Sentence Structure in English Nursing Essay Writing

Sentence Structure in English Nursing Essay Writing Basics

Sentence structure refers to the physical nature of a sentence and how the elements of that sentence are presented. Just like word choice, writers should strive to vary their sentence structure to create rhythmic prose and keep their reader interested. Sentences that require a variation often repeat subjects, lengths, or types.

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Related information about varying sentence structures listed below can be found through later in this Sentence Structure in English Nursing Essay Writing post:

Sentence Structure and Types of Sentences
Run-On Sentences and Sentence Fragments
Parallel Construction
Relative, Restrictive, and Nonrestrictive Clauses
Conjunctions
Modifiers
Commas
Semicolons

Read more on the above 8 topics herebelow.

Varying Subject or Word Choice

One of the easiest ways to spot text that requires variety is by noting how each sentence opens. Writers can often overuse the same word, like an author’s name, or a subject, like pronouns to refer to an author, when beginning sentences. This lack of subject variety can be distracting to a reader. Review the following paragraph’s sentence variety:

My philosophy of education is derived from my personal experiences. I have been an educator for 4 years, and I have learned a lot from more experienced teachers in my district. I also work mainly with students from a low socioeconomic background; my background was quite different. I will discuss how all of these elements, along with scholarly texts, have impacted my educational philosophy. Sentence Structure in English Nursing Essay Writing.

Notice how the writer of this paragraph starts each sentence and clause with a personal pronoun. While the writer does alternate between “I” and “my”, both pronouns refer to the same subject. This repetition of personal pronouns is most common when writing a Personal Development Plan (PDP) or other personal papers. To avoid this type of repetition, try adjusting the placement of prepositional phrases or dependent clauses so the subject does not open each sentence:

My philosophy of education is derived from my personal experiences. Having been an educator for 4 years, I have learned a lot from more experienced teachers in my district. I also work mainly with students from a low socioeconomic background that is quite different from mine. In this paper, I will discuss how all of these elements, along with scholarly texts, have impacted my educational philosophy.

Varying Sentence Length

Another way to spot needed sentence variety is through the length of each sentence. Repeating longer sentences can inundate a reader and overshadow arguments, while frequently relying on shorter sentences can make an argument feel rushed or stunted. Sentence Structure in English Nursing Essay Writing.

Overusing Long Sentences

The company reported that yearly profit growth, which had steadily increased by more than 7% since 1989, had stabilized in 2009 with a 0% comp, and in 2010, the year they launched the OWN project, actually decreased from the previous year by 2%. This announcement stunned Wall Street analysts, but with the overall decrease in similar company profit growth worldwide, as reported by Author (Year) in his article detailing the company’s history, the company’s announcement aligns with industry trends and future industry predictions. Sentence Structure in English Nursing Essay Writing.

Notice how this paragraph is comprised of just two sentences. While each clause does provide relevant information, the reader may have difficulty identifying the subject and purpose of the whole paragraph.

Overusing Short Sentences

In 2010, the company’s yearly profit growth decreased from the previous year by 2%. This was the year they launched the OWN project. The profit growth had steadily increased by more than 7% since 1989. (They stabilized in 2009.) This announcement stunned Wall Street analysts. However, it aligns with the decrease in similar company profit growth worldwide. It also supports future predictions for the industry (Author, Year).

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Notice how this paragraph uses the same information as the previous one but breaks it into seven sentences. While the information is more digestible through these shorter sentences, the reader may not know what information is the most pertinent to the paragraph’s purpose. Sentence Structure in English Nursing Essay Writing.

Alternating Sentence Length

Alternating between lengths allows writers to use sentences strategically, emphasizing important points through short sentences and telling stories with longer ones:

The company reported that profit growth stabilized in 2009, though it had steadily increased by more than 7% since 1989. In 2010, the year they launch the OWN project, company profit growth decreased from the previous year. This announcement stunned Wall Street analysts. According to Author (Year), however, this decrease is exemplar of a trend across similar company profit growth worldwide; it also supports future predictions for the industry.

Varying Sentence Type

One of the trickiest patterns to spot is that of repetitive sentence type. Just like subject and length, overusing a sentence type can hinder a reader’s engagement with a text. There are four types of sentences: simple, compound, complex, and compound-complex. Each sentence is defined by the use of independent and dependent clauses, conjunctions, and subordinators.

Simple sentences: A simple sentence is an independent clause with no conjunction or dependent clause.
Compound sentences: A compound sentence is two independent clauses joined by a conjunction (e.g., and, but, or, for, nor, yet, so). Sentence Structure in English Nursing Essay Writing.
Complex sentences: A complex sentence contains one independent clause and at least one dependent clause. The clauses in a complex sentence are combined with conjunctions and subordinators, terms that help the dependent clauses relate to the independent clause. Subordinators can refer to the subject (who, which), the sequence/time (since, while), or the causal elements (because, if) of the independent clause.
Compound-complex sentences: A compound-complex sentence contains multiple independent clauses and at least one dependent clause. These sentences will contain both conjunctions and subordinators.

Understanding sentence type will help writers note areas that should be varied through the use of clauses, conjunctions, and subordinators.

In her article, Author (Year) noted that the participants did not see a change in symptoms after the treatment. Even during the treatment, Author observed no change in the statements from the participants regarding their symptoms. Based on these findings, I will not use this article for my final project. Because my project will rely on articles that note symptom improvement, Author’s work is not applicable.

Notice how the writer relies solely on complex sentences in this paragraph, even placing dependent clauses at the beginning of each sentence. Here is an example of merely adjusting the placement of these dependent clauses but not the sentence type:

In her article, Author (Year) noted that the participants did not see a change in symptoms after the treatment. Author observed, even during treatment, no change in the statements from the participants regarding their symptoms. I will not use this article for my final project based on these findings. Because my project will rely on articles that note symptom improvement, Author’s work is not applicable. Sentence Structure in English Nursing Essay Writing.

While this change in the placement of dependent clauses does avoid a repetitive rhythm to the paragraph, try combining sentences or using conjunctions to create compound or compound-complex sentences to vary sentence type:

In her article, Author (Year) noted that the participants did not see a change in symptoms after the treatment. Author observed, even during treatment, no change in the statements from the participants regarding their symptoms, and based on these findings, I will not use this article for my final project. Because my project will rely on articles that note symptom improvement, Author’s work is not applicable.

Making these slight adjustments to sentence type helps the reader engage with the narrative rather than focus on the structure of the text. Adjusting your sentence type during a final revision is a great way to create effective prose for any scholarly document. Sentence Structure in English Nursing Essay Writing.

1. Sentence Structure and Types of Sentences

Definitions and Examples of Basic Sentence Elements

Key: Yellow, bold = subject; green underline = verb, blue, italics = object, pink, regular font = prepositional phrase

Independent clause: An independent clause can stand alone as a sentence. It contains a subject and a verb and is a complete idea.

I like spaghetti.
He readsmany books.

Dependent clause: A dependent clause is not a complete sentence. It must be attached to an independent clause to become complete. This is also known as a subordinate clause.

Although I like spaghetti,…
Because he reads many books,…

Subject: A person, animal, place, thing, or concept that does an action. Determine the subject in a sentence by asking the question “Who or what?”

I like spaghetti.
He reads many books.

Verb: Expresses what the person, animal, place, thing, or concept does. Determine the verb in a sentence by asking the question “What was the action or what happened?” Sentence Structure in English Nursing Essay Writing.

Ilike spaghetti.
Hereads many books.
The movieisgood. (The be verb is also sometimes referred to as a copula or a linking verb. It links the subject, in this case the movie, to the complement or the predicate of the sentence, in this case, good.) Sentence Structure in English Nursing Essay Writing.

Object: A person, animal, place, thing, or concept that receives the action. Determine the object in a sentence by asking the question “The subject did what?” or “To whom?/For whom?”

I like spaghetti.
He reads many books.

Prepositional Phrase: A phrase that begins with a preposition (i.e., in, at for, behind, until, after, of, during) and modifies a word in the sentence. A prepositional phrase answers one of many questions. Here are a few examples: “Where? When? In what way?”

I like spaghetti for dinner.
He reads many books in the library.

English Sentence Structure

The following statements are true about sentences in English:

A new sentence begins with a capital letter.
- He obtained his degree.

A sentence ends with punctuation (a period, a question mark, or an exclamation point).
- He obtained his degree.

A sentence contains a subject that is only given once.
- ~~Smith~~ he obtained his degree.
- Sentence Structure in English Nursing Essay Writing.

A sentence contains a verb or a verb phrase.
- He obtained his degree.

A sentence follows Subject + Verb + Object word order.
- He (subject) obtained (verb) his degree (object).

A sentence must have a complete idea that stands alone. This is also called an independent clause.
- He obtained his degree.

Simple Sentences

A simple sentence contains a subject and a verb, and it may also have an object and modifiers. However, it contains only one independent clause.

Key: Yellow, bold= subject; green underline = verb, blue, italics = object, pink, regular font =prepositional phrase

Here are a few examples:

Sheread.
Shecompleted her literature review.
He organized his sources by theme.
They studied APA rules for many hours.

Compound Sentences

A compound sentence contains at least two independent clauses. These two independent clauses can be combined with a comma and a coordinating conjunction or with a semicolon.

Key: independent clause = yellow, bold; comma or semicolon = pink, regular font; coordinating conjunction = green, underlined

Here are a few examples:

She completed her literature review, andshe created her reference list.
He organized his sources by theme;then, he updated his reference list.
They studied APA rules for many hours, butthey realized there was still much to learn.

Using some compound sentences in writing allows for more sentence variety.

Complex Sentences

A complex sentence contains at least one independent clause and at least one dependent clause. Dependent clauses can refer to the subject (who, which) the sequence/time (since, while), or the causal elements (because, if) of the independent clause.

If a sentence begins with a dependent clause, note the comma after this clause. If, on the other hand, the sentence begins with an independent clause, there is not a comma separating the two clauses.

Key: independent clause = yellow, bold; comma = pink, regular font; dependent clause = blue, italics

Here are a few examples:

Although she completed her literature review,she still needed to work on her methods section.
- Note the comma in this sentence because it begins with a dependent clause.

Because he organized his sources by theme,it was easier for his readers to follow.
- Note the comma in this sentence because it begins with a dependent clause.

They studied APA rules for many hours as they were so interesting.
- Note that there is no comma in this sentence because it begins with an independent clause.

Using some complex sentences in writing allows for more sentence variety.

Compound-Complex Sentences

Sentence types can also be combined. A compound-complex sentence contains at least two independent clauses and at least one dependent clause.

Key: independent clause = yellow, bold; comma or semicolon = pink, regular font; coordinating conjunction = green, underlined; dependent clause = blue, italics

She completed her literature review,but she still needs to work on her methods section even though she finished her methods course last semester.
Although he organized his sources by theme,he decided to arrange them chronologically, andhe carefully followed the MEAL plan for organization.
With pizza and soda at hand,they studied APA rules for many hours,andthey decided that writing in APA made sensebecause it was clear, concise, and objective.

Using some complex-compound sentences in writing allows for more sentence variety.
Pay close attention to comma usage in complex-compound sentences so that the reader is easily able to follow the intended meaning.

2. Run-On Sentences and Sentence Fragments

Run-On Sentences

A run-on sentence occurs when two or more independent clauses (also known as complete sentences) are connected improperly. Sentence Structure in English Nursing Essay Writing.

Example: I love to write papers. I would write one every day if I had the time.

There are two complete sentences in the above example:

Sentence 1: I love to write papers.

Sentence 2: I would write one every day if I had the time.

One common type of run-on sentence is a comma splice. A comma splice occurs when two independent clauses are joined with just a comma.

Example of a comma splice: Participants could leave the study at any time, they needed to indicate their preference.

Sentence 1: Participants could leave the study at any time.

Sentence 2: They needed to indicate their preference.

Some comma splices occur when a writer attempts to use a transitional expression in the middle of a sentence.

Example of a comma splice: The results of the study were inconclusive, therefore more research needs to be done on the topic.

Sentence 1: The results of the study were inconclusive

Transitional expression (conjunctive adverb): therefore

Sentence 2: More research needs to be done on the topic

To fix this type of comma splice, use a semicolon before the transitional expression and add a comma after it. See more examples of this on the semicolon page.

Revision: The results of the study were inconclusive; therefore, more research needs to be done on the topic.

You can correct a run-on sentence by connecting or separating its parts correctly. There are several easy ways to connect independent clauses. Sentence Structure in English Nursing Essay Writing.

Correcting Run-On Sentences

A run-on sentence can be fixed by connecting its parts correctly. There are several ways to connect independent clauses.

Use a period. The easiest way to fix a run-on is to split the sentence into smaller sentences using a period. This revision works especially well with longer sentences. Check, however, to make sure that this solution does not result in short, choppy sentences.

Revision example: I love to write papers. I would write one every day if I had the time.
Use a semicolon. Inserting a semicolon between independent clauses creates a grammatically correct sentence. Using a semicolon is a stylistic choice that establishes a close relationship between the two sentences.

Revision example: I love to write papers; I would write one every day if I had the time.
Use a comma and a coordinating conjunction. A comma, paired with a coordinating conjunction (such as and, but, or or), corrects a run-on sentence. This method emphasizes the relationship between the two clauses.

Revision example: I love to write papers, and I would write one every day if I had the time.
Use a subordinating conjunction. Turn one of the independent clauses into a dependent clause. A subordinating conjunction (such as because, unless, and although) connects two clauses to create a complex sentence. This option works to cement the relationship between the two parts of the sentence and may improve the flow of the clauses.

Example: Because I love to write papers, I would write one every day if I had the time.

However you decide to revise for run-on sentences, remember that maintaining sentence variety helps to keep the writing clear and interesting for your readers.

Sentence Fragments

A sentence fragment is a string of words that does not form a complete sentence; there is a necessary component of a complete sentence missing. This missing component may be a subject (usually a noun) or a predicate (verb or verb phrase) and/or when the sentence does not express a complete idea. Sentence Structure in English Nursing Essay Writing.

Here is an example of a fragment with a missing subject.

Example of a fragment: Shows no improvement in any of the vital signs.

The sentence above is a fragment since there is no subject (Who shows no improvement?). Fragments can be corrected by identifying the missing element and including it.

Revision: The patient shows no improvement in any of the vital signs.

Here is an example of a fragment with a missing predicate, or action:

Example of a fragment: The doctors, who were using peer-reviewed research articles that contributed to the body of knowledge in their fields, which was obstetrics.

Notice here that although the sentence is quite long, it still contains no action (What are the doctors doing?). Once identified, the sentence can be corrected easily.

Revision: The doctors, who were using peer-reviewed research articles that contributed to the body of knowledge in their field, improved their knowledge of obstetrics.

3. Parallel Construction

Parallel Construction Basics

Parallel ideas must be presented in parallel grammatical form. Parallel grammatical form means that each part of a sentence uses the same grammatical structure.

Examples of Parallel Construction

Between and And

Incorrect: We debated the difference between the weather in Minnesota in the winter and how hot it is in the summer.

Correct: We debated the difference between the weather in Minnesota in the winter and the weather in Minnesota in the summer.

Both and And

Incorrect: The films were enjoyable to watch and discuss.

Correct: The films were enjoyable to watch and to discuss.

Neither and Nor; Either and Or

Incorrect: Neither the responses to the questionnaire nor what we asked on the survey were answered.

Correct: Neither the responses to the questionnaire nor the responses to the survey were answered.

Not Only and But Also

Incorrect: It was surprising not only that the house sold, but also it sold well over the asking price.

Correct: It was surprising not only that the house sold but also that it sold well over the asking price. Sentence Structure in English Nursing Essay Writing.

Parallel Construction in a Series

Sentences with series, or lists, require particular attention to parallel construction.

Example 1:

Incorrect: This paper will address No Child Left Behind, how to teach effectively, and instructing with multimedia aids.

Correct: This paper will address No Child Left Behind benchmarks, effective teaching strategies, and multimedia instructional aids.

Now, the series has parallel elements (benchmarks, strategies, and aids are all plural nouns).

Example 2:

Incorrect: The students were unprepared, poorly behaved, and disrupted the class.

Correct: The students were underprepared, poorly behaved, and disruptive.

Now, the series has parallel elements (underprepared, behaved, and disruptive are all adjectives).

4. Relative, Restrictive, and Nonrestrictive Clauses

Relative Clauses and Relative Pronouns

Relative Clause

This is a clause that generally modifies a noun or a noun phrase and is often introduced by a relative pronoun (which, that, who, whom, whose). A relative clause connects ideas by using pronouns that relate to something previously mentioned and allows the writer to combine two independent clauses into one sentence. A relative clause is also known as an adjective clause. There are two types of relative clauses: restrictive and nonrestrictive.

Here are a few examples:

The book that she read was important for her literature review. (restrictive)
The participants who were interviewed volunteered to be part of the study. (restrictive)
Walden University, which is entirely online, has main administrative offices in Baltimore and Minneapolis. (nonrestrictive)

Relative Pronouns

	Referring to a human	Referring to something other than a human	Possessive
Restrictive	who, whom, that*	which, that**	whose
Nonrestrictive (with commas)	who, whom	which	whose

*In APA, per Section 3.22, use who or whom instead of that when referring to a human.

**Although both which and that are grammatically correct in restrictive clauses, APA prefers that for restrictive clauses. See APA Section 3.22 for more information on this. Sentence Structure in English Nursing Essay Writing.

Use relative clauses to create more sentence variety.

Restrictive Clauses

Restrictive Clause

A restrictive clause restricts or defines the meaning of a noun or noun phrase and provides necessary information about the noun in the sentence. It is not separated from the rest of the sentence by commas. Restrictive clauses are more common in writing than nonrestrictive clauses. A restrictive clause is also sometimes referred to as an essential clause or phrase. Sentence Structure in English Nursing Essay Writing.

Here are a few examples:

The student who sits in the back of the room asks a lot of questions.
The results that I obtained may invoke positive social change.
The journalist whose story I read yesterday has won prizes for her work.

When the relative pronoun functions as the object of the sentence, it can (and usually is) omitted from the relative clause. Sentence Structure in English Nursing Essay Writing.

Here are a few examples:

The results ~~that~~ I obtained may invoke positive social change.
The article ~~that~~ I requested did not arrive on time.
The participants ~~who~~ I interviewed met me at the local library.

Nonrestrictive Clauses

Nonrestrictive Clause

A nonrestrictive clause adds additional information to a sentence. It is usually a proper noun or a common noun that refers to a unique person, thing, or event. It uses commas to show that the information is additional. The commas almost act like parentheses within the sentence. If the information between the commas is omitted, readers will still understand the overall meaning of the sentence. A nonrestrictive clause is also known as a nonessential clause or phrase. Sentence Structure in English Nursing Essay Writing.

Here are a few examples:

I want to thank my father, Mark Smith, for all of his love and support.
- With the nonrestrictive clause omitted: I want to thank my father for all of his love and support.
The hypothesis, which I tested throughout the research, was rejected. Sentence Structure in English Nursing Essay Writing.
- With the nonrestrictive clause omitted: The hypothesis was rejected.
I have found the article, which I have been looking for.
- With the nonrestrictive clause omitted: I have found the article.

While that is sometimes used in restrictive clauses, it is not allowed in nonrestrictive clauses.

CORRECT: Minneapolis, which has a population of about 400,000, is the largest city in Minnesota.
INCORRECT: Minneapolis, that has a population of about 400,000, is the largest city in Minnesota.
CORRECT: I had to fix my printer, which I bought less than a year ago.
INCORRECT: I had to fix my printer, that I bought less than a year ago.

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A relative pronoun cannot be deleted in a nonrestrictive clause.

CORRECT: Minneapolis, which has a population of about 400,000, is the largest city in Minnesota.
INCORRECT: Minneapolis, has a population of about 400,000, is the largest city in Minnesota. Sentence Structure in English Nursing Essay Writing.
CORRECT: I had to fix my printer, which I bought less than a year ago.
INCORRECT: I had to fix my printer, I bought less than a year ago.

Reduced Relative Clauses

In academic writing, relative clauses are often reduced for a more concise style. This also creates more sentence variety. When reducing a relative clause, it is necessary to delete the relative pronoun and either delete or change the verb. Here are some examples:

Gun control is a controversial issue ~~that is~~ about personal rights. (be + prepositional phrase)
The steps ~~that were~~followed were explained in the Methods section. (passive)
Other researchers ~~who are~~ exploring the same topic have discovered similar solutions. (progressive verb tense) Sentence Structure in English Nursing Essay Writing.
Participants ~~who were~~ available to meet in my office completed their interview there. (be + able adjective)
Some of the subjects lived in urban areas ~~that had~~ with high crime rates. (have as a main verb is replaced by with)
In this paper, I reviewed many research articles ~~that addressed~~ addressing the topic of gun control. (linking verbs or verbs describing facts can be changed to –ing clauses)
The changes ~~that are~~to be implemented with the new curriculum revisions are outlined in the handout. (toclauses)

5. Conjunctions

Basics of Conjunctions

Conjunctions are parts of speech that connect words, phrases, clauses, or sentences. There are three kinds of conjunctions: coordinating, paired, and subordinating.

For more information about conjunctions, also see Compound Sentences, Varying Sentence Structure, and Comma Basics. Sentence Structure in English Nursing Essay Writing.

Coordinating Conjunctions

Coordinating conjunctions connect words or phrases that serve the same grammatical purpose in a sentence. There are seven main coordinating conjunctions in English, which form the acronym FANBOYS:

F: for: The teachers were frustrated, for the school had cut funding for all enrichment programs.*
A: and: In this course, I will write a literature review, a case study, and a final paper.**
N: nor: The students did not complete their homework, nor did they pass the test.
B: but: The study is several years old but still valuable to this study.
O: or: At the end of the class, the students can choose to write an essay or take a test.
Y: yet: The patient complained of chronic pain, yet she refused treatment.
S: so: I have only been a nurse for one year, so I have little experience with paper charting.

* For is rarely used as a conjunction in modern English.
** When the conjunctions and and or connect three or more words or phrases, use a serial comma to separate items in the series.

Transitional words such as however and therefore can also function as conjunctions:

The authors agreed on the prevalence of the problem; however, they disagreed on the problem’s cause.
Several employees complained about the new policies, and therefore, the manager held an all-staff meeting to address their concerns. Sentence Structure in English Nursing Essay Writing.

Paired Conjunctions

Paired conjunctions consist of two words or phrases that help make a point or establish alternatives. While paired conjunctions can be helpful in structuring a sentence, they can also make sentences wordier than necessary, so use these conjunctions sparingly.

both…and
- The project will require significant investments of both time and money.
- Both the students and the teachers were satisfied with the pilot program.
- Note: When two subjects are connected by both…and, use a plural verb (such as are or were).
not only…but also
- Students who did not complete the assignment received not only a poor grade but also a warning from the teacher.
- Not only did the student include full sentences from the source without using quotation marks, but he also failed to properly cite paraphrased material.
either…or
- Either the students were unprepared or the assessment was poorly written.
- Participants in the survey could either choose from a list of possible answers or write in their own responses.
neither…nor
- Students who did not complete the project received neither praise nor rewards.
- The staff neither followed the new policy nor asked for clarification.

Subordinating Conjunctions

Subordinating conjunctions join a subordinate clause to a main clause and establishes a relationship between the two. There are many subordinating clauses, but here are some of the most common:

after
although
as much as/as soon as/as long as
as though
because
before
how
if
in order to/in order that
once
since
than
that
though
unless
until
when/whenever
where/wherever
whether
while

There are two ways to structure a sentence using a subordinating conjunction:

Main clause + subordinate clause
- The teacher administered the test after giving instructions.
- The author must avoid bias if she wants to maintain a scholarly tone.
- I will turn in this assignment at midnight whether or not I complete it.
Subordinate clause + , + main clause
- After giving instructions, the teacher administered the test.
- Sentence Structure in English Nursing Essay Writing
- If she wants to maintain a scholarly tone, the author must avoid bias.
- Whether or not I complete this assignment, I will turn it in at midnight.

That as a Conjunction for Noun Clauses

That has a few different functions in English. This can lead to confusion because some instances of that are more optional than others in academic writing.

One important use of that is for embedding (inserting) a certain type of dependent clause called a noun clause into an independent clause. Frequently, such that-clauses serve as the direct object of a reporting verb (such as found, reported, posited, argued, claimed, maintained, and hypothesized) to introduce a paraphrase, summary, or quotation. Sentence Structure in English Nursing Essay Writing.

Key: Yellow, bold = subject; green, underline = verb; blue, italics = object

For example,

Smith (2015) reported that more research was necessary.
- Smith (2015) = subject
- reported = verb
- that more research was necessary = dependent clause, direct object of the verb reported
The authors hypothesized that there would be significant results.
- The authors = subject
- hypothesized = verb
- that there would be significant results = dependent clause, direct object of the verb hypothesized
Jones (2014) asserted that confidentiality was maintained throughout the study.
- Jones (2014) = subject
- asserted = verb
- that confidentiality was maintained throughout the study = dependent clause, direct object of the verb asserted
Rephrasing these sentences into questions and answers is one way to see that the that-clauses are acting as direct objects.
- What did Smith (2015) report?
  - Answer: that more research was necessary
- What did the authors hypothesize?
  - Answer: that there would be significant results
- What did Jones (2014) assert?
  - Answer: that confidentiality was maintained throughout the study

In formal written English, for clarity, most academic writers choose to keep that when it introduces a noun clause (Caplan, 2012). Leaving out that can cause the reader to misread (at first anyway) the subject of the dependent clause as being the object of the reporting verb (Jamieson, 2012).

For example, if readers see the sentence, Smith (2015) reported more research was necessary (without that), they may understand “more research” as the thing Smith reported and then have to backtrack and reread upon seeing “was necessary.” Sentence Structure in English Nursing Essay Writing.
Any structure that leads to misinterpretation, even temporarily, can be an unwanted distraction from the writer’s message.
In spoken English, however, that may be dropped in such sentences. (Intonation patterns—rising and falling pitch—give the listener clues that may not be present in writing.)

Reference

Caplan, N. (2012). Grammar choices for graduate and professional writers. Ann Arbor, MI: University of Michigan Press. Sentence Structure in English Nursing Essay Writing.

6. Modifiers

Modifier Basics

A modifier is a word, phrase, or clause that modifies—that is, gives information about—another word in the same sentence. For example, in the following sentence, the word burger is modified by the word vegetarian:

Example: I’m going to the Saturn Café for a vegetarian burger.

The modifier vegetarian gives extra information about what kind of burger it is.

A modifier can be an adjective (a word that modifies a noun, like burger), but it can also be an adverb (a word that modifies a verb):

Example: The student carefully proofread her draft.

The adverb carefully is the modifier in this example—it modifies the verb proofread, giving important details about how the proofreading was conducted.

A modifier can even be a phrase or clause, as in the following example:

Example: She studied in the library.

Here, the phrase in the library gives us extra information about the verb, studied.

Modifiers can also be used for sentence variety. See this page on varying sentence structure for more information.

Misplaced Modifiers

When a modifier is ambiguously or illogically modifying a word, we consider it a misplaced modifier. See APA 3.21 for more explanation and examples.

Example: Dolger discovered an ancient Mayan civilization using astronavigation.

The modifier, using astronavigation, is unclear in this sentence. Does it modify Dolger or civilization? A reader will wonder, “Was Dolger using astronavigation? Or was the civilization he discovered using astronavigation?”

Revision 1: Using astronavigation, Dolger discovered an ancient Mayan civilization.

This modifier placement makes it clear that Dolger is the one using astronavigation.

Revision 2: Dolger discovered an ancient Mayan civilization that used astronavigation.

This modifier placement makes it clear that the civilization used astronavigation.

Dangling Modifiers

When a modifier is not modifying a specific word, we call it a dangling modifier. See APA 3.21 for more explanation and examples.

Example: After consulting a selection of current publications, research in this area has been sparse.

In this example, it is not clear who is consulting the selection of current publications. In other words, there is no referent in the sentence.

Revision 1: After consulting a selection of current publications, I determined that the research in this area has been sparse. Sentence Structure in English Nursing Essay Writing.

Now the subject in the sentence “I” matches the modifier “after consulting a selection of current publications.”

Revision 2: According to the selection of current publications, research in this area has been sparse.

Now the modifier “according to the selection of current publications” matches the subject “research.”

7. Commas

Comma Basics

Commas are punctuation marks with a variety of uses. The following constructions require commas:

Serialized lists. In a list with three or more elements, use commas to separate all of the elements of the series.

Example: This KAM consists of Breadth, Depth, and Application.

This punctuation rule is also followed for parallel construction in a series.
Nonessential clauses. Use commas to set off clauses that contain information that is nonessential to the sentence’s meaning.

Example: Walden University, established in 1970, offers many degree programs.

Note that without the middle clause (established in 1970), the sentence still makes sense (Walden University offers many degree programs). Therefore, the clause is nonessential. For more information, view the page on relative, restrictive, and nonrestrictive clauses.
Compound sentences. Use a comma to separate two independent clauses connected by a coordinating conjunction. A coordinating conjunction is a connecting word such as and, but, or or. For more information, view the page on sentence structure and types of sentences. Sentence Structure in English Nursing Essay Writing.

Example: Smith (2001) conducted the research, and Heller (2008) commented on the results.
After a dependent introductory clause, phrase, or word. Use a comma after a dependent introductory clause, phrase, or word.

Example of introductory clause: If you are using this sentence structure, place a comma after the dependent clause.

Example of introductory phrase: Before completing the interviews, I must obtain Walden University approval.

Example of introductory word: Therefore, I created three research questions.

Example of introductory word: However, further research is needed.
Dates. Use a comma to set off the year in exact dates.

Example: The hospital’s pursuit of Magnet status was successful (R. Jones, personal communication, September 18, 2009).
Citations. Use commas to set off the elements of a citation.

Example: The research was “inconclusive in its implications” (Sanders, 2009, p. 45).
Introducing quotations (not seamless). Use a comma when an independent clause introduces a quotation but is not seamlessly integrated into it.

Example: Freud (1900) claimed, “the dreamer…assumes that the dream–even if it does not come from another world–has at all events transported the dreamer into another world” (p. 5).

Visit varying sentence structures for more information on comma usage.
In addition, refer to APA Section 4.03 for more about commas. Sentence Structure in English Nursing Essay Writing.

Common Comma Errors

The following constructions do not require commas:

Months. Do not use a comma when referring to a month within a particular year.

Example: I conducted the study in June 2003.
Complex sentences. Do not use a comma in a sentence that joins an independent clause and a dependent clause with a conjunction (and, or, but).

Example: Smith (2001) found that results were consistent but also suggested further investigation.
Introducing quotations (seamless). Do not use a comma when an independent clause seamlessly introduces a quotation.

Example: Freud (1900) claimed that “the dreamer…assumes that the dream–even if it does not come from another world–has at all events transported the dreamer into another world” (p. 5).
Comma splices. A comma splice occurs when two independent clauses (complete sentences) are separated by just a comma.

Example: Jessica and I went to the movies, we had a good time.

There are many ways to correct the sentence above. Review the information on run-on sentences for examples of correctly joining independent clauses.

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8. Semicolons

Semicolon Basics

Semicolons are punctuation marks used to separate parts of sentences. Use a semicolon in the following instances.

Two independent clauses. Use a semicolon when separating two independent clauses that are not joined by a conjunction. Sentence Structure in English Nursing Essay Writing.

Example: Jones (2014) argued that intelligence was fixed; Smith (2011) argued that ability could be fluid.
To join two independent clauses with a conjunctive adverb (such as however, therefore, consequently, nevertheless, furthermore, moreover). Note that there is a semicolon before the conjunctive adverb and a comma after it.

Example: This structure joins two independent clauses; moreover, it creates cohesion in the text by showing how one idea relates to another.

Example: I had difficulty obtaining a large number of participants; however, I still reached saturation in the interviews. Sentence Structure in English Nursing Essay Writing.
Series. Use a semicolon to separate elements in a series that already contains commas.

Example: Amy ordered three pizzas: one with pepperoni, sausage, mushroom; one with bacon, ham, and green peppers; and one with tomatoes, olives, and red peppers.

Example: Many have claimed that the sky is blue (Hawking, Goldberg, & Rita, 1994; Lima, 2003; Steinberg & Jordan, 2001).

For more information about semicolons, read on the following:

Sentence Structures and Types of Sentences
Run-Ons and Sentence Fragments
Varying Sentence Structures

In addition, refer to APA section 4.04 for more information about semicolon usage and Sentence Structure in English Nursing Essay Writing.