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 Table of Contents  
Year : 2018  |  Volume : 31  |  Issue : 2  |  Page : 130-133

Advancing scholarship by publishing curriculum as an e-book

Department of Medicine; Department of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada

Date of Web Publication30-Nov-2018

Correspondence Address:
Lawrence Cheung
Departments of Medicine and Critical Care Medicine, University of Alberta, 3-129 Clinical Sciences Building, 11350 83 Avenue, Edmonton, Alberta
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/efh.EfH_75_17


Background: Medical educators provide service by developing curricula and writing learning material. In addition, academic institutions expect medical educators to publish scholarship to be considered for promotion and academic advancement. Unfortunately, educators may receive limited time to execute these duties and expectations. One way medical educators can streamline their workload is by publishing educational coursework they have previously written into an e-book through an online publisher. This allows them to transform educational service they have already completed into scholarship required for academic recognition, thus maximizing the efficient use of their time. Intervention: Publishing educational material as an e-book requires four steps. First, medical educators must determine which of their educational materials is best suited for publishing as an e-book. Second, educators must rank the features of each e-book publisher and choose the one that best meets their needs. Third, the educational material must be adapted as a manuscript and submitted for publication. Finally, the e-book must be advertised, promoted, and distributed to its intended audience. In addition, the success of the project should be evaluated. To illustrate this process, we describe the steps we took to publish the learning material we created for our internal medicine residents into an e-book. Lessons Learned: The overall process took approximately 3 months and went smoothly. For future publications, we would determine better ways to track the number of downloads of the e-book, ensure all of our images are adequately large, and consider the use of academic, rather than commercial e-book publishers.

Keywords: Academic promotion, E-book publishing, medical curriculum, medical educators, publishing scholarship

How to cite this article:
Cheung L. Advancing scholarship by publishing curriculum as an e-book. Educ Health 2018;31:130-3

How to cite this URL:
Cheung L. Advancing scholarship by publishing curriculum as an e-book. Educ Health [serial online] 2018 [cited 2022 Jan 21];31:130-3. Available from:

  Background Top

Medical educators design curricula for their students and develop educational materials to help students achieve those curricular objectives.[1] Medical educators are also expected to publish scholarly work to achieve advancement and promotion within their academic institution.[2],[3],[4] Unfortunately, they may receive inadequate time to accomplish both service and scholarship.[5] To streamline their efforts, medical educators can link their service activities with scholarly productivity.[6] To accomplish this, medical educators can submit their educational material to a website such as MedEdPORTAL®, an open-access journal which allows medical educators to publish their material. The target audience typically includes other medical educators who can use the resources to teach and integrate the material into their own curriculum.

However, other medical educators may wish to deliver their educational material directly to the learners, without relying on another educator to disseminate the material. They may also wish to reach a larger target audience through commercial advertising and promotion, services not typically provided by an academic site such as MedEdPORTAL®. Learners may prefer to use a concise, digital educational resource they can easily access in the clinical environment using a smartphone or tablet.

One way to achieve these goals is by publishing the educational material as an e-book using an online publisher. E-books are defined here as an electronic or digital copy of a printed book that can be read on a computer or handheld device. e-books, like printed medical textbooks, are generally not peer reviewed. However, they are becoming recognized as a form of academic scholarship by faculties of medicine.[7],[8] e-books are increasingly being used by medical students and residents as tools to enhance their learning.[9],[10],[11] Publishing educational material through an online publisher is quicker and less expensive than traditional publishing.[12] Relatively quick, inexpensive publishing is especially suited for material targeted to a focused audience – in this case, healthcare professionals instead of the general public.

This article shows medical educators how they can take their written educational material and publish it as an e-book. In doing so, they can efficiently transform work they have already done into scholarship, thus achieving the requirements for promotion and academic advancement. To illustrate this process, we will demonstrate the steps we took to adapt educational material we created for our medical residents' pulmonary rotation and publish it as an e-book using an online publisher.

Publishing the e-book

Four steps to publishing educational material

Publishing educational material as an e-book involves four main steps. First, educators must select material suitable for publication. This may include course work, a textbook, case-based scenarios, or samples of written examinations that they have already developed for their curriculum. Second, educators must carefully compare the features and services each publisher offers and choose the publisher that best meets their needs. Third, educators must adapt their educational material as a manuscript and submit it to the publisher. Fourth, after the manuscript has been eventually accepted, the publication must be advertised, promoted, and distributed.

Selecting educational material suitable for publication

We had previously conducted a needs analysis of the medical residents going through our pulmonary rotation. They wanted learning material that described a practical approach to diagnosing and managing pulmonary diseases and situations during their ward, consult, and clinic rotations. To meet this need, we spent several years writing and revising a pulmonary medicine textbook. This textbook, in portable document format (PDF), contained 23 chapters over 140 pages and covered topics that the internal medicine residents were likely to encounter in clinical practice. For example, it outlined the approach to a variety of pulmonary symptoms and clinical presentations such as hemoptysis or persistent lung infiltrates. It also reviewed practical topics such as the approach to chest tube or tracheostomy tube problems, oxygen delivery devices, and devices delivering inhaled medications. The e-book differed from other textbooks by using an algorithmic approach to the diagnosis and treatment of common pulmonary problems. By using flowcharts as a visual guide, and tables to compare and contrast different diseases, it helped residents think through the necessary steps to achieving a diagnosis and troubleshooting common problems. The feedback from the medical residents was overwhelmingly positive and they felt others outside of our residency program would also find the textbook useful. Based on this feedback, we felt this textbook would be suited for publication as an e-book.

Choosing an online publisher

After selecting material we felt suited for potential publication, we spent 2 weeks researching online publishers such as Lulu publishing, iUniverse, FastPencil, Outskirts Press, Smashwords, and CreateSpace. To compare publishers and select the one that best met our needs, we grouped their services and features into six categories. These categories included editing and writing assistance, publishing formats, distribution channels, book pricing and author royalties, advertising and promotional services, and overall cost of publication.

For example, many publishers offer a package of editing services and writing assistance to correct grammar, punctuation, spelling, and sentence structure, or help focus ideas and organize content. Manuscript revisions may be part of the editing package or may require additional cost. Graphic designers can create an attractive cover page and illustrate content, and some publishers have a library of stock photographs and pictures that authors can insert into their e-book. Publishers can obtain and register an International Standard Book Number (ISBN), necessary for the sale of print books and possibly needed for an e-book depending on how and where it is distributed.

e-books can be published in many different formats. PDF is accessible to everyone. Electronic publication format (EPUB) is usable by software readers such as Apple's iBooks, Barnes and Noble's nook, Adobe Digital Editions, and Google's Play Books. Reading the e-book using Amazon Kindle e-readers requires publishing in their proprietary AZW format. Publishing the e-book in multiple formats would allow us to reach a larger audience. Also, we aimed to have our book read on a computer screen, tablet, or smartphone.

Each publisher has one or more distribution channels to make publication available for its intended audience. Some publishers only list the e-book on their own website, whereas other publishers make the e-book available in multiple markets such as Amazon, iTunes, and Google Books. More distribution channels allow educators to reach a larger audience.

Although most educators will want to publish their work in the spirit of advancing scholarship, they may be interested to know how each publisher sets its book pricing and author royalties. Some publishers set the price themselves, whereas others let the author set the price. The percentage of royalties that the author receives will also vary between publishers. Taxes on e-book profits will vary based on the country of the publisher, and educators who choose a publisher outside of their own country must scrutinize the tax implications.

After the manuscript is published, educators need to advertise and promote their work to potential readers. Some publishers provide extensive advertising and promotion that includes making videos or websites to promote the e-book. Of course, the cost for extensive advertising and promotion can become quite expensive.

Last, educators must compare the costs of publication between publishers. While costs will vary depending on the services provided, they may also vary amongst publishers providing similar bundles of features. Educators must plan how they will pay for the cost of publication.

After comparing the services and features of various publishers, we selected an online publisher that offered to edit our manuscript, create a cover page using their extensive library of stock images, and obtain and register an ISBN for our e-book. To reach as broad an audience as possible, we chose a publisher that used PDF and EPUB formats and could distribute our e-book on their website, the iTunes Bookstore, Google Books, and Amazon. The publisher gave us complete control of the price. We set the price to zero as we wanted our medical residents and other learners to access the e-book without financial constraint. By doing this, we were able to secure full financial reimbursement for this academic work from our university. Because we offered the book for free, there were no royalties or tax concerns for us to consider. Our publisher helped us create a website to advertise the book.

Adapting the educational material as a manuscript and submitting it for publication

After selecting a publisher, we spent 3 weeks adapting our e-book for submission. We originally wrote the textbook for our own medical residents, but needed to modify it for an international audience. This meant removing mention of our local hospitals and replacing trade names for generic names of medications. We created all our own illustrations, either by drawing them freehand or by converting line drawings in Microsoft PowerPoint into images. If we had been unable to produce our own illustrations, the publisher would have provided us with an illustrator for hire. We also ensured that we created all other materials, including tables, graphs, and images. Our images were enlarged to fit on a small smartphone screen as well as a larger tablet or computer screen.

It took us approximately 2 weeks to format our manuscript so that our publisher could convert it into EPUB format. For example, we created our manuscript using Microsoft Word, eliminated unnecessary spacing, adopted the publisher's suggested preformed styles in Microsoft Word, and inserted appropriate paragraph breaks. Fortunately, our publisher had a formatting guide and checklist on their website which was easy to follow.

After submitting the first draft of the manuscript, we spent the next 6 weeks communicating with the publisher, revising the manuscript, and completing the legal paperwork (such as confirming that we created or owned all the images and that all our content was original).

Advertising, promoting, and distributing the e-book

Two weeks after our e-book was published, it was distributed on the publisher's website, the iTunes Bookstore, Google Books, Barnes and Noble, and Amazon. We advertised the book on a website we created for this purpose and promoted our e-book through our own medical education peers and network of residency program directors.

We offered our e-book for free and set the price of our e-book to zero. We wanted to ensure that medical residents and other interested learners could access it at no cost. Also, because we encouraged our own medical residents to download and read the book, we offered the book for free to avoid conflict of interest. With the publisher's help, we created a website to promote the book. We declined the publisher's offer to develop a video advertising the publication on YouTube as we deemed the cost for this service too high and unnecessary. Instead, we utilized our own network of contacts – a published e-mail list of residency program directors throughout the country – to advertise the publication.


We sent an anonymous survey questionnaire to our medical residents asking them to rate the usefulness of our e-book. On a scale of 1–4 (1 – “not useful,” 2 – “somewhat useful,” 3 – “useful,” and 4 – “very useful”), 15.2% rated the book as “useful” and 84.8% rated the book as “very useful,” with no one rating the book as “not useful” or “somewhat useful” out of 46 respondents. Respondents also had an opportunity to provide written feedback. Readers praised the e-book's utility (”a fantastic guidebook dealing with approaches to common pulmonary clinical problems”) and practicality (”it makes all the pathophysiology and clinical practice of pulmonary sciences so easy to grasp that you can read that first and then make sense of the more complicated manuscripts on the subject”). Respondents also liked the portability of the electronic format.

Lessons learned

The whole project – from selecting our educational material to distributing it as a publication – took about 3 months. Overall, the experience went smoothly. The representatives from the company helped us throughout the process.

There were several advantages to publishing the educational material as an e-book rather than with a peer-reviewed online repository. Online repositories generally require the material to be submitted in a restrictive format, complete with detailed learning objectives. The educational material is typically meant for other educators to distribute and teach. In contrast, going with an online publisher gave us the freedom to structure and organize the material the way we wanted and deliver this material directly to the learner. While an e-book is not considered a peer-reviewed publication, our university now recognizes disseminated, nonpeer-reviewed products and processes of scholarship including podcasts, book chapters, textbooks, webinars, and publically available online videos.

However, based on our experience, there are some things we would do differently for future publications. We knew that each of our own medical residents accessed the e-book. However, because our book was free, it was impossible to track how many people downloaded the e-book outside of our residency program. In the future, we would set a small, nominal price for the book. This would keep the book affordable and let us track the book's popularity. Although our e-book was initially listed on the Amazon website, it was eventually removed because some of the images were too small to view in their AZW format. It is vital to test the images beforehand to ensure they are easily viewed on large and small screens. The website developed by the publisher was not necessary and did not seem to significantly enhance awareness of the e-book. We simply included a link for the book ( in the e-mails we sent to own network of contacts. Finally, we only assessed the features of commercial online publishers. In the future, we would try an academic online publisher to better target our audience of learners.

  Conclusion Top

Publishing educational material they have already written is one way medical educators can produce scholarship needed for academic promotion. Publishing that educational material as an e-book is relatively expedient and makes the work easily accessible for medical learners. Adapting learning material, they have already created and publishing it maximizes the use of a medical educator's work performance.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

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