Example-Based Learning as a Guide for Revising a Peer-Reviewed Manuscript

Abstract

Publishing medical research is an increasingly competitive process for junior researchers. One critical step is revising a manuscript with editorial team feedback. This article’s purpose is to utilize a novel example-based learning approach to provide trainees and junior faculty with ten steps on how to successfully navigate the manuscript peer-review process. To this end, each step in the proposed guide is correlated with the authors’ most recent publication experience, with key manuscript and editor response letter versions made available through an open-access digital repository.

Introduction

Publishing health professions research is a daunting task—especially for trainees and junior faculty who lack meaningful research experience [1–3]. Given the effort required to prepare and submit a manuscript, it is easy to overlook the subsequent peer review process. For manuscripts that editors deem appropriate for future publication, one or more formal revisions—based on reviewer feedback—are typically required before publication [4]. A well-crafted revision of a manuscript in response to reviewer comments can significantly increase the chances of publication [5, 6]. There are few publications that help readers navigate the peer-review process. Several articles have explored the overall publication process and how to write a successful manuscript, but specific guidance on how to revise a peer-reviewed manuscript is lacking [7–9]. Furthermore, inexperienced authors may be confused or intimidated by the time and effort required to integrate reviewer feedback into meaningful revisions [10].

In this article, we offer a practical, ten-step guide for researchers with limited publication experience to revise a manuscript drawing upon the perspectives of two medical students (KST; DLC) and two senior faculty members (WCW; PBG). To harness the efficacy of example-based learning [8], we ground each of the steps in the real-world experience of three of the authors (KST; DLC; PBG) in revising a recently published manuscript in medical education [11]. We provide concrete examples of how we implemented these steps in our revisions (Table 1) and provide access to our response letters and several drafts of our manuscript in an open-access digital repository [12].

Table 1.

Implementing the ten-step guide to revising a peer reviewed manuscript

Steps	Example
1. Reviewer comments are constructive	Initial comments on our submitted manuscript were lengthy and some were difficult to address without reshaping entire parts of the paper. Prior to beginning revisions, our team had a frank discussion on whether it was worthwhile to pursue. Looking back, the decision to proceed was rewarding on several fronts: we honed our research question, improved our critical analysis, and ultimately produced a better quality final paper.
2. Start early	We completed two rounds of revisions (R1 and R2) for our paper [12]. The editor allowed four months to complete R1 and two months to complete R2; we submitted each revision in two months and one month, respectively. For a comparison of the first and final manuscript drafts for the two revisions; please see versions 0 and 16 for R1 and versions 17 and 25 for R2.*
3. Evaluate reviewer comments independently	Two members of our research team (DLC, KST) made independent responses for all the reviewer comments; two other members (PBG, WCW) edited the responses. The research team then collaborated on subsequent revisions to finalize the response letters and manuscript.
4. Use an active citation manager	We overlooked this problem and had to manually correct the citations and reference order toward the end of R1. The citation and reference changes can be seen between versions 14 and 15.
5. Save all revisions as separate documents	We saved 25 separate revised files for our manuscript; versions 1–16 were for R1 and versions 17–25 were for R2.
6. Do not shy away from major revisions	R1 involved reworking our research question entirely, requiring us to move and add large passages to improve the cohesiveness and clarity of the paper. These changes can best be seen in versions 1, 2, and 7. Two of our co-authors (DLC and PBG) also worked on a previous paper [15] where an updated literature review was required for the second-round revisions.
7. Address all reviewer comments	We responded to each individual reviewer comment, even if there was overlap with previous comments or changes. Occasionally, responses would simply state: “Please refer to Comment ____”; e.g., comment E6 in response letter 1.
8. It is okay to disagree	We provided explanations for non-implemented reviewer recommendations in comment C3 in response letter 1 and in comments B0 and B3 in response letter 2.
9. Submit a detailed response letter or table with the revised manuscript	Please see the response letters “Response Letter 1” and “Response Letter 2” associated with R1 and R2, respectively.*
10. Pay attention to correspondence	When we submitted our original manuscript, there was a formatting flaw with one of our tables. We answered the Editor’s emailed query and uploaded a reformatted manuscript within 24 h.

*All version numbers referenced can be found in the Brown Digital Repository at: https://repository.library.brown.edu/studio/collections/id_910/

Step 1

Reviewer Comments Are Constructive Criticism

It can be easy to become too comfortable with your paper’s current form and feel discouraged by a reviewer’s comment(s) (e.g., “How can this reviewer not understand my thesis statement?”). Resist this mental block. Remember that the peer-review process is not personal and the more detailed the comments, the higher the investment the (unpaid) reviewer made in your work. Whether they are signaling minor syntax changes that appear to be unnecessary minutiae or suggesting major revisions that alter the paper’s focus, use the reviewer comments as a valuable blueprint on how to improve your paper.

Step 2

Start Early

The revision process is often lengthy and intricate. When facing multiple reviewer comments, authors are often tasked with revising both small and large sections of the manuscript, clarifying biases or flaws in their conclusions or analyzing further the data [4]. Therefore, to ensure a high-quality manuscript is submitted on time, start the review process early. The research team should establish a detailed timeline early on and establish roles and responsibilities for each co-author. Build in extra time to allow for any unforeseen complications. For example, if you realize that you did not conduct crucial data analyses or that you missed out on several key search terms during literature review, extra time will allow you to adjust your revision process without missing the submission deadline.

Step 3

Evaluate Reviewer Comments Independently

Thinking critically about how to address reviewer comments necessitates creative brainstorming and a multifaceted approach to avoid group bias [13]. This is best accomplished by having the primary co-authors individually draft their responses to reviewers and then collaborating to arrive at a final decision on the responses and the resulting revisions to the manuscript.

Step 4

Utilize an Active Citation Manager

Do not waste time on formatting. Become a more efficient researcher by learning to master citation manager software (e.g., Endnote or Zotero) [14]. These programs keep track of your references and can automatically update reference order or citation style with a single click. A citation manager should be an essential part of your manuscript writing process from the onset, and when you begin revisions make sure you are using a document file with the software active before you make changes. Major revisions may entail deleting or rearranging sections of text and an active citation manager will save you many hours of manual reorganization of references and citations.

Step 5

Save All Revisions as Separate Documents

Proper digital file management is paramount throughout the process to ensure manuscript files are not lost. Though everyone’s file management preferences will differ, we recommend saving all manuscript iterations as separate files with a date and description so that you can easily retrieve them. Not only does this help maintain a record of the revisions but this will also allow you to have the files easily available if you need to make major changes or use text from an earlier version of the manuscript. Other tools, such as “Google Docs,” allow multiple users to access a single document simultaneously; however, it may be more challenging to keep a detailed record of revisions. We encourage our readers to experiment with file-sharing software to identify the tool that best suits their needs.

Step 6

Do Not Shy Away from Major Revisions

The editorial board will usually specify whether they are seeking major revisions or minor changes only. In the case of the former, do not hesitate to critically re-evaluate your study design, primary objective(s), or data or - if permissible - to add an additional author who can diversify your research team’s experience and approach. If the subject of your paper is in a rapidly developing field [15], it may be prudent to update your literature review after first obtaining permission from the editor.

Step 7

Address All Reviewer Comments

Receiving editorial feedback is a humbling experience. Show respect for the reviewers’ time and the peer-review process by responding separately to each comment. Not every response needs to be lengthy or detailed; for comments that you have already addressed, respectfully refer the editor to your previous response. Certain feedback points may also be purely observational and not necessitate a response but be sure to still acknowledge these comments in your response letter for completeness and consistency.

Step 8

It Is Okay to Disagree

There may be instances where you disagree with a reviewer’s recommendation or feel that the original text was misinterpreted. In these cases, thank the reviewer for their perspective and then provide a clear and concise rationale as to why you disagree with the suggestion—preferably supported with references. You should also think about how to rephrase the original text to portray the intended idea more clearly.

Step 9

Submit a Detailed Response Letter with the Revised Manuscript

Not all journals will require that you submit a separate document explaining your revisions, but ultimately it is in your best interest to do so. This will provide a platform to show how you systematically address each reviewer’s concerns and to show that you are taking the editorial board’s recommendations seriously. We recommend formatting your responses into a letter addressed directly to the reviewers, but some journals may have their own templates for how to structure such a document [16]. Be sure to label each of the reviewer’s comments and then highlight your responses and the commensurate changes in the manuscript [12]. Adhering to this system will allow the reviewers to quickly cross-reference their critiques with your responses and manuscript revisions. Even if your manuscript review requires multiple rounds of reviewer feedback, put in an equal effort to draft the detailed response letters for each revision. This will demonstrate your attention to detail and maximize your chance of acceptance.

Step 10

Pay Attention to Correspondence

Professionalism matters. During the revision process, you will inevitably need to correspond with the journal editorial staff, whether it is to sort out submission errors or inquire about the status of the current round of reviews. In all cases, be formal, polite, and punctual [17]. We recommend replying to any email from the journal staff within 24 to 48 h—even if your response is simply to acknowledge the correspondence. Do not let this detail slip through the cracks. If the corresponding author is out of town, another team member should be assigned responsibility for tracking and managing journal correspondence.

Conclusions

The volume of manuscript submissions to peer-review journals has increased dramatically over the last few decades [18, 19]. The competitive nature of publishing in high-impact journals underscores the importance of learning how to systematically revise a peer-reviewed manuscript. While our recommendations provide a general framework to structure revision goals and practices, we encourage readers to use these steps to tailor their approach to the priorities of their target journal. Ultimately, we hope this ten-step guide will empower junior researchers to successfully complete the manuscript revision process and become active contributors to the peer reviewed literature.

Authors’ Contributions

PBG conceived of the study; KST and DLC performed the literature review; KST, DLC, WCW, and PBG contributed to the writing.