Clinician’s Commentary on McEachern et al

The emphasis on evidence-based practice (EBP) and cost-effective treatment in the physiotherapy and medical professions has led to an increased need for robust evidence to improve patient care and health outcomes.² Core to this concept is the exchange of research knowledge by means of publication and to translate it into policies and change processes. In addition to the importance of publication for EBP, it is frequently an indicator for academic advancement or promotion, a quality rating of training institutions, or a requirement to obtain a postgraduate degree.³

The expectation would therefore be an increased publication rate over time. Although McEachern and colleagues observed this trend in their study,¹ most studies still report postgraduate publication rates in the medical field of only 30%–45%.^4,5 This indicates that in 55% of cases students’ research may not be published, leading to a waste of resources and injustice to patients, funders and collaborators, and the scientific community.⁶

Reasons for lower publication rates need to be explored. McEachern and colleagues¹ investigated the rate of journal publications in their postgraduate programme, as well as the association of lead advisor role, lead advisor experience, data collection tool, sample size, and research topic. They identified small sample sizes, quantitative study designs, and clinician-led projects as barriers to publication. Other studies have also indicated barriers to successful publication as the time taken to complete a project, lack of continuity of supervisor–student collaboration after completion of coursework, lack of understanding of the publication process, low self-perceived ability in conducting research and publishing,⁷ and confusion or concerns generated by predatory journals.⁵

The publication process itself has also been reported to adversely affect publication rate. It includes factors such as time to write the article, co-authors, an unwillingness or inability to pay publication fees, time for the peer review process, time to publication after acceptance, or rejection after peer review.⁴ Randomized controlled trials, studies involving multiple centres, and studies with high impact and quality are more likely to be published.⁵ Conducting studies with such methodological qualities for postgraduate purposes (when the expectations might be only a mini-dissertation, research report, dissertation or to focus on developing the researcher) is not always feasible, applicable, or expected.

Rejection rates may seem higher than in the past decade because of the shift in physiotherapy and medical journals toward higher-quality, evidence-based research as the need for evidence, publication rates, and number of submissions increases.² This, however, seems contradictory. Although it indicates an increase in high-quality evidence, it is also a barrier to young researchers working toward promotion and development or completion of degrees.

The focus of publication and publication rates should therefore perhaps be revisited. The question can be asked as to whether the focus should instead shift to increasing research productivity and developing competent researchers rather than increasing the number or rate of publication.⁶

Linguistic and non-linguistic challenges among novice writers or researchers need to be addressed.⁸ An increase in the number of venues in which to publish work, in the number of open-access journals, and in the number of doctorally trained researchers in faculties have been indicated as aspects that could help to increase publication rates.⁵

A passion for research and publishing should, however, be cultivated in the institution. Warden and colleagues⁵ have indicated that the odds for publication increase when the research is done in doctorate-granting institutions. Attention should also be given to students’ or researchers’ understanding of publication and research. Strategic research conceptualization, awareness of the socio-cultural context, methodological versatility, writing for multiple academic–linguistic communities, interpreting and responding to reviewers’ comments, gatekeeper awareness, and awareness of editors’ agendas should be taught.⁸ Duncanson and colleagues³ have also suggested that when presenting a writing for publication programme, the focus should be on skills such as reflexivity, teamwork, collegiality, peer feedback, talking about research, and critical thinking about research.

In conclusion, a need exists for high-quality evidence to enhance EBP in the profession. At the same time, however, postgraduate students need to be trained to become competent researchers and authors with high publication rates in the midst of the barriers described here. Novice and authentic methods to solve this problem should be investigated, as well as how knowledge is actually applied beyond publication.⁷ Only then will the main outcome of research and EBP be accomplished.