My article was rejected by the journal I edit: peer review is alive and well at the CMEJ. I am writing this editorial about peer review propelled in large part because a paper I wrote with a team of colleagues not connected with the journal was carefully reviewed, thoughtfully considered, and then declined by the associate editor. This is a testament not just to the robust and rigorous peer review process valued and followed at the CMEJ but to the people that make the journal work, the people who make the processes and policies function properly. While this decision stung (just as we acknowledge in our communication to authors that every decline decision is disappointing), I want to praise the people and the processes, the heart of our peer review, for skillfully declining to publish my paper as submitted.1,2Arguably, peer review is at the heart of what makes an academic journal credible, if not great. This is not to claim that we are unique or better than our sister journals but only to state that we must be doing something right at least some of the time, which it seems, is the best that can be said of peer review in general.As with all decision-making processes there are inevitable errors even in careful peer review. It seems that academic peer review is no different or maybe a bit worse than other similar processes. We reject papers that will eventually (when published somewhere else) contribute to the literature and help move our knowledge of the field along, sometimes in dramatic ways. These are false negatives. We reject papers when we should not have rejected them. Others are accepted and published in our journals but no one else ever reads them or they turn out to be false and/or fabricated. These are the false positives, the papers accepted that should have been declined. What does this look like in practice?I can think of some examples from my own experience. Years ago, I found in a leading journal a paper on problem-based learning that had numerous serious and glaring weaknesses that left me bewildered. I found it hard to comprehend how such a paper could possibly get past the peer review process and end up published. Embarrassingly, I sometimes wonder how a few of my early papers ever were accepted. On the other hand, a paper I wrote with a colleague that introduced and explained an innovative  approach to the treatment of aggregated self-assessments that I helped develop was rejected by a top journal because the reviewers and editors could only think about the topic in the conventional way. Try as they did (I assume they tried), they could not see things differently. There are also numerous instances where thoughtful critique helped shape my ideas so that I could refine them and present them more convincingly on the way to being published. There’s good and not so good in this business.2 Furthermore, they found that three of the top medical journals rejected the top 14 cited articles. Peer review is not always very good at identifying and publishing the top articles, or at recognizing and promoting excellence and innovation. This finding is distressing for those of us hoping to move the theory and practice of medical education forward.Siler and team found (maybe shockingly), that rejected manuscripts that were eventually published in prestigious journals were more cited than manuscripts accepted first time.2 Peer review can sift through the hundreds and thousands of submissions and correctly identify the vast majority of those that are low in quality and potential. While it is not the most attractive or compelling strength of the peer review process - finding and discarding the space junk does not have the same appeal as discovering and refining the gems and treasures - it does provide a valuable service to the community. Furthermore, if we worked hard to accept all those top studies and articles  we could easily end up publishing more of the less desirable articles . Pick your poison.Where peer review seems to be more effective is identifying and declining those articles that are not likely to contribute to the field.3 This is a very good practice as it makes the results of research publicly available as scientists try to build on the work of others as a short cut to finding answers to pressing needs worldwide. Predictably, there have been some mistakes. Some papers have been withdrawn and others soundly criticized by prominent experts in the field. What happened in the peer review process in those cases of false positives? Likely, in the rush to expedite the vanquishing of the COVID-19 virus that so far has held the entire world captive, the editors took chances that they would publish some false positives. This is a good thing, but in these circumstances consumers of research need to be even more vigilant to critique the peer reviewed, published literature (as I did with that article on PBL). The emergency approval and subsequent withdrawal of hydroxychloroquine by the FDA was a similar phenomenon at play, of rushing to find a break-through discovery.Recently, with the rush to find treatments and a vaccine for the COVID-19 virus, journals are fast tracking articles and publishing them at astonishing speeds.Let’s entertain the notion that we can make peer review better, not perfect, but just better. Here are some potential avenues for improvementJournals can create and implement better and easier processes to facilitate the work of the reviewers. At the CMEJ we have undertaken a study of the review process by first asking reviewers about their experiences and then their ideas for making the process better for them and the authors.Journals can treat reviewers as valued colleagues and not just lowly cogs in the publication mills of academia. Many if not most journals print the names of those who have reviewed for them in the last year; some provide letters that can be used on CVs; there are formal ways to provide reviewers with academic credit for completing reviews; at the CMEJ we thank our reviewers each time they complete a review and many of the editors add a personal note to the automatically generated email test; and I send our top reviewers (about 50 of them) a short somewhat personalized “Thank you” email directly from my own email account.4 Graduate programs can include specific skills of critical appraisal along with supervised “team” reviews of submissions. At the CMEJ we encourage these forms of peer review and we find we receive very high quality reviews from those collaborations (though we have no research data to support our claim). Journals can also make the directions easy to follow and can even provide some basic on-line, self-directed training for those just starting out or wanting a refresher.We can better train our reviewers.We can find and keep more reviewers. Marketers know that it is easier (and better) to keep your existing customers than to find new ones. Several of the suggestions I have described above will help with retention and recruitment. Having more reviewers means that everyone does not have as much work to do as it can be spread out over many willing hands which might make this volunteer job a little more attractive.Authors can create an informal or formal internal peer review process and/or engage the services of an editor. This will very likely improve the paper and make it more likely to pass the editorial desk review and go to peer review. Many papers are declined not because the ideas are weak or the methodology inappropriate, but because the quality of the writing is poor and the editors, understandably, do not want to invest the hours needed to work with the authors to bring that aspect of the paper up to standard. Sometimes papers are rejected because the valuable parts are unrecognizable.4 The thoughtful deliberations may yield better decisions.Finally, journal editors can take more time and invest more effort when making these important decisions. In some journals, editors consider together the reviews and their own critiques of the papers and make collaborative decisions.4 Peer review is the worst way to judge research except for all the other ways. On that note, let me introduce the papers that have persevered through the rigours of our peer review process and are featured in this issue of the CMEJ. Finally, let me thank once again all the reviewers who gave of their time and talent to help bring these and all our articles to our readers.Generally, peer review does a reasonable job of what we expect from it, but we can do better. It is certainly better than no peer review or other systems or non-systems that we know about. I will conclude, then, borrowing heavily from the title of Aaron Carroll’s New York Times article from 2018:MacLean and her team in “A pilot study of a longitudinal mindfulness curriculum in undergraduate medical education” described a pilot mindfulness curriculum and the results of their three-year study. They found that mindfulness scores correlated positively with those of empathy and resilience and negatively with perceived stress. They recommended further study.Fung and team, in “Learning by chance: Investigating gaps in transgender care education amongst family medicine, endocrinology, psychiatry and urology residents” interviewed residents from four different specialties likely to provide care to transgender people. They explored resident training experiences related to caring for trans people. They found that there was a lack of education around trans care. They believe medical education needs to address the healthcare disparities of this population.In the article “Medical students’ personal experiences, religion, and spirituality explain their (dis)comfort with a patient’s religious needs,” Schmidt and team studied how students’ own religious and spiritual background reflected their comfort level when addressing a patient with religious needs. They found that students with a personal religious or spiritual background had a higher level of comfort with discussing a patients’ religious concerns. They hope their study will aid medical educators in teaching mind-body-spirit care.transition to practice curricula in a competency-based medical education model,” constructed a definition and developed initial curriculum content for Transition to Practice (TTP). They want the results of their study to provide a prototype for curriculum development and delivery within the competency-based medical education model.Sanaee and team in their article “Practical solutions for implementation of Acai and co-authors in “The role of gender in the decision to pursue a surgical career: A qualitative, interview-based study,” conducted interviews in order to recognize the role of gender in medical students’ decision to pursue a surgical career. They found that gender is more likely to be a barrier than a motivator.unit/service and individual levels.Beavers et. al, in their article “Perceptions of preparedness: How hospital-based orientation can enhance the transition from academic to clinical learning,” explored medical students’ perceptions of hospital-based orientation as a useful tool for transitioning from academic to clinical learning. They argued that the orientation played an important role in learners’ preparedness at the Dawe and McKelvie in “International health experiences in postgraduate medical education: A meta-analysis of their effect on graduates’ clinical practice among underserved populations” completed a systematic review to evaluate the effect of postgraduate international health experiences (IHE) participation on the future careers of clinicians in their work with domestic and/or international underserved populations. They found that participation in an IHE may cause an increase in care for underserved populations, though they recommended further research in this area.In “The Women in Medicine Summit (WiMS): Engaging students to identify and address gender-associated challenges in medicine” Jung and co-authors described a new student-led medical conference (WiMS) that was aimed at discussing gender-distinctive challenges in medicine. They reported positive feedback from the WiMs attendees. They concluded that other medical schools could benefit from similar curricular initiatives.“CBME framework to promote transition to senior” by Acker and team described their CBME framework that combines the traditional method of transitioning residents to senior level independent overnight call with a workplace-based assessment strategy. They found that their method increased confidence and improved comfort for transitioning and transitioned residents. They want their framework to be expanded to other departmentsIn “Ice Cream Rounds: The implementation of peer support debriefing sessions at a Canadian medical school” Hiranandani and Calder-Sprackman described the implementation of Ice Cream Rounds (ICRs) to improve wellness by providing students a safe environment to discuss challenging clinical and professional experiences. They reported that all respondents would recommend ICRs to other medical students.Zhao and D’Eon, in “Five ways to get a grip on grouped self-assessments of competence for program evaluation,” offered ideas for the use of grouped self-assessments to prevent future misuse and to enhance program evaluations. They hope that researchers will review their use of grouped self-assessments to improve practices.In the article, “Reclaiming physician identity: It’s time to integrate ‘Doctor as Person’ into the CanMEDS framework,” Dagnone and team proposed formalizing ‘Doctor as Person’ as the eighth role in the CanMEDS framework. They proposed that this role would aid in increasing the humanity in medical care.In “Creating space for Indigenous healing practices in patient care plans,” Poudel and Chaudhary wrote a letter affirming Logan and team’s previously published article. They applauded Logan’s ideas for integration of indigenous healing practices into the practice of modern medicine; and suggested that the model of study can be replicated in larger geographical sections.Brocklebank and Jowsey have contributed an image to the CMEJ: “Interprofessional education or silo education?” They depicted the difficulties that practitioners may have in working in interprofessional teams having trained in separate buildings and without having interacted much at all.Finally, Nancy Duan in “The universe and I: An exploration of the self and our place in the world” shared a three-part image. She used her images to explore therelationship of the individual to the world around them.Enjoy!Marcel D’Eon, MEd, PhD Editor, CMEJ


Journal of Educational Evaluation for Health Professions (JEEHP):This year has brought us some good news for the First, JEEHP was accepted for inclusion in Scopus by Scopus Content Selection and Advisory Board (CSAB) . AlthougSecond, JEEHP was included in Korea Citation Index (KCI) in April this year, an abstract and reference database maintained by the National Research Foundation of Korea (NRF), which is certainly a prestigious achievement because NRF had not allowed online-only journal without regular frequency to be included in KCI thus far. It had only allowed Scopus, SCIE (Science Citation Index Expanded), SSCI , or A&HCI (Arts and Humanities Citation index)-indexed journals to be included in KCI even if the journal has no frequency. JEEHP is believed to be the first scholarly journal in Korea published as online-only without regular frequency since 2006 [New technology was adopted by the JEEHP this year: (1) review process counter from October 16; (2) country map of authors in each year with a table of content and editorial board members from December 9; (3) country flag of the authors and the editorial board members from December 9; and (4) distribution of countries of the authors in metrics from December 9. Among these, review process counter can be a good incentive to submitting authors. Authors want decisions on their manuscripts as soon as possible, and currently the median value of the period to the first decision is 16 days . CountriJournal performance can be presented based on the bibliometric indexes including total citations and an impact factor. Twelve countries of the authors of 41 articles published this year are presented in The fate of manuscripts submitted to this journal up to December 27, 2019 is summarized in It is anticipated that the enactment of immediate open access publication without embargo period for articles will soon be supported by the US federal funding agencies including National Science Foundation and National Institute of Health ,4. It maI am deeply indebted to following reviewers. Without their tremendous help, I couldn’t have edited and published the journal so beautifully:Abdolghani Abdollahimohammad, Neeka Akhavan, Malhotra Anita, Marcela Andrea Antúnez-Riveros, Colin Block, Raul Alfredo Borracci, Megan Brown, Su-Jin Chae, Lucia Chehade, A Ra Cho, Kyunghee Chun, Cheol-Woon Chung, Derek Clewley, Fabrizio Consorti, Mariana D'amico, Saeideh Daryazadeh, Olivos David, Upreet Dhaliwal, Ilse Erich, Christian Ezeala, Min Huang, Karen Huhn, Yera Hur, Geum-Hee Jeong, Williams Joy, Im Jung Jun, Taehoon Kang, Chien Kevin, Ahmed Khalifa Khalif, Kyung Won Kim, Seock-Ho kim, Young Min Kim, Ju-Yeun Lee, Young Hwan Lee, Eun Young Lim, Paula Kay Martin, argetto-Fernandez Miguel, Kyung-A Nam, Younjae Oh, Robin Parish, Bhina Patria, Rano Mal Piryani, Agarwal Ramesh, Marcus Roll, Dong Gi Seo, Jihyun Seo, Ravi Shankar, Eunah Shin, Mohan Sunkad, Chloe Thabet, Gideon Victor, Yanhua Yi, and Hon Yuen.Voluntary work of audio recording of the abstract when authors were not available, was done by Tom Huh, a student with a major in Biology, Korea University, Seoul, Korea.I am very happy to have published 41 articles this year, including 30 research articles, 2 reviews, 3 brief reports, 1 technical report, 3 editorials, 1 educational/faculty development materials, and 1 announcement. Next year is the year of “white rat” according to the sexagenary cycle. Rats stand for multi-parity, diligence, and abundance of riches in Korean culture. I hope the journal to also prosper in receiving an adequate number of interesting and practical manuscripts for medical health educators. I will be more than happy if the contents of this journal are adopted by many experts in medical health educational fields worldwide.


Authors may have unrealistic expectations regarding journal submission and review processes. The study aimed to describe journal response types and times for manuscripts finalised for submission by the University of the Free State School of Medicine medical editor.this descriptive cohort study with an analytical component included all manuscripts finalised for submission to accredited journals by the medical editor, 2014-2017. Excel spreadsheets capturing all stages of the manuscript process were used to confidentially note information regarding submission and subsequent journal responses.ninety-five manuscripts were submitted to 72 peer-reviewed accredited journals. The total number of submissions was 163. Only 46 (48.4%) manuscripts were accepted by the first journals submitted to. Rejected submissions (n=82) had a median journal response time of 15.5 days (range 0-381 days), with a third being sent for review. Nine manuscripts were accepted with no revisions needed. Accepted submissions (n=72) had a median of one round of revision (range 0-4 rounds), and a median time of 119.5 days (range 0-674 days) from submission to final acceptance.within our setting, half of first submissions were unsuccessful, but rejection usually occurred rapidly. Acceptance for publication occurred at a median time of 4 months after one round of revision. If health professionals were made aware of expected outcomes and response times, it may prevent authors from falling victim to the publication practices of predatory journals. Health professionals are involved in research as researchers themselves and as supervisors to undergraduate and postgraduate students. For example, a research component in medical education has proven to be vital for the development of successful medical professionals ,2. Critisacrificing adequate and thoughtful peer review and editorial assessment is a mistake for research in medicine. Timely assessment and dissemination of medical research findings is certainly important, but for most articles, rushing to publication in days or weeks will not improve health outcomes. Inexperienced authors such as postgraduate students or new health professionals, in particular, tend to have unrealistic expectations regarding the review process. These authors are inclined to withdraw submissions when there is no rapid journal response, or the journal requires modifications to the manuscript [if we can have your manuscript in the next 7 days, it will appear in the next issue of our journal' - a typical e-mailed solicitation) or seem to be willing to publish manuscripts on any topic. Beall [et al. [The cornerstone of research publishing is thorough peer review. As the editor in chief of the Journal of the American Medical Association stated in 2017 : sacrifinuscript ,10. A dac. Beall  was of tc. Beall . Wallach [et al.  has poinAim: the aim of this study was to describe journal response types and times for manuscripts finalised for journal submission by the School of Medicine (SoM) medical editor, University of the Free State (UFS), from 2014 to 2017.Study population and sampling: this descriptive cohort study with an analytical component included all manuscripts finalised for journal submission by the SoM medical editor from 2014 to 2017. These manuscripts were written by health professions professionals and students in the SoM, UFS.Data collection: a data form was compiled by the authors to capture the following information from the medical editor´s Excel spreadsheets containing all the stages and activities of the manuscript process: manuscript and journal characteristics, journal response times and types, need for author intervention to speed up journal response, technical problems experienced with submission platform, number of reviewers involved, number of rounds of feedback from journal until final decisionPilot study: the first submission of each of the four years was included in a pilot study to test the data form and assess the available information. The data form was amended to add a few new items: tracking numbers on medical editor database, nature of contact with journal before submission, whether the manuscript was actually sent for review by the journal and whether the journal editor him/herself gave any feedback. In addition, some options were added or rephrased. The pilot study cases were included in the main study.Data analysis: the data were entered into an Excel spreadsheet. The results are presented by frequencies and percentages , and medians and ranges .Ethical consideration: the protocol was approved by the Health Sciences Research Ethics Committee, UFS (HSREC 143/2017). Permission to conduct the study was obtained from the Head of the SoM, Dean of the Faculty of Health Sciences, Dean of Students Affairs, and Vice-Rector of Research. No details regarding the authors of manuscripts were noted or reported on.Ninety-five (n=95) manuscripts were submitted. Due to only 48.4% of manuscripts being accepted by the first journal submitted to, the total number of submissions was 163. Submissions were made to 72 different peer-reviewed, accredited journals: 32 South Africa (SA)-based journals - 104 submissions; 46 journals based elsewhere - 59 submissions. Most of the submissions were full-length articles (87.1%), while the remaining submissions included review articles (5.5%), scientific letters (3.7%), case reports (1.8%), technical notes (1.2%) and an abstract (0.6%). Almost all of the submissions (95.1%) were done through online platforms. There were 13 different online platforms. For six submissions at six journals, the platform changed during the review process. Technical issues regarding platforms  were experienced with 16 (10.3%) platform submissions to 13 journals. Less than 5% of submissions were made to a pre-specified email address. For one journal where one submission was sent electronically, emails, including reviewer feedback, from the journal did not reach the authors.Regarding final decisions by journals, rejected submissions had a median response time of just over 2 weeks, and accepted submissions approximately 4 months. Extreme values of more than a year occurred. Only 3.4% of submissions initially requiring revisions were subsequently rejected. Accepted submissions had a median of one round of revision (range 0-4 rounds), and were accepted after a median time of 4 months. The nine submissions not reflected as having a final response consist of eight submissions for which the authors declined to do the proposed resubmission or revisions, and one submission that was erroneously archived by the journal. In 12 submissions (7.4%), there was evidence that author enquiries were made to the journal regarding progress before first journal response. This was done after a median of 147.5 days (range 84-266 days). For five submissions (3.1%), author enquiries were made regarding progress during later review rounds. For three submissions, reviewer feedback or final decision were clarified with the journal. Of the 82 finally rejected submission, 32.5% were sent out for review. The main reasons for rejection was out of scope of journal/not suitable for journal readership (31.2%), methodological issues (30.0%) and no new information (13.8%). For 11.3% of rejected submissions, no reason was given.As found in our study, it can be anticipated that a manuscript may need to be submitted to numerous journals before acceptance . A call A study of internal editor review (before peer review) of manuscripts submitted to Academic Medicine  found thet al. [Mun  has cautet al.  have stret al.  has indiet al. . Most onStudy limitations: numerous factors other than those considered in this study can play a role in journal response times. Wallach et al. [h et al.  found reh et al. . The forWithin this setting, the majority of first submissions were unsuccessful, but rejection usually occurred rapidly and only rarely after revisions were requested. Accepted submissions were accepted at a median time of 4 months, after one round of revision. Understanding and awareness of possible expected outcomes and response times could ease some of the tension surrounding the publication process and prevent authors from being vulnerable to predatory journals, who make tantalising claims of rapid publication times.Recommendations: these findings will be of value to the authors in their day-to-day interaction with researchers, to advise them regarding realistic/expected processes, responses and timelines. As described by Balch et al. [h et al. : 'succesPublishing is a key aspect of health professionals' lives and seemingly often fraught with obstacles;Published data on the speed of the publication process has mainly focused on submissions to individual journals.Quantified data regarding submissions and resubmissions over a broad spectrum of medical and health profession journals;Such quantified data regarding expected outcomes and response times and the practical guidelines provided can help researchers to plan appropriately for the publication process and prevent authors from being vulnerable to predatory journals, who make tantalising claims of rapid publication times.


Biochemia Medica is an open access journal that does not charge manuscript processing or publishing. All editorial staff are continuously educated and directed to follow the highest ethical and scholarly publishing standards in all steps of the manuscript processing. They are all laboratory medicine professionals, who apart from their regular jobs, are in charge of different phases in Journal processing as volunteers. The publisher of the Journal is scientific and professional association of laboratory medicine professionals, Croatian Society of Medical Biochemistry and Laboratory medicine (CSMBLM). During November and December 2018, without knowledge of the editorial staff, unknown perpetrator(s) downloaded a respectable number of articles published in Biochemia Medica as PDF and launched an illegal web page under the same journal name with downloaded articles. Although this was a very harmful experience, we have learned a lot from it and we would like to share this with scientific journals’ community. Therefore, we would like to share this harmful experience, and to present a short workflow on how to manage situations like this if it will be necessary for any scientific journal in the future. It is well known that predatory journals do not follow standard polices proposed by the World Association of Medical Editors (WAME). Predatory journals are usually newly established journals that spread their “call for papers” worldwide and charge the publication in open access journals .In practice, each manuscript submitted to the Journal passes several phases during editorial, peer reviewing and publishing process. The steps between the first online submission and the first Editor-in-Chief’s decision are schematically presented in Research integrity checkup of the manuscript consists of text similarity analysis using Crosscheck plagiarism detection service provided by CrossRef .In October 2018, after two-year preparation, editorial-publishing office of the journal Biochemia Medica in portable document format (PDF) and launched an illegal web page under the same journal name with downloaded articles. They represented themselves as Journal published by CSMBLM and used the name of Editor-in-Chief to send “call for paper” e-mails with all other relevant information they gathered from our web page in order to get potential authors’ interest. They stated that the journal covered wide area of natural science and biomedicine to attract wider range of authors from different areas. They promised fast peer-review and publication in just a few days from submission. The first suspicion was raised by Journal’s Editor-in-Chief based on the e-mail received at the end of December during Christmas holidays  downloaded a respectable number of articles published in holidays . The dayBiochema Medica’s Editorial Board member is a professor from one of the Turkish University, we have asked him to help us contact the Turkish Cyber police and Turkish national CERT. Previously listed activities resulted favorable for our Journal because the first server host and illegal web page were removed in two days. However, few hours after that we have noticed that the illegal web page became available again and was hosted by another server provider.We contacted immediately our server provider and web page designer who in short time identified the server that hosted the illegal web page and its location in Turkey. They also advised us to contact the Turkish server provider and to inform them about copyright violation by the web page they had hosted. We have kindly asked them to remove illegal web page immediately. In very short time, Turkish server provider did so. We have also contacted the Department for Cyber Criminal of the Ministry of the Interior of the Republic of Croatia and National Computer Emergency Response Team (CERT), an expert group that handles computer security incidents. Furthermore, we have contacted staff from Portal of Croatian Professional and Scientific Journals (HRČAK). All of them advised us how to collect and how to save “original e-mail headers” received from cyber criminals and from the authors who might collaborate with them. As one of the We have contacted again Croatian National CERT, Croatian server provider, our Turkish collaborators and HRČAK. All of them agreed that it will not be enough to contact server providers because it seemed that cyber criminals have a strategy to move from one server provider to another and that we have to contact Registrar which was localized somewhere in India. HRČAK staff helped us to compose a report on our Journal’s copyright violation for acquiring financial gain. In two weeks’ time from the first notification about violation, Registrar blocked the illegal web page.Biochemia Medica’s Instructions for authors. Some of the authors sent more than one manuscript. Editor-in Chief answered to each e-mail and informed authors that unknown Cyber criminals deceived them. Some of the authors sent us e-mails received from Cyber criminals including “e-mail headers” as well as the acceptance decision and invoices (During this process and later, many potential authors found our original web page and contacts surfing the internet. Some of them were confused by existence of two different Journal web pages and later they were confused when the illegal one terminated but they submitted their manuscripts through contacts available on this web page. All those manuscripts were out of scope and not in compliance with invoices . Prices Although this was a very harmful experience, we have learned a lot from it and we would like to share this with scientific journals’ community. Therefore, we present a short workflow on how to manage situations like this if it will be necessary in the future .


Prior studies have shown that most conference submissions fail to be published. Understanding factors that facilitate publication may be of benefit to authors. Using data from the Canadian Conference on Medical Education (CCME), our goal was to identify characteristics of conference submissions that predict the likelihood of publication with a specific focus on the utility of peer-review ratings.Study characteristics  from all oral abstracts from 2011-2015 and peer-review ratings for 2014-2015 were extracted by two raters. Publication data was obtained using online database searches. The impact of variables on publication success was analyzed using logistic regressions.In total, 953 oral abstracts were reviewed from 2011 to 2015. Overall, the publication rate was 30.5% (291/953). Of 531 abstracts with peer-review ratings, between 2014 and 2015, 162 (31%) were published. Of the nine analyzed variables, those associated with a greater odds of publication were: multiple vs. single institutions (odds ratio (OR) = 1.72), post-graduate research vs. others (OR=1.81) and peer-review ratings (OR=1.60). Factors with decreased odds of publication were curriculum development (OR=0.17) and innovation vs. others (OR=0.22).Similar to other studies, the publication rate of CCME presentations is low. However, peer ratings were predictive of publication success suggesting that ratings could be a useful form of feedback to authors. In a review of the literature on evaluation in higher education, Tan9Productivity in academic medicine is often measured by metrics established for basic science and clinical research. Indeed, in most universities, promotion, remuneration, and tenure systems reward individuals using traditional citation-based journal rankings.10,11 This is not unique to the field of medical education. A Cochrane review of over 29,000 abstracts presented at biomedical scientific meetings reveals a mean publication rate of 44.5%.12 The average rate of publication of abstracts presented at international conferences in various scientific disciplines has been found to vary widely from 8% to 81% depending on the field of research.10A common strategy used by many researchers as a step toward publication is to present their work at medical education conferences. This does not however guarantee publication, which is often referred as an indication of academic success. Despite the increasing number of attendees and presenters at such conferences, there is evidence that most submissions fail to go on to peer-reviewed publications.13 Further, with growing fiscal constraints placed on faculties of medicine, some might question the benefit of attending and presenting at conferences if it is not recognized for promotion and/or does not lead to a publication.There are potential long-term consequences to researchers not publishing. For example, publications are an important metric for academic promotion, and failure to publish completed research may lead to unnecessary duplication of work, by repeating research projects that failed to be published in the literature.10,11 However, this research is based on conferences that took place more than a decade ago. With the exponential growth of medical education research and the increasing attendance at research meetings, it is important to see if this pattern of publication has changed. In addition, identifying characteristics of conference presentations that lead to an increased chance of publication would also be informative.Given the perceived benefit of presenting work at research meetings and the negative consequences of not publishing, documenting the publication rate of conference presentations is important. Past research has shown that only about 35% of presentations in the field of medical education are eventually published.Therefore, the goal of this study was to determine characteristics associated with publication including the predictive value of the conference abstract review process. Secondary aims included identifying the rate of peer-reviewed journal publications stemming from oral presentations of abstracts presented at a national meeting over a 5-year period, from 2011 to 2015.14 focusing on this conference should be representative of the literature. The number of presentations each year now averages around 400 with roughly 1500 people attending. Applicants must indicate whether their abstract should be considered for an oral abstract only, poster only or could be considered for either upon submission. The number of submissions received yearly is not publicly available.To address our research question, we focused on the Canadian Conference on Medical Education (CCME). In Canada, CCME is the premier venue of presentation of work spanning the education continuum from undergraduate medical education to continuing professional development. Considering that Canadian medical education researchers are responsible for 37% of published research in medical education,All oral abstracts from the 2011-2015 CCME conferences were considered. We chose to focus on oral abstracts for two reasons. First, prior studies have shown that oral abstracts are twice as likely to lead to publication compared to poster presentationsTo determine publication status, Medline, Embase and Google Scholar were searched using the names of the first and second authors. If the first search was negative, first and last authors were then searched, followed by key words from the title, abstract or both. In addition, conference submissions go through a rigorous peer-review process to ensure that quality work is presented at the conference and as part of this process, there are peer review ratings that can be incorporated into the study. CCME has been archiving conference abstract peer-reviewed ratings since 2014. As a subsequent analysis, the average rating assigned to each oral abstract submission from 2014 and 2015 were linked to the collected data to determine whether these ratings were predictive of publication status.15 Inter-rater agreement was obtained if the second reviewer was extracting the exact same data from the oral abstracts compared to the first reviewer. If inter-rater agreement was not attained, a third reviewer, with advanced knowledge and experience in research methodology, arbitrated to find a consensus.Once the data extraction was done, 20% of the extracted data was reviewed by two investigators, by doing a cross-review to ascertain standardization method of extraction between investigators. The study team felt that 20% was a reasonable portion of data to review given some evidence that omission and inaccuracy errors in systematic review data extraction ranges from 10.0 to 15.7%.Each oral abstract was then reviewed by one of the two investigators who extracted the following information: type of scholarship , research method , study participants , interprofessional, unspecified population or other), number of study sites (single or multiple), number of institutions in the author group, main abstract theme , publication status (positive or negative), publication date (if positive), journal type , publication type  and publication model ).The study received exemption from the Ottawa Health Science Network Research Ethics Board (OHSN-REB).Descriptive statistics were used to describe publication status, time to publication and publication type. We ran two multivariable logistic regression models to ascertain the effects of the various variables on publication success. The first model included all abstracts from 2011-2015 with the independent variables mentioned above. Because these were categorical variables, dummy coding was used with a total of 21 variables being entered into the model. Within each category, the variable with the highest number was used as the base reference for dummy coding. For this analysis, a backward logistic regression model was used. This type of analysis is appropriate if one is exploring data and there is no theoretical reason why one variable might be more important than another. Using data from 2014-2015, the second analysis incorporated the average peer review rating. Due to the smaller sample size and considering the redundancy in the dataset, only the significant variables identified in the previous analysis plus the CCME rating were used in this logistic regression model.In total, 953 oral abstracts from 2011 to 2015 were reviewed, with an inter-rater agreement of 90.5% (172/190) for the 20% cross-reviewed abstracts. The overall publication rate was 30.5% (291/953). The oral abstracts presented in 2011 were published at 28.6% (32/112), 44.7% (46/103) for 2012, 24.6% (51/207) for 2013, 28.2% (74/262) for 2014 and 32.7% (88/269) for 2015. The oral abstracts’ characteristics leading to a successful publication are summarized in The median time to publication, calculated by the conference year subtracted from the publication year, was 1 year, ranging from -1  to 7 years. The mean time to publication and standard deviation were 1.3 and 1.32 years respectively. The characteristics of the published oral abstracts are presented in For the first analysis using 2011-2015 data, of the 21 predictor variables, a total of eight were statistically significant as shown in For the second analysis, the eight significant variables identified above plus the 2014-2015 CCME average peer-review ratings were included. The peer-review process used by CCME involved independent review by four experts in medical education. A total of five variables were statistically significant . Three vDissemination of scholarly work and research is important to advance a specific field and for academic promotion, but it is challenging to establish which characteristics increase the odds of eventual publication. A common strategy used by many researchers is to present their work at medical education conferences, but this may not necessary lead to publication success. In this study we considered abstracts presented at CCME to determine not only the successful publication rate, but also if we could identify any factors that would increase the likelihood of publication.11 These data can be interpreted in two ways. The initial inclination may be to imply that publication rate has not increased despite the increased number of submissions, conference attendees, and medical professionals with formal degrees in medical education. However, despite the drastic increase in number of submissions to conferences, the rate of publications has remained relatively similar which means that an absolute larger number of scholarly projects have been published (from 32 published abstracts in 2001 to 88 in 2015). This could possibly be explained by the increase in journals dedicated to medical education and special education issues in other types of journals.16We found that, between years 2011 and 2015, 30.5% of all oral abstracts presented at CCME were published in the literature. Most studies were published within 12 months of presentation in journals dedicated to medical education. Our overall publication rate was in keeping with that reported in studies by Cheng et al. (22%) in simulation education10 and may not be surprising given that multicenter studies have many advantages over single center studies including a potentially broader range of researcher expertise, larger and more diverse sample sizes which may make findings more generalizable and foster collaboration between sites.17 We also found differences in our study, compared to prior studies, which has shown that PGME population, as a research subject, was more likely than UGME to be published. Amongst research methods, qualitative research methodologies were also associated with an increased odds ratio of successful publication. There has been a call in recent years for more qualitative research in medicine in general18 and in medical education.19 The reason is that qualitative research methods can address aspects of a research question that are different than what can be found using quantitative research methods.We were able to identify conference oral abstract characteristics that led to increased odds of publication. The strongest predictor of successful publication was having multiple institutions represented in the author group. This is similar to past studiesOral abstracts that did not clearly specify a population and those focused on postgraduate trainees had a higher odds ratio of successful publication. Studies with ‘unspecified populations’ were typically those analyzing concepts  or utilizing data banks for research purposes. It is possible that research on data is more readily accessible than research with participants given that ethical requirements, recruitment, and availability of resources work in favor of these types of studies. It is not apparent why studies with postgraduate participants were published with a higher rate than other types of participants. There may be more journals with this target audience and there might be an interest to study this population, as post-graduate trainees are at a career turning point near their independent practice and gather assessment data from a wider variety of sources .This study also identified characteristics that were associated with decreased odds of successful publication. Interestingly, all types of scholarship  other than what is traditionally considered education research were associated with a lower rate of publication. This may be reflective of these types of scholarship typically being more descriptive of local initiatives, which focus more on sharing experience with their peers in other institutions, as opposed to being more widely generalizable or adding to the literature. Finally, studies that did not clearly fit within traditional methodologies  were also associated with a lower rate of publication which likely reflects lack of clarity in the methodological approach used.A subsequent analysis that incorporated these predictive variables in addition to CCME peer-review ratings found similar results, further confirming that scholarly works involving multiple institutions and focused on postgraduate education were more likely to be published. Although labor intensive, this study supports the utility of the peer-review process in identifying abstracts of ‘higher’ quality given that higher score help predict publication status.14 We reviewed abstracts from multiple years, and by ending in 2015, we could ensure that researchers had sufficient time to publish their work. It is possible that more recently presented work may have been more successfully published but given the stability in publication rate over the last decade, this seems less likely. Although the search strategy was thorough and was done by two independent reviewers, some publications might have been missed, despite using Medline, Embase and Google Scholar. Many manuscripts had titles that differed from the original oral abstracts. Principal, second and senior authors in the author group also varied, potentially leading to not being able to capture a publication.Limitations of this study include that this review was performed on oral abstracts from a single conference rather than exploring different medical education conferences. We are however confident that CCME is representative of medical education research at large because Canadian researchers are highly published, representing 37% of the medical education literature, but publication rate may be different for other medical education conferences.Other characteristics, such as having a PhD researcher amongst the authors were not explored. Potentially PhD researchers may be more grounded in theory and could bring a perspective to a study that clinician educators may not have. PhD researchers may also be expected to publish more in the literature, in most institutions, as compared to medical students, residents or staff physicians who are usually more clinically focused. If so, collaborating with a PhD researcher should be considered for future studies as this might be another characteristic leading to publication. Unfortunately, not all oral abstracts mentioned the educational degree of their authors. Finally, while presentation at conferences may not always lead to publication, the peer-review process may still prove helpful to researchers as they may receive crucial feedback from reviewers. It would be interesting to investigate how researchers use this feedback to influence future submissions and whether it is felt to be impactful for future work. This would likely be best explored with qualitative research methodologies.In summary, while conference presentations are often considered a step towards publication, this research has demonstrated that this is not always the case with only 30.5% of CCME oral abstracts being published as full studies. We were able to identify specific characteristics that lead to increased or decreased odds of publication including the predictive value of conference peer-review scores. While presentation at conferences may not always lead to publication, the peer-review process may still prove helpful to researchers as they may receive crucial feedback from reviewers with expertise in medical education.


Although peer review is considered one of the main pillars of modern science, experimental methods and protocols seem to be not a rigorous subject of this process in many papers. Commercial equipment, test kits, labeling kits, previously published concepts, and standard protocols are often considered to be not worth a detailed description or validation. Even more disturbing is the extremely biased citation behavior in this context, which sometimes leads to surrogate citations to avoid low-impact journals, preprints, or to indicate traditional practices. This article describes some of these surprising habits and suggests some measures to avoid the most unpleasant effects, which in the long term may undermine the credibility of science as a whole. Recently, an editorial article with the title “The method comes first” was published , which oOrganic Syntheses has followed a fascinating concept starting in 1921 [It is puzzling to see that a vast number of experimental protocols are not based explicitly on peer-reviewed work. This means that the question of whether a protocol is published before, in, or after a discovery paper is by far not the most relevant one. In addition, it can be questioned whether a traditional peer review is able to elucidate the quality and completeness of a protocol at all. The journal The above-mentioned situation might be unintentional or not. In the former case, the authors may have planned to publish a separate method paper, which unfortunately never happened. This is also caused by the difficulty of publishing such papers. Many journals perform something like cherry-picking, which means, in this context, that the discovery paper is considered to be much more attractive, and methods are rarely seen as “exciting” . This maMost scientists would agree that this  statement does not meet the requirements for a scientific publication. However, in an indirect form, similar phrases are used quite frequently, and in most cases, unintentionally. For example, the term “phosphate buffer” does not imply the pH, the concentration, and even the exact composition, not to talk about any additives. Quite often, protocols contain some crucial steps, which are only known in a specific lab. These protocol gaps are sometimes hidden in the use of equipment, compounds, or reagents, which are not described in the literature or are not commercially available. Most reviewers overlook such lacking detail. In plenty of labs, some traditional recipes exist, on which the work of the group is based. Often, they have never been documented explicitly in a refereed journal or even somewhere else, except in an internal lab protocol. In many cases, the authors may consider their method as standard and not worthy to be mentioned. All who ever worked in different labs know that the individual protocols may be highly relevant for success. A similar problem arises with the lack of detail in the citation of antibodies  and otheThis statement, combined with one or several citations, appears to be satisfactory for many readers. However, this sometimes affords surprises. First of all, the reference may not lead to the expected protocol, but only to a paper with a similar topic, or also annoying, to another citation, which may lead nowhere. This is even more frustrating if such an irrelevant article was hidden behind an expensive paywall or needed a lot of effort to obtain access to it. Citation cascades may weaken a protocol so much that it is of no value anymore. Besides, most experimental protocols are continuously modified, often in an unobtrusive way in that the authors think these changes do not merit a separate publication. Obviously, after some time, the protocol changed in significant parts, and the citation of the old paper in newer work is not adequate. The recent concept of a “living paper” (similar to ) with doThis statement is even weaker, particularly when the cited paper was published decades ago. It is not very likely, according to our experience, that any of these protocols are used without some or even major modification. Even when the revision is indicated but not specified in detail, the protocol has to be considered to be incomplete or even irreproducible. The most puzzling fact is the habit that the papers with the highest citation numbers  of all tThis statement has several issues. First of all, most instructions or data sheets of reagents, labeling kits, or test kits contain several options and are formulated in a relatively open way. For example, several buffers may be mentioned, which might be used under a broad range of conditions. This definitely does not mean that the results are the same. In addition, the instructions of a manufacturer are not a peer-reviewed document. These documents often are anonymous and do not show a publication date. Updates are usually not documented, and archives of such documents do not exist in most cases. Furthermore, these instructions can be withdrawn at any time without notice. Finally, some users might modify the protocols somehow without documenting the changes properly. In some cases, literature citations are given in these instruction sheets. However, most often, these citations do not point to a primary publication or a validation of the method and only show the use of the respective commercial product. Sometimes it seems that a commercial supplier even avoids mentioning original papers. Due to copyright issues, the external archiving of these documents is not possible in most cases. Open access publication of such data sheets or instructions by the commercial supplier might be an option for the future.Complex systems, either commercial or home-made setups, are often not adequately described. Most companies are reluctant to disclose details of their construction, which might be crucial for proper functioning and understanding. Sometimes, even the physical background of such devices is disguised, and original papers are not given. The standard user cannot trace back the source of such a device and is limited to a model number. Even patents, which are considered to be sources of primary information about commercial systems, are not very helpful for this purpose since a patent is not intended to teach the reader unambiguously but, more or less, to confuse and alienate respective competitors. If the company, which delivered the device, goes out of business, details about the systems might be lost irreversibly. In the case of home-built equipment, some groups might avoid describing too much detail in order to keep competitors out of the field.Surprisingly, manufacturer’s instructions, textbooks, patents, preprints, Ph.D. theses, or other documents outside of the traditional journals seem to be highly undercited. Today, digital access to some of these records can be monitored, which appears to support this notion. Some authors seem to use a protocol from a source mentioned above and finally cite a somehow related paper from a high-impact journal as a surrogate. Unfortunately, some journals even suggest such practices by discouraging to cite “non-refereed documents” and to prefer “high-quality papers.” Many authors might understand this advice as a request to delete citations of  protocol documents mentioned above and replace them with (surrogate) articles from high-impact journals  to improMost commercial software packages are not open source, and hence, their algorithms are undocumented in most cases. This is a classical black-box application. Even the indication of the version of a software package does not help much, particularly if this specific version is not available anymore: All these results may not be reproducible. This shows the big advantage of open source software, either self-coded or taken from another source—provided that the used version is completely published.With the advent of open access publications, their advantages emerged more and more. In the case of experimental protocols, direct and unlimited access to cited documents is quick and not hampered by paywalls. Additionally, the fast and unhindered linkage to other similar papers makes the comparison of similar protocols easier. Even automated tools based on artificial intelligence (AI) might be feasible when full-text processing is admitted.Although peer review is considered a central pillar of scientific work, many experimental papers contain significant parts that do not underlie such quality control. Even worse, documentation of large sections is frequently lacking, either due to a commercial context or because the method is considered to be standard.The Lancet in 2014 with the title “Research: increasing value, reducing waste” [It seems to be important to remind us of the still unresolved reproducibility crisis, which has been discussed repeatedly, e.g., in . In addig waste” , which aAs it was mentioned in the respective editorial , which iHence, I would like to suggest some simple measures, which might improve the situation, without increasing the effort too much:Authors should always describe the full protocol of their methods used in their paper. In the digital age, at least in the supplement, plenty of space is available. It is nearly impossible to report too much detail. External protocols should only be cited if it is interesting to discuss their context and not as a substitute for a description. It seems to be obvious that protocols should not be hidden behind paywalls. This lesson was ultimately learned during the coronavirus pandemic. Why should this be different when SARS-CoV-2 is defeated?Referees should not accept papers in which the experiments cannot be reconstructed in all aspects. Citations of general protocols or methods should not be counted as an equivalent of the experimental documentation, only as an acknowledgment of previous work and an indication of a potential external validation. Referees, who have no practical experience in methods used in a manuscript, should refuse to write a review. Only someone with long-term experience with a method can spot the weak points. To assign referees specialized in specific methods might be an option.Editors should refrain from limiting experimental descriptions either in length or from specific sources. Notably, the implicit pressure to use surrogate citations should be avoided, which is often disguised as an effort for more quality in science. Any reference of a protocol with a DOI should be considered to be acceptable. A preprint with a detailed protocol used in a respective work is definitely preferable to a vague citation of a 50-year-old “high-impact” paper, from which the authors often do not even know the full text.Organic Syntheses, founded 100 years ago [In the long-term, the complete separation of method documentation and discovery papers might lead to a new era of scientific publication, particularly when the protocols in method papers are published online as “living papers,” including all improvements of a protocol and any changes documented with time-stamps. Furthermore, the benefit of peer review in its present form should again be discussed if large parts of scientific publications unintentionally seem to get along without it. Finally, validation efforts should be bundled in a useful and transparent way, similar to the concept used by ears ago . In any


Upsala Journal of Medical Sciences (UJMS) in your hands. For quite a long time we have discussed whether we should join the present trend in scholarly publishing, i.e. terminating the printing of scientific journals. In our case, it will mean an interruption of a 155-year-old tradition  in Stockholm. Amongst the speakers a small company had been invited – Open Academia – run by two people with great experience in scholar publishing who at present serve nine other journals. They offer the exact key services we need and, what’s more, at a modest price. Most importantly, we can retain control over the design and maintenance of our journal website and layout. Moreover, finances are based on a cost-per-published-page model. We are very much looking forward to this collaboration. There will be a lot of work but also opportunities to give both our journal and our website a fresh look.All in all, this has made us look for an alternative publishing process. Last February, the editors of our journal and the At this point in time, it might be a good idea to look back to see what we have achieved together with Taylor & Francis (T&F) over the last 10 years. The number of submitted manuscripts has doubled , the numUJMS it has meant an obvious change for the better. We are still placed just above the top 90th percentile amongst journals in ‘General medicine’, but our score value has more than doubled over the last 10 years (In our editorial 2 years ago we elaborated on the introduction of a new bibliometric scoring system introduced by Elsevier – the so-called CiteScore . Since t10 years .We are grateful for this opportunity to thank some of our collaborators at T&F – Håkan Pårup, Therese Granlund, and Sarah Hands – all of whom have contributed extensively over this 10-year period. One major problem for all journals of our size and reputation is finding referees for the submitted papers. We truly pay tribute to all of you who have graciously offered your time to read our manuscripts. Without better support for this system – yes, it might be regarded as old-fashioned, but still there is no better alternative – it might all collapse and be handed over to strictly commercial interests. This is an issue, very much emphasized in the summing-up document of the editor conference mentioned above.So, although this is the last issue of the journal produced on paper in the classical way, we plan to continue to publish four issues a year as before. When each issue has been finalized it will be sent as a PDF file to all members of the Upsala Medical Society by e-mail. You will be able to glance through it as you can do with many of our daily journals nowadays or indeed even print it out. In the latter case, you will be able to save it on your bookshelf in the time-honoured way for simple and reliable consultation whenever you like.


Scandinavian Journal of Work, Environment and Health (SJWEH) will become a full open access (OA) journal. Under the “gold” OA status, all new articles will be published as “unlocked content” on the journal’s website. This makes the final version of an article freely accessible for everyone, and allows for distribution and adaptation as long as the authors are duly acknowledged as they retain the copyright. Online subscriptions will no longer be needed and thus terminated, whereas subscriptions for the printed journal will continue.As of 1 January 2021, the Going full OA is a major step in the 45-year history of the journal. With this step, we join the rapidly growing Open Science movement . A core To become one of the first occupational health and safety journals to go full OA is a double-edged sword. On the one hand, we are proud to be a first mover and support the Open Science movement. On the other hand, there is an economic risk for the journal. Unlike other major journals in occupational health and safety, SJWEH is published not by a large commercial publishing house but by a not-for-profit organization: the Nordic Association of Occupational Safety and Health (NOROSH) . Thus, tUnder the gold OA model, authors are requested to pay an article processing charge (APC) of currently €2300 (NOROSH members: €1150) to publish their papers in the journal. The fee is waived for articles from research institutes in a low income country  , while aOA increases the opportunity for article citations . The fivSometimes a concern is voiced that the gold OA and APC model may result in a decline of quality because journals might be tempted to publish as many articles as possible to generate income . Indeed,www.norosh.org/pmwiki.php/Main/Membership).The Open Science movement is an exciting development transforming the way research is communicated and shared. We are proud to be a part of this movement, and we ask our authors, reviewers and readers to support the advancing of scientific knowledge in the field by continuing to send high quality papers to the journal, performing rigorous peer-reviews, and reading and discussing our content. Furthermore, qualifying institutions may support the Open Science movement and SJWEH by considering membership in NOROSH  (for fur


Undoubtedly, we are living in a period of great challenge for the field of medical science. The COVID-19 epidemic is an emerging and rapidly evolving situation that has brought up scientific concepts that were no longer relevant. For a long period of time, we did not experience situations that had such a high mortality rate affecting entire populations, or diseases that followed their natural courses with little prospect of treatment or reversal of their clinical presentation.Though we are accustomed to the concept of scientific evidence that is preferably based on large clinical trials that take years to complete, we must now rely on case studies, single cohort studies, and even the opinions of experts. However, we know that we cannot lose sight of the criteria for evidence-based medicine, and must remember to evaluate all potential biases existing in this type of scientific information without limiting its dissemination. Each piece of information always has some value, by proposing new hypotheses, expanding the debate, and evolving into new quality scientific research.With regard to the current situation, nearly 2,000 papers with reference to COVID-19 have been registered in the PubMed database since the beginning of 2020. They include laboratory studies, clinical reports, guidelines, editorials with experts' opinions, and several observational studies. These studies show initial observational evidence regarding possible pharmacological treatments or the use of prolonged respiratory support methods as means of avoiding mortality, morbidity, or even to decrease some secondary outcomes, such as the viral load. Several potential COVID-19 treatments have been described, including drugs already in use for HIV and malaria, experimental compounds that work against an array of viruses in animal experiments, and antibody-rich plasma from people who have recovered from the disease. Other studies are dedicated to identifying groups at risk and the various factors involved—even moving toward the proposition of scores that determine the best allocation of resources and clinical interventions according to the actual status of the patients. From these data, we can also observe the rapid response of the international scientific community through the proposal and initiation of randomized multicenter clinical studies that will quickly determine the real prospect of the use of several types of treatment. Besides all of these efforts, the development of anti-viral vaccines is connecting several groups around the world, representing a necessary development for the prevention and ultimate eradication of COVID-19.This new situation requires scientific journals to ensure the rapid publication of existing information, but at the same time to ensure its quality and identify the potential biases and limitations of the published data. As a task force of great relevance, scientific editors must filter through the existing material, while not failing to rely on the peer review process, and must immediately deliver a response to the authors and provide resources for the publication of data. In this regard, the benefits of open access publications are obvious, especially for research in which urgency and speed are so important. Unfortunately, the proportion of new scientific research being published in open access journals is disappointingly small. However, considering the urgency presented by the COVID-19 epidemic, there are some interesting initiatives to increase the openness of research, data, and publications. Nevertheless, we still see that only 30% of the articles related to this disease provide full text accessibility in the PubMed database.The CLINICS journal, as an official publication of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), now has the mission of expanding the scientific literature on all aspects of COVID-19. As a general and open access medical journal with an editorial board and reviewers of high scientific qualifications, that is committed to the importance and necessity of research on the current situation, CLINICS is in a prominent position of great responsibility.


Nonverbal communication is studied by a worldwide community of researchers. Thousands of peer-reviewed papers have been published on the subject , rules of evidence and procedure foster, to some extent, the use of false beliefs about deception cues and unsubstantiated, discredited, and pseudoscientific claims. During bench trials, for example, judges have to establish the facts to which laws are applied. Essentially, they observe and listen to witnesses and, subsequently, assess their credibility. Based on the witnesses' credibility, judges will give more or less weight to their testimony. This is how judges will often decide what happened when witnesses have different accounts of a same event , appeals to authority , and anecdotal evidences ?Scholars, on the other hand, should conduct deception research also with members of the judiciary, not only law enforcement, and publish articles in law journals. Changing court culture takes time, but judges regularly turn to law journals for their decisions rather than peer-review articles because unlike the latter, expert testimony is not necessarily required for the former Hesler, . FurtherThe author confirms being the sole contributor of this work and has approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer JM declared a past co-authorship with the author VD to the handling editor.


Much has been said about the need for improving the current definitions of scientific authorship, but an aspect that is often overlooked is how to formulate and communicate these definitions to ensure that they are comprehensible and useful for researchers, notably researchers active in international research consortia. In light of a rapid increase in international collaborations within natural sciences, this article uses authorship of this branch of sciences as an example and provides suggestions to improve the comprehensibility of the definitions of authorship in natural sciences. It assesses whether the definition of authorship provided by the European Code of Conduct for Research Integrity can deal with current issues and problems of scientific authorship. Notably, problems that are experienced in project groups with researchers coming from multiple countries. Using theories developed by Jürgen Habermas and Robert Merton, a normative framework is developed to articulate ethical authorship in natural sciences. Accordingly, enriching the current definition of authorship with normative elements and using discipline-specific metaphors to communicate them are introduced as possible ways of improving the comprehensibility of the definition of authorship in international environments. Finally, this article provides a proposal to be considered in the future revisions of the European Code of Conduct for Research Integrity. Scientific authorship, as “the traditional vehicle of scientific communication”, faces an increase in the number and range of actors which it links  that provide a general description of what determines who an author is. These codes are the official tools in laying out professional responsibilities and explaining the limits of acceptability in academia  to them with the expectation to receive similar favors in the future , have the highest rates of international collaborations  is chosen. The publisher, All European Academies (ALLEA) consists of 59 Science Academies based in more than 40 countries ALLEA , and thupublication and dissemination as an important aspect of good research practice. Issues such as sequence of authorship, timely, open, transparent and accurate communication to the general public, acknowledgment of the important contribution of others and disclosure of conflict of interests are also mentioned. More importantly, ECCRI encourages authors to acknowledge that authorship is based on “a significant contribution to the design of the research, relevant data collection, or the analysis or interpretation of the results” , and remotely linking that definition to the fundamental principles of research integrity that are not always relevant to the realities of scientific authorship, this article suggests adding separate normative elements to this definition, which are relevant to the concept of ethical authorship. Doing this not only explains who is an author, but also readily clarifies who is an ethical author , to providing a more comprehensive picture that also entails the characteristics of an ethical author (depending on what authorship may mean in the given disciplines and time). Providing a definition that is enriched with these normative components will potentially also give guidance in relation to conflicting interests/perspectives (e.g. on who deserves to be a co-author) on authorship in practice through using underlying norms of practices of authorship.Using this method seems to take the stress away from defining authorship with n ethical author, a new method will be suggested to articulate the concept of authorship in ways that will make the provided definition in COCs more accessible and useful in practice. To that end, this section will first propose a theoretical framework to extract the normative elements involved in determining what ethical authorship is in the natural sciences. Later, means of communicating those norms will be suggested. These suggestions aim to decrease the likelihood of making dissimilar interpretations from the definition of authorship, and make them more practical and relevant to international collaborations.In light of challenges faced in providing a definition of authorship that copes with the complexities of modern science, this article suggests using normative elements in addition to (more) descriptive elements in defining authorship. As mentioned in the introduction, while defining authorship is complex, the presence of international co-authors who come from various institutions and cultural backgrounds make the task of explaining what authorship entails even more difficult. Therefore, through delineating the characteristics of aScientists working today have a myriad of options for the publication of their work. Since the scientific community is best placed to judge the merits of authored science and to provide critical remarks  community seem especially relevant to the issue of authorship in science. Building on the work of C.S. Peirce, he considered the scientific community as an almost ideal speech community, as an approximation of the normative ideal of communication where (via anonymous peer review and other techniques) manipulation and strategic communication is abolished, hierarchies do not count and no other force is at work than the force of the stronger argument Zwart .Given the role of scientific authors in communication of claims about nature, using Habermasian views seems to be crucial to the current context as these can help lay out what it means to be an ethical author based on an author’s role in producing objective scientific knowledge. In doing that, this article uses a dichotomy that was suggested by Habermas in the 1970s and will develop it further using his later theories on the communicative act.reflective and productive knowledge. He asserts that productive knowledge is the type that does not question its own epistemological foundation and hence, lacks self-reflection. Reflective knowledge, on the other hand, is the result of genuine discourse and reflection  is to achieve consensus on them  actions. According to him, understanding necessitates communication, but motivations for communication can either be Habermas . Thus, iOn the basis of this understanding of scientific knowledge, normative elements of authorship that contribute to the production of this type of knowledge can be extracted. One way of doing this is to start with the functions of authorship for science and highlighting the required normative features that result in the production of objective scientific knowledge.only with the purpose of validating conclusions and aimed at improving understanding. That is to say, from the perspective of authoring scientists, the aims of communicating results ought to be becoming self-reflective, and improving the scientific community’s understanding of nature via genuine discourse.Given the emphasis that Habermas puts on conditions of communication for the production of objective scientific knowledge, his theories can guide this article in delineating the normative aspects involved in authorship in the natural sciences. To practice authorship in accordance with Habermasian ideals implies communicating perceptions of natural phenomena to other scientists science), and the interests of two other important stakeholders, namely scientists and scientific institutions, seem to remain unaddressed.Yet, these ideals put forward by Habermas expose scientific authorship to a new tension. While important normative elements of ethical authorship can be extracted from Habermasian theories, they seem rather general (be communicative rather than strategic) and may not be immediately practical or realistic. Moreover, highlighting self-reflection and initiation of genuine discourse for understating nature, as legitimate conditions of producing objective science, seems to satisfy the interests of one of the stakeholders of scientific endeavor  authorship is the mean between deficiency (i.e. insufficient emphasis on the importance of sharing knowledge through scholarly publications) and excess (i.e. publishing merely to boost performance indicators).reasonableness in productivity and communication is not very difficult. One can correctly argue that similar to the notion of ‘significant’ in the context of ‘significant contribution’, ‘reasonable’ in the context of ‘reasonableness in productivity and communication’ is open-ended and requires further qualification to prevent misunderstanding in international co-authorships. Thus, although Habermas helps this article in identifying the basis and contours of ethical authorship in the natural sciences, using his theories contributes to a new practical tension. Namely, yet another open-ended statement (i.e. reasonableness in productivity and communication) is being used to explain what is it to be an ethical author. In terms of (Aristotelian) virtue ethics: the difference between reasonable and unreasonable, between sufficient, insufficient and excessive, cannot be defined exactly (in quantitative terms) but is rather a matter of attitude and ethos, which is missing here.Given the critiques that were leveled against the ECCRI’s definition of authorship in this paper, identifying a new tension about the state of reasonableness in productivity and communication of scientific knowledge.One way to address this problem is to turn to other sources that, while sharing a core fundamental basis with Habermasian theories, are more pragmatic in dealing with issues that are linked with personal and institutional gains from publications. Given the tight links of authorship with the reward system of science  the boundaries of ‘reasonableness in productivity and communication’ will be limited with Mertonian values. That yields a normative continuum with a green zone in the middle that represents reasonableness in productivity and communication (the “mean” of virtue ethics). This article argues that this green area entails the essence of what it is to be an ethical author in the natural sciences Fig. .Fig. 4ThNow that some normative elements suitable for the definition of authorship in the natural sciences are identified, the next challenge is to suggest methods for the communication of these to international co-authors. As mentioned earlier, one way of communicating these definitions at the moment is via COCs such as the ECCRI, but given the challenges of communicating norms of authorship to international co-authors, a new approach in formulating and communicating these normative elements will be suggested.In the last section, a hybrid solution was used that was a combination of theories developed by Habermas and Merton. It was concluded that in the natural sciences, scientists must publish the results of their observations, experiments, and analyses with the aim of becoming self-reflective and improving the understanding of the scientific community, without exclusively thinking about their own interests, through adhering to the ethos of science as put forward by Merton.The next challenge is to find effective methods for communicating these abstract normative elements to international co-authors in a way that is sensitive to differences in terms of research cultures and conventions between disciplines and global regions. Given the challenges of providing descriptive prescriptions that are useful in daily practice, this article suggests the use of relevant metaphors as an effective way of explaining the ethos of reasonableness in the communication of scientific knowledge. To further understand the role that metaphors can play in the communication of norms of authorship, the following two sections will explain the advantages and challenges of using metaphors in the current context.This section will stress the usefulness of metaphors in explaining the norms of ethical authorship of the natural sciences to international co-authors, and suggests that using metaphors in parallel with descriptive prescriptions of the COCs is likely to improve the understanding of international co-authors about these norms.It is argued that metaphors can be used as interpretive conceptual resources that allow one to understand the logic and entailments of concepts Johnson . Hence, Furthermore, since the perceptions and inferences that follow from the use of metaphors are believed to benefit actors in both understanding and making the appropriate action , developed metaphors will not be irrational or non-conceptual. Regarding the second critique, given that this article suggests using metaphors that are developed by field-experts and in addition to descriptive definitions, metaphors aimed at explaining the suggested concept of ethical authorship are likely to trigger similar moral values for co-authors independent of their nationality or culture. Thus, with the use of metaphors that allow scientists to infer similar normative values, prescriptions are less likely to be misinterpreted in a multinational environment.The next section will introduce a metaphor that can better explain the notion of ethical authorship in the natural sciences based on the normative framework that was suggested in this article.immediate experience and the latter a mediated experience  adopted in describing their perception of nature. Once the observer shares an observation, the interpreter experiences a communication: a symbolically established relationship with the observer. While both observer and interpreter are related to sectors of reality, the first has an Habermas .testimony in a court about a witnessed event. In this metaphor, the communication addresses an event that happened in the natural world, and the scientist(s) who observed the natural event are metaphorically acting like a voluntary witness.The idea that the observer has an immediate access to observable events while interpreters have a mediated access suggests that in empirical-analytic natural sciences where scientists express the details of one of their analyses/experiments about the natural world, communication of claims with other scientists can be seen as a metaphoric In relation to complying with the suggested framework, the voluntary witness satisfies the requirements of ethos of reasonableness:As this article argued, from the perspective of ethical authors, the aims of authorship of results in the natural sciences ought to be (a) becoming self-reflective, and (b) improving the scientific community’s understanding of nature via a genuine discourse. Therefore, a good voluntary witness in this metaphor needs to fulfill both of those conditions too. Since a voluntary witness is under no obligation to testify, it is safe to assume that she is genuinely interested in communicating observations. Furthermore, given that in most cases there are also other witnesses (whether voluntary or not) who could have seen the same event from a different perspective, or with dissimilar means (e.g. color vision deficiency affects how one sees colors), the mere presence of a voluntary witness in the hearing suggests that one is there to have her observations confirmed and recognized. Through having one’s testimony compared with testimonies provided by other witnesses, one will contribute to a genuine discourse, and finally, once judged by a competent jury, one will become aware of the flaws/misinterpretations in one’s own testimony.Also, in relation to the Mertonian ethos of science, the metaphoric voluntary witness remains relevant and meets the requirements of the normative framework. Regarding universalism, a good witness’ claims are not dependent on personal criteria such as race, nationality or religion. One can be a witness as long as the person involved is capable of knowing, and shows that she has indeed carefully observed the event about which she testifies. Communism would imply that the testimony belongs to the public domain and the jury, lawyers, prosecutors, or other witnesses are free to use the testimony that was provided by the voluntary witness as long as they mention the source. The focus is on sharing and transparency, rather than on secrecy. A good voluntary witness is also likely to be disinterested in what the ruling will be, and although interested in the topic and eager to have her observations and points of view recognized, ideally, she would not favor a side in the court. Organized skepticism would imply having a skeptical attitude towards what is being discussed. Good voluntary witnesses would not accept what they hear on its face value and will be critical about the provided facts and arguments by other witnesses.good voluntary witness and asking scientists to consider this as a model addresses several challenges involved in international collaborations. Perhaps highlighting a crucial similarity between authorship and witnessing explains this more clearly. Although at first glance authorship may seem a clear concept, on further inspection multiple ambiguities arise, as we have seen, due for instance to cultural and conventional differences of authorship between cultures or research fields . The witness concept is similar to authorship in this sense. Although it may initially seem straightforward, the precise meaning of the concept, as well as the obligations involved, may differ depending on the context. For instance, because witnesses play different roles in inquisitorial compared to adversarial systems, they might have dissimilar obligations. The term ‘witness’ may have a specific meaning (witnessing a concrete event) but also a more general meaning , and this can be discerned in authorship as well, for authors can be authors of specific publications, but also authors in a more general sense . Still, this article argues that in being a witness (as well as in being an author) a number of quintessential values are involved, such as, for instance, trustworthiness and impartiality, even if the precise role and function of witnesses (or authors) may differ in various contexts and traditions. That said, because the witness is a familiar concept, it is more likely to trigger similar moral values. Thus, it is safe to assume that by asking the question ‘how does a good voluntary witness act?’, ‘with honesty’, ‘objectively’ or ‘neutrally’ will be among the first mentioned qualities. Furthermore, due to its legal implications and use, a witness is likely to come across as an important function, which comes with certain responsibilities, one of which entails ‘respect’ for the subject of inquiry and those involved. A witness is valued for her observations as a ‘reliable’ participant and can be held ‘accountable’ if necessary.In explaining the concept of ethical authorship, using the notion of a In terms of the limitations of this metaphor, depending on the context one can think of factors that restrict its applicability. For instance, in countries where the public trust in the legal system is rather low, or countries where the adversarial legal system is used, the role of witness might be interpreted slightly differently, and hence, this metaphor might not be as useful as other places. Furthermore, a witness (no matter how well-intended or voluntary) might misremember facts, causing the testimony to become inaccurate, and an opportunistic person might try using this as an excuse for justifying dishonest reporting. It should also be clear that this metaphor is not going to benefit disciplines that do not require direct observations or empirical research.Given the rapid growth of international co-authorships, this article provides suggestions to improve the comprehensibility of current definitions of authorship for international co-authors. Via laying out the dynamics of modern authorship practices and analyzing the definition of authorship provided in the ECCRI, it was argued that this definition could be misinterpreted and misunderstood. Hence, enriching the current definition using normative elements that are specific to the practice of authorship was suggested. Due to the rapid growth of international co-authorships in the natural sciences, this branch of science was used as an example to create a framework for extracting the normative elements involved in the authorship of claims about nature.Using theory of communication and human interests in science developed by Habermas and Mertonian ethos of science, it was argued that scientists would ideally use publication as a means for facilitating understanding and validation of their results. In doing that, furthering scientific careers and benefitting from the fruits of scientific publications through gained credit is not necessarily unethical as long as scientists adhere to the ethos of science. Finally, it was suggested that using metaphorical statements that were developed by field-experts and supervisors on the basis of the suggested framework, provides a platform for communication of norms of authorship and their importance within international project groups.memory, the kind of educational takeaway message that scientists need to carry in order to deal with the moral question of future circumstances.Without empirical research to determine the effectiveness of using metaphors, no one can claim with certainty that by using metaphors misunderstanding of norms will be completely prevented. What this article claims is that given the normative aspects that are involved in determining authorship in the natural sciences, using metaphors makes these norms less likely to be misinterpreted, and hence, in combination with current definitions, informs scientists about the ideals that are necessary for ethical authorship. In addition to improving the comprehensibility of open-ended definitions for international groups, using metaphors extends the reach of COCs, and provides space for conversation and self-reflection. A metaphor becomes the All authors agree on the sequence of authorship, acknowledging that authorship itself is based on a significant contribution to the design of the research, relevant data collection, or the analysis or interpretation of the results ALLEA , p. 7;this article suggests considering the inclusion of the concept of ethical authorship and describing the state of reasonableness in the communication of scientific knowledge and noting the usefulness of metaphors in explaining this state. One proposal to consider and use in the ECCRI could be:Ethical Authorship refers to authors’ motivations for publications, the best of which entails using publications for validating methodology and results, and improving the understanding of the scientific community regarding the discussed issue. Using metaphors or other creative methods, supervisors and field-experts explain the concept of Ethical Authorship to their colleagues. One useful metaphor to explain what ethical authorship means in natural sciences, is to encourage authors to behave like a voluntary witness who witnessed an event in nature, and aims to testify about its details to the scientific community.Therefore, in addition to the current definition of authorship provided by ECCRI:Conducting empirical research among co-authors of different nationality/discipline to determine the success rates of using different metaphors in improving the comprehensibility of authorship definitions could be among useful topics for future research.