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20УПОТРЕБЛЕНИЕ ПАССИВНОГО ЗАЛОГА В МЕДИЦИНСКИХ ЖУРНАЛЬНЫХ
СТАТЬЯХ (ЛИТЕРАТУРНЫЙ ОБЗОР)
Матвеева Ирина Александровна Андижанский государственный медицинский институт
Среди авторов, редакторов, издателей и преподавателей английского языка не угасают споры и дискуссии о роли грамматической категории пассивного залога и употреблении его в написании статей медицинского научного характера. Одна сторона участников дебатов выдвигает аргумент, что авторам медицинских статей следует меньше употреблять глаголы в форме пассивного залога, потому что они становятся менее понимаемыми и более вербальными для читателя, чем альтернатива в активном залоге. Противники этой позиции утверждают, что при написании статей медицинского характера на английском языке предпочтительнее употреблять глаголы в пассивном залоге, так как он отражает объективность научного метода.
Ключевые слова: пассивный залог, предпочтительный стиль, медицинские статьи, объективность научного метода, средняя употребляемость, избежание ответственности.
THE USAGE OF PASSIVE VOICE IN MEDICAL JOURNAL ARTICLES
(LITERATURE REVIEW)
Authors, editors, publishers as well as English teachers have a choice about the role of the passive voice in their publications, and there is considerable debate about what that role should be. On one side of the debate is the argument that medical writers should minimize use of the passive voice because it is less clear, less forceful, and more verbose than active voice alternatives. The opposing argument is that the passive voice should be the predominant style of most types of medical writing because the passive voice reflects the objectivity of the scientific method.
Key Words: passive voice, predominant style, medical writing, objectivity of the scientific method, median frequency, avoiding responsibility.
TIBBIYOT MAQOLALARIDA MAJHUL NISBAT QO'LLANISHI (ADABIYOTLAR SHARHI)
Mualliflar, muharrirlar, noshirlar va ingliz tili o'qituvchilari orasida majhul nisbatning grammatik kategoriyasining roli va uning tibbiy ilmiy xarakterdagi maqolalarni yozishda ishlatilishi haqidagi tortishuvlar va munozaralar so'nmaydi. Bahslarning bir tomoni tibbiy mualliflar majhul nisbat fe'llarni kamroq ishlatishlari kerak, chunki ular faol alternativaga qaraganda o'quvchi uchun kamroq tushunarli va verbal bo'lib qoladi. Ushbu pozitsiyaning muxoliflari tibbiy maqolalarni ingliz tilida yozishda majhul nisbatda fe'llardan foydalanish afzal deb ta'kidlaydilar, chunki bu ilmiy uslubning ob'ektivligini aks ettiradi.
Kalit suzlar: majhul nisbat, afzal uslub, tibbiy maqolalar, ilmiy uslubning ob'ektivligi, o'rtacha foydalanish, javobgarlikdan bosh tortish.
DOI: 10.24411/2181-0443/2020-10108
Introduction. The subject of "English in Medicine" in the curriculum of medical students includes a great deal of practice in reading and writing professional articles. Students of 2-3 courses used to write reports and prepare presentations; students of Master's course have to write special medical articles for publication them in medical journals in the beginning of their professional and scientific careers. A lot of time at English lessons is dedicated to the reading and writing medical articles. During my teaching the subject of "English in Medicine" it was noted that understanding medical articles by the students was significantly complicated and inhibited by the verbs in Passive Voice. Fortunately, having obtained more experience in reading such kind of articles, future doctors become capable to feel and analyse the usage of verbs in Passive Voice in medical scientific style.
Literature review. Having listed the existing literature on this point, I have thoroughly learned opinions of medical writing experts. According to Anitra Sheen: "Passive voice is the bane of medical writing. It pervades medical literature with the haze and heaviness of stagnant air. Writers sometimes use passive voice in an attempt to make their work sound scholarly and scientific, when actually they are perpetuating a writing tradition that is fraught with ponderous and obscure language." The grammatical "voice" of a sentence is defined by the relationship of the verb to the subject. In an active voice sentence, the subject does the acting. In a passive voice sentence, the subject is acted on, or not mentioned. The sentences "Data were collected by a member of our research team from patients with pneumonia" and "Data were collected from patients with pneumonia," use passive voice constructions. An active voice version of these sentences is "A member of our research team collected data from patients with pneumonia." Authors, editors, and publishers have a choice about the role of the passive voice in their publications, and there is considerable debate about what that role should be. On one side of the debate is the argument that medical writers should minimize use of the passive voice because it is less clear, less forceful, and more verbose than active voice alternatives. The opposing argument is that the passive voice should be the predominant style of most types of medical writing because the passive voice reflects the objectivity of the scientific method, avoids using a first person pronoun in a way that would be impolite and conforms to the style with which medical peers are most familiar. An important void in the discussion of the use of the passive voice is the lack of data about the frequency and pattern of its use in medical writing. The primary goal of this study is to fill that void by reporting the frequency of passive voice sentences from a sample of papers from 3 major medical journals. Our secondary goals are to present a scientific framework for studying the passive voice in medical writing and to produce a reference that explains the passive voice issue.
Methods and materials. They calculated the percentage of sentences with a passive voice construction in three types of articles from 3 major medical journals: The Journal of the American Medical Association (JAMA), The New England Journal of Medicine (NEJM), and The Lancet. They chose these journals primarily because their high impact factors suggest that they are well respected and thus serve as a model for writing style. Secondary considerations were that these journals have different publishers, editorial staffs, and that each issue contained articles from many different fields of medicine. They evaluated three types of articles from each journal: Opinion Paper, Review Article, and Original Research Report. Authors used the term "Opinion Paper" to describe peer-reviewed commentaries whose author is not a journal editor.
In a study such as this one, it was difficult to interpret results without understanding how they relate to nonmedical writing. To provide a perspective on the results, they also evaluated 30 articles in The Wall Street Journal (WSJ) as a so-called nonmedical article control group. They chose the WSJ as a control publication because we thought that there are similarities between the readership of the WSJ and that of medical journal articles in
terms of level of education and because the articles that we selected contain detailed analyses of complex subjects. The year of publication of all medical journal articles in this study was 2006; the WSJ articles were published in 2007. They selected the medical journal articles at random yet ensured that the authors of the articles represented many different medical specialties. They did not screen the articles for writing style or any other feature of composition before selecting them for inclusion in the study. The sample size was 30 articles from each journal, with 10 of each type of article from each journal. Therefore, we evaluated 90 medical articles: 30 Opinion Papers (10 from each journal), 30 Review Articles (10 from each journal), and 30 Original Research Reports (10 from each journal).
The 90 medical journal articles and 30 WSJ articles were listed in the appendix, which was available in the online version of this article. The main endpoint in this study was the percentage of sentences that contained at least 1 passive voice construction. They coded sentences with both active and passive constructions as passive voice sentences, and we counted sentences with 2 or more passive constructions as one passive voice sentence. We manually identified passive voice sentences. Specifically, one of them (RA) evaluated every sentence in each article to determine the number of sentences with passive voice construction. For the first 20 articles, another one of them (JK) repeated the process so that both of them independently recorded the voice as active or passive in every sentence in the article. The group then discussed any discrepancies and made a final determination that they both agreed on. After doing the 2-person analysis on 20 articles, there were no differences in their calculations in the next 10 articles, so, for the remaining 90 reviews, only one of them determined passive voice frequency without a double check by the other.
Some word processing programs include a grammar-checking program that calculates passive voice frequency. It is much easier to count passive voice frequency with such a program than with a manual approach. However, the accuracy of the calculations of grammar-checking programs is unknown. To determine the accuracy of a computer program in identifying passive voice sentences, they compared the results obtained by the manual approach with the calculations made by the grammar-checking program in Microsoft Office Word 2003 (Microsoft Corporation, Redmond, WA). This is the only analysis for which we used a computer program to count passive voice sentences. The example sentences in the Introduction section of this paper illustrate the two forms of passive voice construction, which they refer to as "doer mentioned" and "doer not mentioned," where "doer" refers to the actor or doer of the action of the verb. For example, the sentence "Data were collected from patients with pneumonia," is considered to be "doer not mentioned" because the person collecting the data is not identified. For each passive voice sentence, they recorded if the form was "doer mentioned" or "doer not mentioned." To address the use of first person pronouns, they recorded the percentage of sentences with an active voice construction involving a first person pronoun. Sentences with more than 1 first person pronoun were counted only once. For all analyses in this study, they evaluated only text that was directly related to the composition of the article.
They excluded text that was associated with the title of the article, header or footer text, footnotes, figure legends, text boxes, margin notes, references, conflict-of-interest statements, and references. They also excluded text that was part of a quotation because the authors of the article had no control over the construction of a passage from a previously published work or anything spoken by a person. They used SAS and JMP software (SAS Institute, Cary, NC) for all statistical analyses. The standard analysis of variance (ANOVA) procedure provided a test of whether the percentage of sentences with passive voice differed according to both publication and type of article. For each ANOVA, the Tukey adjustment for multiple comparisons controlled the experiment-wise error rate so that it did not exceed a=.05. Among Original Research Reports, accurate analysis of all possible pairings of paper sections (Abstract vs Introduction vs Methods vs Results vs
Discussion) required repeated measures ANOVA to adjust for the fact that any given paper contributes data points to the analysis; as with standard ANOVA, the Tukey adjustment controlled the experiment-wise error rate. ANOVA with Dennet's multiple comparison procedure provided the analysis of WSJ vs each of these individual sections; Dennett's test facilitated comparison of multiple groups within a given variable to a single control (in this case, WSJ).
Results. Passive Voice Frequency. The median percentage of passive voice frequency was similar for articles in the 3 medical journals but was much higher than in the WSJ articles (20%- 26% vs 3%). When the passive voice frequency was plotted by the 5 sections of Original Research Reports, the median frequency was higher in all sections than in the WSJ articles. The highest median percentage was in the Methods sections, with a passive voice frequency that was more than twice that in the other sections. The following pairwise comparisons were significant.
Discussion. The data showed that there was a high frequency of the passive voice in medical journal articles. In our study, more than 20% of the sentences in such articles had passive voice constructions and percentages greater than 30% were not uncommon. The authors could not compare their results on passive voice frequency with those of other studies because their results are the only published data on this subject. The results of their study validate what writing experts have been saying for many years about excessive use of the passive voice in medical writing. They could not find a survey study or consensus statement addressing the question of why authors of medical journal articles use the passive voice so frequently. No publication guideline mentions goals or limits for the use of the passive voice, and some of the most prestigious references are worded in a way that may encourage authors to use the passive voice whenever it is acceptable to do so.
Passive Voice proved to be helpful in avoiding responsibility. There is some overlap between this motive and concern about the impropriety of a first person pronoun, but the references we reviewed focus on the psychological urge to avoid "going out on a limb" as a reason for writing in the passive voice. The distinguishing feature of the passive voice is that it makes the receiver of the action more important than the doer. Every resource on medical writing that the authors have sited in this paper gives examples of situations where it is appropriate to use a passive voice construction, with the main one being when the action is more important than the doer is. Excessive use of the passive voice is not the only problem with modern medical writing, but it is a well-defined problem with a simple solution: medical journal editors should make passive voice frequency a standard for publication.
Conclusion. Having listed the existing literature on the point, I have thoroughly learned opinions of medical writing experts and concluded that Passive Voice proved to be helpful in expressing scientific objectivity, and can be recommended for usage in medical scientific articles. In addition, it is very important for medical students as well as young scientists to read and analyse medical journal articles with the usage of verbs in Passive Voice.
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