Why Syntopical Reading Matters To Medical Literature

The mark of a true subject matter expert is their in-depth knowledge of the literature pertaining to that subject. As these individuals will tell you their expertise is derived from years of reading and re-reading the content, then contemplating and challenging the assumptions and conclusions, and ultimately designing experimental models to test the robustness of the findings. It is important to recognize that the origins of their knowledge base is formed from reading. More specifically, reading well.

In order to develop your knowledge base in a similar fashion, you too must learn how to read well – not simply read a lot. The difference being, in reading well, you invest time and conscious, deliberate effort in understanding the content in front of you. While this is no easy task, many pharmacists stop before they’ve even started because of the daunting task laid before them. Without a plan and method to conduct this type of reading, the task simply gets brushed aside and rationalized away.

However, you can benefit from learning the structure of syntopical reading as a method to systematically accomplish your continuing education objectives. Although not specifically about how to read a scientific paper, “How To Read A Book” can teach us principles of a reading framework that will allow you to develop the tools to grow your knowledgebase. We’ve already examined the four key aspects of reading in previous articles. But to remind ourselves of them those four elements are:

  1. Elementary reading (Beginning, middle, end)
  2. Inspectional reading (skimming systematically – get the most out of a book within a given relatively short time yet too short of a time to get everything that could be gotten)
  3. Analytical reading (Organized, thorough, complete – the best reading you can do)
  4. Syntopical reading (Comparative reading – reading many papers/books at once and places them in relation to one another and to a subject about which they all revolve)

How to Read Syntopically

Imagine you have read a landmark paper on a core disease topic in your practice. As a new or even experienced pharmacist, it may be challenging to correctly place this new evidence within the context of the existing guidelines, evidence, and current practice. The challenge is even more difficult when you haven’t read the guidelines (ever, or for quite some time), aren’t fully updated on supporting evidence, and have been practicing based on protocols.

But there are a few steps you should follow in order to start reading syntopically. These principles can help you regardless of existing knowledge of the current literature since it will attempt to resolve that issue. Furthermore, these steps cannot be taken without first completing (at least) inspectional reading and analytical reading of the manuscript. 

The first step is to thoroughly inspect the manuscript. From your notes on the analytical reading of the manuscript in question, you can identify key statements and conclusions from the authors. From these key statements and conclusions, we must attempt to identify similar statements and terms from the existing evidence related to this topic. By identifying the key supporting evidence the authors used as the rationale for the study, you must now read (using inspectional techniques) these guidelines and articles as well. In doing so, you will compare multiple articles with a specific question in mind, ultimately growing your understanding of concepts pertaining to the results at hand. 

This process can become time-consuming. It is fundamental for building your expertise in this subject and correctly placing the manuscript in question in its appropriate place among the literature. The more time and effort placed here, the easier it will become, over time, to complete this step for new evidence, guidelines or commentaries that are relevant to it and your practice.

After completing this reading with specific key statements and conclusions in mind, you will undoubtedly identify new questions pertaining to the study methods and results. Take time to fully articulate your questions. Put together a list of questions you hope to address in your syntopical reading journey. Revisit these questions as you read to see which are answered and which remain unresolved. This process may not be completed with the available evidence, but it can be referenced back to when new evidence is published. Alternatively, if you find yourself in an academic appointment, it will establish your next research question and project. 

From the key terms, questions, and answers you have resolved, you must now analyze the answers you’ve received. What do different authors seem to agree on? What remains controversial? Where does the discussion in the field seem to be headed? If you can cogently answer these questions, you have likely achieved an expert-level understanding of a subject.

To review, these are the key steps to accomplishing syntopical reading

  • Thoroughly inspect the manuscript. 
    • To identify similar statements and terms from the existing evidence related to this topic
  • Inspectionally read through these guidelines and articles 
    • Compare multiple articles with a specific question in mind, ultimately growing your understanding of concepts pertaining to the results at hand 
  • Identify new questions pertaining to the study methods and results. 
    • Fully articulate your questions 
  • Analyze the answers you’ve received
    • What do different authors seem to agree on? What remains controversial? Where does the discussion in the field seem to be headed?

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