration of Helsinki (2013) and obtained written informed consent from each of the respondents to participate and we anonymized the presentation.

External Funding

The Problem-Solving Oriented Training Program for Advanced Medical Personnel was funded by the Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT).


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Richard Hays - (15/03/2019) Panel Member Icon
Thank you for the revision, although my main question is still not answered: why is the outcome measure the writing of a letter to the editor? I understand that this may be simply to measure ability to critically appraise and express findings succinctly, two important sets of skills. Apart ffrom I’m that, the design of this study was appropriate. However. Letters to the editor are not all that common, so I wonder if there might be a better measure, such as writing a report on a patient based on reading a research paper? That may be a much more usable outcome. I planned to make this point on the original version, but a revision was submitted very rapidly, based on just a single review. It would be wise to wait a while before revising, as more reviews would provide broader feedback and may result in a gutter revision.
Possible Conflict of Interest:

I am Editor of MedEdPublish

Sateesh Babu Arja - (12/08/2018) Panel Member Icon
Thank you for revising the article based on reviews. It is more clearer now. I appreciate your attempt of conducting workshops to train the young physicians on how to write the letters to the editors.