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WRITING A THESIS PAPER:

Instructions for Students of Oriental Medicine

essay by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon

The purpose of writing a thesis paper is to advance your capabilities that will aid in developing your career. Among the things you will learn are:

  1. How to select an area of specialization and what the implications of that choice will be on the evolution of your career. When you select your thesis topic, you will be determining an area where you will have specific knowledge; this action is parallel to choosing a medical specialty.
  2. What the range of information resources available to you is, and what limitations exist. When you research your topic, you will have to look through a broad range of information resources and will find some items difficult to retrieve or access, and there will be presentations of varying quality. You will become more familiar with this situation as, in the scope of your practice, you are presented with patients having difficult or unusual conditions.
  3. The process of sifting through information in order to sort out the valuable from that which has little or no value. As you read through the resource materials, you will find that some information is clearly useful but that other information may lead you down the wrong path because it is not based on accurate, well-organized, and truthful pursuit of knowledge. Learning to recognize the varying quality of information will help you avoid providing information-and treatment regimens-that have no foundation.
  4. How to organize the knowledge you gain into groups of related concepts so that you can get a more complete picture of what the various resources are showing you. Many disparate facts will be collected, but will only make sense if organized into groups that have some internal consistency. This activity will also help you organize the disparate symptom and sign information that is presented by patients into a coherent diagnostic understanding that will lead to successful treatment.
  5. How to describe what you've learned to others in such a way that they can understand it clearly. The process of writing the thesis will teach you how to interpret what others have written, because you will understand the process that they went through to make their presentation. It will assist you in conveying the knowledge you gain over the years to less experienced practitioners and to describe the concepts of traditional medicine to patients.

Having learned these facts, processes, and methods, you should then be able to:

The art of preparing a thesis paper is supposed to be taught first in middle school and high school (book reports and library projects) and then in college courses which may have included term papers. It reaches a higher level when a person prepares a master's thesis, and its highest level when a person prepares a Ph.D. thesis. At the Ph.D. level, the individual not only carries out library research in preparation of a thesis paper, but also conducts new research, collecting facts that have not been previously published. In that way, the person who accomplishes the task learns not only the above-mentioned things, but also how to conduct research so that the reported results are meaningful. As a result, the graduate has learned how to interpret other research reports in a critical manner.

THESIS ADVISOR

The first step in developing a thesis project is to be assigned an advisor. The advisor is a professional with many years experience in the field you are studying, who has already prepared one or more formal thesis papers (or their equivalent in the form of technical articles subject to review). The advisor's experience includes carrying out a thesis project that is at least as stringent and extensive as the one now being assigned (e.g., the one that leads to a Masters or Ph.D.). The advisor is familiar with the pitfalls in the literature so as to assist a student in picking out an appropriate topic, getting to the correct resources, and presenting information that is of value to the profession.

There are four essential meetings with the thesis advisor prior to writing the final thesis paper. There may be a need for even more contact, in order to clarify various issues as they arise. First, the thesis advisor and student should meet in order to get a mutual understanding of what is involved in the thesis project and what is expected. A second meeting is essential once the student is ready to propose a topic; the advisor may suggest a different topic (for example, if the selected one has inadequate literature resources), a modified topic (perhaps a more limited aspect of the selected area of concern), or a particular approach to the topic (e.g., focusing on collecting data from the field or focusing on doing a literature search). Once the project is underway, a third meeting should take place, in which the student should present the advisor with an outline of what is pictured as the overall thesis presentation, the basic information sources that have been accessed, and the focal point of the work. This will give the advisor a chance to suggest modifications before the work of writing the thesis proceeds too far. A draft of the thesis will next be presented in a fourth meeting so that the advisor can get an idea of whether or not the student has grasped the fundamentals and can point out any significant weak areas.

Obtaining guidance from those who have more experience is an important lesson in itself. Traditional medicine is an art that is passed on from accomplished physicians and scholars to those who are entering the field. If one gets into the habit of ignoring the wealth of knowledge and experience of those who have been there before, then the tradition cannot be passed on. If one goes to the advisor seeking too much help, depending on the advisor's knowledge rather than doing the hard work involved in the thesis project, the advisor may inform you that you need to learn how to perform certain tasks yourself. Thus, there is a balance between two essential methods of gaining knowledge: learning how to do things oneself and learning how to recognize one's own limitations and get guidance from others.

SELECTION OF TOPICS

The process of selecting a topic for the thesis is an important one. Too often, the student is bound up in his or her personal interests and wants to select a topic that will satisfy an immediate need rather than considering one's profession as a whole. Thus, for example, a student may first wish to pick a thesis topic that will address a disease condition that is suffered by the student or the student's family member or friend. While such a selection may appear to give meaning to the project (because it is perceived as having an immediate application), it is usually not the method that is most appropriate to developing a professional specialty.

Some subjects are not sufficiently addressed in the available literature to satisfy the needs of a thesis paper. For example, if you are concerned about a disorder that is not being successfully treated by modern medicine, you have to consider first whether that disorder, or one like it, is even mentioned in the traditional literature. Further, if it is a relatively rare condition, you will have to consider whether or not pursuing such an unusual case will really help with your professional development (it may or may not).

A student is not expected to know what area of specialization they will eventually end up in (if any; some will remain in a general practice with no specialty). The thesis subject may inspire one to pursue that area of specialization or it may reveal that it is an area that is not so desirable after all. Still, you should pick a subject that represents a potential area of specialization, if not for you, then for some of your colleagues who will be able to read your thesis and be inspired by it.

Unless the thesis project, during its assignment, has been limited to a certain subject area (e.g., treatment of a disease), you should consider a variety of potential areas: history of medicine, analysis of a specific technique (diagnosis or therapy), basic concepts of the medical field, and so on. Whatever the subject selected, there must be a body of information that can be relied upon to prepare the thesis report. It will not do to simply take a subject that is of interest and then write what you think about it based on what you already have learned, even if you can expand upon it by adding a couple of interesting facts. A major purpose of the project is to discover something new by wading through a considerable amount of information.

THESIS OR PAPER?

In the first section of this essay, I've used the term thesis to describe the project, but it may only be a paper (article). The term thesis implies that you will propose something and then find out if it is true or not. A paper simply describes an area of interest; in most cases, people begin writing a paper with a specific idea in mind that would correspond to a thesis. However, their interest may not be in finding out whether or not the underlying thesis is true, but just in supporting their underlying idea. In that case, if some facts point a different way, they might be simply ignored, which develops an unhealthy habit of dealing with information in a prejudiced manner.

There are a variety of subjects that can be raised surrounding a topic. For example, suppose that you have decided to write something about the traditional Chinese medical treatment for diabetes. You can simply review the literature and present what you find (a paper, not a thesis). However, if there is a thesis required in the project, your thesis might be a variety of things that would orient the development of your paper. Consider the following sample topics:

Traditional Chinese medicine offers a successful treatment for diabetes. This thesis topic would require you to find and evaluate literature that purports to show success of treatments, and would require that you access other literature about how one evaluates such claims.

Traditional Chinese medicine has a long history of diabetes treatment. This thesis topic doesn't require you to evaluate the effectiveness of treatment, but does require an analysis of historical records and determining, for example, whether a condition described in ancient literature really is diabetes.

Traditional Chinese medicine practitioners treat diabetes as a yin deficiency syndrome. This thesis topic doesn't require you to evaluate either the effectiveness of treatment or history, but does require you to analyze the reported treatment methods and to determine whether or not they correspond to the proposed syndrome.

Traditional Chinese medical approaches to diabetes are applicable to patients who are being treated by modern methods. This thesis would require an analysis of both the modern and traditional methods of treatment and an evaluation of the extent to which they are compatible. The results of any such "integrated treatment" reported in the literature would be critically reviewed.

Rehmannia is an herb that should be evaluated for potential effectiveness in treatment of diabetes. This thesis would require an analysis of the herb and the studies of it in relation to diabetes, which might include chemical, pharmacological, and clinical evaluations suggesting its potential benefits.

For each of these thesis topics, the literature research that is done may confirm the proposal, may contradict the proposal, or may give a result that neither supports nor contradicts the proposal. Therefore, one has to be open minded about what is found in the literature. The point of the thesis paper is not to prove that the initial proposal is true, but to use the initial proposal as a basis for collecting and presenting information. Before settling on a topic, it is a good idea to review some of the literature and see whether or not there is something there that addresses the specific thesis. If it turns out that there is little supporting or contrary evidence, then the thesis paper will not be very inspiring. In that situation, whether you present a simple paper or thesis, it may be necessary to shift the thesis topic to one that can be reasonably addressed by the existing literature. Your advisor should be able to help you determine whether or not you've succeeded in accessing the main body of literature for the chosen subject.

SEARCHING THE LITERATURE

Whether you are conducting a literature-only search, or are planning to do some field research, it is necessary to find out what has been done before, so a literature search is always the initial step. Field research, collecting information that is not published, should never be done without carefully investigating what has been published first. Research is always based on following up something that has been done before.

The school that assigns a thesis project should already have a library that offers a wide range of valuable literature, and this is the best starting point. There are three basic types of resources:

  1. Books. Books have the advantage of presenting an extensive review of a subject or placing a subject of interest within a broader context. Books have the disadvantage of sometimes being out of date and, especially if not a formally prepared text book, of not having any requirements placed on the author to verify the source or validity of statements made. Text books have the advantage of containing information that is widely recognized, but they have the disadvantage of often lacking in depth.
  2. Formal journals. Journals have the advantage of offering new information and, to varying extents, having information that is properly referenced and that has been evaluated by others with experience in the field before being allowed into the publication. It is important to read several articles (whether or not on the thesis subject) from high quality journals in order to gain a perspective on what is required in those journals (examples: Journal of the American Medical Association; New England Journal of Medicine; Science; Nature). These most-formal journals will help you determine whether or not the presentation you read on the subject of choice in other journals is up to a reasonable standard and will alert you to what may be missing. Journal articles also have the advantage of presenting more details than found in most books.
  3. Informal journals and newsletters, popular books. Informal publications, usually without any attempt at a scholarly style of presentation, are rarely of any help in preparing a thesis article and should be avoided.

Books and articles that have proper referencing to their sources of information will assist you in the process of discovering which sources are not present in the library. You must determine whether or not other potentially valuable resources can be obtained elsewhere. An increasing amount of information is accessible via internet search mechanisms, including such interlibrary services as MedLine for medical information (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi).

FIELD RESEARCH

Field research, that is, collecting information that is not available in publications, is usually not a possibility for thesis projects and should only be taken on if practical. Well-conducted research is usually very time consuming and very expensive, which is why it is not normally part of thesis projects outside of major universities. Interviews and surveys can often be conducted, though even these methods may turn out to be much more difficult than perceived at first.

An area of field research that is usually manageable is a survey of local resources. As an example, a thesis paper may be aimed at describing what Oriental medical services are available in the local community, who is providing services, what is the cost, etc. In order to conduct and report on such a survey, it is important to first research the general matter of survey techniques to learn about how to avoid relaying incorrect information and how to deal with missing information.

Evaluating the effect of a treatment is usually not manageable: this is clinical research and is amongst the most difficult of all research projects to do well, even by professional researchers. The school where the thesis paper is required may have its own clinical facility. Field research at this facility might be aimed at determining what disorders are being treated, how often patients come to the clinic, what is the typical duration of therapy, etc. However, such projects are still quite difficult and should not be encouraged, as they require the student to examine confidential files and it is usually not possible to check the recorded information by interviewing the busy practitioners or interviewing patients who are not expecting to participate in such a study.

ORGANIZING THE INFORMATION

Each time a piece of relevant information is found, it must be preserved. This can either be done by making a photocopy, by copying it down (if short), or by keeping a reference so that it can be retrieved again later. Ultimately, each source of information must be referenced in the article. It is important to know proper referencing methods, and the best resource is a formal journal publication (see above); always use a referencing method that corresponds with what is used in this type of publication. There are slight variations amongst the publications, but one should stick to a style once it is selected. The reference information will include the author(s), title, and source (for journals, journal name, volume, number, and pages; for books, book title, publisher, publisher location, pages). If you take information for your report from a source and don't have the proper reference information, you will have to retrieve it again later, so always get the reference information at the time it is first found.

The information to be presented will eventually have to be organized into subjects, such as general description, historical information, research information, etc. After reading through the sources that have been obtained, an outline of the planned report should be made, displaying the types of information that are now available to you, in sets that are logically connected.

WRITING THE THESIS

A rough draft of the thesis can be initiated by writing out what you've learned from the research in a manner that is simply comfortable for you to do in a short time, with the understanding that it will take several drafts to reach the form of an acceptable thesis article. However, before writing down each sentence, ask yourself "why am I including this information?" Sometimes, information is put into a thesis paper only because it is available, not because it is relevant. For example, suppose you are writing about a traditional Chinese treatment strategy for a particular disease. Why spend three pages of text writing about how many cases of the disease there are, or even describing at length the modern treatment methods? Is it relevant to the presentation? If not, don't include it; if it is partly relevant, include only the essential points.

It is important to keep in mind basic writing skills: sentence structure and paragraph form. These aspects of your writing are independent of the nature of the topic or the fact that it is a thesis paper. As each draft of the paper is worked though, the structural quality of the sentences and paragraphs should improve. This will reflect not only your review of the existing document to find errors or shortcomings, but also your increasing understanding of the subject as you try to explain it to others.

For the follow-up drafts, it is necessary to review each of the sentences and ask yourself: "How do I know this?" In a thesis paper, most statements must be backed up by something authoritative, with a reference to the source material. Not every sentence or every paragraph will have a reference, but it should be entirely clear to both you and the reader how you have come up with your statement. If you have stated something that you believe but for which there is no supporting information, then you are obligated to either leave it out or to make it clear that this statement is what you personally believe. There is one exception to the rule, which must be pursued carefully. If there is generally known, broadly accepted information, then it need not be referred to a source. As a trivial example, if you want to point out that the sky is blue, you don't have to reference that to an authority nor indicate that this is just your opinion. Most statements of this nature are transitional; that is, they link one piece of referenced information to another, otherwise, they would be nonessential because they are widely known.

When you make reference to historical information or to the opinions expressed by experts, it is often wise to provide a direct quote. By contrast, if one is making reference to scientific findings or to other statements of fact, it is not necessary to make a direct quote from the original source but only necessary that you accurately portray the information.

For the final drafts, it is important to review each statement to make sure that what it is referring to is correct. For example, if you are referring to a report in a journal about a study, make sure that you refer to the report, not to the study (e.g., you may indicate that you have an English language report, but it is not "an English-language study"). Be careful of words such as "this" and "it," that may be unclear as to the subject to which they refer. Remember to differentiate a medical system from the people who are involved in it; if you say "TCM believes...," this is an error, because it is people that believe, not TCM (further, you may have to specify which people believe what you have indicated, as there can be divergent opinions held within the profession). TCM doesn't have beliefs, it may be said to have certain dogma or generally accepted facts (you may have to specify the current status of the statement; Who agrees with it now?). Be careful of unusual methods of presenting terms: excessive capitalization and excessive use of quotation marks around words are common problems in thesis papers on traditional medicine. It is also necessary to review the order in which the information has been presented to make sure it provides a logical progression of idea to the reader.

THE LESSON

The completed thesis project should provide new information and insight to the thesis advisor, the other faculty members, and other students who read it. The author is able to accomplish this goal by having delved into literature on a special subject that may not have been previously reviewed by those who read the thesis, or at least, the subject has not been previously reviewed at the same depth and/or with the same focus. What is reported in the thesis should be able to stimulate the interested reader to examine certain areas further, and reveal even more.

The writer of the thesis has become familiar with literature resources that will be useful for future needs as a practitioner, scholar, and/or teacher. Most importantly, the writer will have learned the process by which information is transmitted from one person to another and realize that:

By recognizing these different ways in which information is generated and passed on, you become a responsible member of the community of educated people that deals with retaining, passing on, and developing knowledge. By properly carrying out the thesis project, you are welcomed into the world of respected knowledge-bearers. You will be able to better assist others in recognizing the varying quality of information in circulation, saving them from many dead-end paths.

Both traditional medicine and modern science eventually come together with this procedure of evaluating and transmitting knowledge. Unsupported contentions are gradually weeded out, allowing the contentions that retain support, as well as those that are still in need of evaluation, to show through. As a result of the process, both traditional medicine and modern medicine offer successful methods of dealing with human health and provide valuable insights into how to live so as to maintain and improve health. These medical and scientific fields also offer a never ending wealth of areas for investigation and development.

August 2000