PIC OT – “In users* with musculoskeletal problems, do e-Iearning videos, compared to instructor based
learning use in physiotherapy intervention, have a more beneficial effect?” *Users refer to the ones
who use the videos (it can be patients, students, healthcare providers
CITING AND REFERENCING IN ‘MODIFIED VANCOUVER STYLE’
European School of Physiotherapy, Hogeschool van Amsterdam, September 2009
A scientific text is based on sources in literature. At all relevant points in the text the author
states from whose work certain facts or views have been derived. This is accomplished by
giving citations, short notes in the main text referring to a list of references at the end. A
reference describes the source in such a way that the reader is able to retrieve it easily and to
globally judge its merits.
Citations and references are made up according to a certain style. The Physiotherapy
Department has decided to adopt a ‘modified Vancouver style’ from 1 september 2009 on.
This document describes the ‘how’ and ‘why’ of this style. We will start with the ‘how’.
Citations in the text consist of the author’s name (without initials) plus the publication year,
between brackets. If a publication is authored by two or more persons, only the first author is
mentioned, followed by the expression ‘et al.’ (abbreviation of Latin ‘et alii’ = and others). If
the author’s name is part of a sentence, only the year of publication is mentioned. Multiple
citations are put in chronological order.
The advantages of transponential anadiplosis have been propagated by Johanson and
colleagues (2001). However, several placebo-controlled studies failed to demonstrate
significant effects (Montana et al. 2004, Angloberto et al. 2006, Welten et al. 2007). On the
other hand, the design of these studies has been severely criticized (Laclaire 2008a) so any
conclusion seems to be premature.
In scientific books and articles one may find other modes of citing, but these are not accepted
by the ESP. So, do not use numbers between brackets, numbers in superscript, or footnotes.
The list of references is arranged alphabetically, according to the names of the first authors of
the listed publications. Sometimes a sub-arrangement is necessary; the box below shows how
to do that. The reference list should be all-encompassing; it is not allowed to make separate
lists of articles, books, and webpages.
Reference list: principles of organisation
Laclaire A ……. 2003
Laclaire HL ….. 1999
Laclaire HL …… 2008 (a)
Laclaire HL …… 2008 (b)
Laclaire HL, Blok KR ……. 2007
Laclaire HL, Pölle MP …….. 2005
CONSTRUCTION OF REFERENCES
The references are organized according to the Vancouver style, which is very simple and
unadorned. There are no words that have to be underlined, italicized, or printed in bold face,
and the number of punctuation marks (commas, abbreviation dots) is very modest.
A reference is best conceptualized as a paragraph consisting of 4–8 short sentences each
ending with a full stop. We will give a few examples of the most frequent sources.
Author(s). Last name plus Initial(s) without dots. Between authors’
names just a comma (don’t use ‘and’ or ‘&’).
Title(: subtitle). Only the first word of the title is capitalized. Subtitle
(Edition) Only in case of second or higher edition. Always
Place: Publisher; year. Publisher’s name as ‘bare’ as possible.W.F. Freeman
Company is stripped to Freeman, and Springer Verlag
(p. XX-XX.) Page numbers can be added to indicate the location of the
quote or quoted passage. State the first and the last page,
avoiding unnecessary digit repetitions: page 112-114 is
written as p. 112-4.
Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice.
3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 212-32.
Chapter in edited book
Author(s) of the chapter. See above
Title(: subtitle) of the chapter. See above
In: Name(s) of editor(s), editors.
Title of book . See above
(Edition.) See above
Place: Publisher; year. See above
p. XX-XX. See above
Dillingham TR, Braza DW. Upper limb amputations. In: Frontera WR, Silver JK, Rizzo Jr
TD. Essentials of physical medicine and rehabilitation: musculoskeletal disorders, pain, and
rehabilitation. 2nd ed. Philadelphia: Saunders Elsevier; 2008. p. 593-8.
Describe as if it were a book. After the title, add an ‘editorial note’ like [master thesis],
[paper], [PhD thesis], or [dissertation]. Instead of the publisher, state the name of the
academic institution, preceded by its place of settlement.
Duyvis F, Van den Ham KK, Smit HS. Obesity in couch potatoes: prevention and
intervention [bachelor thesis]. Amsterdam: Hogeschool van Amsterdam; 2006. p. 23.
Author(s). 6 at most; if more, use the expression ‘et al.’.
Title. Only first word is capitalized; subtitle after colon.
Name of journal. If possible in standard abbreviation, if not: the full name.
See website http://www.ncbi.nlm.nih.gov/sites/entrez .
‘Digit string’. Year;volume(issue):pages.
Kollen BJ, Lennon S, Lyons B, Wheatley-Smith L, Scheper M, Buurke JH, et al. The
effectiveness of the Bobath concept in stroke rehabilitation: what is the evidence? Stroke.
Website or webpage
Author. If no natural person can be identified as the author, state
the authority that is responsible for the text. If this is
unknown as well, the reference starts with the title of the
Title. The same as in paper sources, but followed by the
editorial note [online], [e-book], [webpage], or the like.
Place: Publisher; year [date indication]. The ‘place’ is the place of settlement of the
publisher, the publisher is the authority that runs the site.
Web information is often not dated. In that case one has
to give an estimation of the year, e.g. ‘c 2005’ (c = circa)
or ‘2004-2007’. Between [ ] one states the ‘last update’,
followed by the expression ‘cited’ plus the date of the
Web address. The complete address, preceded by the expression
‘available from’ and/or ‘URL:’.
Murdoch University Library. How to cite references – Vancouver style [online]. Perth:
Murdoch University; c 2005 [last update Feb. 2008; cited 2009 May 16]. URL:
The best source for the Vancouver style user. Examples plus explanations. Adequate cross
references facilitate navigation through the 16 pages. Regular updates. The responsible
institution is the library of a medium-sized Australian university, which is not the ultimate
authority but very conscientious in applying the ICMJE rules.
This website consists of 6 pages packed with examples of Vancouver-style references of
every conceivable type of source, including special cases like articles that are retracted after
being published. No elucidations are give, but most examples are self-explaining.
Here one finds titles, standard abbreviations and ISSN’s of the most important biomedical
journals. Click in the menu behind Search on ‘Journals’ and type in the window behind for
(fragments of) journal names or abbreviations. For instance: Physiotherapy, Rehabilitation or
Occupational resp. JAMA, Arch or Nederl.
EPILOGUE: WHY ‘VANCOUVER’? WHY ‘MODIFIED’?
The Vancouver reference style has been developed by the International Committee of Medical
Journal Editors and established in 1978 during a ICMJE congress in Vancouver, Canada. The
style is perfectly tailored to the needs of the primary user group: writers and editors of scientific articles in the biomedical domain. These articles often contain dozens of citations (among
which many multiple ones) and the references are both numerous and long, with many weird
names to spell. Knowing this, the features of the Vancouver style are readily understood:
1) Very economical, easy-to-write description of literature sources
2) Numerical citation system, and in accordance with this:
3) Numbered references, listed in order of appearance
From an educational perspective, the Vancouver system has two big advantages: its userfriendliness and the fact that it is widely used by journals and textbooks in the territory of
physiotherapy and related disciplines. But there are drawbacks as well. Particularly the
features 2) and 3) are problematic. The disadvantage for writers is the vulnerability of the
numerical citation system. Errors occur easily, especially when superscript is used, and are
hard to correct. This is even more so when a text is being prepared by a group of collaborating
students exchanging files. The disadvantage for readers (e.g. teachers, assessors, fellow
students) is that citations cannot be valued at a glance. Also, it is difficult to check if certain
authors have been consulted when the list of references is non-alphabetical.
These considerations have led the Physiotherapy Department to adopt a modified Vancouver
system. The individual references are styled according to ‘Vancouver’, but they are listed in
alphabetical order (non-Vancouver) and for the citations the name-year-system is employed
(also non-Vancouver). This eclectic practice is absolutely not uncommon; indeed, many
reputed publishers in different countries do exactly the same. The purpose is similar: to get
‘the best of two worlds’.
Written by J.J. Bakker MSc, on behalf of the Physiotherapy Department of the ASHP