By Shawn Kennedy, MA, RN, AJN interim editor-in-chief
"fast movement"/jonasj, via Flickr
I read with interest, and also a little concern, a post on a newish blog called Nurse Story.com, which argued for faster Web-based publishing without peer review or much editing.
Yes, the open access model of scientific publishing, with full transparency for all aspects of the review and revision process, is worth watching. Yes, more and more publishing companies are going the online only or online mostly route (and while it’s PC to say it’s in pursuit of being green, I’d bet the primary reason is because it’s cheaper). And yes, it’s much faster to publish on the Internet. You can throw up an article or blog post and change content online by the minute. But is fast and quick all we need? Technology is changing nursing practice, but is it changing our knowledge base so quickly that we shouldn’t take time to weigh and sift the good from the bad?
I agree that not all content may need peer review (some opinion pieces, news, personal essays or artwork, profiles, to name a few)—but all content should at the very least be fact-checked. And if you care about accurate writing, it should be edited so that the meaning is clear. But how, without peer review and careful editing, do you ensure accuracy for research and clinical content that practitioners will use to guide practice? How do you ensure that the content is unbiased and that the person who is writing it has nothing to gain financially or otherwise? How do you know if the writer included all the data and not just the favorable data?
Peer review is by no means a guarantee of accuracy, but it’s another level of vigilance. Even with peer review, some bad research has slipped by (a case in point: the research linking vaccines and autism that was just retracted; see Scott Hensley’s article on the NPR health blog). Good peer reviewers are worth their weight in gold: they uncover the content that’s “off,” or point out significant studies that are missing from an author’s account of a clinical topic, or flag content plagiarized (whether consciously or unconsciously) from another colleague.
But reviewing takes time. Could the time be shorter? Yes, if that’s all the reviewer did. But most have full-time jobs immersed in their fields—which is why they’re valuable as reviewers. And reviewers are checks on editors—we can be biased, too.
I addressed this in a post last September: “many nurses and other health care professionals feel that they can get information free on the Internet and so don’t see a need to subscribe to a professional journal. With less income, journal publishers feel the need to scale back staff and resources. But someone is paying for the production of the content on the Internet—if it’s not a reputable organization or journal, who is it? Is it unbiased? Is it evidence-based, and who vetted the evidence and the authors? Let the readers—and their patients—be wary of what they read online and ask themselves just who paid for it, and why.”
Web sites and blogs are great places for timely content and many voices. We don’t peer-review our blog posts, but we do edit and fact-check them–just not as exhaustively as the clinical content in our print or online journal. We feel we owe it to our readers to make sure that what we publish, whether in print, online, or this blog or our Twitter or Facebook sites, is the truth.
Thank you for posting this very relevant and timely topic; especially with the increased awareness and public scrutiny related to evidence-based practice. We need to encourage our nursing colleagues to search, appreciate, evaluate peer-reviewed literature as well as vetting out sites not based on truth, fact or science; the true challenge is deciphering the many interent sources.
Kelly
Clinical Nurse Specialist
Shawn – Thank you for the interest, and link ping-back to my blog. I commented on your reply to my original post and want you to be assured that by no means am advocating that peer-review go away. In fact, moving the science forward in research through publication is critical to the science. However, I do believe the process is quite elongated at this point in time, perhaps due in part to not having technology so accessible in the past.
The internet is indeed full of un-researched, un-truths, and we need to help our patients weed through all of that and interpret what the evidenced says clearly for them. My only hope is that the publication world begins to help the science move forward at a more rapid pace and technology is our opportunity for that.
Further, there are some great nurse bloggers out there who are interpreting science and research, as well as hashing out new ideas through technology. Isn’t it wonderful, for example, that you and I have sparked a whole discussion here and have been able to interact through it! I love it :)!
Open access through blogging and journaling allows the collaboration between peers to happen in the open and maybe even opens the process up to many more, making it more accessible. What an exciting time to be a nurse.
Keep up the excellent work at AJN. Thank you!