4-3 Road to Publication

Overview

Have you ever dreamed of having a paper published with your name on it? The journey to get there can be more challenging than it seems. Getting started in academic scholarship can be challenging. Walking from idea conception through to publication and dissemination can seem like a very long road. In this chapter you will explore the overall journey that scholars and scientists take to get their work published.

Vignette

Dr. Shashi Benson was so proud of her postdoctoral fellow, Nico. Nico had just presented his education scholarship abstract at an international conference and received rave reviews. The abstract was selected as the top trainee abstract at the conference and was getting a lot of attention on the conference hashtag. Nico also reported that several individuals had approached him and stated that they were interested in reading his manuscript.

“You need to take a few moments to revel in your success,” stated Dr. Benson proudly, “But your fans are right… We should try to write this up.”

Nico nodded with trepidation. He’d written a few papers up before, but other than his dissertation papers, he’d never been at the helm of a project team. “I agree – I think riding this momentum would be fantastic! I jotted down some notes immediately after my presentation based on the comments and questions I received after my abstract session… so I’m hoping to turn that into the limitations and discussion parts of my paper.”

Dr. Benson smiled. Nico was really starting to think like a scientist. “Good! That means you were on the ball with things! You’re definitely owning the ‘first author’ chops on this go around! What else do you need help with? How can I help Nico?”

Nico scratched his head. He’d found this really amazing guide at the McMaster Program for Faculty Development – the Health Profession Education Research manual… He thought back to the section on the “road to publication” and pondered what he could get Dr. Benson to help with?

Deeper Dive into this Concept

First off, if you’re reading this section, you’re likely thinking about publication of your scholarly work. Congratulations on taking the first step down the road to publication! Many projects in health professions education don’t make it past the abstract stage, so that you’re thinking about taking a step down this road should be recognized.

The Challenge

Let’s be honest – presenting at conferences is exciting. Often, scientists or trainees are incentivized to get on the road to present their work at a national or international conference. However, taking that conference abstract and turning it into a full paper – that is a different story.

In one study, it was found that only 35% of medical education submissions out of two conferences (Research in Medical Education at the American Association of Medical Colleges; Canadian Conference on Medical Education [CCME]) were eventually published (1). Another more recent study found that only 31% of papers at CCME were eventually published (2).The road to publication can be a difficult one, mired by fragmentation of time, lack of “protected time” (i.e. funded time to engage in education scholarship), prioritization of other work (Clinical! Trainee support! Administrative! Leadership!), and a general sense of ill-reward for the extra effort (3). Unfortunately, our HPER chapter cannot help you with these. One big barrier, however, is the lack of expertise and access to mentors to help with this work.

An Approach

To start us off, the following is a short video that features Drs. Teresa Chan and Sandra Monteiro discussing 10 steps that are involved in getting your project from idea to publication.

Below, we have detailed these same 10 steps…. and added some additional literature and insights to assist you in your journey.

Step 1: Figure out your idea

When beginning your scholarly journey, it may be helpful to think broadly about the educational problem that inspires you, then gradually narrow your scope into a single research question. Scan the literature on the topic or discuss your idea informally with colleagues. Also consider your goals and the end product of your scholarship. Are you looking to produce a curricular innovation, program evaluation, or review paper? Are you looking to build upon or challenge an established practice or educational theory?

Step 2: Read broadly. Understand the conversations that are out there.

Think about journals as conversations between scholars – by scanning the literature, you can ‘eavesdrop’ on these conversations to get a sense of what’s already known, identify controversies or unanswered questions, and identify influential thinkers in the field (4).

Don’t be afraid to step outside your comfort zone and read outside your specific discipline or epistemology. Medical education scholarship often bridges and intersects research in cognitive psychology, behavioural economics and other social sciences. Read the literature with a view toward crafting your own research question (5). Don’t be afraid to move back to Step 1 and refine your idea after situating it within the broader scholarly discourse.

Most importantly, stay organized! Maintain a list of the most relevant papers you find, take detailed notes, and reflect on how concepts in the literature are connected to one another. Strategies to search the literature efficiently are covered in Chapter 2-1.

Step 3: Build your team

At this point, you will either be a member of a team that is already working together, or building your own team from scratch. Consider who you would like to include and how they would fit into your project. You might want to invite team members that specialize at finding articles (research librarian), writing, study design (methodologist), data analysis (statistician), or who have specific insight into your educational context or problem (frontline educators or learners). At this stage, it is critical to explicitly discuss authorship so as to avoid awkward misunderstandings and hurt feelings at the end of your project. Collaborating effectively with a research team is covered in more detail in Chapter 4-2.

Step 4: Develop and write your study protocol

A study protocol acts as a roadmap or playbook for your research team. It outlines background information that you identified from your literature review, specifies your hypotheses, aims and research question, and lays out your methods in detail. It also serves two other concrete purposes – a research protocol is often required to gain research ethics approval (or exemption) from your institution and it can also be adapted to apply for research grants.

Step 5: Data collection

Data collection should only proceed after appropriate institutional ethics review or exemption (refer to Chapter 4-1 for more detail). Consider pilot testing your data collection instruments with your study team or a small group of participants before rolling them out for broader use. For example, pilot testing an online questionnaire might identify technical glitches or issues with an individual item’s clarity or relevance to the research question (6). Consider technological aids that can help with data collection, such as Google Forms or Microsoft Forms (for questionnaires) or Covidence (for systematic reviews of the literature).

Step 6: Data analysis

As a junior researcher, it is helpful to have a data analysis expert on your research team. Most data analysts prefer to be involved early in the research project. If they are involved early, they can help align your research question to your data analysis plan and write the Data Analysis portion of the research protocol. If you’re a graduate student, involving your supervisor at this stage can also be helpful. Consider familiarizing yourself with data analysis software that is relevant to your project and seek out expert consultation when needed.

Step 7: Writing with your team

First, take stock of your findings and reflect on whether they support or refute your original hypothesis and how they might be situated within the broader literature. Putting your research on paper can be a daunting task (even for experienced scholars!) To make things more manageable, set a schedule and put the ‘project manager’ in charge. Employ the diverse strengths and knowledge of your research team to write collaboratively. It may be helpful to delegate writing specific sections of the paper to different members of the research team depending on their knowledge and experience. Tools like Google Docs or Zotero (a free reference manager that can be used with Google Docs) can help your team work collaboratively in real-time. More information on writing collaboratively can be found in Chapter 4-2.

Step 8: Putting together your first draft

Write with a view toward persuading your audience that your work is important, timely and relevant to them.

Consider framing the introduction of your paper using the problem/gap/hook heuristic to draw readers into your work and to situate your research into the broader scholarly conversation (4). Specify your methods section in enough detail that a reader could theoretically replicate your work. In the Discussion, interpret your findings and connect them to the literature you identified in Step 2.

Getting your paper published needs persistence and resilience! Pick your target journal along with a few other journals that will be your backups in case your paper isn’t accepted to your top choice. When choosing a journal, consider your target audience and whether the journal is open access and/or has any Article Processing Charges. Make sure your research team is familiar with the International Committee of Medical Journal Editors (ICJME) criteria on authorship (7).

Step 9: Submit to your target journal

Congratulations on making it this far! At this point, you have written your paper and painstakingly formatted it based on your target journal’s specifications.

At this point, it’s important to recognize that only 10-20% of papers are ultimately accepted for publication. Even when a paper is ultimately accepted, authors are usually asked to ‘revise & resubmit’ their manuscript which can sometimes mean extensive revisions based on feedback from reviewers and editors. Even if your manuscript is rejected after peer review, use reviewer comments to reframe and improve your paper before submitting it onward to the next journal. Make sure that you only submit your article to one publication at a time. Unless you are publishing a preprint (8), most journals will require you to guarantee that you have your work under consideration at their journal exclusively. This means that you must either wait for a journal to reject your article or withdraw an article before submitting it elsewhere. Preprints, which have been popularized during the COVID-19 pandemic) are used by scientists to share their findings in a pre-peer review format in a manner that allows them to gather feedback from the broader scientific community (9). Popular preprint archives are usually associated with particular scholarly populations, although there are general preprint servers as well:

• General Preprint Servers – Authorea, OSF Preprints, PeerJ
• Social Sciences: Social Science Research Network (SSRN), SocArXiv
• Health professions include: medRxiv, bioRxiv

For some insights on the journal editor’s point of view, listen to this MacPFD Spark podcast which features Dr. Teresa Chan interviewing Dr. Laura Roberts & Mary Beth DeVilbiss from the leading journal Academic Medicine.

Step 10: Share your success!

Phew! You successfully published your paper. Congratulations!! Now take a deep breath and consider how you will let others know about your findings and ultimately translate your research into action. Think about implementing your findings locally, presenting your work at local, national or international conferences, and amplifying your key messages through social media, blog posts or podcasts. Consider using a knowledge translation framework, like the Knowledge-to-Action cycle (10), to implement your research findings systematically and deliberately. Refer to Chapter 4-5 for more information on knowledge translation and dissemination activities.

Vignette Conclusion

“You know what, Dr. Benson? I’ve actually been writing as I go for this paper, so my rough draft of the abstract, introduction, and methods are largely done. Do you mind if I send you the link to the paper and you can review it with an editor’s eye?” Nico asked.

“Yes that makes sense – but please, I’ve told you too many times, please call me Shashi,” Benson replied. She was very proud that her apprentice was becoming so masterful at this whole process. “But before I review, do you have a sense of your target journal so I can read with that group in mind?”

“Yeah, so in the HPER manual they suggest that we plan three to five journals deep, in case we don’t get an immediate acceptance. LOL!” Nico chuckled. He knew how hard this whole game was, but he thought it was good advice to have a back up plan… or four.

“In discussions with the team so far, I think we were thinking of hitting up: Journal of Continuing Education in the Health Professions, Perspectives on Medical Education, and then maybe Canadian Medical Education Journal? I think these are all really great journals so I would be really happy if we publish in any of them.”

“Great choices Nico,” Shashi stated. “I’ll take a look then at the journal’s ‘About’ page and figure out what their editorial stance is all about and review a few papers from your first choice journal that are from the same article type so that I get a feel for things…”

“Oh, I’ll add a few of my favourite articles from that journal to the email I’ll send you. Not a problem!” Shashi exclaimed as she beamed with pride. Nico was really coming into his identity as a health professions education scholar

References

1. Walsh CM, Fung M, Ginsburg S. Publication of results of abstracts presented at medical education conferences. JAMA. 2013 Dec 4;310(21):2307-9. https://jamanetwork.com/journals/jama/article-abstract/1787399
2. Guay JM, Wood TJ, Touchie C, Ta CA, Halman S. Will I publish this abstract? Determining the characteristics of medical education oral abstracts linked to publication. Canadian Medical Education Journal. 2020 Dec;11(6):e46. https://journalhosting.ucalgary.ca/index.php/cmej/article/view/69558
3. Zibrowski EM, Weston WW, Goldszmidt MA. ‘I don’t have time’: issues of fragmentation, prioritisation and motivation for education scholarship among medical faculty. Medical Education. 2008 Sep;42(9):872-8. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2923.2008.03145.x
4. Lingard L. Joining a conversation: the problem/gap/hook heuristic. Perspectives on Medical education. 2015 Oct;4(5):252-3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602011/
5. Mattick K, Johnston J, de la Croix A. How to… write a good research question. The clinical teacher. 2018 Apr;15(2):104-8. https://onlinelibrary.wiley.com/doi/abs/10.1111/tct.12776
6. Artino Jr AR, La Rochelle JS, Dezee KJ, Gehlbach H. Developing questionnaires for educational research: AMEE Guide No. 87. Medical teacher. 2014 Jun 1;36(6):463-74. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059192/
7. Defining the Role of Authors and Contributors. International Committee of Medical Journal Editors. 2021. Accessed on October 21, 2021, available at: http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html
8. Maggio LA, Artino Jr AR, Driessen EW. Preprints: Facilitating early discovery, access, and feedback. Perspectives on medical education. 2018 Oct;7(5):287-9. https://doi.org/10.1007/s40037-018-0451-8
9. Fraser N, Brierley L, Dey G, Polka JK, Pálfy M, Nanni F, Coates JA. The evolving role of preprints in the dissemination of COVID-19 research and their impact on the science communication landscape. PLoS biology. 2021 Apr 2;19(4):e3000959.  Final publication doi: 10.1371/journal.pbio.3000959 Preprint here – doi: 10.1101/2020.05.22.111294v3.abstract
10. Straus SE, Tetroe J, Graham I. Defining knowledge translation. Can Med Assoc J. 2009 Aug 4;181(3-4):165-8. https://www.cmaj.ca/content/181/3-4/165.short

About the Authors

name: Siraj Mithoowani

institution: McMaster University

Siraj Mithoowani (he/him) is an Assistant Professor within the Division of Hematology & Thromboembolism, Department of Medicine, Faculty of Health Sciences, McMaster University. He is a member of McMaster Education Research, Innovation, and Theory (MERIT) program.

name: Teresa Chan

institution: McMaster University

Teresa Chan (she/her) is an Associate Professor in the Department of Medicine within the Division of Emergency Medicine and cross-appointed to the Division of Education & Innovation. She is an associate member of the Department of Health research methods, Evidence, and Impact. She is also the Associate Dean, Continuing Professional Development Office (CPD) and a Clinician Scientist, McMaster Education Research, Innovation & Theory (MERIT) Program, Faculty of Health Sciences, McMaster University.