An international survey and modified Delphi process revealed editors' perceptions, training needs, and ratings of competency-related statements for the development of core competencies for scientific editors of biomedical journals

Development and validation of a rurality index for healthcare research in Japan: a modified Delphi study

OBJECTIVES

Rural-urban healthcare disparities exist globally. Various countries have used a rurality index for evaluating the disparities. Although Japan has many remote islands and rural areas, no rurality index exists. This study aimed to develop and validate a Rurality Index for Japan (RIJ) for healthcare research.

DESIGN

We employed a modified Delphi method to determine the factors of the RIJ and assessed the validity. The study developed an Expert Panel including healthcare professionals and a patient who had expertise in rural healthcare.

SETTING

The panel members were recruited from across Japan including remote islands, mountain areas and heavy snow areas. The panel recruited survey participants whom the panel considered to have expertise.

PARTICIPANTS

The initial survey recruited 100 people, including rural healthcare providers, local government staff and residents.

PRIMARY OUTCOME MEASURES

Factors to include in the RIJ were identified by the Expert Panel and survey participants. We also conducted an exploratory factor analysis on the selected factors to determine the factor structure. Convergent validity was examined by calculating the correlation between the index for physician distribution and the RIJ. Criterion-related validity was assessed by calculating the correlation with average life expectancy.

RESULTS

The response rate of the final survey round was 84.8%. From the Delphi surveys, four factors were selected for the RIJ: population density, direct distance to the nearest hospital, remote islands and whether weather influences access to the nearest hospital. We employed the factor loadings as the weight of each factor. The average RIJ of every zip code was 50.5. The correlation coefficient with the index for physician distribution was -0.45 (p<0.001), and the correlation coefficients with the life expectancies of men and women were -0.35 (p<0.001) and -0.12 (p<0.001), respectively.

CONCLUSION

This study developed the RIJ using a modified Delphi method. The index showed good validity.

Advancing Self-Evaluative and Self-Regulatory Mechanisms of Scholarly Journals: Editors’ Perspectives on What Needs to Be Improved in the Editorial Process

Meticulous self-evaluative practices in the offices of academic periodicals can be helpful in reducing widespread uncertainty about the quality of scholarly journals. This paper summarizes the results of the second part of a qualitative worldwide study among 258 senior editors of scholarly journals across disciplines. By means of a qualitative questionnaire, the survey investigated respondents’ perceptions of needed changes in their own editorial workflow that could, according to their beliefs, positively affect the quality of their journals. The results show that the most relevant past improvements indicated by respondents were achieved by: (a) raising the required quality criteria for manuscripts, by defining standards for desk rejection and/or shaping the desired qualities of the published material, and (b) guaranteeing a rigorous peer review process. Respondents believed that, currently, three areas have the most pressing need for amendment: ensuring higher overall quality of published articles (26% of respondents qualified this need as very high or high), increasing the overall quality of peer-review reports (23%), and raising reviewers’ awareness of the required quality standards (20%). Bivariate analysis shows that respondents who work with non-commercial publishers reported an overall greater need to improve implemented quality assessment processes. Work overload, inadequate reward systems, and a lack of time for development activities were cited by respondents as the greatest obstacles to implementing necessary amendments.

Reaching consensus on an analgesia protocol for paediatric burn patients in a resource-scarce South African community

BACKGROUND

Despite the exceptional burden of burns in low- and middle-income countries (LMIC) and the importance of adequate analgesia in burn care, there is a lack of analgesia protocol developed in resource-scarce settings. This necessitates the development of an analgesia protocol applicable to the resource-scarce setting. This study presents the findings of a modified Delphi study aimed at achieving consensus by a panel of experts in the management of burn injuries from low- and middle-income settings across Africa.

METHODS

A two-round Delphi survey was conducted to achieve consensus on an analgesia protocol for paediatric burn patients for a resource-limited setting. The Delphi panel consisted of nine experts with experience in management of burn injuries in low-income settings.

RESULTS

Consensus was determined by an a priori threshold of 80% of agreement for a drug to be included in the analgesia protocol. There was a largely overarching agreement with regard to the background analgesia protocol and strong agreement regarding the use of an initial dose of ketamine and midazolam for procedural sedation.

CONCLUSION

A modified Delphi method was used to obtain expert consensus for a recently adopted analgesia protocol for burn-injured children in a resource-limited setting, with experts in the management of burn injuries in low- and middle-income settings. The expert consensus leads to the rigour and robustness of the protocol. Delphi methods are exceptionally valuable in healthcare research and the aim of such studies is to find converging expert opinions.

Benefits and obstacles to cell therapy in neonates: The INCuBAToR (Innovative Neonatal Cellular Therapy for Bronchopulmonary Dysplasia: Accelerating Translation of Research)

Cell-based therapies hold promise to substantially curb complications from extreme preterm birth, the main cause of death in children below the age of 5 years. Exciting preclinical studies in experimental neonatal lung injury have provided the impetus for the initiation of early phase clinical trials in extreme preterm infants at risk of developing bronchopulmonary dysplasia. Clinical translation of promising therapies, however, is slow and often fails. In the adult population, results of clinical trials so far have not matched the enticing preclinical data. The neonatal field has experienced many hard-earned lessons with the implementation of oxygen therapy or postnatal steroids. Here we briefly summarize the preclinical data that have permitted the initiation of early phase clinical trials of cell-based therapies in extreme preterm infants and describe the INCuBAToR concept (Innovative Neonatal Cellular Therapy for Bronchopulmonary Dysplasia: Accelerating Translation of Research), an evidence-based approach to mitigate the risk of translating advanced therapies into this vulnerable patient population. The INCuBAToR addresses several of the shortcomings at the preclinical and the clinical stage that usually contribute to the failure of clinical translation through (a) systematic reviews of preclinical and clinical studies, (b) integrated knowledge transfer through engaging important stakeholders early on, (c) early economic evaluation to determine if a novel therapy is viable, and (d) retrospective and prospective studies to define and test ideal eligibility criteria to optimize clinical trial design. The INCuBAToR concept can be applied to any novel therapy in order to enhance the likelihood of success of clinical translation in a timely, transparent, rigorous, and evidence-based fashion.

Journal editors: How do their editing incomes compare?

Background: The work of journal editors is essential to producing high-quality literature, and editing can be a very rewarding career; however, the profession may not be immune to gender pay gaps found in many professions and industries, including academia and clinical medicine. Our study aimed to quantify remuneration for journal editors from core clinical journals, determine if a gender pay gap exists, and assess if there are remuneration differences across publishing models and journal characteristics. Methods: We completed an online survey of journal editors with substantial editing roles including section editors and editors-in-chief, identified from the Abridged Index Medicus "Core Clinical" journals in MEDLINE. We analyzed information on demographics, editing income, and journal characteristics using a multivariable partial proportional odds model for ordinal logistic regression. Results: There were 166 survey respondents (response rate of 9%), which represented editors from 69 of 111 journals (62%). A total of 140 fully completed surveys were analyzed (95 males and 45 females); 50 (36%) editors did not receive remuneration for editorial work. No gender pay gap and no difference in remuneration between editors who worked in subscription-based publishing vs. open access journals were detected. Editors who were not primarily health care providers were more likely to have higher editing incomes (adjusted odds ratio [OR] 2.96, 95% confidence interval [CI] 1.18-7.46). Editors who worked more than 10 hours per week editing earned more than those who worked 10 hours or less per week (adjusted OR 16.7, 95%CI 7.02-39.76). Conclusions: We were unable to detect a gender pay gap and a difference in remuneration between editors who worked in subscription-based publishing and those in open access journals. More than one third of editors surveyed from core clinical journals did not get remunerated for their editing work.

Consensus-based urban sustainability framework for Iraqi cities: A case study in Baghdad

The paper proposes a comprehensive sustainability framework for urban development projects in hot, dry developing regions. Such a framework is required due to the lack of knowledge in these regions of issues including population-inflation, traffic congestion, environmental pollution, water shortages and high energy consumption. Iraq is one such developing country having a hot, dry, semi-arid climate with unique socio-cultural factors which have been impacted by four decades of war. New development projects are underway but scant attention has been paid to sustainability, specifically in cities e.g. Baghdad. This framework has been developed using expert consultations to reach a consensus on its dimensions, three in total: the use of satellite cities around existing cities for various purposes (residential, industrial, commercial and administrative) with the creation of a green belt, the determination of criteria for future domestic energy projects, e.g. the minimum energy requirements for an average Iraqi family and on-site renewable sources such as solar energy, and the application of a set of urban sustainable development factors to improve the quality of services and human well-being. This study presents, for the first time, a comprehensive sustainability framework for a country that has suffered several decades of wars and international sanctions. This framework was subsequently validated using semi structured interviews with 15 local intra-organizational leaders. The key findings of this paper based on this validation show that 12 out of 15 intra-organizational leaders highly recommended the adoption of the developed framework, highlighting their level of understanding, accepting, feasibility and challenging, and their future scope to develop this framework in order to enhance the quality of life at the city scale. Moreover, the leaders of the Mayoralty of Baghdad emphasised to adopt the developed framework in order to mitigate the current and future challenges of the capital Baghdad, including housing deficit, traffic problems, economical issues, and environmental pollution. The key contributions of this study is its investigation of locality-specific issues in war-torn countries such as Iraq, specifically this includes; (a) analyzing locality-specific problems based on engagement with stakeholders, and the general public, (b) proposing a framework to solve multiple problems, including lack of environmental strategies, traffic congestion, housing deficit, rapid urbanization and population growth and, (c) validation of the framework through engagement with intra-organsational leadership in different ministries and organizations like, ministry of housing and construction, Mayoralty of Baghdad, ministry of water resources, UN-HABITIAT program in Iraq, ministry of electricity, National consultation engineering committee, and etc.

National Competencies for Registered Nurses in Primary Care: A Delphi Study

A Delphi (consensus) process was used to obtain national agreement on competencies for registered nurses (RNs) in primary care. A draft of competencies was developed by key informants. Following this, nurses with primary care experience/expertise completed a Delphi survey to rate the importance of competency statements on a six-point Likert scale. Statements not reaching consensus (agreement ≥80%) were modified and included in a second (final) round. The first survey was completed by 63% (n = 86/137) of participants and 84% (n = 72/86) of these participants completed the second survey. Most statements (n = 45) achieved agreement after the first survey; one statement was dropped and two were combined following the second round. The final list of competencies consists of 47 statements across six domains (professionalism; clinical practice; communication; collaboration and partnership; quality assurance, evaluation, and research; leadership). National competencies will help strengthen the RN workforce within primary care, improve team functioning, and support role integration/optimization.

Developing Academic Advisors and Competence Committees members: A community approach to developing CBME faculty leaders

INTRODUCTION

Implementing competency-based medical education (CBME) at the institutional level poses many challenges including having to rapidly enable faculty to be facilitators and champions of a new curriculum which utilizes feedback, coaching, and models of programmatic assessment. This study presents the necessary competencies required for Academic Advisors (AA) and Competence Committee (CC) members, as identified in the literature and as perceived by faculty members at Queen's University.

METHODS

This study integrated a review of available literature (n=26) yielding competencies that were reviewed by the authors followed by an external review consisting of CBME experts (n=5). These approved competencies were used in a cross-sectional community consultation survey distributed one year before (n=83) and one year after transitioning to CBME (n=144).

FINDINGS

Our newly identified competencies are a useful template for other institutions. Academic Advisor competencies focused on mentoring and coaching, whereas Competence Committee member's competencies focused on integrating assessments and institutional policies. Competency discrepancies between stakeholder groups existing before the transition had disappeared in the post-implementation sample.

CONCLUSIONS

We found value in taking an active community-based approach to developing and validating faculty leader competencies sooner rather than later when transitioning to CBME. The evolution of Competence Committees members and Academic Advisors requires the investment of specialized professional development and the sustained engagement of a collaborative community with shared concerns.

A scoping review on the roles and tasks of peer reviewers in the manuscript review process in biomedical journals

BACKGROUND

Although peer reviewers play a key role in the manuscript review process, their roles and tasks are poorly defined. Clarity around this issue is important as it may influence the quality of peer reviewer reports. This scoping review explored the roles and tasks of peer reviewers of biomedical journals.

METHODS

Comprehensive literature searches were conducted in Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Center, EMBASE, MEDLINE, PsycINFO, Scopus and Web of Science from inception up to May 2017. There were no date and language restrictions. We also searched for grey literature. Studies with statements mentioning roles, tasks and competencies pertaining to the role of peer reviewers in biomedical journals were eligible for inclusion. Two reviewers independently performed study screening and selection. Relevant statements were extracted, collated and classified into themes.

RESULTS

After screening 2763 citations and 600 full-text papers, 209 articles and 13 grey literature sources were included. A total of 1426 statements related to roles were extracted, resulting in 76 unique statements. These were grouped into 13 emergent themes: proficient experts in their field (3 items), dutiful/altruistic towards scientific community (7 items), familiar with journal (2 items), unbiased and ethical professionals (18 items), self-critical professionals (4 items), reliable professionals (7 items), skilled critics (15 items), respectful communicators (6 items), gatekeepers (2 items), educators (2 items), advocates for author/editor/reader (3 items) and advisors to editors (2 items). Roles that do not fall within the remit of peer reviewers were also identified (5 items). We also extracted 2026 statements related to peer reviewers' tasks, resulting in 73 unique statements. These were grouped under six themes: organisation and approach to reviewing (10 items), make general comments (10 items), assess and address content for each section of the manuscript (36 items), address ethical aspects (5 items), assess manuscript presentation (8 items) and provide recommendations (4 items).

CONCLUSIONS

Peer reviewers are expected to perform a large number of roles and tasks for biomedical journals. These warrant further discussion and clarification in order not to overburden these key actors.

Updated Editorial Guidance for Quality and Reliability of Research Output

Over the past few years, updated editorial policy statements of several associations have provided a platform for improving the quality of scientific research and publishing. The updates have particularly pointed to the need for following research reporting standards, authorship and contributorship regulations, implementing digital tools for the identification and crediting academic contributors, and moving towards optimal ethical open-access models. This article overviews some of the recent editorial policy statements of global editorial associations and reflects on the role of the regional counterparts in advancing scholarly publishing. One of the globally promoted documents is the Recommendations of the International Committee of Medical Journal Editors (ICMJE). Its latest versions contain statements on proper research reporting, reviewing, editing, and publishing. Points on ethical target journals and 'predatory' sources are also available. This year, in a move to update its editorial policy, the Committee on Publication Ethics (COPE) released the Core Practices, comprehensively reflecting on the major issues in publication ethics. Updated joint statements of medical writers associations are also available to implement transparent policy on contributorship in sponsor-supported research projects and related reports. Several suggestions are put forward to improve global editorial statements on online profiling, crediting, and referencing. It is also highlighted that knowledge and implementation of updated editorial guidance is essential for editors' good standing.

Improving the biomedical research literature: insights from authors' editors can help journal editors define and refine their core competencies

A team of stakeholders in biomedical publishing recently proposed a set of core competencies for journal editors, as a resource that can inform training programs for editors and ultimately improve the quality of the biomedical research literature. This initiative, still in its early stages, would benefit from additional sources of expert information. Based on our experiences as authors’ editors, we offer two suggestions on how to strengthen these competencies so that they better respond to the needs of readers and authors – the main users of and contributors to research journals. First, journal editors should be able to ensure that authors are given useful feedback on the language and writing in submitted manuscripts, beyond a (possibly incorrect) blanket judgement of whether the English is “acceptable” or not. Second, journal editors should be able to deal effectively with inappropriate text re-use and plagiarism. These additional competencies would, we believe, be valued by other stakeholders in biomedical research publication as markers of editorial quality.

Core competencies for scientific editors of biomedical journals: consensus statement

BACKGROUND

Scientific editors are responsible for deciding which articles to publish in their journals. However, we have not found documentation of their required knowledge, skills, and characteristics, or the existence of any formal core competencies for this role.

METHODS

We describe the development of a minimum set of core competencies for scientific editors of biomedical journals.

RESULTS

The 14 key core competencies are divided into three major areas, and each competency has a list of associated elements or descriptions of more specific knowledge, skills, and characteristics that contribute to its fulfillment.

CONCLUSIONS

We believe that these core competencies are a baseline of the knowledge, skills, and characteristics needed to perform competently the duties of a scientific editor at a biomedical journal.

An international survey and modified Delphi process revealed editors' perceptions, training needs, and ratings of competency-related statements for the development of core competencies for scientific editors of biomedical journals

Background: Scientific editors (i.e., those who make decisions on the content and policies of a journal) have a central role in the editorial process at biomedical journals. However, very little is known about the training needs of these editors or what competencies are required to perform effectively in this role. Methods: We conducted a survey of perceptions and training needs among scientific editors from major editorial organizations around the world, followed by a modified Delphi process in which we invited the same scientific editors to rate the importance of competency-related statements obtained from a previous scoping review. Results: A total of 148 participants completed the survey of perceptions and training needs. At least 80% of participants agreed on six of the 38 skill and expertise-related statements presented to them as being important or very important to their role as scientific editors. At least 80% agreed on three of the 38 statements as necessary skills they perceived themselves as possessing (well or very well).  The top five items on participants' list of top training needs were training in statistics, research methods, publication ethics, recruiting and dealing with peer reviewers, and indexing of journals. The three rounds of the Delphi were completed by 83, 83, and 73 participants, respectively, which ultimately produced a list of 23 "highly rated" competency-related statements and another 86 "included" items. Conclusion: Both the survey and the modified Delphi process will be critical for understanding knowledge and training gaps among scientific editors when designing curriculum around core competencies in the future.