CE Home > Writer's Guidelines
Division of Continuing Education
Guidelines for Authors
CE Writers Guidelines May 2013 (pdf)
Updated Jan 2013
Each issue of our magazines includes a peer-reviewed continuing education module
that allows nurses to earn one contact hour. We are looking for modules that are
timely, relevant and compelling for practicing nurses. Prospective authors should
be able to demonstrate their expertise in the subject matter through experience,
education or both. To understand the tone, style and format of our CE modules, visit
our website, nurse.com (click on Education/CE
and then Self-Study Modules), and review a few of them.
To be considered for continuing nursing education, a manuscript must be authored
or coauthored by an RN and must include the following items:
A one-sentence goal statement for the module, separate from the narrative.
For example: The goal of this program is to provide nurses with information about the incidence, etiology, identification and treatment of abdominal trauma.
Three objectives, using action verbs that require readers to demonstrate their understanding of the topic.
A clinical vignette (See “Tips for Writing a Clinical Vignette” below.)
Evidence-based information. We divide evidence-based practice, or EBP, into three categories: A, B and C. Level ML, multilevel,
indicates a clinical practice guideline is based on two or more levels of evidence. (See “Levels of Evidence” below or go to
for an explanation.)
To determine the level of evidence-based information in your module, you must evaluate the reference work (a research study, guideline or position statement, for example)
from which you obtained the information. After doing that, include the level (A, B, C or ML) in parenthesis at the end of the sentence in which the information appears.
If the information is from an online source on the reference list, include the URL in the text.
“The research study [provide the exact URL of the study] indicates that practice X is still the appropriate method of doing Y.1” [i.e., the reference number to the source] (Level A).
º Identify three factors that ...
º Discuss four nursing interventions
º Describe two ways patients ...
When identifying EBP levels in the narrative:
An introduction (lead) that packs a punch and captures the reader’s attention.
If you use a case study as a lead, make it succinct and directly related to topic.
Other considerations involving a case study lead: If possible, use a case study
involving an actual patient scenario, but do not use real names.
o Limit the number of references you identify by level to eight.
o Use references that can be easily verified (e.g., through sources such as Pub
Med, journal websites or Internet search). Refrain from using references that may
only be accessed or verified through paid membership.
Use primary references when possible.
o Select studies or references that are most representative of the EBP levels and
relevant to clinical practice.
An original, researched, referenced manuscript of about 3,600 words, written
in a conversational style. (The word count is for the main text and clinical vignette
only. Do not include the objectives, references, or exam in the word count.) If
you include a sidebar (of around 150 words), the main text should be shorter, about
3,200 words. The clinical vignette should be from 400 to 450 words.
Manuscripts must be word-processed and double-spaced with margins of at least 1
inch. The text must provide current, advanced, testable information on clinical
or professional topics relevant for practicing nurses.
If your CE module includes information about an off-label use of a product
(the use of a product for a purpose other than that for which the FDA approved it),
a statement in writing informing us of that fact.
A complete reference list, including book or journal titles, dates and page
numbers, with footnoted citations in AMA style (10th edition). Because of space
constraints, try to limit references to 25. Generally, references should not be
more than 3 to 5 years old. Use primary references whenever possible. Do not use
reference material available only online and only by subscription; most readers
will not be able to access it without paying a fee. If you use an article that
appears in a subscription journal that is available both online and in print,
include both the URL and the print reference information according to AMA style
(see reference examples below.). That way, readers without a subscription can
access the article without cost at a library. Number the footnotes consecutively
in the text. Once a citation has a number, it keeps it throughout the narrative,
and it should correspond to the numeric order of the reference list.
An exam in a separate file from the module: 12 multiple-choice questions with four responses each with the correct answers indicated. (See “Tips for Writing Test Questions” below.)
One to five points of explanation for the correct answer of each of the 12 exam
questions. The points of explanation should not be a restatement of the answer —
rather new information related to the content in the module and to what the question
is covering. Your explanation points should be succinct.
1. Three risk factors for suicide include:
a. Male gender, alcoholism and depression
b. Female gender, married and high income
c. Female gender, living in a city and on welfare
d. Female gender, physical illness and three children
Males complete suicide at a rate four times that of females. The risk of suicide
in alcoholics is 50% to 70% higher than in the general population. A
relationship exists between depression and suicide: The risk of suicide is
increased by more than 50% in depressed people.
• A resume or curriculum vitae for each author.
• A signed Gannett Education author’s agreement.
• A signed Gannett Education vested interest self-disclosure form.
Note: Authors must guard against plagiarism. The dictionary
defines plagiarism this way: “To take and pass off (ideas or words of another)
as one’s own; to use (another’s production) without crediting the source.”* To avoid plagiarizing, you must credit the journal articles,
books and websites you drew information from by citing them in the reference list.
If you use someone else’s exact words, put quotation marks around them and list
the source in your reference list.
*Plagiarize. Merriam-Webster.com Web site.
http://www.merriam-webster.com/dictionary/plagiarize. Accessed January 9,
a word, contact Nan Callender-Price, RN, MA, executive director of continuing education,
to discuss your idea (925-283-7263 or
email@example.com). We are looking for manuscripts that are
original and practical, useful and informative for any nurse, yet innovative and entertaining.
We look for topics that cover the “holes” in the literature, important subjects
that have been missed or undercovered — what nurses need to know before they know
they need to know it. For a sense of what we publish, go to our website:nurse.com.
After your topic
is approved, email your module goal, objectives, outline and curriculum vitae in
attachments to Callender-Price. She will review your materials, let you know whether
any changes are required before you begin to write and discuss the deadline for
submission of your manuscript. Once you complete your manuscript, please e-mail
it to her in an attachment.
Paid peer reviewers
(experts in your subject matter) will rigorously review your manuscript. In about
three to five weeks, we will notify you about their decision. If reviews are favorable,
you will be asked to revise the manuscript according to their suggestions.
When your manuscript
is in its final version, you will receive an edited copy for your approval. The
only changes you may make at that point are those related to accuracy or clarity
of information. Most modules are published in all editions of Nursing Spectrum and
NurseWeek and on our website.
Honoraria are awarded on an individual basis.
For More Information
Contact Nan Callender-Price
Executive Director of Continuing Education
Create a clinical vignette of 400 to 450 words reflecting information in the module
and testing the reader’s knowledge. Include four multiple-choice questions with
a rationale for the correct answer. Below is an example.
Mr. King arrives in the ED at 2 a.m.with SOB. Vital signs are 154/92; 98-112-30.
Lungs have bibasilar crackles up ½ posteriorly. Oxygen saturation by pulse oximetry
is 90%, and his heart reveals an S3. The monitor shows sinus tachycardia. An initial
B-type natriuretic peptide (BNP) assay is 1,650 pg/mL. He receives furosemide (Lasix)
40 mg IVP and O2 at 3 L/min via nasal cannula. He diureses 500 mL of urine. At 6
a.m., He goes to telemetry with a diagnosis of heart failure. Admission vital signs
are 122/74; 98-102-24. Lungs have bibasilar crackles. The monitor shows sinus tachycardia.
He receives enalapril (Vasotec) 2.5 mg PO. At 10 a.m., BP is 106/60. He diureses
600 mL of urine. A repeat BNP assay is 1,100 pg/mL.
1. In telemetry, the initial nursing
assessment of Mr. King should include:
a. Chest X-ray.
b. Oxygen saturation.
Answer: b. On admission, O2 sat is only 90%.
2. The BP on admission to the telemetry
unit was lower because of:
b. Circulating BNP.
d. Oxygen administration.
Answer: a. Diuresis decreases excess circulating volume and lowers BP.
3. The BP decreased after administration
of enalapril as the result of:
a. Excretion of excess sodium.
b. Excretion of excess volume.
c. Systemic vasodilatation.
d. Increased contractility.
Answer: c. Ace inhibitors produce vasodilatation, lowering BP and decreasing the
workload on the failing ventricle.
4. BNP levels decrease in response:
b. Increased contractility.
c. Increased blood pressure.
d. Decreased volume.
Answer: d. BNP decreases in response to diuresis and loss of excess circulating
Evidence-based practice is a conscientious, problem-solving approach to clinical
practice that incorporates the best evidence from well-designed studies, patient
values and preferences, and a clinician’s expertise in making decisions about a
patient’s care. Unfortunately, no standard formula exists for how much these factors
should be weighed in the clinical decision making process. However, there are a
variety of rating systems and hierarchies of evidence that grade the strength or
quality of evidence generated from a research study or report. Being knowledgeable
about evidence-based practice, and levels of evidence, is important to every clinician
as clinicians need to be confident about how much emphasis they should place on
a study, report, practice alert or clinical practice guideline when making decisions
about a patient’s care.
Gannett Education’s Rating System:
The levels of evidence listed here have been developed with the help of nurse experts and
other industry resources. We thank those who have contributed to making our system relevant
and applicable to determining the levels of evidence that support our CE publications.
Evidence-based information ranges from Level A (the strongest) to Level C (the
weakest). In 2013, we have added Level ML, multilevel, to identify clinical practice guidelines that contain recommendations based on more than one level of evidence:
LEVEL A: Evidence
Randomized control trials: the classic “gold standard” study design. In
RCTs, subjects are randomly selected and randomly assigned to groups to undergo
rigorously controlled experimental conditions or interventions.
Systematic review or meta-analysis of all relevant RCTs. A systematic review
is a critical assessment of existing evidence that addresses a focused clinical
question, includes a comprehensive literature search, appraises the quality of studies
and reports results in a systematic manner. Meta-analysis a study design that uses
statistical techniques to combine and analyze data from many RCTs.
Clinical practice guidelines: based on systematic reviews of RCTs. Evidence-based
clinical practice guidelines provide the strongest level of evidence to guide clinical
practice because they are based on rigorous reviews of the best evidence on specific
LEVEL B: Evidence
Well-designed control trials without randomization: In this type of study,
random assignment is not used to assign subjects to experimental and control groups.
Therefore, this type of research is less strong in internal validity because it
can’t be assumed the subjects in the study are equal on major demographic and clinical
variables at the beginning of the trial. Frequent problems with this type of study
include intentional or unintentional bias in sample enrollment; nonblinding, unclear
criteria for participant selection; or unreliable or invalid tools.
Clinical cohort study: an examination of groups of people who have common
characteristics or exposure experiences to compare outcomes in those exposed vs.
outcomes in those not exposed (e.g., development of heart disease after exposure
or nonexposure to 10 years of secondhand smoke).
Case-controlled study: use of an observational approach in which subjects
known to have a disease or outcome are compared with subjects known not to have
that disease or outcome. Subjects are matched on characteristics so that they are
as similar as possible except for the disease or outcome. Case-control studies are
generally designed to estimate the odds (using an odds ratio) of developing the
studied condition or disease and can determine if an associated relationship exists
between the condition/disease and risk factors.
Uncontrolled study: studies that do not control participant selection or
interventions (e.g., a convenience sample, such as patients on a given unit, may
be studied because it’s the only group reasonably available).
Epidemiological study: studies that observe people over a long time to
determine risk or likelihood of developing diseases. These studies include retrospective
database searches or prospective studies that follow a population over time.
Qualitative study/quantitative study: descriptive, word-based phenomena,
such as symptoms, behaviors, culture and group dynamics. Quantitative studies use
statistical methods to establish numerical relationships that are correlational
or cause and effect.
LEVEL C: Evidence obtained from:
Consensus viewpoint and expert opinion:
a study that obtains agreement about
specific practices from all clinical experts on a review panel. Expert opinion involves
obtaining agreement from a majority of clinical experts on a review panel. Note:
This level of evidence is used when there are no quantitative or qualitative studies
in a particular area.
Meta-synthesis: a systematic review that synthesizes
findings from qualitative studies using an interpretive technique to bring small
study findings, such as case studies, to clinical application.
LEVEL ML (multilevel):
clinical practice guidelines, recommendations based on evidence obtained from:
More than one level of evidence as defined in Gannett Education’s rating system.
Agency for Healthcare Research and Quality Evidence-based Practice Centers (ahrq.gov/clinic/epc)
The Cochrane Collaboration:
National Guideline Clearinghouse: (guideline.gov/index.aspx)
References for EBP:
Alfaro-LeFevre R. Critical Thinking, Clinical Reasoning, and Clinical Judgment:
A Practical Approach. 5th ed. St. Louis, MO: Elsevier-Saunders; 2013.
Ebell MH, Siwek J, Weiss BD, et al. Strength of recommendation taxonomy (SORT):
a patient centered approach to grading evidence in the medical literature. Am Fam
Physician. 2004;69(3):548-556. http://www.aafp.org/afp/2004/0201/p548.html.
Published February 1, 2004. Accessed January 9, 2013.
Evidence-based medicine toolkit. American Academy of Family Physician Web site.
Accessed January 9, 2013.
Is all evidence created equal? University of Illinois at Chicago University Library Web site. http://www.uic.edu/depts/lib/lhsp/resources/levels.shtml.
Updated March 7, 2008. Accessed January 9, 2013.
Levels of evidence. Centre for Evidence-Based Medicine Web site.
http://www.cebm.net/index.aspx?o=1025. Published March 2009. Updated
April 15, 2011. Accessed January 9, 2013.
Melnyk BM, Fineout-Overholt E. Evidence-Based Practice in Nursing & Healthcare. A Guide to Best Practice. Philadelphia, PA: Lippincott Williams & Wilkins. 2005.
Newhouse RP, Dearholt SL, Poe SS, Pugh LC, White KM. Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines. Indianapolis, IN: Sigma Theta Tau International;
Strength of Recommendation Taxonomy (SORT). American Academy of Family Physicians Web site. http://www.aafp.org/online/en/home/publications/journals/afp/afpsort.html.
Accessed January 9, 2013.
Understanding research study designs. University of Minnesota Bio-Medical Library Web site. http://www.biomed.lib.umn.edu/guides/understanding-research-study-designs. Accessed
January 9, 2013.
Use AMA style. (Refer to AMA Manual of Style, 10th edition.)
List footnoted citations under a “Reference” heading. Number citations consecutively in the text. Once a citation has a number, it keeps it throughout the narrative.
List general references not cited in the text under a “Bibliography”
Abbreviate journal names according to AMA style (i.e., according to the
National Library of Medicine abbreviations. For more information go to
Up to six authors, list them all
Hron G, Kollars M, Binder BR, Eichinger S, Kyrle PA. Identification of patients
at low risk for recurrent venous thromboembolism by measuring thrombin generation.
More than six authors, list first three, et al.
Carpenter CC, Fischl MA, Hammer SM, et al. Antiretroviral therapy for HIV infection
in 1997. Updated recommendations of the International AIDS Society-USA panel. JAMA.
Books (entire book)
Weedon D. Weedon’s Skin Pathology. 3rd ed. London, England: Churchill
Dooley JS, Lok AS. Burroughs AK, Heathcote EJ, eds. Sherlock’s Diseases of the
and Biliary System. 12th ed. Hoboken, NJ: Wiley-Blackwell; 2011.
Books (chapter in edited book)
Schenk EA. Management of persons with neurological problems. In: Phipps WJ, Manahon
Donovan F, Sands JK, Marek JF, Neighbors M, eds. Medical-Surgical Nursing: Health
and Illness Perspectives. 7th ed. St. Louis, MO: Mosby; 2002:1787-1865.
CDs, DVDs, audiotapes, videotapes:
(list author first if provided)
Wound Healing. [videotape]. Irvine, CA: Concept Media; 2006.
In citing data from a website, include the following elements (if available) in the order shown:
Author(s), if given (often no authors are given). Title of the specific item cited
(if none is given, use the name of the organization responsible for the site). Name
of the website site. URL [provide URL and verify that the link still works as close
as possible to publication]. Published [date]. Updated [date]. Accessed [date].
Examples of online material:
Burt RK, Loh Y, Pearce W, et al. Clinical applications of blood-derived and marrow-derived
stem cells for nonmalignant diseases. JAMA. 2008;299(8):925-936.
Published February 27, 2008. Accessed January 9, 2013.
Guidelines and recommendations: interim guidance about avian influenza (H5N1) for U.S. citizens living abroad. Centers
for Disease Control and Prevention Web site.
Published March 24, 2005. Updated January 13, 2011. Accessed January 9, 2013.
Dissertation or master’s thesis
Caruso E. An Examination of Organizational Mentoring: The Case of Motorola [dissertation].
London, England: University of London; 1990.
Name of author (if given), title of article, name of the newspaper, date of the
newspaper, section (if applicable) and page numbers.
Steinmetz G. Kafka is a symbol of Prague today; also, he’s a T-shirt. Wall Street
Journal. October 10, 1996:A2, A6.
presented at a meeting or conference (not yet published)*
Greenspan A, Eerdekens M, Mahmoud R. Is there an increased rate of cerebrovascular
events among dementia patients? Poster presented at: 24th Congress of the
Collegium Internationale Neuro-Psychopharmacologicum (CINP); June 20-24, 2004; Paris,
Khuri FR, Lee JJ, Lippman SM, et al. Isotretinoin effects on head and neck
cancer recurrence and second primary tumors. In: Proceedings from the American Society
of Clinical Oncology; May 31-June 3, 2003; Chicago, IL. Abstract 359.
Cialis [package insert]. Indianapolis, IN: Eli Lilly & Co; 2012.
*Once these presentations are published, they take the form of a reference to a journal,
book or other medium in which they are published.
Keep the questions, answers
and points of explanation brief: a maximum of 1, 000 words total.
Make all questions
multiple choice with four possible options, “a,” “b,” “c” and “d.”
test questions should measure mastery of the objectives. After you have written the test,
check that it includes questions relating to each objective.
Make sure the correct option is derived from the narrative and defensible as the best answer.
Be certain that the three incorrect options are plausible.
Do not write “multiple-multiple” questions, that is, those that present a
list of options, then ask the test taker to choose “a and b,” “a, b and c,” etc.
Avoid the options “None of the above” and “All of the above.” Also, avoid phrasing questions in the negative, for example, using “all of the following EXCEPT.”
Limit yourself to
one question that involves statistics, number of cases
or the like. Examples: “What percentage of ventilated patients develop ventilator-associated
pneumonia?” “How many cases of HIV/AIDS were recorded in the U.S. in 2008?” “What
is the prevalence of migraine among U.S. women?”
Use the same terminology in the test as in the narrative. (For example, if
the narrative refers only to “hypertension,” use “hypertension,” not “high blood
pressure,” in the test.)
Be sure the order of questions matches the sequence
of information in the
narrative, e.g., question No. 1 should correspond to the information appearing in the narrative first.
Avoid using words in the correct option that are also found in the stem (the
first part of the question). Doing so provides “clues” to the correct answer.
Make sure options are not mutually exclusive. For example, if option
“a” reads, “Slows the heart rate,” and option “b” reads, “Increases the heart rate,”
these two options are mutually exclusive. The test taker can be reasonably certain
that “c” and “d” are extraneous, and that either “a” or “b” is the correct answer.
Be sure that one or more of your options are not included in another option.
For example, if option “a” reads, “Affects the heart rate,” and option “b” reads,
“Slows the heart rate,” option “b” is actually included in option “a.” Thus, if
“b” is a correct response, “a” is also.
Include an answer key.