2013

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Cuidebcck cn 5cientic PubIishing
Advice fcr students and ycung investigatcrs in the eId cf
HeaIth 5ervices and PcIicy esearch
The Canadian Association for Health Services and Policy Research (CAHSPR)
Student Working Group (SWG)
The Health System Performance Research Network (HSPRN)
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Cuidebcck designed by:
Rochelle Hayward- Graphic Designer
rochellehayward@live.ca
Cuidebcck Lead
Matthew Menear
PhD candidate, Public Health
University of Montreal
Ccntributing Authcrs 5WC Members
MicheIIe Amri
Masters candidate, Public
Administration
Queens University
5aneIa Cajic
Masters candidate, Applied Health
Services Research
Dalhousie University
Lindsay Hedden
PhD candidate, Population and
Public Health
University of British Columbia
5eija krcmm
PhD candidate, Health Services
Research
University of Toronto
uth Lavergne
PhD candidate, Population and
Public Health
University of British Columbia
Anne MahaIik
Masters candidate, Applied Health
Services Research
Dalhousie University
Adam T. MiIIs
PhD candidate
Johnson Shoyoma Graduate
School of Public Policy
University of Regina
Leah 5mith
PhD candidate, Epidemiology
McGill University
EIeni Wener
MA candidate, Disability Studies
University of Manitoba
Invited Authcr
cb Fraser
Masters of Nursing
University of Toronto
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Abcut this guidebcck
There are many published resources available to help graduate students learn about the process of
publIshIng scIenIIc papers In peer-revIewed journals. However, In our experIence, much oI Ihe besI advIce
we receive during our studies is passed on to us from our peers and mentors who teach us the unwritten
IrIcks oI Ihe Irade when II comes Io publIshIng In our eld.
Given this reality, this guidebook aims to provide students and young researchers involved in health
services and policy research (HSPR) with helpful, practical information on the various stages of the publishing
process. Much of this information has come directly from students and several of the top researchers in the
HSPR eld. Dur hope Is IhaI IhIs guIde demysIIes Ihe publIshIng process and helps Io make your publIshIng
experIence more posIIIve and successIul.
AckncwIedgments
The authors are grateful to Shivoan Balakumar, Agnes Grudniewicz and Saskia Sivananthan of the CAHSPR
SWG and Natasha Lane, Ashlinder Gill and Kristen Pitzul from the HSPRN for their helpful ideas, comments and
edIIs on Ihe guIdebook. We also Ihank CAHSPR Ior IheIr sIrong supporI oI Ihe SWC and Ior HSPRNs nancIal
support for the creation and dissemination of this guidebook.
The authors thank researchers and students who enhanced the guidebooks relevance by sharing their
advIce and experIences wIIh us, IncludIng RoberI orIulussI (DalhousIe UnIversIIy}, CIllIan Hanley (UnIversIIy
oI rIIIsh ColumbIa}, ClaIre Kendall (UnIversIIy oI DIIawa}, Sara KIrk (DalhousIe UnIversIIy}, MarIlyn MacDonald
(Dalhousie University), Kim McGrail (University of British Columbia), Peter Norton (University of Calgary), Joan
Sargeant (Dalhousie University), Sharon Straus (University of Toronto), Wendy Sword (McMaster University),
and Jennifer Zelmer (Editor-in-Chief, Healthcare Policy).
FInally, Ihe auIhors exIend specIal Ihanks Io Rob Fraser, InvIIed auIhor oI ChapIer 1U. Rob Is Iounder oI Rob
D. Fraser & Associates consulting services and the site Nursing Ideas, and is author of an award-winning book
titled The Nurses Social Media Advantage.
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TabIe cf Ccntents
The Ten CommandmenIs oI scIenIIc publIshIng ...................................................................... 6
ChapIer 1 - Ceneral publIshIng advIce Ior IraInees new Io Ihe eld .................................... 7
ChapIer 2 - TraInee-menIor relaIIonshIps and scIenIIc publIshIng ...................................1U
Chapter 3 - Commonly encountered authorship issues .........................................................13
ChapIer / - TargeIIng journals Ior publIcaIIon .........................................................................17
Chapter 5 - Commonly encountered writing issues ................................................................23
Chapter 6 - An overview of the peer review process ..............................................................28
Chapter 7 - Interacting with editors and reviewers, and dealing with criticism ...............31
Chapter 8 - Publishing qualitative research ..............................................................................35
ChapIer 5 - PublIshIng wIIhIn research projecI lIIe cycles ....................................................38
ChapIer 1U - DIgIIal Iools and scIenIIc communIcaIIon .......................................................44
Conclusion .........................................................................................................................................5U
References ....................................................................................................................................... 51

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The Ten Ccmmandments cf scientic pubIishing
1. Thou shalt always be on the lookout for publishing opportunities
2. Thou shalt identify a mentor who can guide you and provide support, resources
and opportunities for publishing
3. Thou shalt turn hard work into publications
4. Thou shalI choose your IargeI journal early and wIsely, emphasIzIng I
over impact factor
5. Thou shalt write to think, not think to write
6. Thou shalt be inspired by great writing style, while also developing your own voice
7. Thou shalI noI submII a paper wIIhouI readIng and adherIng Io Ihe specIc
submIssIon guIdelInes oI Ihe journal youre submIIIIng Io
8. Thou shalt receive criticism with an open mind and an open heart, and not let
rejecIIon deIer you Irom publIshIng work you belIeve In
9. Thou shalI leI scIenIIc InIegrIIy and Ihe spIrII oI dIscovery guIde you,
not career ambition
1U. Thou shalt embrace digital tools throughout the research and publishing process
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CeneraI pubIishing advice fcr trainees new tc the eId
and curiosity often leads to trouuuubbllle oof! Well, after this I should think nothing of falling down
stairs (Alice, as she falls down the rabbit hole in Alice in Wonderland)
If youre reading this guide, then chances are your curiosity has caused you to tumble down the rabbit
hole and enIer Ihe wonderIully peculIar and sIImulaIIng eld oI research IhaI Is HealIh ServIces and PolIcy
Research, or HSPR for short. If you didnt plan on ending up here, youre certainly not alone! HSPR is
comprIsed oI members wIIh a dIzzyIng array oI backgrounds. I we gravIIaIe Io IhIs eld, IIs because we
fundamentally share one belief: that we can improve peoples health and well-being through changes to
our health care system and health policies.
For Ihose who are new Io Ihe eld, denIng Ihe boundarIes oI HSPR can be challengIng. ox 1.1
provIdes Iwo denIIIons oI HSPR. The rsI comes Irom Ihe CanadIan AssocIaIIon Ior HealIh ServIces
and Policy Research (CAHSPR) and the latter from AcademyHealth, which is the main HSPR association
in the United States.
cx 1.1 Deniticns cf H5P
H5P dened by CAH5P:
a problem-orIenIed eld InIo whIch people enIer Irom a wIde range oI dIscIplInary backgrounds Io work
IogeIher Io nd ways IhaI healIh care can besI be organIzed, nanced, and delIvered.
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H5P dened by AcademyHeaIth:
Ihe mulIIdIscIplInary eld oI scIenIIc InvesIIgaIIon IhaI sIudIes how socIal IacIors, nancIng sysIems,
organIzIng sIrucIures and processes, healIh IechnologIes, and personal behavIors aecI access Io healIh
care, the quality and cost of health care, and ultimately our health and well-being. Its research domains are
individuals, families, organizations, institutions, communities, and populations.
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The fcIIcwing excerpt
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aIsc cers a gccd descripticn cf the H5P membership:
health services research can be done by those who dont really consider themselves health services
researchers. The topic (e.g., quality) and the goal of the study (e.g., better quality) determine whether
someone is doing health services research. Those of us who consider ourselves health services
researchers musI recognIze IhaI our chosen eld Is noI a closed shop where one needs a unIon card
before they can work.
ndeed, many elds oI sIudy have IIes Io HSPR and make up Ihe broader unIverse oI IhIs eld (see FIgure 1
Ior examples}:
Figure 1. WcrdIe cf H5P-reIated eIds
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Regardless oI wheIher youre a selI-IdenIIed member or jusI a dabbler In Ihe eld, Ihe dIverse
and uId naIure oI Ihe HSPR membershIp has ImplIcaIIons wIIh respecI Io Ihe publIcaIIon oI our
ideas and discoveries.
What are these implications? Well, as mentioned, much of the research conducted in HSPR is highly
collaborative in nature. Youll routinely work and publish within teams composed of people that may
have very dIerenI Ideas, proIessIonal IraInIng, experIences, skIlls, and expecIaIIons wIIh respecI Io
publIshIng. UndersIandIng and communIcaIIng Ihe rules Ior eecIIve Ieamwork In IhIs conIexI Is
ImporIanI Ior successIul publIshIng eorIs. Is also common IhaI your research collaboraIIons expose
you Io many dIerenI research IopIcs and Iypes oI research IhaI exIends Io a wIde-rangIng audIence.
Accordingly, knowing your particular audiences and the best vehicles to reach them is another important
skill that HSPR researchers must develop.
Why is it impcrtant tc pubIish7
As a IraInee, you may nd yourselI pursuIng sIudIes In a seIIIng where lIIIle emphasIs Is placed on
publIshIng In peer-revIewed journals. ThIs mIghI happen because oI Ihe kInd oI research IhaIs beIng
carried out in your team or because of the philosophies or personalities of your supervisor or colleagues.
In such situations, its important to consider the following arguments in favour of adopting a more
pro-publishing approach throughout your studies:
When we publIsh, we grow Ihe exIsIIng knowledge base In our eld. n an applIed and problem-orIenIed
eld such as HSPR, Ihe poIenIIal ImpacIs oI publIshIng arenI IrIvIal, as our work may have relevance
to people facing similar problems across the country and even around the world. Publishing your
research allows oIhers Io beneI Irom your hard work and reduces Ihe lIkelIhood IhaI Ihey wIll carry
ouI redundanI projecIs and wasIe valuable resources.
Publications are a critical component of how academic scientists are evaluated. As a trainee, your
publication record will be evaluated when you apply for studentships or and other awards. Indeed,
Ihe weIghI accorded Io your publIcaIIon hIsIory Increases as you progress In your sIudIes (Ior example,
as one moves Irom a masIers sIudenI Io a docIoral sIudenI Io a posI-docIoral Iellow}. For junIor and
senior investigators, your ability to obtain a faculty position, grants, promotions, tenure, and so on is
commonly and largely contingent on your publication track record. In other words, your publication
record is an indicator of your competence, commitment, and potential as a researcher.
Much of the research we do is funded by agencies and organizations that receive their funding from
publIc sources. CIven Ihe role IhaI Iaxpayer money plays In supporIIng our dIscoverIes, some argue
IhaI we have an oblIgaIIon Io publIsh and share our ndIngs wIIh Ihe publIc.
PublIshIng also helps us grow as researchers. Every publIshIng opporIunIIy Is a learnIng experIence and
provides us with an opportunity to receive an outside opinion on the relevance, rigour, and impact of
our work. Even Ihe occasIonal rejecIIon can ulIImaIely lead us Io doIng beIIer research.
FInally, IIs a Iun IhIng Io do I can be very excIIIng Io see Ihe IruIIs oI our labour appear In prInI or on
Ihe nIerneI, and psychologIcally II helps us move on Io Ihe nexI projecI or phase In our research.
Even Ihough Ihere are many good reasons Io publIsh, II doesnI seem Io sIop people Irom ndIng jusI
as many excuses noI Io publIsh Common excuses Include beIng Ioo busy, havIng poor wrIIIng skIlls, noI
having any ideas or results worth sharing, preferring to place greater emphasis on building relationships
wIIh research parIners or pursuIng oIher Iorms oI scIenIIc communIcaIIon, eIc. WhIle any oI Ihese
reasons may be valId Ior posIponIng publIcaIIon eorIs, IIs rIsky Ior researchers Io have a publIcaIIon
droughI Ior an exIended perIod oI IIme. DoIng so may lead Io job InsecurIIy, lack oI IundIng Io pursue or
compleIe projecIs, or an InabIlIIy Io pay salarIes Ior Ieam members down Ihe road. n our vIew, IraInees
and researchers IacIng barrIers musI aI some poInI nd ways Io overcome IheIr challenges and adequaIely
communicate the results of their work.
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What are the generaI expectaticns fcr H5P trainees with respect tc scientic pubIishing7
Since publishing factors into your evaluation as a researcher, its helpful to have a sense of whats
expecIed oI you In Ierms oI publIshIng aI dIerenI sIages oI your sIudIes and research careers. Please
note, however, that publishing standards in research are rarely easy to pin down and that career paths in
HSPR vary widely. The researchers we spoke to in writing this guidebook sometimes had divergent views
on what the standards should be. That being said, heres an attempt to present some general guidance
Ior sIudenIs aI dIerenI sIages oI IheIr IraInIng (ox 1.2}:
cx 1.2. CeneraI pubIishing expectaticns (may vary by specic eId cf study]
Fcr masters IeveI trainees:
SIudenIs enIerIng an HSPR-relaIed masIers program IypIcally have lIIIle publIshIng experIence. I
you do, youre ahead of the curve but if you dont theres no reason for concern at this point! Your
oIher research experIences, grades, skIlls, and IraInIng envIronmenI are more ImporIanI In your InIIIal
evaluation. As you pursue your degree, however, you hopefully will be in a position to contribute to one
or several papers as an auIhor. PublIshIng a paper as a rsI auIhor on Ihe IopIc oI your masIers projecI Is
consIdered a major plus In evaluaIIons as II suggesIs IhaI youre able Io nIsh whaI you sIarIed.
Fcr PhD students:
SImIlar Io masIers sIudenIs, IraInees applyIng Ior a PhD are noI expecIed Io have exIensIve
publIcaIIon records. However some experIence wIIh wrIIIng and publIshIng Is desIrable. I youve
goI a rsI-auIhor publIcaIIon In a decenI journal Ihen you may be In good shape when II comes Io
seeking a doctoral award of some kind.
Many PhD programs oer sIudenIs Ihe opIIon oI wrIIIng a IradIIIonal IhesIs or an arIIcle-based IhesIs.
If youre interested in an academic career, you should consider the latter as the work involved has greater
resemblance to what youll be asked to do later as an independent researcher. Youll also potentially
compleIe your PhD wIIh aI leasI Iwo or Ihree papers as a rsI auIhor, whIch wIll hopeIully seI you up Ior
success aI Ihe posI-docIoral or junIor researcher levels. A producIIve PhD sIudenI may nIsh hIslher
degree wIIh 5 Io 1U publIcaIIons, wIIh Ihe majorIIy as rsI auIhor.
Fcr pcst-dcctcraI feIIcws and junicr researchers:
For young researchers seeking a career in academia, evaluators look for a certain level of productivity
thats maintained over time. Productive researchers might publish several articles per year, with
mosI publIshed as rsI auIhor and aI leasI some In hIgher ImpacI journals. AI IhIs level, showIng you
can esIablIsh new collaboraIIons and publIshIng wIIh dIerenI research groups or parIners are vIewed
in a positive light.
FinaI Wcrds
Dver Ihe pasI decades, Ihe HSPR eld has grown In leaps and bounds and now occupIes an ImporIanI
place In Ihe CanadIan research landscape. As Ihe eld maIures, sIandards Ior research qualIIy and
performance understandably rise as well. Many trainees we have interviewed for this guidebook say
that they often feel as though there is enormous pressure on them to publish, be productive, always
perform at a high level, etc. However, students shouldnt be preoccupied with chasing the trendy topic
or trying to publish work they dont care about to pad their CV. The value in publishing comes from
sharIng your dIscoverIes and Ihe research ndIngs IhaI you Ieel wIll conIrIbuIe Io Ihe eld and make
a dIerence In some way. HopeIully Ihe resI oI IhIs guIdebook wIll provIde helpIul InIormaIIon
IhaI demysIIes Ihe publIcaIIon process and allows you Io share Ihe IruIIs oI your labour wIIh Ihe resI
of us in the HSPR community.
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Trainee-mentcr reIaticnships and scientic pubIishing
As a young researcher, youre bound to encounter obstacles and uncertainties as you go through the
publication process. In order to ensure that you have the support you need to advance your work in a
timely and pain-free manner, its critical that you build strong relationships with your supervisors and
other individuals who can guide you.
A supervisors role is to guide and support your development, help you build your independence,
and maxImIze your poIenIIal In accordance wIIh your educaIIonal and lIIe goals. n mosI cases, your
supervIsor has acquIred exIensIve experIence wIIh respecI Io publIshIng, oIIen Iheyll be able Io provIde
you Invaluable InIormaIIon and advIce abouI Ihe Ins and ouIs oI scIenIIc wrIIIng and publIshIng.
However, some supervIsors are unable Io devoIe sucIenI IIme Io workIng wIIh IheIr sIudenIs Io help
them develop these key skills.
Whether your supervisor makes this form of mentorship a priority or not, its useful to broaden your
perspective about who can act as a mentor regarding publishing issues. Potential mentors can be your
peers, especially other graduate students who are more advanced in their studies, as well as other
researchers in your program or institution who have strong publication track records. Mentors might
also be people IhaI you meeI aI scIenIIc conIerences or IraInIng evenIs IhaI seem especIally open Io
providing occasional advice and constructive criticism. Establishing a diverse personal network of formal
and informal mentors can help safeguard against a lack of support that might hinder the progress of your
research or publIshIng eorIs.
Hcw can mentcrs heIp us7
MenIors IypIcally share Iwo Iypes oI experIIse: explIcIIlIechnIcal experIIse and more IacII experIIse.
ExplIcIIlIechnIcal experIIse relaIes Io IhIngs such as your menIors knowledge abouI lIIeraIure on a
particular topic or about methodological techniques that they have acquired through their studies
and careers (e.g. knowing that a particular report was written on a topic relevant to your study). Tacit
experIIse reIers Io Ihe more personal lessons, InsIghIs, and pracIIces IhaI menIors have acquIred Ihrough
IheIr experIences In academIa (e.g. knowIng how Io Irame argumenIs In a paper so IhaI II appeals Io
a specIc journal}. SpendIng qualIIy IIme wIIh your menIors and IappIng InIo boIh Iypes oI menIor
experIIse can be crIIIcal Io your own developmenI and success.
Here are some specIc examples oI how menIors can help you when II comes Io scIenIIc publIshIng:
5etting a standard: MenIors can seI Ihe sIandard Ior excellence wIIhIn IheIr Ieams, pushIng
Ieam members Io achIeve Ihe same levels oI IImelIness, rIgour, scIenIIc InIegrIIy, and
performance as they do.
Teaching ycu the ccnventicns: Mentors have learned how the research process works and theyre
able to teach you about how to go about the usual business of doing research and publishing your
resulIs. For example, your menIors can help Ieach you whaI Io expecI durIng Ihe publIshIng process
or how to interact respectfully with other co-authors.
Prcviding mcraI suppcrt: DccasIonally, menIors can be Ihere Io provIde moral supporI when you
encounIer dIculIIes or crIIIcIsm In your research. HelpIng you deal wIIh IaIled aIIempIs aI
securIng IundIng or Ihe rejecIIon oI papers Is a key role IhaI all menIors should play.
Indeed, the trainee-mentor relationship is like any other relationship, and good mentors will be
open to discussions about the challenges you face and to devising strategies to motivate you.
Prcviding empIcyment cppcrtunities and nanciaI suppcrt: Through IheIr research projecIs or
funds, mentors can provide you with opportunities to get involved in research or in the
preparation of manuscripts.
HeIping ycu manage time and pricrities: Time management and learning to prioritize your activities
are two skills that are essential to research and to publishing. Many supervisors argue that these are
key areas where students often initially struggle. Mentors are typically very sensitive to how
valuable time is and can work with students to develop their skills, focus their activities, and
limit hours lost to less important tasks.
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What are cur respcnsibiIities when it ccmes tc cur mentcrs and pubIishing7
WhIle your menIors wIll lIkely play an InuenIIal role In your academIc career, youre ulIImaIely
responsIble Ior geIIIng Ihe mosI ouI oI your educaIIonal experIence. WIIh IhIs In mInd, IIs ImporIanI Io
consider the following advice:
5eIect ycur mentcrs wiseIy: You should consider many factors before selecting your mentors
(especIally your supervIsors}. For example, you should InquIre abouI your menIors Irack record, IheIr
availability, their relationships with past mentees, their alignment with your skills and interests, and
their ability to help you develop collaborations with other mentors outside of your relationship.
When possible, its helpful to ask others what they think of your mentorship options and discuss
Ihe above Issues dIrecIly wIIh poIenIIal menIors beIore makIng a nal decIsIon. DonI be aIraId
to ask blunt questions or describe your needs honestly when youre interviewing potential
supervisors. Such meetings are not a time to hold back or misrepresent yourself for the purposes
of making a good impression.
Take an active rcIe: As a trainee, its crucial that you assume ownership over your studies and allow
your supervisors and mentors to help you consider the options rather than choose a direction for
you. Its up to them to suggest a path but up to you to blaze your own trail!
HandIe ycur business: A peI peeve oI many supervIsors Is when sIudenIs nd ways Io have oIhers do
their work for them. Whether its doing the necessary reading, collecting the data and crunching
the numbers, or drafting a paper section, you need to be resourceful and work at becoming as
independent as possible.
5eek cIaricaticn where needed: As resourceful as you may be, they are still likely to be times when
you get stuck or are uncertain about what your mentors may be asking of you. Its important
Io be proacIIve and seek clarIcaIIons when you need Ihem. ReachIng ouI and havIng a clear
understanding of what needs to be done is important to avoid unnecessary delays and frustrations.
UtiIize peer mentcrs where pcssibIe: Peer mentors can be a valuable resource for any trainee. Youre
likely to spend a lot of time with your peers (e.g. over lunch, in the lab) and often theyre in a good
posIIIon Io provIde you wIIh honesI Ieedback abouI your research or oer hearIIelI encouragemenI.
Interestingly, one study
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found that trainees who worked with other students in a group writing
seIIIng beneIed Irom a sense oI responsIbIlIIy, comIorI, and encouragemenI, and many were able
to use healthy and productive peer competition to their advantage.
Pay it fcrward: As you progress Ihrough your career, IIs a greaI experIence Io Iake on menIorshIp roles
Ior peers or more junIor sIudenIs. ThIs helps you jusI as much as II helps oIhers and puIs you on Ihe
path of learning to become a good mentor in your own right!
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What can be dcne tc make the trainee-mentcrship reIaticnship wcrk weII
when it ccmes tc pubIishing7
We put this question to two senior health services researchers, Dr. Kim McGrail from the University of
rIIIsh ColumbIa and Dr. Sharon SIraus Irom Ihe UnIversIIy oI ToronIo. ox 2.1 presenIs IheIr advIce.
cx 2.1. Advice cn trainee-mentcr reIaticnships
kim said:
For students, they should learn about the policies around publication in their research team early on
and understand who can be what type of author in what circumstances.
For mentors, its important to provide students with opportunities but not become so involved in
manuscripts to the point that the students own voice is lost. Mentors need to know themselves and
gaIn a sense oI IheIr own sIyle so Ihey can parIner eecIIvely wIIh sIudenIs.

5harcn said:
For sIudenIs, IIs abouI learnIng Io seI objecIIves and sIIckIng Io Ihem. LearnIng Io manage IIme
and compeIIng prIorIIIes eecIIvely are essenIIal skIlls IhaI supervIsors may need Io assIsI
their students with.
For menIors, IIs abouI realIzIng IhaI dIerenI people have dIerenI needs and Ihus may requIre
dIerenI Iypes oI assIsIance. MenIors musI deIermIne whaI a parIIcular sIudenI needs so Ihey can
help them access the appropriate guidance or support. When it comes to publishing, mentors should
provide lots of feedback and constructive criticism because writing and publishing is often
a challenge for young researchers.
FinaI Wcrds
Cood menIorshIp Is assocIaIed wIIh a varIeIy oI posIIIve beneIs
5
, and its important that you make
serIous eorIs Io InIeracI wIIh your menIors and buIld Ihose relaIIonshIps. However, even Ihe besI
mentors cant reasonably provide you with all the guidance you need on every front. So seek out multiple
menIors and role models IhaI can help you navIgaIe dIerenI problems. I youre noI geIIIng whaI
you need from the mentors in your surroundings, then its your duty to bring that to your supervisors
attention and see how they can help. No one should be shy to meet with their supervisor and discuss
mentorship issues, and your supervisor will likely appreciate being more aware of your needs. However,
its also important to not rely too much on your mentors for everything. Indeed, its up to you to steer the
ship, and allow your mentors to be the wind in your sails.
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CcmmcnIy enccuntered authcrship issues
Authorship issues are important because it is through authorship that we assign responsibility and
give credit for intellectual work
6
. Authorship issues have implications for personal and professional
reputations, career advancement and research funding, and even the reputations of institutions.
eIng an auIhor on a newly publIshed paper oIIen provIdes a saIIsIyIng, even excIIIng IeelIng.
However, Ior some people Ihe publIcaIIon experIence Is unIorIunaIely bIIIersweeI or IrusIraIIng because
Ihey perceIve IhaI IheIr eorIs In Ihe research or on Ihe paper have noI been adequaIely acknowledged.
The collaborative nature of HSPR means that were often writing and publishing papers as a team.
I Ihere are mIscommunIcaIIons and dIsagreemenIs around auIhorshIp, II can negaIIvely Inuence
the relationships between and reputations of those involved. As such, its very important to openly
discuss authorship issues early on in the research process so that everyone involved is on the same
page and negaIIve experIences are avoIded. elow we descrIbe who should be consIdered an
auIhor on a paper and we explore several auIhorshIp Issues IhaI youre lIkely Io encounIer as a
trainee and young researcher.
Whc shcuId be ccnsidered fcr authcrship cn a scientic manuscript7
I used Io be IhaI dIerenI research groups would have very dIerenI polIcIes wIIh respecI Io who
could be considered an author on a paper. Talk to some of the more senior researchers around you and
were sure that they could share a few horror stories of unfair practices!
Increasingly though, theres a growing consensus regarding what elements are necessary to constitute
auIhorshIp on a paper. Dne oI Ihe reasons Ior IhIs has Io do wIIh Ihe work by cerIaIn groups Io esIablIsh
crIIerIa Ior auIhorshIp In bIomedIcal journals. A good example Is Ihe Vancouver sysIem developed by
the International Committee of Medical Journal Editors
7
. The Vancouver rules for authorship, as theyre
commonly known, have been adopIed by over 5UU journals, and Ihey sIaIe IhaI:
AuIhorshIp credII should be based on 1} subsIanIIal conIrIbuIIons Io concepIIon and desIgn,
acquIsIIIon oI daIa, or analysIs and InIerpreIaIIon oI daIa, 2} draIIIng Ihe arIIcle or revIsIng II crIIIcally Ior
ImporIanI InIellecIual conIenI, and 3} nal approval oI Ihe versIon Io be publIshed. AuIhors should meeI
condIIIons 1, 2, and 3.
7
The rules IurIher sIaIe IhaI parIIcIpaIIon solely In daIa collecIIon or analysIs doesnI jusIIIy auIhorshIp,
nor does sImply provIdIng general supervIsIon over Ihe publIcaIIon process. WhIle noI all HSPR journals
subscribe to these criteria, they can serve as the foundation for an authorship policy within individual
research Ieams. Also, an IncreasIng number oI journals requIre IhaI auIhors be very clear abouI Ihe
contributions of each author on the paper, in some cases publishing this information.
Even with clear criteria, it can sometimes still be a challenge to know whether to include some people
as auIhors In cerIaIn cIrcumsIances (see ox 3.1 Ior some IrIcky auIhorshIp sIIuaIIons}. FurIhermore, one
limit of the Vancouver and other authorship criteria is that they dont often cover the occasionally tricky
Issue oI auIhorshIp order. The Ins and ouIs oI IhIs Issue are dIscussed nexI.
cx 3.1 Tricky authcrship situaticns (discuss these with ycur mentcrs and peersI]
5cenaric 1: When Roxanne was doIng her masIers degree, she proposed Io her supervIsor Io wrIIe an
arIIcle around some daIa her supervIsor had acquIred buI dId noI plan Io exploII. Roxanne made a plan
for the paper, did the analyses and began drafting the manuscript. Unfortunately, she could not complete
Ihe paper beIore graduaIIng and ndIng employmenI ouIsIde oI Ihe healIh eld. Two years laIer, Illy,
a new PhD student, became aware of the data and began the same process adopting a similar angle.
Roxannes paper, Ihough IncompleIe, InspIred Illy and made wrIIIng hIs own paper much easIer. When
Illy compleIed Ihe manuscrIpI, he wondered wheIher he should Include Roxanne as a co-auIhor. He
IrIed Io conIacI Roxanne buI was unable Io reach her. WhaI should he do?
1/
5cenaric 2: MarvIn Is a young researcher who has been leadIng a research projecI wIIh Iwo oIher
collaborators. Wendy is one of these collaborators and is also a good friend of Marvin. Wendy is also a
young researcher buI her ImplIcaIIon In Ihe projecI has been lImIIed because shes been overwhelmed
wIIh IeachIng responsIbIlIIIes. She InIIIally IacIlIIaIed Ihe recruIImenI oI subjecIs Ior Ihe projecI buI has
been largely unavaIlable sInce IhaI IIme. MarvIn has advanced Ihe projecI enough Io wrIIe a rsI paper
on results hes particularly interested in. He decides to send Wendy the paper for her comments, even
Ihough she has lIIIle experIIse In Ihe area Iocused on In Ihe paper. Wendy reIurns Ihe paper, wIIh mInor
correcIIons Io spellIng. However, Wendy asks MarvIn II she could be IdenIIed as lasI auIhor on Ihe paper
because doIng so would lIkely help her be promoIed In her nexI Ienure evaluaIIon. Wendys acIIons
wouldnt ordinarily merit authorship but she is a good friend and future collaborator. What should he do?
Dces authcrship crder matter7
You beI II does And Ior many reasons. Is commonly assumed IhaI Ihe rsI auIhor on an arIIcle Is
the person who has made the greatest intellectual contribution, including taking on most or all of the
wrIIIng and conIrIbuIIng sIgnIcanIly Io Ihe research IIselI. DIIen, Ihe Ideas and argumenIs IeaIured In
a parIIcular paper are credIIed largely Io Ihe rsI auIhor, a habII reInIorced by Ihe IacI IhaI IhIs auIhors
name oIIen appears In Ihe IexI oI oIher arIIcles whenever Ihe paper Is cIIed. AssIgnIng credII Io Ihe
rsI auIhor has ImplIcaIIons Ior academIc evaluaIIon, and young researchers may have major dI culIIes
acquIrIng jobs or research IundIng II Ihey have no rsI-auIhor publIcaIIons Io IheIr name. Also, Irom a
pracIIcal sIandpoInI, beIng Ihe rsI auIhor also means IakIng Ihe lead on a varIeIy oI publIcaIIon Iasks
IhaI Ihe oIher auIhors wonI be responsIble Ior (see Ihe nexI secIIon}.
Another common convention is to see a more senior researcher occupy the last spot in the authorship
order. This spot can be coveted since this person may be considered the driving force intellectually
and nancIally Ior Ihe research
8
. In some universities and funding agencies, the number of last-author
publications is considered an important metric in evaluations as it provides evidence of mentorship and
leadership. Such publications are not only important for more established researchers but also young
investigators who are in the process of building their career and research team.
AsIde Irom Ihe rsI or lasI auIhor, does II make a dIerence where your name may appear In Ihe lIsI
of authors? Given that many researchers associate authorship order with degree of contribution, it may
be beIIer, Ihough Ihe IangIble beneIs oI auIhorshIp are vIrIually Ihe same Ior auIhors ranked anywhere
oIher Ihan rsI or lasI. The Iwo excepIIons are when mulIIple auIhors are IdenIIed as Ihe lead auIhors
on a paper or when authors publish as a group (e.g. the CAHSPR Student Working Group), but these
sIIuaIIons donI happen Ioo oIIen and some journals donI permII Ihem.
What respcnsibiIities and ccnsequences ccme with being the rst authcr and
ccrrespcnding authcr7
I you wanI Ihe glory IhaI comes wIIh beIng a rsI auIhor cauIIon All IhaI glIIIers may noI be
gold. n addIIIon Io IulllIng Ihe auIhorshIp crIIerIa, helshe Is generally expecIed Io Iake on a number
oI addIIIonal responsIbIlIIIes. mporIanIly, Ihe rsI auIhor Is expecIed Io acI as a leader wIIhIn
the authorship team when it comes to issues like obtaining ethics approval, assigning authorship,
esIablIshIng wrIIIng deadlInes, compIlIng revIsIons Irom co-auIhors, eIc. asIcally, Ihe rsI auIhor should
be Ihe one doIng Ihe mosI work Is also ImporIanI Io recognIze IhaI, whIle Ihe rsI auIhor Is usually
Ihe rsI Io receIve credII Irom Ians, Iheyre also Ihe rsI Io receIve crIIIcIsm or blame. No auIhor wanIs Io
read, YDUR LAST NAME eI al. were IoIally wrong In IheIr analysIs oI . ThIs example may seem a
bII harsh, buI IIs provIded Io hIghlIghI Ihe IacI IhaI, as rsI auIhor, you really do assume more
responsIbIlIIy Ior Ihe nal producI Ihan oIher auIhors. FurIhermore, youre responsIble Ior
protecting the reputations of your co-authors, so taking the time to ensure that your product meets
hIgh scIenIIc sIandards Is IIme well spenI.
15
AlIhough Ihe specIc expecIaIIons vary by journal, In general, Ihe correspondIng auIhor Is Ihe
individual who assumes responsibility for receiving and responding to inquiries about the article before
and aIIer IIs publIshed. Helshe musI submII Ihe arIIcle, receIve Ihe responses Irom Ihe edIIorIal board,
facilitate communication among the co-authors about the feedback, submit any revisions, and work with
Ihe edIIorIal oce aIIer Ihe paper has been accepIed Io approve prooIs and nalIze Ihe manuscrIpI.
All done? Not necessarily. Inquiries about the paper may come from readers (in the form of online
commentaries or emails) or even from the media. Again, its the responsibility of the corresponding
author to inform the co-authors about any inquiries and ensure theyre addressed promptly.
Who, Ihen, should be named as correspondIng auIhor? n many cases, Ihe rsI auIhor Iakes on Ihe
responsIbIlIIy oI beIng Ihe correspondIng auIhor. ThIs Is a naIural role Ior Ihe rsI auIhor sInce hel
she presumably already has an intimate relationship with the article (and is therefore in the best
position to address questions) and has already facilitated communication among the authors during
the preparation of the manuscript. It isnt unusual, however, for the senior author to take on the role of
correspondIng auIhor, especIally when Ihe rsI auIhor Is a junIor sIudenI (e.g., MasIers-level}. ThIs Is
because senIor auIhors may be more comIorIable communIcaIIng eecIIvely wIIh Ihe journal and co-
auIhors and would lIkely be more experIenced In dealIng wIIh posI-publIcaIIon InquIrIes. Dn Ihe oIher
hand, more senIor sIudenIs (e.g., PhD-level} could gaIn valuable experIence Irom IakIng on IhIs role.
SInce learnIng how Io eecIIvely communIcaIe wIIh a range oI IndIvIduals (auIhors, readers, medIa} Is a
critical skill for any upcoming researcher, this may be a perfect opportunity to develop such important
abilities while support from mentors is readily available.
What are the advantagesldisadvantageslissues cf scIc authcrship vs. grcup authcrship7
Up unIIl Ihe 155Us, sole auIhorshIp was Ihe norm Ior scIenIIc wrIIIng. SInce Ihen, Ihere has been
such a rIse In mulII-auIhored papers IhaI sole auIhorshIp has become Ihe excepIIon raIher Ihan Ihe rule.
This trend is partly attributed to increased pressure on researchers to accumulate as many publications
as possIble, IhIs pressure Is IelI even aI Ihe earlIesI sIages oI ones IraInIng. WIIhouI a doubI, mulII-
authorship enables us all to be involved in more publications. However, there are also a number of
addIIIonal beneIs. For example, beIng a conIrIbuIIng member oI a mulII-auIhored paper can be a
sign to a future employer or collaborator that you work well as part of a team. Also, having your name
publIshed alongsIde esIablIshed researchers may granI you a cerIaIn level oI credIbIlIIy. DerIng
opporIunIIIes Ior auIhorshIp Io oIher researchers may also lead Ihem Io exIend Ihe same oer Io you In
the future. The concept of multi-authorship can be advantageous within a research group as it can help
IosIer cooperaIIon (raIher Ihan compeIIIIon} among IIs members when a pIece oI work Is publIshed,
everybody wins!
Perhaps Ihe mosI ImporIanI beneI oI beIng parI oI a mulII-auIhored paper Ior sIudenIs Is IhaI II
allows them to contribute to larger scale research early in their careers. Today, sole authored papers
tend to be published only by well-established researchers, usually in commentary or editorial form.
Students typically dont have the resources (e.g. data) to produce an original research manuscript
or even execuIe a hIgh-qualIIy revIew paper compleIely on IheIr own. FurIhermore, IIs generally
undersIood IhaI IraInees beneI Irom Ihe experIIse oI aI leasI one senIor collaboraIor.
Having said that, solo authored papers are not completely out of reach to students, one must simply
IhInk a lIIIle ouIsIde-Ihe-box. For InsIance, sIudenIs read a loI, especIally In IheIr area oI experIIse,
and may feel compelled to respond to one of these articles in the form of a commentary or debate
article. A well-argued, insightful debate article or commentary may not only demonstrate initiative and
passIon, buI may also help prove IhaI your Ideas and experIIse exIsI IndependenIly oI your menIors.
For oIher Ideas Ior poIenIIal publIshIng opporIunIIIes, see ChapIer 1U.
16
What are the mcst ccmmcn authcrship prcbIems that arise and what can be dcne abcut
them7
CIven IhaI mulII-auIhor papers have become Ihe norm, IIs noI surprIsIng IhaI conIcIs around
authorship have become more frequent. Here are some of the more common problems that can arise
9
:
Disputes cver rst authcrship and authcrship crder: Probably the most common disputes occur
because oI dIsagreemenIs over who should be Ihe rsI auIhor on a manuscrIpI or Ihe order In a
lIsI oI auIhors. I may happen, Ior InsIance, IhaI a more senIor researcher InsIsIs on beIng a rsI
auIhor even Ihough a IraInee or more junIor researcher has made a greaIer InIellecIual
contribution to the work.
Lack cf reccgniticn: This occurs when someones name does not appear in the list of authors despite
hImlher havIng made an ImporIanI conIrIbuIIon Io a sIudy. A common example Is when research
assistants (RAs) do much of the grunt work around data collection or analysis but are then not
consulted during the paper writing process. If youre an RA, you should clarify your position with
your employer and ensure that if you want to be an author of a paper, that you can be placed in a
position to meet all the agreed-upon requirements.
Inapprcpriate cc-authcrship: This can occur in a variety of situations. More senior researchers may
assume that all publications originating within their research team should have their names on
them, regardless of their involvement in the research or manuscript. Authors may decide to
grant authorship strategically to people who dont truly merit it as a gift to show respect or as
a means of making the paper seem more legitimate (thinking that the big name will help
get the paper accepted).
Chcstwriting: In this case, someone is hired to contribute substantially to the writing of a paper and is
(deliberately or not) left out of the author list for that paper. While its normal to have someone help
with the editing of a manuscript, ghostwriting becomes unethical when writers are paid to
wrIIe Ihe very subsIance oI a paper and Ihen pass II o as someone elses work wIIhouI beIng
adequately acknowledged. The practice is particularly scandalous if the ghostwriter is a
professional that is sponsored by an organization that stands to gain from the publication
(a pharmaceutical company for instance).
There are a myrIad oI oIher IacIors IhaI may lead Io auIhorshIp dIspuIes, IncludIng conIcIIng
personalities, power struggles or inequalities, hidden agendas, and so on. When working with a group of
auIhors Ior Ihe rsI IIme, beIng explIcII aI Ihe very begInnIng oI Ihe projecI abouI Ihe plan Ior auIhorshIp
is essential. Everyone should be candid about his or her interests in getting involved and the role they
would like to play in the process. The more open and honest people are right from the start, the more
likely it is that everyone will avoid uncomfortable situations later on down the road. In the event that an
uncomIorIably sIIuaIIon nds you and youre sIuck, IIs usually besI Io Iry Io work ouI problems In house
before reaching out for help from other mentors or leaders in your graduate program.
FinaI Wcrds
From a student perspective, we understand that it can sometimes be uncomfortable to discuss
authorship issues with your supervisor or with other senior researchers. However, if ever the authorship
policies in your research team or group are unclear, its important to put your shyness aside and spark a
conversaIIon on Ihe IopIc beIore Ihe research advances Ioo Iar or you InvesI a sIgnIcanI amounI oI IIme
In a projecI. Dur moIIo Is: No surprIses Make no assumpIIons abouI Ihe auIhorshIp polIcIes In eecI
and ask abouI Ihem dIrecIly. More oIIen Ihan noI, youll nd IhaI people are happy Io dIscuss dIerenI
scenarios are very open to having students contribute to publications. If ever the policies are not what
you expecIed, aI leasI youll know In advance and wIll be able Io adjusI your InvolvemenI accordIngly.
17
Targeting jcurnaIs fcr pubIicaticn
As menIIoned In ChapIer 1, Ihe HSPR eld Is mulIIdIscIplInary In naIure and as such Ihere Is oIIen a
large number oI journals Io choose Irom when seekIng publIcaIIon. denIIIyIng journals IhaI mIghI be
most suitable for your research is an important step and best done early on in the publication process.
There are many reasons Ior IhIs. A pracIIcal reason Is IhaI manuscrIpI guIdelInes vary across journals.
ThereIore, selecIIng a poIenIIal journal early helps Io seI Ihe sIrucIure oI your paper (e.g. Iype oI paper
and lengIh, number oI Iables or gures allowed, eIc.}. Is also ImporIanI Io selecI a poIenIIal journal
earlIer Ihan laIer because: 1} II Iorces you Io IhInk abouI whaI your conIrIbuIIon represenIs and who
your target audience should be, and 2) there are important consequences for you and others tied to your
choIce oI journal. We expand on Ihese poInIs below.
Hcw can we kncw hcw impcrtant cur ccntributicns are7
A stcry:
n Ihe mId-155Us, a research Ieam Irom uebec InIIIaIed a projecI sIudyIng healIh problems among
homeless youIh In MonIreal. TheIr sIudy InIended Io examIne raIes oI HV InIecIIon buI aIIer several
participants in their cohort died during the study, the research team decided to add mortality rates to
the list of collected variables. After a few years of data collection, a masters student who was part of
the research team analyzed the mortality data and shared it with her supervisor, who replied You know
whaI? WhaI we jusI Iound Is worIhy oI publIcaIIon In IAMA. The masIers sIudenI wroIe up Ihe ndIngs,
submitted it to JAMA and it was accepted! The paper
1U
was a major coup Ior Ihe research Ieam and
especIally IIs rsI auIhor, Ihe masIers sIudenI.
How dId Ihe sIudenIs supervIsor know IhaI Ihe ndIngs were oI such ImporIance? For InexperIenced
researchers, II can someIImes be dIculI Io know whaI your scIenIIc conIrIbuIIon represenIs and whaI
relevance your work has Ior your eld. I may be IhaI youve been workIng on someIhIng Ior a long IIme
and you become overcritical of your work or you simply underestimate (or overestimate) the importance
oI a ndIng Irom your sIudIes.
Here are four questions you can ask yourself to help you assess your works importance
11
:
Am askIng a hIghly orIgInal research quesIIon DR has my research quesIIon been addressed In
prevIous sIudIes (perhaps In dIerenI seIIIngs or wIIh dIerenI populaIIons}?
Are my meIhods InnovaIIve or aI Ihe cuIIIng edge oI rIgour DR are Ihere ImporIanI meIhodologIcal
limitations in my study?

Do my meIhods allow me Io be condenI IhaI have acIually answered my research quesIIon DR are
my methods misaligned with my research questions in some way?
WIll my research lead Io a sIgnIcanI advance Io our undersIandIng oI Ihe research problem or ImpacI
people In an ImporIanI way DR are Ihe ImpacIs oI my research more modesI?
Working out the answers to these questions can help you assess the importance of your work and give
you an InIIIal sense abouI Ihe poIenIIal journals you should be IargeIIng Ior publIcaIIon. FIndIng Ihe rIghI
journal I Ior your paper saves IIme In Ihe publIcaIIon process and opIImIzes Ihe beneIs oI your work
for yourself and others.
18
Whats an Impact Factcr and hcw impcrtant is it7
Like nuclear energy, the impact factor is a mixed blessing
12
The Ierm ImpacI IacIor Is one IhaI mosI researchers are usually exposed Io IaIrly early In IheIr
careers. A journals ImpacI IacIor (F} Is a measure oI Ihe Irequency wIIh whIch Ihe average arIIcle In Ihe
journal has been cIIed In a parIIcular year or perIod
13
. The higher the number, the higher the perceived
ImpacI oI Ihe journal. ox /.1 provIdes Ihe Iormula IhaI Thomson ReuIers uses Io calculaIe a journals F
for its annual Journal Citation Reports publication.
cx 4.1. Hcw impact factcrs are caIcuIated, using the Canadian MedicaI Asscciaticn
1curnaI (CMA1] as an exampIe
CMAIs ImpacI IacIor (F} Ior 2U1U:
A = Ihe number oI IImes arIIcles publIshed In CMAI In 2UU8 and 2UU5 were cIIed by Indexed journals
durIng 2U1U
= Ihe number oI subsIanIIve arIIcles (or source IIems} publIshed by CMAI In 2U1U (In IhIs case,
substantive articles would include things like original research or review articles but not editorials, news
reports, Letters-to-the-Editor, etc.)
F oI CMAI In 2U1U = A l = 5.U2
ThIs F ranked CMAI as Ihe 5Ih mosI ImpacIIul journal In Ihe caIegory oI general medIcal journals.
The ImpacI IacIor was InIended as a means Io rank and evaluaIe Ihe ImporIance oI journals Ior Ihe
research communIIy whIle elImInaIIng bIases due Io cerIaIn journal characIerIsIIcs (Ior example Ihe
amount of content they put out, their frequency of publication, their age). Journals with high IFs are
generally viewed as more prestigious and so not surprisingly the IF has become a widely used measure in
academic evaluation, including for the assessment of trainees and young researchers.
However, the IF and its use in evaluating researchers are not devoid of controversy, particularly in the
healIh servIces and polIcy eld. ConsIder Iwo posI-docIoral Iellows In HSPR, ob and LIz. ob publIshed
a paper on Ihe epIdemIology oI and servIce needs Ior a rare Iorm oI cancer In Ihe journal Cancer Research
(F = 8.23, ranked 12Ih In Ihe eld oI Dncology} whereas LIz publIshed Ihe resulIs oI parIIcIpaIory acIIon
research projecI wIIh polIcymakers In Ihe journal HealIh PolIcy and PlannIng (F = 1.38, ranked 6Ih In Ihe
eld oI HealIh PolIcy}. When we evaluaIe Ihe achIevemenIs oI Ihese Iwo posI-docs, we can be preIIy
sure that Bobs research and paper will be more impactful than Lizs, right?
NoI so IasI A rsI poInI Io remember Is IhaI journal Fs vary by eld oI research. For example, journals
IocusIng on cancer research Iend Io have much hIgher Fs Ihan journals publIshIng healIh polIcy research.
Secondly, a journals F Is noI a predIcIIon oI how many IImes a specIc auIhors arIIcle wIll be cIIed,
so LIzs arIIcle could well be cIIed 1U IImes per year IollowIng IIs publIcaIIon whIle obs cIIed only
twice per year.
In a similar vein, one should be cautious about making assumptions about the quality of research
based on publIcaIIon wIIhIn a parIIcular journal. The parIIcIpaIory acIIon research projecI led by LIz
may have been carrIed ouI wIIh excepIIonal rIgour and may very well be as or more ImpressIve Ihan
obs epIdemIologIcal analysIs. FInally, Ihe concepI oI ImpacI capIured by Ihe journal F Is clearly very
narrow, In IhaI IIs relaIed solely Io journal publIcaIIons. However, your research can have many oIher
types of impact, such as on clinical practice, patient behaviours or outcomes, policymaking, etc.
Given the applied nature of HSPR, it seems prudent to keep this bigger picture in mind when
evaluaIIng dIerenI journals and papers.
15
Despite its drawbacks, its clear that the IF is here to stay for at least the foreseeable future. Why?
ecause IIs easIly accessIble Ior a wIde range oI journals.
Because researchers are familiar with it and many consider it the best metric currently available for
measuring impact.
ecause when used properly, II provIdes us wIIh a quIck and general sense oI boIh Ihe journals
presIIge and how dIculI II may be geI an arIIcle publIshed under IIs IIIle.
Aside from the IF, what other metrics of impact are out there? Two other citation-based metrics are
Ihe EIgenIacIor and Ihe h-Index. The EIgenIacIor dIsIInguIshes IIselI Irom Ihe F by noI only consIderIng
Ihe number oI IImes arIIcles are cIIed by reIerenced journals buI also Ihe Inuence oI Ihe journals
doing the citing
1/
. The h-Index Is noI applIed Io journals buI raIher assesses Ihe quanIIIy and qualIIy oI
a researchers scIenIIc ouIpuI
15
. The meIrIc Iakes InIo accounI Iwo maIn pIeces oI InIormaIIon: (1} Ihe
number of articles that the person has published, and (2) the number of times each article has been cited.
For example, II ob has publIshed 1U research papers, among whIch 5 have been cIIed 1U IImes or more,
Ihen obs h-Index Is equal Io 5.
Is also worIh menIIonIng IhaI, as more and more journals provIde onlIne plaIIorms, an IncreasIng
number of web-based metrics are being developed, including the number of online article views and
even twitter tweets or tweetations! All of the alternative measures named above have their strengths
but also important weaknesses. Therefore, its worth gaining some familiarity with these metrics so
IhaI you can beIIer assess how your journal choIce wIll ImpacI oIhers percepIIon oI your research and
publishing record.
What factcrs cther than IF shcuId inuence cur chcice cf jcurnaI7
When we asked several well-known HSPR researchers this question, the overwhelming response was
IargeI audIence. n oIher words, who needs Io know abouI your research ndIngs? To whom are you
really speakIng In your paper? Is wonderIul Io IhInk IhaI your ndIngs have relevance Ior docIors,
nurses, administrators, policymakers, researchers, patients, the general public, and so on and this may
really be Ihe case Some journals do have broader readershIps Ihan oIhers and so II may be possIble Io
expose your work Io mulIIple sIakeholders aI Ihe same IIme. However, mosI oI Ihe IIme youll probably
have Io Iocus on a parIIcular sIakeholder group or Iwo and IaIlor your message Io IhaI specIc audIence.
To paraphrase Kim McGrail from the University of British Columbia, if you want your paper to actually be
read by physicians in Canada, youd better publish in the Canadian Medical Association Journal, because
IhaIs largely whaI Ihey read Usually, a journals websIIe provIdes InIormaIIon abouI IIs readershIp.
Readership can also usually be discovered by asking your supervisors, colleagues and mentors.
denIIIyIng your IargeI audIence Is also crIIIcal as II wIll lIkely Inuence how you wrIIe Ihe paper
IIselI, IncludIng how you InIroduce your IopIc, Ihe Iypes oI argumenIs you choose and ndIngs or Ideas
you emphasIze, eIc. ThIs Is anoIher reason why IIs Ideal Io IargeI your journal early In Ihe publIcaIIon
process before too much writing gets done.
uI whaI do you do II youre lookIng aI Iwo journals IhaI have sImIlar Fs and sImIlar IargeI audIences?
WhaI oIher IacIors may you look aI Io help you pIck Ihe rIghI journal? Here are a Iew Ideas:
LccaI cr internaticnaI: Lets say your research has implications for the clinical practice of general
practitioners (GPs). Is it important that Canadian GPs be aware of your research or is your work
relevanI Io a broader group oI CPs In many oIher counIrIes? I you wanI your message Io specIcally
reach CanadIan CPs, you should IargeI a CanadIan journal such as CanadIan FamIly PhysIcIan, as
opposed Io an approprIaIe-soundIng (buI poorly IargeIed} journal lIke Ihe Iournal oI PrImary HealIh
Care, whIch specIcally IargeIs CPs In New Zealand
2U
Manuscript types and guideIines: DIerenI journals accepI dIerenI Iypes oI papers (see ChapIer 5}
so you wIll probably IargeI journals accordIng Io whaI you IhInk Is Ihe besI vehIcle Ior your message.
Also, guIdelInes on aspecIs such as manuscrIpI lengIh, number oI Iables or gures allowed, or abIlIIy
Io aIIach addIIIonal les alongsIde your arIIcle may jusIIIy IargeIIng one journal over anoIher.
Turnarcund time: There are sIgnIcanI beIween-journal dIerences In Ihe IIme II Iakes Irom Ihe
moment a paper is submitted until the paper is reviewed and sent back to the authors. This
InIormaIIon can be Iound eIIher on Ihe journals websIIe or Ihrough conIacIIng Ihe edIIors. However,
you should avoid contacting editors for information that can be found on their website. Turnaround
time may be a very important factor to consider if its important that you have a paper reviewed or
accepIed beIore a parIIcular deadlIne (e.g. a sIudenIshIp, granI, or job applIcaIIon}.
Acceptance rate: TaIlorIng a manuscrIpI Io a specIc journal requIres IIme and eorI, IhereIore IIs besI
to minimize the number of times required to do this for any particular manuscript. If a paper has
been rejecIed several IImes, you may begIn Io consIder journals wIIh a hIgher accepIance raIe so IhaI
the paper has a better chance of getting published. Its not usually a good idea to give up too soon
on a qualIIy paper buI nancIal or IIme pressures may make IhIs meIrIc an ImporIanI one Io consIder.
Prcmcticn cf ycur paper: Some journals are more acIIve Ihan oIhers aI promoIIng Ihe arIIcles
Ihey publIsh. For InsIance, some journals Increase arIIcles vIsIbIlIIy by hIghlIghIIng Ihem on
IheIr websIIe or promoIIng Ihem vIa socIal medIa. These eorIs can allow your work Io reach new
or broader audiences.
FInally, we IhInk IIs exIremely ImporIanI Io consIder wheIher Ihe journals conIenI Is Ireely accessIble Io
all readers, accessible only to its subscribers, or something in between. The reasons for this are outlined
In Ihe nexI secIIon.
What is an Dpen Access jcurnaI7
RaIse your hand II IhIs has happened Io you: youre doIng a lIIeraIure revIew Ior a paper or projecI and
you happen to fall upon the reference for a recent article that is clearly related to your topic of interest.
However, when you Iry Io access Ihe Iull IexI oI Ihe arIIcle, Ihe journal resIrIcIs your access Io Ihe paper,
unless of course youre willing to fork over a handsome fee for access!
FrusIraIIng Why canI we jusI Ireely access all journals conIenI aI any IIme? Well, Ihe sImple reason
Is IhaI journals are noI esIablIshed wIIh Ihe InIenIIon oI beIng revenue neuIral. To make a neI proI,
journals adopI varIous busIness models, some oI whIch Involve resIrIcIIng access Io journal conIenIs. n
Table /.1, we presenI Ihree maIn journal Iypes, reIerred Io here as Ihe reader pays, auIhor pays and
hybrId models, and ouIlIne IheIr key dIerences. elow, we dIscuss Ihe ImplIcaIIons oI Ihese journal
Iypes Ior you and your choIce oI journal Io submII Io.
21
eader pays
(TraditicnaI]
Authcr pays
(Dpen Access]
Hybrid
1curnaI exampIes
JAMA, CMAJ,
HealIh AaIrs
PLDS MedIcIne, MI,
Dpen MedIcIne
Lancet, Healthcare
Policy
1curnaI media fcrmats
Usually print and web-
based formats
DIIen web-based
formats only
PrInI andlor web-based
formats
Dwnership cf rights fcr
inteIIectuaI ccntent
Rights transferred
from the authors to the
journal
Authors retain rights
over their work
Rights often transferred
Io Ihe journal unless Ihe
authors choose open
access option
Permissicn requests
fcr use
Must pass through the
journal or publIsher
Must pass through the
corresponding author
Usually Ihe journal buI
sometimes the author
PubIicaticn fees
Covered by InsIIIuIIonsl
individuals who must
purchase access to the
journal
Covered by authors,
through their
institution, research
funds or other sources
Covered by InsIIIuIIonsl
individuals and possibly
the authors as well
Access fees fcr readers
Readers pay to access
articles unless covered
by their institutions
subscription
None arIIcles are Iree
to anyone worldwide
Readers pay unless
fees are covered by
their institution or an
open access option was
chosen by authors
TimeIiness cf access
Usually yes if your
institution holds a
subscription or the
reader is willing to
pay a Iee Ior access,
some journals Ihough
dont publish prior to
publication date
Yes conIenI Is
immediately available
on web often in form of
ahead-of print articles
Depends can be
immediately available
or available freely after
a delay (which can be
waived if readers pay
a fee)
ArticIe fcrmatting
Restrictions on length
of articles and number
oI Iableslgures
Typically no restrictions
to article length and
number oI Iablesl
gures
Typically restrictions
on length of articles
and number oI Iablesl
gures
Pcst-pubIicaticn use
and disseminaticn
Restrictions on use
(e.g. making your paper
available on a website)
and dissemination
(e.g. may need to ask
permission to share
copies of the paper)
No restrictions
over ability to use,
disseminate, transform,
or self-archive
publications
Restrictions vary by
journal, specIc journal
editorial policies should
be consulted
TabIe 4.1. Dierences acrcss three basic jcurnaI types
5cientic quaIity
and prestige Comparable qualIIy and presIIge across journal models
22
Why should you care Io whIch Iype oI journal you submII your manuscrIpIs? As can be seen In
Table /.1, Ihere are consIderable dIerences beIween Ihe Ihree journal Iypes and each has ImporIanI
ImplIcaIIons Ior auIhors. TradIIIonal or reader pays journals are sold on subscrIpIIon Io InsIIIuIIons.
Access Io journal arIIcles Is resIrIcIed Io journal subscrIbers and payIng cusIomers. As a sIudenI, you may
be able Io Ireely access journal conIenI Ihrough your InsIIIuIIons lIbrary buI IhIs access IsnI
really Iree, II comes wIIh a lIcensIng cosI Io your InsIIIuIIon. When you publIsh In Ihese journals,
you IransIer copyrIghIs oI your work Io Ihe journal, whIch may lImII your abIlIIy Io selI-archIve or
disseminate your papers (e.g. distribute your articles when teaching). More importantly, individuals or
InsIIIuIIons IhaI have dIculIy payIng subscrIpIIons or arIIcle access Iees wIll noI be able Io ImmedIaIely
access your work.
n Dpen Access or auIhor pays journals, you reIaIn copyrIghIs over your work, journal conIenI Is
usually immediately made freely available online to anyone in the world after paper acceptance, and you
are unrestricted in your ability to disseminate or transform (e.g. translate into another language) your
work. The ease of access means that your paper may ultimately have a broader visibility and impact than
II II had been publIshed In a IradIIIonal journal. However, Ihe Dpen Access journal wIll ask IhaI you pay
a publication fee prior to publication that can be upwards of several hundreds (or even thousands) of
dollars. While this open access fee may seem like a disincentive to students especially, some universities
have already reached agreemenIs wIIh publIshers Io allow alIaIed sIudenIs and researchers Io publIsh
aI reduced or no cosI. n some cases, journals may even waIve IhIs Iee Ior sIudenIs dependIng on IheIr
nancIal cIrcumsIances.
WIIh hybrId journals, you may or may noI geI Ihe besI oI boIh worlds, II ulIImaIely depends on Ihe
journal. Your arIIcle can be publIshed IollowIng Ihe IradIIIonal rouIe or, Ior an up-IronI Iee, be made
available freely on the web with some or little restrictions on post-publication use. All students should
develop Ihe habII oI readIng Ihe edIIorIal polIcIes oI Ihe journals Ihey are consIderIng so IhaI Ihey Iully
undersIand Ihe consequences oI publIshIng In Ihose journals.
FinaI Wcrds
As students, its important to learn how to craft a clear message when sharing your ideas and research
ndIngs. SelecIIng a journal Io publIsh In Is acIually a key parI oI IhaI process. Iournals are one vehIcle
by whIch your message geIs Io your IargeI audIence. For any gIven paper Ihere may mulIIple journals
Irom whIch Io choose and arrIvIng aI a nal choIce IsnI always easy. WIIh experIence, youll learn Io
nd Ihe rIghI I Ior your papers and cuI down on Ihe IIme II Iakes Ior Ihem Io nd a home and
leave their mark.
23
CcmmcnIy enccuntered writing issues
There are many resources Io help sIudenIs learn how Io wrIIe scIenIIc arIIcles. However, sIudyIng
The Elements of Style
16
or adherIng Io oIher guIdes on Ihe IechnIcal aspecIs oI scIenIIc wrIIIng can
usually only Iake you so Iar. More oIIen Ihan noI, a varIeIy oI oIher Issues Inuence wheIher your paper
wrIIIng experIence Is posIIIve or negaIIve.
This chapter addresses some of these other challenges that can make the actual writing phase so
daunting, especially for students who are new to the process.
What is prcper etiquette when writing papers ccIIabcrativeIy7
Your supervisor and colleagues are likely pretty busy people. Usually, theyre not only involved in their
research but also in teaching, supervising, requesting funding, doing committee work, etc. When working
wIIh Ihem on a paper, and especIally when you expecI Io be rsI auIhor on Ihe paper, IIs ImporIanI Io
follow a certain etiquette that demonstrates respect for them and promotes a fair, collaborative writing
process. ox 5.1 presenIs some rules oI eIIqueIIe wIIh respecI Io wrIIIng a paper In a Ieam conIexI.
cx 5.1 Five ruIes cf etiquette when writing ccIIabcrativeIy
Hcw can ycu nd time tc write7
A major challenge Iaced by many young researchers Is eecIIvely managIng Ihe compeIIng demands on
IheIr IIme and ndIng Ihe IIme Io puI words Io paper. Here are ve helpIul sIraIegIes IhaI sIudenIs and
senior researchers have used to help them meet this challenge and boost their productivity:
Writing every day: Some people make writing an everyday activity, even if it means only writing for
an hour or two per day. By writing every day, progress can be made slowly but surely and a
consistent rhythm can be achieved. Another advantage is that it can prevent you from falling
into the trap of waiting for the perfect moment to write, a moment that, for all sorts of reasons,
usually never comes.
CcnscIidating activities in cur scheduIe: For people who have teaching, clinical, or other duties to
carry out on top of their research work, it may be possible to reorganize your activities to free up a
few hours a week to devote to writing. This may require approval of supervisors or employers and
possibly give rise to one or more intense workdays each week, but for some students its a step thats
needed to create protected time to focus on writing.
1. CommunIcaIe your role as rsI auIhor Io all co-auIhors Involved In Ihe paper and lead an early
discussion around authorship. This discussion can occur during a meeting and an agreement
should be reached early.
2. Provide the other authors with a timeline so that they know when youll be sending the
manuscript to them for feedback and when you plan to submit for publication.
3. When seeking their feedback, provide a deadline. You need to give them enough time to read the
paper and provide feedback, but also give yourself enough time to incorporate their feedback
(minimum 2-3 weeks). If necessary, dont be shy to send out a friendly reminder as deadlines
approach. If your deadline passes and you still havent heard from some authors, try to speak
to them directly in person or by phone to discuss whether you submit without their feedback.
4. Do your best to gather and incorporate feedback from each co-author. If you disagree with
proposed changes, be sure Io deIend your posIIIon openly and respecIIully. Dnce youve
IncorporaIed IheIr Ieedback, send a nal versIon oI Ihe paper you wanI Io submII Io all co-
auIhors aI leasI Iwo weeks beIore your expecIed daIe oI submIssIon.
5. When you geI a decIsIon Irom Ihe journal, make sure you share Ihe news wIIh your co-auIhors
and keep them engaged as you prepare your response. As with the initial submission, you
need Io gIve Ihem su cIenI IIme Io send Ieedback, II Ihey have some, beIore re-submIIIIng
Io Ihe journal.
24
Iccking cut time fcr writing: When possible, it can be helpful to reserve a series of consecutive days
devoIed compleIely Io wrIIIng. We know oI some senIor researchers IakIng enIIre monIhs o IheIr
work every year in order to concentrate on writing papers. A similar, smaller-scale approach is to
devote a full week or two to paper writing every couple months or so. These retreats can even take
place outside of your work settings (e.g. at a summer cottage). The advantage of such approaches is
that you can focus deeply on your work and avoid distractions from colleagues or others.
Civing ycurseIf seIf-impcsed deadIines: Many people (the procrastinators!) are better at making time
to do things when there is a clear deadline for achieving them. In the case of studentships or grant
applIcaIIons Ihe deadlInes are usually exIernally Imposed and clear. However, when wrIIIng a paper
IIs very easy Io puI o wrIIIng and Ieel IhaI Ihere are no consequences Io IhIs. A beIIer approach Is
to self-impose deadlines for your papers and commit to sending manuscript drafts to your supervisor
or colleagues by certain dates. The pressure of keeping your commitments is a great motivator to
putting time into your manuscripts and keeping the process moving along.
5hut up and write: This is not rude advice but an actual technique
17
! The technique involves inviting
a group of writers to a location (e.g. a cafe or library), spending a few minutes chit chatting over
coee, and Ihen decIdIng Io shuI up and wrIIe Ior a pre-deIermIned perIod oI IIme (usually 3U Io
6U mInuIes}. AIIer IhaI, people Iake a break and Ihen eIIher sIop or repeaI Ihe process. The group
dynamic can help facilitate the writing process and provide participants with a support system as
soon as each wrIIIng perIod expIres.
Not every approach listed here will be ideal for everyone. The trick is to discover approaches that
work Ior you and allow you Io nd IhaI specIal groove IhaI helps you Io see a paper Ihrough Irom
beginning to end.
Hcw can ycu gc abcut crafting a cIear message7
Every arIIcle should Iell a sIory. For InexperIenced auIhors, decIdIng whaI IhaI sIory Is can be a
challenge. How Ihen do we deIermIne whaI maIn messages Io share? A rsI sIep Is Io make sure IhaI
you know the literature well and that youre familiar with some of the main narratives being circulated
by oIher auIhors. NexI, you can look aI your objecIIves and especIally your maIn resulIs and ask yourselI,
To whom is my paper really going to be speaking ? Knowing this helps you tailor your language and key
messages Io a parIIcular sIakeholder group. Dnce your audIence Is naIled down, you may Iry Io nd Ihe
killer graph (or in qualitative research, the killer quotes) that helps build your story and
ouIlInes Ihe resI oI Ihe paper. When youve decIded whaI maIn ndIngs Io Iocus on, you can skeIch
out an outline of the article in point-form, always keeping in mind the one or two main messages you
think are most important.
A common dilemma arises when you have lots of data to present and you have to decide whether to
lump all your ndIngs InIo one paper or splII Ihese ndIngs InIo mulIIple publIcaIIons. Dn Ihe one hand,
an arIIcle IhaI presenIs several ImporIanI and relaIed ndIngs may be more lIkely Io nd a home In
Iop-IIer journals and be consIdered a major conIrIbuIIon Io Ihe eld. Such papers can be challengIng Io
wrIIe, however, and II may be dIculI Io Iocus Ihe paper around one or Iwo clear messages. Dn Ihe oIher
hand, breaking down the paper into smaller pieces (also referred to as Least Publishable Units
18
) can
potentially lead to several publications that, while more focused, may be less impactful.
WhIle IhIs approach has IIs beneIs, such as beIng able Io go InIo more deIaIls on specIc IopIcs
or provIde addIIIonal conIexIual InIormaIIon, II also opens you up Io crIIIcIsms Ior emphasIzIng
quantity over quality.
So, to lump or not to lump? The answer to the question depends on your circumstances and those of
Ihe research projecI. For sIudenIs early In IheIr graduaIe sIudIes, a sIngle publIcaIIon In a respecIed
journal can be consIdered a major accomplIshmenI and valued as much as or more Ihan mulIIple low-
impact publications. Drafting these types of articles forces you to determine the essential key messages
in your research and be concise, all critical skills in your development as a good writer. As you progress
and become a post-doctoral fellow or young investigator, it may begin to be appropriate to consider a
mIx oI approaches where you pursue major publIcaIIons buI also smaller ones IhaI are a lIIIle easIer Io
produce and whIch keep you wrIIIng and regularly conIrIbuIIng Io your eld. Such a hybrId approach may
allow you to live up to the noble ideals of academia, while also recognizing its pressures and realities.
25
What are the quaIities cf a gccd abstract7
Some people treat their papers abstract as an afterthought. This is a mistake as abstracts are
ImporIanI and wrIIIng a good one Is one oI Ihe mosI dIculI IhIngs Ior any researcher Io do. AbsIracIs
musI be clear and concIse, and convey your enIIre paper In jusI a Iew words. The absIracI Is whaI aIIracIs
readers Io your paper and helps Ihem decIde II Ihey should read Ihe Iull IexI. They also ouIlIne your maIn
messages and help readers remember your key ndIngs. n addIIIon Io beIng clear and brIeI, Ihe besI
abstracts are able to capture readers interest and keep their attention. Your abstract is your
rsI, and maybe only, opporIunIIy Io persuade journal edIIors IhaI your paper deserves Io be
considered for publication.
Cccd abstracts are
19
:
Accurate: The content and purpose of your paper should come across clearly, and only information that
actually appears in your paper should be described.
Ccncise: Each sentence of your abstract should be carefully crafted to present the full merits of your
paper. Being concise involves:

1. RephrasIng Ideas Irom Ihe arIIcle Io condense Ihe meanIng
2. Giving information only once (not repeating yourself)
3. Avoiding sentences that contain no real information (if a sentence doesnt move the
reader toward your purpose, leave it out).
4. Writing in clear and dynamic prose.

5eIf-ccntained: ExcepI Ior sIandard abbrevIaIIons (Ior example, vs. Ior versus}, all abbrevIaIIons and
acronyms should be dened. I unIamIlIar or IechnIcal words are necessary, dene Ihem Ioo.
Ncn-evaIuative: An abstract is not the place for personal opinions about the value of your work.
Easy tc read: AbsIracIs should be undersIandable Io people who arenI experIs In your eld. To make
your abstract more readable, you can:

1. AvoId jargon and use compleIe, shorI senIences. I possIble, donI omII arIIcles or oIher small
words in order to save space
2. Vary your sentence structure to avoid choppiness
3. Use the past tense when describing what was done, but where appropriate use active rather
than passive verbs
/. Check Ihe IransIIIons beIween senIences Io ensure Ihe ow Is good.
Dont forget about your abstract! Allow enough time to produce a good one. Write a rough draft, edit it
for weakness in organization, delete unnecessary information and wordiness, add important information
that is missing, strengthen your transitions, read your abstract out loud, and check and double check the
grammar, spellIng, and puncIuaIIon. Also, have your supervIsor, menIors, or a non-experI read II aI leasI
once. Your abstract shouldnt be seen as a tedious chore in the publication process, but rather as an
integral part of the paper youve written.
26
When is a manuscript ready tc submit7
The sooner the better! Its so easy to let an article languish while you tinker with details (or take care of
oIher prIorIIIes IhaI have rmer deadlInes}. UnIorIunaIely, manuscrIpIs do noI age well.
So youve nIshed your analysIs and adhered Io your selI-Imposed wrIIIng deadlInes. Youve also
gIven some IhoughI Io whIch journal youd lIke Io IargeI. Is IIme Io IIe up loose ends (see ox 5.2 Ior a
checklIsI} and send II o.
DI course, Ihere are always some weaknesses In Ihe sIudy you wIsh you could address, buI you canI
cover everything in a single manuscript. If you have good reasons why you couldnt address limitations in
your analysis, describe them clearly, but dont let worrying about them keep you from clicking submit.
They might even give you ideas for another paper!
cx 5.2 - Cetting ycur manuscript ready tc submit
Cather the infcrmaticn ycu need:
Check journal requIremenIs Ior IormaI, lengIh, and accompanyIng maIerIals.
Familiarize yourself with the submission process (usually online but in some cases via email).
FinaIize the manuscript:
Have at least one person who hasnt been working on the manuscript read it through for clarity and
typos. It really helps to have fresh eyes!
TrIple-check all Iables, gures, or quoIaIIons. Make sure IhaI numbers IhaI should add-up, do.
Make sure abbrevIaIIons or acronyms are explaIned aI rsI occurrence (or elImInaIed II possIble}.
Check IhaI page numberIng, margIns, lIne spacIng, IonI, headerslIooIers, and Ihe InclusIon oI
IdenIIIyIng InIormaIIon are consIsIenI wIIh journal requIremenIs.
Ensure any Iables and gures are In Ihe correcI le IormaIs and are eIIher Included wIIhIn Ihe
manuscrIpI or as accompanyIng les, as requIred. Check IhaI Ihe conIenI Is clearly explaIned In
captions, legends, and notes.
Check the format of all references. Reference management software is a huge help, but there will be
errors that can only be caught by hand.
CcIIect materiaIs fcr submissicn:
Prepare your cover letter (see Chapter 7).
denIIIy relevanI key words. I may be helpIul Io look aI MedlIne MESH subjecI headIngs (see Ihe US
National Library of Medicine website
2U
) or key words used in the literature you cite.
Identify potential reviewers (if required). Your supervisors or co-authors may have suggestions, or the
authors of papers you cite may be good candidates.
Some journals ask Ior a secIIon descrIbIng key messages or whaI your sIudy adds.

Take a deep breaIh, and send II o

As Ihe IllusIrIous Dr. RoberI Evans once saId, DIsserIaIIon papers are never nIshed, only abandoned.
You shouldnI be anxIous abouI leIIIng go oI a paper, even II you Ieel IIs noI perIecI. ndeed, aI some
poInI Ihere are dImInIshIng reIurns Io addIIIonal InvesImenIs oI eorI In your manuscrIpIs. Learn Io leI
go and leI peer revIewers do IheIr job and provIde Ieedback Ior IurIher ImprovemenI. And when you
nally do submII, celebraIe a lIIIle and enjoy Ihe IacI IhaI IhIs Is o your plaIe, aI leasI unIIl Ihe glowIng
reviews come back!
27
What are cther usefuI DDs and DDNTs7
Here are several other useful tidbits passed on to us from HSPR students and researchers:
DD read closely some oI Ihe besI arIIcles In your IopIc area. reakIng down a classIc paper and sIudyIng
whaI makes II greaI Is a sImple buI eecIIve way Io Improve your own wrIIIng.
DD make II a habII oI joIIIng down your Ideas as soon as Ihey come and Ihen workIng aI developIng Ihem
further as much as you can. Good ideas can come at any time so be ready!
DDNT worry abouI whaI order you wrIIe Ihe paper In. Some experIs argue IhaI IIs besI Io wrIIe ouI
secIIons In a cerIaIn order, e.g. objecIIves, resulIs, meIhods, InIroducIIon, dIscussIon, absIracI and IIIle.
However, writing is a highly personal process and few among those we interviewed adhered to a single
approach. Theres no right or wrong way to do it.
DD pay sIgnIcanI aIIenIIon Io how your paper Is wrIIIen and presenIed. Even arIIcles on excellenI
research run hIgh rIsk oI rejecIIon II Ihey are poorly wrIIIen or noI persuasIve enough.
DDNT submII a paper wIIhouI havIng read very careIully Ihe InsIrucIIons Ior auIhors. We canI Iell you
how much edIIors haIe II when people Ignore journal guIdelInes, so avoId IhIs mIsIake
DD become a revIewer yourselI durIng your graduaIe sIudIes. ThIs opIIon Is parIIcularly approprIaIe Ior
more senIor IraInees who are condenI In IheIr experIIse and wanI Io learn more by crIIIquIng oIhers.
FinaI wcrds
NoI every sIudenI Is a gIIIed wrIIer or can easIly express Ihemselves In words. Trouble organIzIng your
Ideas or conveyIng a clear message are common dIculIIes encounIered by young wrIIers. DIIenIImes
though, an inability to put a paper together in a timely way will relate less to your skill as a writer and
more Io your own uncerIaInIIes or InexperIence dealIng wIIh some oI Ihe Issues dIscussed In IhIs chapIer.
Is ImporIanI Io IreaI each wrIIIng projecI as a learnIng experIence IhaI helps buIld your compeIence
and knowledge around publishing. Learning some of the tricks of the trade can make the process less
sIressIul and hopeIully more ecIenI, Iun, and successIul.
28
An cverview cf the peer review prccess
DurIng your graduaIe school experIence and IuIure career (academIc or noI} youll have Ihe opporIunIIy
Io submII manuscrIpIs Io journals and research proposals Io granIIng agencIes. n each case, Ihe peer
revIew process wIll be used Io judge and raIe your proposed projecI or compleIed research. ThIs chapIer
Iocuses on Ihe peer revIew process used by journals Io selecI arIIcles Ior publIcaIIon, buI some oI II wIll
apply to the peer review process for grant proposals as well.
Keep reading for some insight into why the peer review process is used, the main steps involved,
why II can Iake longer Ihan you expecI, how you can speed up Ihe revIew process, and whaI revIewers
are looking for.
Why peer review7
Have you ever wondered why your research, and that of well-established academics, has to undergo
scrutiny by a number of your peers? The quick answer is that its the primary way to ensure quality
so that the research we reference and use as foundation for our own research is original, valid, and of
high quality
21, 22
. The peer revIew process has been Ihe sIandard Ior more Ihan 3UU years. WIIhouI II, we
couldnI be as condenI In Ihe qualIIy and relevance oI papers publIshed by a journal.
As much as we may dread having our research and writing critiqued, without peer review wed miss out
on receIvIng valuable Ieedback IhaI ulIImaIely Improves our work. WIIh peer revIew, your nal accepIed
manuscrIpI may be consIderably dIerenI Irom Ihe InIIIal one you submIIIed Ior revIew. ThIs Is okay.
Scrutiny by your peers often increases the relevance and reliability of your research, and hence your
condence In Ihe nIshed producI.
What are the main steps in the review prccess7 Why can it take sc Icng7
Just because its been around for centuries doesnt mean that the peer review process is speedy or
familiar to us. The process can be broken down into three main stages. Lets look at each stage as a
manuscrIpI goes Irom InIIIal submIssIon Io nal publIcaIIon.
5tage 1 (submissicn]: This stage begins once youve submitted your manuscript. Assuming youve
Iollowed all submIssIon guIdelInes Ior Ihe journal, your manuscrIpI wIll be assIgned Io an edIIor. The
edIIor may decIde Io rejecI II ImmedIaIely or Io send II Ior Iull revIew. Some journals requIre agreemenI
Irom more Ihan one edIIor Io rejecI a manuscrIpI aI IhIs sIage.
I your manuscrIpI Is noI rejecIed ImmedIaIely, Ihe edIIor musI nd Iwo Io Iour peer revIewers Io
critique your paper. This stage usually takes from a week to a month, depending on the manuscripts
topic, the availability of reviewers, and whether you have suggested potential reviewers in your cover
leIIer. EdIIors usually sIrIve Io nd aI leasI Iwo researchers (preIerably more} Io revIew Ihe manuscrIpI
buI can also approach oIher experIs or polIcymakers. Is ImporIanI Io keep In mInd IhaI poIenIIal
revIewers are doIng IhIs on a volunIeer basIs. Theyre oIIen busy people and, dependIng on Ihe journal,
topic, or methodologies used, there may not be a large pool of reviewers to approach.
5tage 2 (peer review]: Dnce revIewers have been chosen, your manuscrIpI moves Io SIage 2, whIch
begIns once Ihe manuscrIpI Is senI Io peer revIewers (Ihe journal may send you a noIIcaIIon when your
manuscrIpI enIers IhIs sIage}. MosI journals gIve revIewers a deadlIne and ask Ior a conrmaIIon IhaI
the reviewer can complete the process within that timeframe. If not, the editors will approach another
reviewer. Even so, reviewers may take longer to send in their comments.
Dnce all revIews are compleIe and receIved, Ihe edIIors meeI Io go over Ihe IndIvIdual revIews and
come to a decision. Editors consider not only how good the paper is now, but also how good it might
become after revision
23
. The possible decisions are accept (a rare outcome at Stage 2), accept with
revIsIons, revIse and resubmII, or rejecI (see ChapIer 7}.
Larger, more popular journals (such as Ihe MI} generally have IasI Iurnaround IImes, whereas smaller,
more specIalIzed journals usually Iake longer. I IypIcally Iakes up Io Iour Io sIx monIhs (buI someIImes
even a year} Irom Ihe IIme you submII your arIIcle Io nd ouI wheIher IIs accepIed or, more commonly, In
need oI revIsIons (SIages 1 and 2}. RejecIIons are oIIen communIcaIed more quIckly. Turnaround IImes
depend on Ihe journal (how sIrIcI II Is wIIh IImelInes} and on revIewers (IheIr avaIlabIlIIy and how busy
Ihey are}. You can conIacI Ihe journal edIIor or ask colleagues who have submIIIed Io your chosen journal
to get an idea of its turnaround time.
29
5tage 3 (revisicn tc pubIicaticn]: ThIs nal sIage begIns once youre noIIed oI Ihe revIewers
decIsIon. I Ihe manuscrIpI Is rejecIed you can choose Io submII II Io a dIerenI journal. I revIsIons are
necessary, youll have to make the appropriate changes, write a letter to the editor that responds to all
the reviewer comments and points of change, and send the revised manuscript back to the editor (see
Chapter 7 for more about interacting with the editor during this time). The editor will review the revised
manuscrIpI and accompanyIng leIIer. I Ihe revIsIons are noI accepIable, Ihe manuscrIpI can be rejecIed
(but this shouldnt happen if you have addressed the reviews adequately). If the revisions are complete,
the manuscript will be accepted, sent for copy-editing, and then published at some future time.
SIage 3 can Iake Ihree monIhs or longer, dependIng on Ihe exIenI oI revIsIons needed, IIme Io
make revisions, and the time to publication. If the review of your paper is taking an unusually long
time (compared to the length of time they said it would take), contact the editors, inquire about the
sIaIus oI your paper, and explaIn why II would be ImporIanI Ior you Io hear back Irom Ihem sooner
rather than later.
Adding up the time required for each stage reveals that it can sometimes take more than 9 months from
Ihe IIme you submII your manuscrIpI unIIl you see II In prInI (longer II you have Io make major revIsIons
or have submIIIed Io a journal wIIh parIIcularly long IImelInes}.
For a ow charI oI Ihe peer revIew process, check ouI Ihe CMAI websIIe (www.cmaj.calsIIelauIhorsl
edprocess.xhIml}. The charI Is specIc Io Ihe CMAI, buI gIves you a general sense oI Ihe process your
manuscript will go through.
Hcw can we acceIerate the review prccess7
Authors can take several practical steps to help accelerate the review process:

Target the right jcurnaI fcr the right reascns: You can decide whether your manuscript is appropriate
Ior a journal by readIng abouI Ihe journals scope or consulIIng IIs mIssIon sIaIemenI. ChoosIng Ihe
rIghI journal Ior your manuscrIpI wIll help you avoId a mIsmaIch and speed up Ihe process oI geIIIng
your work published (see Chapter 4).
Also some researchers have submIIIed manuscrIpIs aI an early sIage jusI Ior Ihe revIew and
Ieedback, compleIely aware IhaI IheIr papers wIll be rejecIed
24
. Dont do this. You shouldnt
waste editors and reviewers time in this way and delay the publication of other completed,
quality research.
FcIIcw submissicn guideIines: Theyre called guidelines for a reason and are available on the website
oI any journal. Follow Ihem exacIly - IhIs canI be emphasIzed enough. EdIIors are amazed aI how
many manuscripts are submitted that do not meet the submission guidelines. These manuscripts are
oIIen ImmedIaIely rejecIed sImply because Ihey do noI Iollow journal requIremenIs around word
limits, formatting, citation style, and other submission guidelines.
e thcrcugh: EdIIors and revIewers noIIce aws so donI be sloppy. Make sure IhaI have cleaned up
any language errors or IormaIIIng changes appearIng In your paper. Check your Iables and gures,
make sure Ihey maIch your IexI and vIce versa. These may seem lIke small deIaIls, buI when Ihere
are enough oI Ihem II can Io lead Io rejecIIon.
Prepare a gccd ccver Ietter: A key element to your submission is your cover letter. You can indicate
your raIIonale Ior choosIng Ihe journal youre submIIIIng Io, II may noI be ImmedIaIely apparenI Ior
some research IopIcs (new meIhodology In an exIsIIng eld, cross-dIscIplIne research, eIc.}. Your
cover leIIer can even suggesI poIenIIal revIewers Io choose (or noI choose}, whIch can help speed up
the review process (see Chapter 7).
Make revisicns a pricrity: Some delays in the review process are out of your control, but responding to
edIIors or revIewers commenIs IsnI among Ihese. I your paper IsnI rejecIed, one oI Ihe besI ways
to accelerate the review process is to make your revisions a priority and get the revised paper back
to the editors as quickly as possible. Establish timelines for your co-authors and stay on them so that
you can incorporate their feedback and resubmit quickly.
Cet exampIes cf successfuI submissicns: Journal editors suggest that students and new researchers
nd examples oI a submIIIed manuscrIpI, Ihe edIIorIal response, Ihe auIhors leIIer In response Io
Ihe edIIor, and Ihe nal manuscrIpI wIIh revIsIons. Cood examples oI Ihese sIeps In Ihe peer revIew
process are prIceless. Is very helpIul Io see how experIenced auIhors respond Io edIIors. A well-
organized and well-written response letter can help revised manuscripts get accepted more quickly.
Ask your supervIsor, menIors, and peers wIIh publIcaIIons Ior Ihese examples.
3U
What dc reviewers Icck fcr when reviewing a manuscript7
You can also speed up the review process (and make reviewers happy) by knowing what reviewers
wIll be assessIng. Some basIc elemenIs IhaI revIewers look Ior are orIgInalIIy, relevance, sIgnIcance,
generalizability, clarity, and contribution to the target topic
25
. A summary of questions considered by
revIewers are provIded In ox 6.1
26
.
cx 6.1 uesticns ccnsidered by reviewers cf ycur manuscript
Is the title informative? (Use a simple, yet descriptive, title)
Does the introduction frame the area of the research accurately and adequately by discussing
Ihe exIanI (yeI currenI} lIIeraIure? s any lIIeraIure noI consIdered? Are conIcIIng
ndIngslvIewpoInIs omIIIed?
How orIgInal and ImporIanI Is Ihe research? Does II conIrIbuIe someIhIng novel Io Ihe eld? (e
specIc In your InIroducIIon, explaIn whaI your research conIrIbuIes}
s Ihe experImenIal desIgn rIgorous? WhaI are IIs sIrengIhs and weaknesses?
Is the data high quality?
Are the appropriate statistical analyses used?
Is the interpretation of the data appropriate?
Does the discussion of the data provide valuable insights?
Are the arguments sound, and the conclusions appropriate and valid?
Does the manuscript stay within the word limits?
Is the writing clear and concise?
Are Ihe gures and Iables easy Io undersIand, accuraIe, and compleIe?
Are there any ethical issues not addressed?
FinaI wcrds
This quick overview of the peer review process hopefully sheds light into why its done, how its done,
and what you can do to succeed in it. Use this chapter as a guide, but dont hesitate to talk to other
researchers Ior more advIce. Try Io become a revIewer (every journal has dIerenI ways oI recruIIIng
potential reviewers) and learn how to do it. If you can constructively critique the work of others you will
be beIIer able Io see Ihe gaps and aws In your own research and wrIIIng.
31
Interacting with editcrs and reviewers, and deaIing with criticism
ThroughouI your IIme as a sIudenI and durIng your career, you wIll have sIgnIcanI InIeracIIon wIIh
edIIors and revIewers oI academIc journals. These InIeracIIons can unIorIunaIely be a mIneeld, IhIs
chapter outlines how to successfully navigate it. It will present the important points of how and how not
to interact with both reviewers and editors, what to do when you disagree with a reviewers assessment,
and how Io handle Ihe rejecIIon oI a manuscrIpI.
What shcuId I incIude in my ccver Ietter tc the editcr7
Cover letters are usually between a half page to a full page in length. To know what to include in your
leIIer, sIarI by checkIng Ihe journals requIremenIs, as mosI journals wIll be explIcII abouI whaIs needed.
Generally, your letter will need to include the following elements:
Name, address, and contact details for the corresponding author.
A description of your study.
nIormaIIon abouI Ihe ImporIance oI your sIudy and whaI II adds Io Ihe exIsIIng lIIeraIure.
A summary oI your objecIIves, meIhods, and your mosI ImporIanI resulIs.
A brIeI sIaIemenI abouI why your sIudy Is ImporIanI Io Ihe journals specIc audIence.
ConrmaIIon IhaI all sIudy co-auIhors read and approved Ihe nal versIon oI Ihe arIIcle.
You may be asked Io Include a conIcI oI InIeresI declaraIIon, sIgned by Ihe correspondIng auIhor only,
or by all sIudy auIhors. Some journals also ask IhaI you submII a lIsI oI poIenIIal revIewers wIIh your
cover leIIer. e sIraIegIc abouI who you suggesI. They should be knowledgeable abouI Ihe specIc area
your work Ialls wIIhIn. However, II you choose an experI In Ihe eld, IIs possIble helshe wIll pass Ihe
review on to a student, and students are more likely to be overzealous in their criticisms!
I youre submIIIIng a paper IhaI has been prevIously rejecIed elsewhere, you can consIder IncludIng
prevIous revIews In your cover leIIer because Ihey can be helpIul Io Ihe nexI seI oI revIewers, reduce
duplication of comments, and demonstrate how you have improved the manuscript since your last
submission. If not formally requested, its a good idea to check with the editor about whether you should
include them or not. If you choose not to include previous reviews, it can be valuable to comment upfront
on weaknesses IdenIIed Irom a prevIous revIewer wIIh Ihe goal oI pre-empIIng poIenIIal crIIIcIsm by
Ihe new revIewers. For example, perhaps a revIewer poInIed ouI IhaI you used a measuremenI Iool IhaI
helshe doesnI lIke and suggesIed IhaI you use a dIerenI Iool InsIead. n your nexI submIssIon, Include a
paragraph about why you selected your tool and not the initial reviewers preferred measure.
Lastly, although it can be tempting to do so, avoid duplicating your abstract in your cover letter. Journal
edIIors wIll read your paper (or aI leasI your absIracI} beIore sendIng II o Io peer revIew, and Ihe
duplication will be both obvious and irritating.
I submitted my paper and havent heard anything. Ncw what7
Peer review can be slow, often lasting several months (see Chapter 6). It will likely take much longer
than you hope it will. If youre unsure about average turnaround times and this information is not
avaIlable on Ihe websIIe, you can emaIl Ihe journal dIrecIly Io know whaI Io expecI. Dnce youve
submIIIed, Ihe journal may send you a conrmaIIon noIIce IndIcaIIng IhaI your arIIcle has been passed on
Io peer revIewers, you can use IhIs opporIunIIy Io InquIre abouI Ihe journals average Iurnaround IImes.
LasIly, Iheres noIhIng wrong wIIh conIacIIng a journal edIIor Io polIIely InquIre abouI where your
paper Is In Ihe peer revIew process and when you may expecI a response. For journals wIIh an onlIne
submission process, this information is usually easily available once you log in to the system.
32
What kind cf respcnse can I expect7
As menIIoned In ChapIer 6, you can expecI Ihe IollowIng responses:
Accept: Is excepIIonally rare Ior a journal Io accepI an arIIcle as Is on IIs rsI submIssIon. Even
when an article is commissioned, revisions are typically requested. Thus, you shouldnt go into a
submIssIon process expecIIng any journal Io accepI your InIIIal submIssIon.

Accept, with revisicns: ReceIvIng an accepIance wIIh revIsIons Irom a journal Is cause Ior celebraIIon.
If this happens, you should focus on those revisions as soon as possible because your chances of
successfully publishing your work are now very high. If you revise your article as per the editors
request, it will be published, yay! In this case, the peer reviewers are unlikely to see your article
agaIn. nsIead, youll communIcaIe dIrecIly wIIh Ihe journals edIIors who wIll handle your revIsIons.
evise and resubmit: If more substantial revisions are required, you may receive a request to resubmit
your arIIcle. PublIcaIIon In Ihe journal Is noI guaranIeed, buI your chances are sIIll good. As wIIh an
acceptance with revisions, you should focus on getting the requested revisions completed as soon as
you can. Aim to have the revision done within a month or two at most. Typically, once your revisions
are complete, your article will be sent back to the original reviewers, who will have been asked to re-
review the article. If youve addressed all their criticisms, your article will be accepted and published.
In some cases, however, the editors will elect to send the article to a new set of reviewers or will
review your revisions themselves. Its in your best interest to ask the editor whether your article
will be sent back to the same reviewers. Editors or a new set of reviewers will likely be more lenient
about whether youve integrated all the comments from the original review.
Youre not obligated to resubmit your article, especially if you feel that the reviewers comments
are not reasonable or feasible to address. However, its almost always in your best interest to
resubmit when youre given the opportunity to do so. Your chances of successfully publishing the
arIIcle wIIh Ihe orIgInal journal are much hIgher Ihan II you sIarI Irom scraIch wIIh a new journal.
eject: No one lIkes Io hear IhaI IheIr paper has been rejecIed, buI II happens Io everyone, IncludIng
Ihe mosI respecIed scholars. SuggesIIons Ior why your paper mIghI have been rejecIed are dIscussed
below. You have Iwo opIIons when dealIng wIIh Ihe ouIrIghI rejecIIon oI a paper. I you dIsagree
with the reviewers criticisms, youre free to write the editor back and request a re-review (very
uncommon buI an opIIon II Ihere really Is no oIher journal maIch Ior your paper}. AlIernaIIvely, you
can choose Io submII your arIIcle Io anoIher journal (Ihe more common response}.
My paper has been acceptedI What ncw7
FIrsI IhIngs rsI: CongraIulaIIons You should denIIely do someIhIng Iun Io celebraIe your success
The journal wIll send you a prooI, whIch Is a draII oI how your paper wIll appear In Ihe journal. Read Ihe
prooI careIully ThIs Is your lasI chance Io make mInor changes and x any Iypos. You may also be asked
Io sIgn a conIcI oI InIeresI waver aI IhIs IIme II you havenI done so already. Also, II youre publIshIng
along the traditional route you and your coauthors may be asked to sign a copyright transfer agreement,
so youll have to collect some signatures. Plan ahead for this step if youre publishing with people
workIng In dIerenI geographIc locaIIons, as orIgInal sIgnaIures are usually needed. LasIly, and mosI
importantly, update your curriculum vitae (CV) right away. Youll thank yourself for being vigilant with CV
updaIes Ihe nexI IIme youre applyIng Ior a sIudenIshIp or granI.
Hcw dc I respcnd tc requests fcr mincr cr majcr revisicns7
AI rsI glance, a revIewers suggesIed revIsIons may look daunIIng. I can be helpIul Io creaIe a Iable or
spreadsheeI wIIh a lIsI oI all Ihe revIsIons, Ihe dIculIy level oI each requesI (Irom easy Io challengIng},
and your plan Io Iackle Ihem (see Table 7.1}. egIn by rereadIng Ihe paper and makIng some oI Ihe easIer
revisions. This will help you re-familiarize yourself with the article you likely havent looked at for several
monIhs and wIll make IacklIng some oI Ihe more challengIng revIsIons jusI a lIIIle bII easIer.
When you are responding to reviewers comments, make sure you address each point completely! In
the cover letter that accompanies your re-submission, address each comment in sequence and indicate
specIcally where In your paper (page, paragraph, senIence} you have made Ihe necessary adjusImenIs.
Make II easy Ior Ihe edIIor and revIewer Io see exacIly where and how youve responded Io Ihe revIews.
It may also be helpful to share your revised paper with colleagues to gain insight on whether youve
adequately addressed reviewers concerns.
33
TabIe 7.1. ExampIe cf espcnse tc eview TabIe fcr twc reviewers (A, ]
eviewer ccmments Di cuIty espcnse
A.1: ThIs Is an InIeresIIng
article that addresses a topic
oI ImporIance Io Ihe eld.
Dne ImporIanI concern have
however Is IhaI Ihe objecIIves
are poorly worded and the true
purpose of the paper is unclear.
The results the authors present
do not seem to match the
intentions they lay out in their
introduction.
Easy
Currently the paragraph
conIaInIng our objecIIves reads:
Dur aIms wIIh IhIs sIudy were
to.
This paragraph has been revised,
and now reads: The rsI
objecIIve oI IhIs sIudy was Io

A.2: The two scales the authors
used to measure health service
quality seem to produce
contradictory results. How do
Ihe auIhors explaIn IhIs?
Easy
The following sentence has
been added to the discussion
section: The two scales used
to measure service quality have
been shown in previous studies
Io assess somewhaI dIerenI
aspecIs oI qualIIy, wIIh Ihe rsI
measuring
.1: ThIs Is an InIeresIIng sIudy.
However, the authors seem to
only have used patient reported
data for their assessments
of service quality. Given the
authors close links with service
providers, couldnt medical
records be used to verify the
accuracy of patient reports?
Challenging
The following sentence was
added to the discussion section:
Dne lImIIaIIon Io our sIudy Is
that indicators of service quality
were based solely on patient
reported data
cx 7.1. 5peciaI case: Ycur articIe is tcc Icng
Is noI uncommon Ior an edIIor Io requesI IhaI you shorIen your paper sIgnIcanIly. ThIs can
sometimes be a challenging task, especially since addressing reviewers questions and concerns often
involves lengthening sections of the article. So, how can you tackle this?
First: Do a read-Ihrough exclusIvely Ior economy oI language, reIormulaIIng senIences and cuIIIng
down wherever possible.
5eccnd: Consider eliminating a nonessential paragraph in its entirety. Typically, the Discussion and
Background sections are the best places to do this.
Third: Your reIerences In Ihe IexI someIImes counI as words, so Iake a look aI Ihem and make sure
youre not citing papers unnecessarily.

Fcurth: Pass your article to a colleague and ask them to identify additional sections or sentences they
feel arent essential to the article.
Fifth: Dnce youve shorIened Ihe paper, read II Ihrough careIully Io ensure IhaI Ihe papers ow
remains intact.
34
What if the reviewers are wrcng7
Remember that peer reviewers are volunteers, and theyre human (most of them anyways!). Mistakes
are made. So, be on your besI behavIor when wrIIIng your response Io Ihe revIews, be polIIe and IhankIul
even when you completely disagree with a reviewers comments. If you disagree with a change request,
buI Ihe requesI Is mInor, easy Io ImplemenI, and does noI aecI Ihe scIence oI your manuscrIpI, IIs
probably best to acquiesce and make the change.
That said, youre not obliged to incorporate every change suggested by the reviewers. For instance, if
you fundamentally disagree with a reviewers suggested change and elect not to accept it, you should
explaIn IhoughIIully why IhaI aspecI oI your paper should go unchanged and supporI your argumenI
wIIh evIdence. I Ihere IsnI any evIdence, seek ouI Ihe advIce oI an experI In your eld, and cIIe IhaI
communication as evidence. Its also more polite to validate the reviewers point of view before you
make a case Ior your posIIIon (e.g., The revIewers poInI Is well Iaken, however, we Ieel sIrongly IhaI}.
n your leIIer Io Ihe edIIor, you musI explaIn how you responded Io each oI Ihe revIewers commenIs. Is
one thing to disagree with a suggestion or two, but dismissing every comment from a reviewer shows a
close-mIndedness IhaI IsnI usually apprecIaIed by journal edIIors.
Why was my paper rejected7
There are many reasons why a journal may rejecI a paper. eIore your arIIcle Is even senI Io peer
revIew, an edIIor may rejecI II on Ihe grounds IhaI II IsnI relevanI Io IheIr journals readershIp, hasnI
been prepared accordIng Io IheIr guIdelInes Ior submIssIon (Ior example, IIs over Ihe lengIh lImIIs},
or because they feel it doesnt make enough of a substantive contribution to the knowledge base for
Ihe journals eld.
Dnce II has been senI on Io peer revIew, your arIIcle may be rejecIed Ior a hosI oI dIerenI reasons.
Most of these revolve around inappropriate or incomplete methodology. This includes incorrect use of
sIaIIsIIcal meIhods, a small or bIased sample, aws In Ihe sIudy desIgn, InapproprIaIe InsIrumenIaIIon,
or Ihe over-InIerpreIaIIon oI resulIs. AddIIIonal aws Include lack oI clarIIy around sIudy objecIIves,
an InadequaIe or ouIdaIed lIIeraIure revIew, InsucIenI daIa presenIaIIon, poor gures or Iables, or
generally poor writing.
My paper has been rejected. What ncw7
As menIIoned above, when your paper Is rejecIed, you generally have Iwo choIces: you can wrIIe Ihe
journal edIIors Io appeal Ihe orIgInal decIsIon and ask Ior a new revIew, or you can submII elsewhere.
Is very unusual Ior edIIors Io granI re-revIews, so unless youre exIremely condenI IhaI Ihe orIgInal
reviewers were incorrect or biased in their criticisms, the best option is to improve your article and
submit it elsewhere.
Make sure you consider all the comments made by the reviewers before you submit your article
agaIn. We oIIen Ieel a knee-jerk reacIIon Io dIsmIss commenIs IhaI we Ieel are o-base or Ill-InIormed.
However, II a revIewer In your eld doesnI undersIand your paper, Ihen Ihere Is lIkely room Ior you Io
clarIIy your wrIIIng. ndeed, IncorporaIIng revIsIons InIo a rejecIed paper usually dramaIIcally Improves
its quality! And there is always the possibility that the same reviewer will be asked to referee your
arIIcle, even when you submII Io a new journal. HealIh servIces and polIcy research In Canada Is a small
community after all!
FinaI wcrds
As a student and a researcher, youll interact with editors and peer-reviewers on a regular basis
throughout the publishing process. This overview covers a few of the most common issues and questions
related to how best to manage these interactions, thereby increasing the likelihood of your paper being
accepIed Ior publIcaIIon. Remember IhaI almosI every paper wIll requIre revIsIons beIore IIs nally
accepIed, and mosI wIll Iace a rejecIIon or Iwo. DonI be dIscouraged Take Ieedback serIously, and
respond thoughtfully and courteously to editors and reviewers. You wont always like what reviewers
have to say about your work, but theres almost always something you can learn from their comments.
35
PubIishing quaIitative research

If youre newly entering an HSPR-related training program, youll typically meet little resistance if you
decIde Io pursue a qualIIaIIve research approach Ior your research projecI. You may noI realIze IhaI II
wasnI Ioo long ago IhaI such approaches were wIdely dIsmIssed as less rIgorous or even unscIenIIc
Nowadays, aIIIIudes have begun Io change due Io serIous advocacy eorIs and educaIIon around
qualitative traditions and methods. However, despite this evolution in attitudes, qualitative researchers
still face some unique issues when seeking to publish their work.
Whats dierent when pubIishing quaIitative research7
The basIc sIeps Involved In publIshIng qualIIaIIve research are no dIerenI Ihan Ihose Involved In
publIshIng quanIIIaIIve work. You musI do Ihe research, IargeI a journal, wrIIe your paper, submII II, and
revise it based on the comments made by reviewers.
Several Issues, however, may make Ihe experIence oI publIshIng resulIs Irom your qualIIaIIve sIudy
qualIIaIIvely dIerenI compared Io publIshIng oIher Iorms oI research. Here are a Iew examples:
Ccntributicn ccnsideraticns: Dur research can allow us Io conIrIbuIe Io our elds In a number oI
ways. We can advance knowledge or theory, invent new methods, or provide potential solutions to
recurrIng challenges. When doIng qualIIaIIve research, we oIIen also delve deeply InIo unexplored,
complex problems and geI Io know Ihe people IacIng Ihese problems. We may Ieel oblIgaIed Io
expose unIaIr pracIIces, emancIpaIe oppressed IndIvIduals or groups, or Iry Io evoke an emoIIonal
response in readers that may lead to positive actions
27
. Try and remember that you may not be able
to accomplish each of these goals at once and that you should determine what main purpose your
paper serves prior to writing it.
Targeting a jcurnaI: Dver Ihe pasI Iwo decades an IncreasIng number oI journals have opened IheIr
doors Io qualIIaIIve research. However, whIle you may noI have a hard IIme ndIng a maInsIream
HSPR-relaIed journal IhaI accepIs qualIIaIIve research papers, geIIIng your work publIshed In Ihese
journals, especIally hIghly ranked ones, Is usually a whole oIher sIory. RecenI sIudIes examInIng
journal publIcaIIon raIes have revealed IhaI beIween 1558 and 2UU8 qualIIaIIve arIIcles accounIed
Ior less Ihan 1U% oI orIgInal research arIIcles In HSPR and managemenI journals and beIween 1
and 6% oI arIIcles In Ihe Iop general medIcal journals
28, 29
These numbers indicate that positivist
worldviews still predominate the publishing landscape and that qualitative research remains
somewhat marginalized in medical and HSPR communities.
PublIshIng In some maInsIream HSPR journals can also be a challenge because oI Ihe naIure oI
qualIIaIIve arIIcles, whIch oIIen aIm Io provIde rIch, conIexIual descrIpIIons oI people or IhIngs, or In-
depIh exploraIIons InIo evenIs or peoples experIences. I can be hard Ior auIhors, especIally novIce
ones, Io I Ihese deIaIls InIo IheIr papers when a journal Imposes a relaIIvely low word lImII Ior IIs
arIIcles (e.g. 25UU Io 35UU words}. SImIlarly, II you use a meIhodologIcal approach IhaI may be less
common (e.g. phenomenology, meta-synthesis), youll need to use valuable space to describe the
approach Io readers unIamIlIar wIIh II. Dpen access journals havIng no word lImIIs are an aIIracIIve
option for qualitative papers, but paying the fees for publication can pose problems for some
authors. Taken together, authors of qualitative research articles may have fewer options available to
Ihem when II comes Io ndIng Ihe rIghI journal Ior IheIr papers.
Crafting a cIear message: Settling on one or two main messages to build your article around can be
a sIgnIcanI challenge Ior qualIIaIIve researchers, especIally InexperIenced ones. WIIh all your
InIervIews or Iocused groups compleIed, documenIs analyzed, andlor observaIIons and personal
reecIIons joIIed down, youre now Iaced wIIh mounIaIns oI paper Io sIII Ihrough and InIerpreI. As
most people who have done qualitative research can attest to, youll likely discover so many new and
interesting things during the process that everything seems important and worth reporting about!
SynIhesIzIng your ndIngs and exIracIIng Ihe key messages can be really Iough and IIme-consumIng
and usually requires assistance from your mentors. Similarly, making decisions about whether to
reporI ndIngs as a sIngle arIIcle or mulIIple ones Is also a rouIIne challenge. I you decIde Io dIvIde
your papers up, draft a good, detailed plan for each one in advance so that youre sure that they each
report something original and meaningful without overlap.
36
eviews and revisicns: WhIle many journals are now able Io access revIewers wIIh experIIse In
qualitative research, if youve adopted a design or approach that may be less commonly applied
In HSPR II may Iake longer Io nd a revIewer wIIh knowledge oI IhaI approach and IIs probably
unlIkely IhaI Iheyll be experIs In your specIc research IopIc on Iop oI IhaI. SImIlarly, some
qualitative methods are new and evolving (e.g. realist reviews, meta-syntheses) and it can be
challengIng Ior some journals Io undersIand Ihese meIhods, provIde qualIIy revIews, and ulIImaIely
publish your paper.
If your paper does receive an appropriate peer review, it can happen that youll be asked to
plunge back into your data, make new interpretations, and bolster arguments or areas of your paper
that were weak. If the delay between the times you submitted your paper and received your review
Is long, II can be dIculI Io geI back InIo Ihe rIghI mIndseI Io make Ihe approprIaIe revIsIons. Such
revisions may be time-consuming as well if your data isnt well organized and you have to search for
Ihemes or quoIes among dozens oI parIIcIpanIs. I you IargeI a journal wIIh longer Iurnaround IImes
for your qualitative paper, you might want to touch base with your data every so often so that your
analysis stays fresh in your mind.
What are scme ccmmcn mistakes authcrs make when trying tc pubIish quaIitative
research7
Perhaps Ihe sIngle mosI ImporIanI reason why we mIghI have dIculIy publIshIng qualIIaIIve research
stems from our own lack of competence with qualitative epistemologies and methods. Learning from
more experIenced researchers abouI IheIr experIences In publIshIng qualIIaIIve sIudIes can Improve our
knowledge and help us avoid common mistakes. Below we present such wisdom as well as advice from
the broader literature:
Dcnt try tc gc it aIcne (frcm 1can 5argeant]: Doing qualitative research can be a long and sometimes
tricky process. The process is made even longer and trickier when the proper supports are not
avaIlable Io us when we have quesIIons or encounIer dIculIIes. Is ImporIanI IhaI IraInees
InexperIenced wIIh qualIIaIIve research have a menIor Ihey can reach ouI Io In such sIIuaIIons.
Even Ihose wIIh prevIous qualIIaIIve research experIences should have such a person avaIlable Io
Ihem as each new projecI presenIs IIs own unIque challenges. Is a good habII Io seek ouI oIhers
who are doing qualitative research and engage them in discussion about their work and your own.
Not only might you establish a mentoring relationship but you could also become involved in
oIher new projecIs.
e cIear abcut ycur methcds (frcm Wendy 5wcrd]: First, right from the beginning of your research,
you should have a clear idea as to the type of methodology you plan to use in your study and the
IheoreIIcal perspecIIve IhaI InIorms IhIs meIhodology. For example, Is your sIudy a case sIudy? Are
you doing ethnographic or grounded theory research? Is your worldview constructivist, postmodern,
or realist? Its important that your methodology is clearly stated and that your theoretical approach
matches your research questions and methods. Making statements such as, A qualitative method
was used In a paper Is InsucIenI, your sIudy desIgn should be explIcIIly sIaIed (e.g. consIrucIIvIsI
grounded theory).
Second, not only is it important to provide details about the methodology and theoretical
framework youve used but you must also clearly indicate other information about methods,
such as recruitment and sampling strategies, approach to data collection and analysis,
sample interview questions, etc. Without such information, no other researcher is able to
replicate your study.
Dcnt present data withcut ccntext cr interpretaticn (frcm Wendy 5wcrd]: Thorne wrote, Data do not
speak for themselves.
3U
ndeed, IraInees can someIImes nd II a challenge Io InIegraIe
quoIes and oIher Iorms oI qualIIaIIve daIa eecIIvely In a paper. n a resulIs secIIon, Ior example,
its not ideal to overuse quotes while providing little interpretation or assume that a particular
quoIe says II all. RaIher, quoIes need Io be placed In conIexI and each should serve Io IllusIraIe
a poInI beIng made. AuIhors musI provIde sucIenI conIexI and InIerpreIaIIon Io allow readers
to gain a deeper understanding of what the participants are saying and how it sheds light on the
research topic of interest.
37
Dc ycur hcmewcrk (frcm MariIyn MacDcnaId]: As menIIoned, noI all journals publIsh qualIIaIIve
research. Is very dIshearIenIng and IIme-consumIng Io wrIIe a manuscrIpI and submII II Io a journal
only Io nd IhaI Ihey do noI accepI reporIs Irom qualIIaIIve sIudIes or IhaI you have noI meI IheIr
guIdelInes In some way. Is crIIIcal Io read Ihe guIdelInes Ior auIhors oI all oI Ihe journals youre
IhInkIng oI IargeIIng and also helpIul Io look Ihrough Ihe conIenIs oI Ihe journals Io see how oIIen
qualitative research studies are published. Finding studies similar to your own published in a
parIIcular journal Is a good sIgn IhaI your paper Is approprIaIe Io submII and IhaI Ihe journal edIIors
have revIewers wIIh Ihe experIIse Io peer-revIew your work.
5tay cccI abcut criticism (5ara kirk]: Youve spent countless hours reading transcripts, meticulously
organizing and analyzing data and writing a thoughtful paper only to be harshly criticized by
a revIewer oI Ihe journal you submIIIed your paper Io. DoIng qualIIaIIve research can be a very
personal process and crIIIcIsm and rejecIIon can hurI In Ihese cIrcumsIances. WhIle IhIs IeelIng
is understandable, its important not to let this feedback deter you. We need to be open to
such feedback both before and after submission so that our work can be deemed an important
conIrIbuIIon Io people oIher Ihan jusI ourselves.
Write cIearIy and creativeIy: Several authors have argued for greater clarity and creativity in reporting
results from qualitative research
31, 32
. Language and ow Iake on added ImporIance In a qualIIaIIve
research article and its important to present your results in a logical manner to build your arguments
and make your ndIngs more convIncIng. AdopIIng a rsI-person voIce IhaI allows your personalIIy
Io shIne Ihrough and does jusIIce Io your sIudy parIIcIpanIs Is oIIen desIrable and helps readers
connecI wIIh your IexI.
FinaI Wcrds
Rather than beginning with a hypothesis to be tested or proven, qualitative research typically begins
wIIh an Idea or IopIc and moves Ioward a hypoIhesIs as Ihe research progresses, gaIherIng a sIgnIcanI
amounI oI InIormaIIon along Ihe way. Such research helps us gaIn a beIIer undersIandIng oI Ihe complex
world we live in. Similarly, HSPR often begins with a problem and moves toward a potential solution.
ualIIaIIve research has much Io oer Ihe HSPR eld and hIgh-qualIIy papers deserve a place among Ihe
mosI hIghly ranked journals In our eld.
38
PubIishing within research prcject Iife cycIes
As in other academic disciplines, life as a health services or policy researcher tends to have a certain
cyclIcal avour Io II. Dn a regular basIs, researchers musI generaIe Ideas Ior new research projecIs,
IdenIIIy collaboraIors, apply Ior IundIng, waII Ior decIsIons, manage Ihe award, carry ouI Ihe projecI,
and ensure IhaI Ihe resulIs are dIssemInaIed eecIIvely. As projecIs wInd down, Ihe cycle begIns agaIn
In Ihe hopes oI achIevIng new goals, generaIIng new knowledge, and eecIIng new change. FaIr or noI,
publIshIng plays a pIvoIal role In makIng Ihese cycles happen. UnIIl recenIly, Ihe norm was Ior scIenIIc
communications to occur mostly at the end of each cycle. Today, however, with increased competition
In publIshIng and IundIng, many oI Ihe Iop researchers have become adepI aI publIshIng dIerenI Iypes
oI papers aI dIerenI sIages oI Ihe projecI lIIe cycle. The purpose oI IhIs chapIer Is Io explore how
creaIIvIIy and plannIng can open up sImIlar possIbIlIIIes Ior IraInees and help you gaIn more experIence
with publishing and enhance your productivity.
What types cf articIes are avaiIabIe tc us in the H5P eId7
Publishing the results of original research is the predominant form of publishing in peer-reviewed
journals. However, IIs a mIsIake Io IhInk IhaI one necessarIly needs Io have research resulIs, hard daIa oI
some kind, to be able to publish. There are many alternatives to consider that can allow you to get your
publIshIng IeeI weI. A lIsI oI Ihe mosI common Iypes oI scIenIIc arIIcles Is provIded In box 5.1.
cx 9.1. Ccmmcn types cf scientic articIes
DriginaI research articIes: These are papers presenting original results of quantitative or qualitative
sIudIes IhaI generaIe new knowledge (as opposed Io synIhesIzIng exIsIIng knowledge} on a parIIcular
topic. Theyre the most common type of article.
rief repcrts: These reports can be similar to original research articles, only shorter! They can be ideal
Ior valIdaIIon sIudIes or when presenIIng secondary ndIngs oI a research projecI.
Literature reviews: RevIew papers synIhesIze ndIngs Irom oIher sIudIes and are Ihus very valuable In
Ihe HSPR eld. RevIews can Iake many Iorms, IncludIng narraIIve revIews, sysIemaIIc revIews, meIa-
analyses, scopIng revIews, rapId revIews, realIsI revIews, meIa-synIheses oI qualIIaIIve research, eIc. Dne
experI In Ihe eld, Ieremy CrImshaw oI Ihe Cochrane EecIIve PracIIce and DrganIzaIIon oI Care Croup,
encourages every HSPR student to learn how to carry out a high-quality review at some point during their
graduate studies.
DiscussicnlEssays: These papers may include reviews of the literature, but aim primarily to make
arguments, convince readers of a particular point of view, present ideas on a topic, or suggest areas for
future research.
Ccmmentaries: These papers IypIcally Iake Iwo Iorms: 1} a shorI paper IhaI accompanIes anoIher arIIcle
In Ihe journal Issue and conIexIualIzes IhaI arIIcle and helps readers Io InIerpreI IIs ndIngs andlor 2}
an opinion piece that presents an authors arguments about an important or controversial issue in health
care. Some journals publIsh commenIarIes by InvIIaIIon only buI oIhers welcome unsolIcIIed IexIs.
5tudy prctcccIs: This type of paper, which is becoming increasingly common, presents details of
proposed or ongoing research. Such articles are great for students because youre typically asked to
wrIIe deIaIled proIocols Ior your projecIs anyway as parI oI your graduaIe sIudIes.
Meeting repcrts: These papers reporI key messages or ouIcomes oI a scIenIIc conIerence, conIerence
evenI, or research meeIIng. Such papers can also be IerrIc Ior sIudenIs parIIcIpaIIng In InIeresIIng
training activities, such as research practicums or summer institutes.
Debate articIes: These are articles that usually ask authors to defend a position on a controversial issue.
n some journals, debaIe arIIcles presenIIng opposIIe vIews are publIshed sIde-by-sIde, someIImes called
point-counterpoint articles. These papers represent interesting opportunities for trainees to pair
IogeIher Ior a publIshIng experIence.
39
EditcriaIslLetters tc the editcrlepIies: Editorials are usually short reports that authors are invited to
wrIIe by Ihe journal edIIors. TheIr purpose Is IypIcally Io commenI on one or several arIIcles publIshed
In IhaI journal Issue. LeIIers Io Ihe edIIor and replIes are usually reacIIons Io arIIcles IhaI have recenIly
been publIshed, II accepIed, Ihey can be publIshed rapIdly aIIer beIng receIved by Ihe journal.
Case repcrts: Case reporIs can Iake many Iorms, IncludIng a descrIpIIon oI a specIc research experIences
(e.g. ImplemenIIng a new pracIIce In a hospIIal}, an unusual or InIeresIIng paIIenI care experIence, or an
event that sheds light on an issue or provides practical or educational lessons for others.
ThecrylMethcds papers: These papers showcase unique contributions to advancing theory or
research methodology.
AmazIngly, Ihe lIsI oI arIIcle Iypes In box 5.1 Is Iar Irom exhausIIve. Theres a wIde range oI journals
avaIlable Io us In HSPR and, dependIng on Ihe parIIcular journal, varIous oIher Iypes oI arIIcles can be
solIcIIed. Is really helpIul Ior sIudenIs Io IamIlIarIze Ihemselves wIIh Ihe range oI journals IhaI
publish in their topic areas so that they can understand more fully the publishing opportunities
IhaI exIsI Ior Ihem.
What are scme strategies fcr pubIishing within prcject cycIes7
A IypIcal research projecI lIIe cycle has sIx maIn sIages (FIgure 5.1}. n conIrasI Io mosI descrIpIIons oI
research cycles where Ihe Idea oI publIshIng or dIssemInaIIng resulIs Is presenIed aI a nal sIage In Ihe
cycle, we feel that publishing has the potential to happen at every stage of the process.
Figure 9.1. Prcject Iife cycIe stages
SIage 1
Initial Concept
Stage 2
PlannIng Ihe projecI
Stage 3
Creating a proposal
Stage 4
ProjecI sIarI-up
Stage 5
Data collection
& analysis
Stage 6
ProjecI conclusIon
/U
5tage 1: The rsI sIage oI Ihe research cycle Is where you usually Iry Io IdenIIIy a problem and an Idea
Ior a projecI IhaI helps address IhaI problem. To help puI Ihese problems and Ideas InIo conIexI and geI
a sense as to their importance, you typically seek out background information on them. This can be done
by searchIng Ihe lIIeraIure or speakIng wIIh your peers, oIher experIs, or people dIrecIly aecIed by Ihe
problem (e.g. paIIenIs}. As much as possIble, you wanI Io deepen your knowledge oI Ihe problem, rene
your Ideas, and begIn IormulaIIng some InIIIal research quesIIons andlor hypoIheses.
PctentiaI strategies: ThIs rsI sIage oI Ihe cycle lends IIselI well Io a varIeIy oI arIIcle Iypes, IncludIng:
Review papers: This is an obvious choice because literature searching and synthesis is a key step in
Ihe process oI conIexIualIzIng a research problem and renIng our Ideas and research quesIIons.
Full-blown systematic reviews (quantitative or qualitative) are usually time-consuming and labour
InIensIve, buI can be exIremely helpIul In sheddIng lIghI on a specIc IopIc area and provIdIng
InsIghIs InIo nexI sIeps. Such revIews are essenIIally sIudIes In Ihemselves, as such, adequaIe
experIIse, IIme and resources are needed Io carry Ihem ouI. LearnIng Io conducI hIgh qualIIy revIews
Is a greaI Iool Ior sIudenIs Io have In IheIr Ioolbox. An addIIIonal beneI Is IhaI revIew papers are
oIIen cIIed even more Ihan orIgInal research arIIcles. DIher Iypes oI revIews, such as rapId
revIews and scopIng revIews, should be explored as well. n some cases, Ihese may be more
feasible and appropriate.
CommenIarIeslLeIIers Io Ihe edIIor: These papers also lend Ihemselves well Io SIage 1 oI Ihe cycle
because we can write about how a previously published paper has left some questions of interest
unanswered or how some Issue In healIh care has receIved InsucIenI research aIIenIIon. These
papers are also someIImes used Io expose research problems more Iully and presenI research
agendas IhaI communIIIes oI researchers In parIIcular elds should consIder workIng on.
Debate: Is the problem youre interested in polarizing or unappreciated for some reason? If so, perhaps
you can write a debate article in which you provide your scholarly perspective on the issue and
defend why the problem is of particular importance.
Case reports: deas Ior research projecIs can come Irom a varIeIy oI sources. I yours came Irom
a specIc paIIenI experIence or evenI IhaI hIghlIghIed a larger ImporIanI Issue, wrIIIng a case
report may be for you.
5tage 2: In the planning stage, we seek out collaborations and engage potential partners in our research,
we work on renIng our research quesIIons and IocusIng our objecIIves, and we begIn desIgnIng Ihe
study and choosing the right methods to carry it out. In some cases, we may need to acquire new skills
beIore we Iake on a projecI or else we may Iry Io conducI pIloI work or a IeasIbIlIIy sIudy Io IacIlIIaIe Ihe
planning process. In essence, were trying to gain a clear understanding of what were trying to do and
how were going to do it.
PctentiaI strategies: Any oI Ihe sIraIegIes proposed Ior SIage 1 can also be applIed here.
In addition, some other interesting possibilities for publishing may present themselves at this
second stage in the cycle:
Meeting reports: does your research projecI brIng IogeIher an InIeresIIng group oI collaboraIors? I
so, perhaps a research day could be organIzed where members share IheIr experIIse and Ideas Ior
IuIure sIeps, IhIs InIormaIIon could serve as Ihe IoundaIIon oI a group publIcaIIon. SImIlarly, II a
conference you attended comes to an important conclusion about a problem or leads directly to a
new projecI, a meeIIng reporI could be an approprIaIe opIIon Ior sharIng IhIs InIormaIIon wIIh a
broader audience. Finally, students who participate in special training activities can sometimes
Ieam up wIIh oIher sIudenIs or researchers and descrIbe Ihe experIence and lessons learned
from their activities.
TheorylmeIhods papers: I Ihe projecIs you begIn Io develop are InnovaIIve In IheIr IheoreIIcal or
meIhodologIcal approach or perhaps apply exIsIIng IheorIes or meIhods Io new problems In an
interesting way, it can be very valuable to share this information by publishing a detailed account
of the innovation.
Brief report: If you have some preliminary data that you can share or can conduct a validation study of a
tool or technique, a brief report may be an ideal vehicle for publishing early in the research cycle.
/1
5tage 3: Creating a proposal begins with identifying potential sources of funding, crafting a research
projecI proposal wIIh Ihe InpuI oI collaboraIors and colleagues, and preparIng Ihe research proposal
for submission by gathering all the additional attachments required for the evaluation process (e.g. CVs,
letters of support, signatures, etc.).
PctentiaI strategies: Writing research proposals is intensive work and can leave the main people drafting
Ihe proposals wIIh lIIIle IIme Io do anyIhIng else. However, IundIng compeIIIIons have Ihe beneI oI
provIdIng hard deadlInes IhaI push researchers, noI only Io submII projecIs on IIme, buI also Io move
their potential publications forward. As such, all of the publishing options mentioned above are in play
durIng IhIs sIage and can poIenIIally beneI Irom Ihe presence oI moIIvaIed IndIvIduals and Ihe pressure
Io compleIe wrIIIng projecIs beIore a cerIaIn daIe.
5tage 4: After a proposal or two has been submitted and youre slowly emerging from your post-
submission stupor, its time to wait (and wait and wait) for a funding decision. If the results are positive
and Ihe projecI Is Iunded, Ihere are usually loIs oI IhIngs Io do Io geI sIarIed, IncludIng hIrIng or IraInIng
personnel, acquIrIng equIpmenI, and makIng whaIever oIher projecI arrangemenIs are necessary. ThIs
lasI sIep usually Includes seekIng approval Ior Ihe projecI Irom all relevanI eIhIcs commIIIees. AI IhIs
sIage, a clear pIcIure oI how Ihe projecI wIll acIually be conducIed usually sIarIs Io Iorm and sIudenIs In
particular may have a good idea as to what their contribution may be.
PctentiaI strategies: The wait time between proposal submission and funding decisions is usually a good
IIme Io conIInue Io gaIher daIa or InIormaIIon abouI Ihe projecI and work on papers IhaI have already
been sIarIed. n Ihe evenI oI granI rejecIIon, such advancemenIs Improve Ihe poIenIIal Ior success Ihe
nexI IIme around. Dnce a projecI receIves IundIng, has become beIIer dened, and has receIved eIhIcs
approval, one type of article is worth pursuing if possible:
SIudy proIocolsldescrIpIIve arIIcles: Writing a study protocol for your masters, doctoral, or post-
docIoral projecIs Is valuable because II Iorces you Io IhInk abouI many oI Ihe deIaIls oI your projecIs
and provIdes you wIIh a road map Ior compleIIng Ihese projecIs a IImely manner. n many graduaIe
programs, these protocols are evaluated formally and so being able to publish the protocol is an easy
bonus IhaI can also lead Io addIIIonal helpIul commenIs Irom exIernal revIewers. A growIng number
oI HSPR journals accepI proIocols and so sIudenIs should assess wheIher IheIr papers are elIgIble. n
addIIIon Io sIudenI proIocols, papers IhaI descrIbe larger research projecIs and IheIr meIhodology
are useIul Io publIsh early on as Ihey can InIroduce Ihe projecI Io Ihe research communIIy and serve
Io cuI down on descrIpIIons oI Ihe projecI and IIs meIhods In laIer publIcaIIons. Even papers IhaI
provIde deIaIls on how non-researcher collaboraIors may have goIIen engaged wIIh Ihe projecI (e.g.
polIcymakers, healIh provIders, paIIenI populaIIons} are IncreasIngly valued In Ihe HSPR eld.
5tage 5: In this stage, data collection begins and eventually were able to analyze this data, interpret
II, and make some prelImInary conclusIons based on Ihe resulIs. DependIng on Ihe projecI, Ihe daIa
collection and analysis processes could be very short or, alternatively, could carry on for several years.
Similarly, the available data set could be relatively small or could instead be a huge database containing
years oI daIa Io examIne.
PctentiaI strategies: Its during Stage 5 that data begin to be transformed into new knowledge. As such,
Ihe research Ieam can IypIcally begIn Io produce orIgInal research arIIcles and brIeI reporIs IhaI reecI
IheIr research objecIIves. As In oIher sIages, mosI oIher publIshIng opIIons remaIn avaIlable (IncludIng
revIews IhaI Include ndIngs Irom your projecI, commenIarIes based on InsIghIs arIsIng Irom your
research, or validation studies that required your data to be collected). In addition to paper publications,
IIs common Ior sIudenIs and researchers Io presenI early research ndIngs aI scIenIIc conIerences In
the form of posters and oral presentations and gather feedback from their peers about the relevance
of and enthusiasm for their work. In some cases, the abstracts from these conferences are published,
provIdIng an exIra boosI Io your CV
5tage 6: n SIage 6, you IypIcally Iry Io creaIe consensus on your nal resulIs and work Io communIcaIe
Ihese resulIs as eecIIvely as possIble. DependIng on your projecI, Ihere may be lessons learned IhaI
requIre ImmedIaIe acIIon and collaboraIIon wIIh parIners. AI IhIs sIage you also reecI on Ihe projecI,
assess whaI worked and whaI dIdnI, and evaluaIe Ihe poIenIIal Ior anoIher sIudy IhaI buIlds o oI II.
42
PctentiaI strategies: PublIshIng papers deIaIlIng Ihe resulIs oI orIgInal research Is whaI Is expecIed aI
the end of the research cycle. Publishing original research articles is critical to sharing the knowledge
weve generated, advancing science and potentially making an impact somewhere in our health system
or on peoples healIh. DIher Iypes oI papers can and maybe should be carrIed ouI durIng IhIs sIage (e.g.
dIscussIon papers Inuenced by our ndIngs, debaIe pIeces IhaI IncorporaIe our daIa, or brIeI reporIs on
more perIpheral research ndIngs}, however, publIshIng orIgInal research shows IhaI we can nIsh whaI
we start and is vital to obtaining new funding and sparking new research cycles.
What pubIishing cppcrtunities exist cutside cf cur research prcjects7
While weve hopefully made it clear that you have a wide range of opportunities available to you
regardIng publIshIng wIIhIn research projecI cycles, IIs ImporIanI Io menIIon as a nal noIe IhaI
you donI even need Io waII Io be parI oI a specIc projecI beIore geIIIng Involved In publIshIng.
DpporIunIIIes IhaI you can capIIalIze on may also arIse whIle youre doIng your graduaIe coursework or
ouIsIde oI your sIudIes, Ior example.
Gillian Hanley, a post-doctoral fellow and former Chair of the CAHSPR SWG, suggests that students
always keep their radar on alert for publishing opportunities. If a course you take requires that you
produce a literature review or an essay on a given topic, why not try to turn that into a publication? It
will probably require more time and elbow grease, but the results could be well worth it. For Jennifer
Zelmer, EdIIor-In-ChIeI oI Ihe journal HealIhcare PolIcy, a paper she wroIe as a sIudenI Ior a course she
was taking became one of her most cited papers! As her story shows, when youre prepared, creative, and
open Io new possIbIlIIIes, II becomes much more lIkely IhaI Ihe scIenIIc communIIy hears your voIce.
Hcw dc we baIance writing prcjects that are reIated versus unreIated tc cur graduate
studies7
WrIIIng papers can be Iun, and havIng a Iew arIIcles Io our name Is clearly benecIal Ior our career. ThaI
said, there is a risk to being overzealous, pursuing every opportunity that comes our way, and devoting
Ioo much IIme and energy Io wrIIIng projecIs ouIsIde Ihe scope oI our own research sIudIes. When gIven
Ihe opporIunIIy Io conIrIbuIe Io a paper, II can be hard Io say no, especIally II Iheres a clear payo In
Ierms oI buIldIng our resume, gaInIng experIence, or even beIng nancIally compensaIed.
Remember this though: every opportunity has an opportunity cost. Not focusing on our own research
projecIs can someIImes have serIous consequences IhaI may noI be Iully apparenI Io us aI Ihe IIme oI
our decIsIon. No maIIer how knowledgeable we are abouI a IopIc or how sImple a wrIIIng projecI seems,
wrIIIng always Iakes IIme a valuable and lImIIed resource Ior researchers and sIudenIs alIke. WrIIIng
projecIs can also go o Ihe raIls and IaIl Io make II Io publIcaIIon. Is Ihus essenIIal IhaI sIudenIs
learn Io weIgh Ihe pros and cons oI geIIIng Involved In wrIIIng projecIs unrelaIed Io IheIr own graduaIe
studies. Here are some questions to ask yourself when facing that decision:
How much IIme mIghI II Iake Io compleIe Ihe wrIIIng projecI and how InIensely (hours per day or per
week) will I need to work on it?
WIll be nancIally compensaIed Ior my work?
WhaIs Ihe maIn beneI IhaI mIghI obIaIn Irom parIIcIpaIIng In IhIs wrIIIng projecI (e.g. learnIng new
things, new collaborations, better resume, etc.)?
WhaI mIghI be Ihe poIenIIal ImpacI (posIIIve or negaIIve} oI Ihe wrIIIng projecI Ior oIhers (e.g.
colleagues, other researchers, clinicians, policymakers, patients, etc.)?
I Ihe wrIIIng projecI doesnI pan ouI or Iakes 2-3 IImes longer Io compleIe Ihan expecIed, how
screwed am I? Whats the opportunity cost?
43
I aIIer askIng yourselI Ihese quesIIons Ihe pros donI sIgnIcanIly ouIweIgh Ihe cons, IIs lIkely IhaI
passIng on Ihe currenI wrIIIng projecI and waIIIng Ior Ihe nexI opporIunIIy Is Ihe besI choIce. DIherwIse,
II may be all sysIems go wIIh a new publIshIng experIence. WhIchever Ihe case, IIs ImporIanI Ior you
Io develop good judgmenI and learn when Io open Ihe door when opporIunIIy knocks and, ImporIanIly,
when to keep the door shut.
FinaI wcrds
As young researchers, were not immune to the realities of the current research environment. Many of
us feel pressure to publish, especially those of us who are more advanced in our studies. Publishing isnt
the be-all and end-all of science, but we cant deny its importance either. The good news is that there
are many journals ouI Ihere and more opporIunIIIes Io publIsh Ihan were usually aware oI. WIIh a lIIIle
IhoughI and someIImes Ihe supporI oI a menIor or peer, we can nd ways Io gaIn valuable experIence
and even become productive in our own right.
44
DigitaI tccIs and scientic ccmmunicaticn
By Rob Fraser
What is scciaI media7
Theres no need to get worried about what is or isnt social media. The term can seem a bit vague, which
makes sense. Is IaIrly new, and Ihere are a loI oI denIIIons beIng suggesIed Ior II. WIkIpedIas SocIal
Media article
33
was revIsed over 2,UUU IImes sInce II was rsI sIarIed. Dne oI Ihe sImplesI denIIIons Io
grasp Is Ihe 2UU5 denIIIon oI socIal medIa:
primarily Internet- and mobile- based tools for sharing and discussing information.
34
SImply IakIng o Ihe rsI ve words oI IhaI denIIIon allows us Io Include everyIhIng Irom sIone
tablets and hieroglyphics up to the latest mobile phones and web services. People have been inventing
ways Io Improve and expand Ihe way we share InIormaIIon Ior mIllennIa. Technology has always been
creating newer and faster ways to send, record, transmit, copy, and edit information.
Social media is not a new invention, its really an evolution of digital tools.
Although the term social media may be a fad, mobile and web-based tools are here to stay. Therefore,
young researchers can maxImIze Ihe ImpacI oI IheIr work by leveragIng any and all Iools avaIlable
Io Ihem. n addIIIon, Ihese Iools add sIgnIcanI value Io Ieams oI senIor researchers IhaI may noI be
familiar with emerging technologies and how they can be applied to research and knowledge translation.
What digitaI tccIs are avaiIabIe tc heaIth services and pcIicy researchers7
The Iools avaIlable are conIInually expandIng and changIng. RaIher Ihan geIIIng losI In Ihe deIaIls
oI Ihe specIc company or websIIe provIdIng a Iool, researchers should Iocus on Ihe IuncIIon IhaI II
supporIs. Table 1U.1 below Iocuses on Ihe varIous applIcable caIegorIes and IuncIIons oI Iools, and Ihe
IhIrd column lIsIs only a Iew oI Ihe poIenIIal examples Ior Ihe Iools.
TabIe 10.1. DigitaI tccIs reIevant tc H5P researchers
35
Categcry DigitaI tccI ExampIe
Communication
Blogging
Microblogging
Geolocation
Social networking
Aggregators
Wordpress, Blogger
Twitter, Yammer
Foursquare, Facebook Places
Facebook, LinkedIn
Feedly, Netvibes
Collaboration
VoIcelVIdeoconIerence
Wikis
Social bookmarking
ReIerence managerslSocIal
bibliography
Social news
Social documents
ProjecI managemenI
Skype, Google Hangouts, GoToMeeting
Medpedia, PBWorks, Wikia
Delicious, Diigo, BibSonomy
CiteULike, Mendeley, Zotero
Reddit, Digg, Newsvine
Google Docs, Zoho
Basecamp, Huddle, SharePoint
Media Sharing
Photographs
Video
Live streaming
Presentation sharing
File sharing
Flickr, Picasa
YouTube, Viddler, Vimeo
Justin.tv, Livestream, Ustream
Scribd, Slideshare, Sliderocket
Dropbox, ox
45
These tools and services range in cost. Many have a Freemium model, which allows basic
functionality with limitation on certain features at reduced or no cost. This can allow you to keep costs
low and, II Ihe Iools premIum IeaIures add sIgnIcanI value, Ihen upgradIng Is always possIble.
Which tccIs are mcst usefuI during the pubIicaticn prccess7
esearch phase:
5canning the envircnment: RSS (real simple syndication) feeds allow you to subscribe to organizations,
blogs, research journals, news sources or search resulIs. Many people are aware oI emaIl newsleIIers,
buI mIghI noI help Ihe IeelIng oI beIng overwhelmed when your emaIl Inbox Is already overloaded. RSS
provides a feed that can be collected and displayed using RSS Feed Readers, like Feedly. This allows you
to skim over new articles and decide if you want to read them or visit the site, rather than spending a lot
of time visiting individual sites to check if there are any updates. There are also many mobile applications
for smartphones and tables that allow you to check your RSS feeds while on the go.

uiIding partnerships: WorkIng wIIh mulIIple InsIIIuIIons, proIessIons, and parIners Irom dIerenI
geographic locations is becoming more important. When trying to work with people that are no longer
Irom Ihe same organIzaIIon or even In Ihe same cIIy, Ihe use oI dIgIIal Iools can have sIgnIcanI value.
ConsIderIng Ihe prIce oI posIage, shIppIng les, or even long dIsIance callIng, Ihe cosI oI collaboraIIon
can add up. Using videoconferencing tools can like Skype can keep voice calls free. Google Hangouts now
allow multiple people to videoconference at no cost. These types of services greatly reduce the barriers
geography used to create, and make it easier to get feedback and participation from partners.
UsIng paper Is noI a very IImely or ecIenI meIhod oI communIcaIIon and IrackIng documenI versIons
over email can be challenging too. Collaborative document editing through services like Google Docs can
allow multiple individuals to: view, comment, and edit a spreadsheet or manuscript at the same time. This
can allow parallel processes instead of sequential ones, meaning that two contributors can concurrently
work on the same thing, rather than having to wait a week until someone has completed their changes.
These types of time saving help meet deadlines and accelerate research.
Writing phase:
Drganizing infcrmaticn: When IransIIIonIng Io wrIIIng, ndIng reIerences and InIormaIIon sources Is
crIIIcal. UsIng servIces IhaI allow you Io archIve and sorI InIormaIIon can be a sIgnIcanI advanIage Io
researchers. Adding a tag to a blog post, reference, or social bookmark allows you to associate it with
particular keywords, which help with retrieval. Social bookmarking allows you to save references to
websIIes and add Iags. DelIcIous and DIIgo are examples oI socIal bookmarkIng servIces IhaI allow you
to organize interesting references you come across on the web. This can help you see what others have
found, organize what you come across, and then pass your work along to others. Using the search function
on DelIcIous Io search dIabeIes Ior example would reIurn websIIes mosI commonly Iagged wIIh IhIs
term. This helps identify quality and reduces search time.
For sIudenIs, organIzIng arIIcles and reIerences Is a challenge. SIgnIcanI amounIs oI IIme and eorI
can be wasIed IryIng Io nd an old reIerence you know you had somewhere. HavIng mulIIple compuIers
(homelwork, deskIopllapIop} can make IhIs worse. Mendeley Is one example oI a reIerence manager
that allows you to store, organize, annotate, and share research articles. You can also sync your research
lIbrary across mulIIple compuIers. ThIs means you easIly nd your papers. AddIIIonally, you can creaIe
public references lists, so others can see what youre working on, which helps others and can lead to
new collaboraIIons. For example, durIng presenIaIIons, provIde a lInk Io your shared reIerence lIsI. ThIs
creaIes a socIal resource IhaI does noI go ouI oI daIe aIIer Ihe presenIaIIon, allowIng oIhers Io nd your
current shared reference list regardless of when they check the list.
CcIIabcrating with cthers: SharIng les and research resources Is anoIher way Io make collaboraIIon
easIer. WheIher IIs small les such as draIIs oI manuscrIpIs or larger les, such as daIaseIs, Images or
movIes, le sharIng servIces lIke Dropbox or ox can allow you Io quIckly and easIly IransIer and share
les and Iolders, especIally ones IhaI are Ioo large Ior emaIl IransIer, wIIh colleagues. Tools Ior managIng
your own research libraries like Mendeley can also allow you to share folders with other researchers. This
means IhaI when Ihey add a le Io a Iolder or collecIIon you auIomaIIcally have II Ioo. UsIng Ihese Iools
can help you reduce unnecessary email and having to repeatedly search through your email archives.
46
5haring phase:
Digital tools reduce the barriers to publishing and sharing information. Personal computers and printers
are much cheaper than a printing press. The addition of the web means now a computer with an Internet
connection allows you to share your work globally. For the price of a laptop, access to the Internet, and
a bit of time, anyone can publish a blog or website. Producing audio and video material is also possible
aI dramaIIcally reduced cosIs. HIgh DenIIIon (HD} vIdeo cameras come as cheap as a Iew hundred
dollars and vIdeo hosIIng sIIes lIke YouTube allow you Io posI les Ior Iree. Decreased prIces creaIe new
opportunities for individuals to create and publish information, especially when your publications are
open access. This allows you to share what youre working on, and spread quality research faster. Whether
IIs your educaIIon, experIence, or IIme spenI gaIherIng and analyzIng resources, IndIvIduals aI all levels
can contribute something that can help others. Publishing and sharing ideas develops a personal brand,
establishes credibility, and creates opportunities that may not be possible or happen otherwise.
Hcw can we share cur ideas and research eectiveIy7
5tart by sharing usefuI rescurces: Feeling reluctant to create content or share isnt unusual. The easiest
way Io geI begIn Is Io sIarI sImply and wIIh small sIeps. For example, IhInk abouI Ihe IIme you InvesI
In readIng Ihe laIesI Issue oI a journal. There may be 15 arIIcles, buI you only nd Ihree IhaI are well-
wrIIIen and useIul Io your eld oI work. TakIng Ihose and sharIng IheIr lInks on TwIIIer or LInkedn
can save others time, promote research, and develop your professional image.
Use buiIt in scciaI media functicns: Dnce Ihe Idea oI sharIng becomes more naIural, look Ior ways
to make it easier. Many blogs, news sites, and growing numbers of academic publishers are adding
comment sections as well as sharing functionality. These buttons allow you to share and comment
with a simple click of a button.
Create and share ccntent: ThInk abouI whaI you work on or whaI you sIudy. DIIen youre noI Ihe only
person working on the topic. This means many people are doing similar work. So your professional
perspecIIve and work can be Iremendous value Io oIhers, especIally In nIche elds. There are many
ways to share and develop you own ideas by regularly writing on a professional blog. Most research
sIarIs wIIh some Iorm oI lIIeraIure revIew, II you Iake IIme Io do IhIs, why noI share some ndIngs
with others? Using social bibliography tools like Mendeley can allow you to share a research folder,
or others may choose to use their website or blog to do this.
Use apprcpriate ccntent channeIs: Focus on creaIIng conIenI IhaI reecIs your skIlls and InIeresI. I
youre not a great writer, consider using video or audio. Posting what you make on the appropriate
hosIIng servIces allows oIhers Io beIIer nd II. There are servIces Ior sharIng phoIos (FlIcker, PIcasa,
etc.), videos (YouTube, Vimeo, etc.), and documents (Scribd, Slideshare, etc.) that make it easy to
create content channels for others to subscribe to. Using these features allows you to consistently
release maIerIals and develop sIgnIcanI resources oIhers wIll share.
Create ycur cwn webpage: There are varIous ways Io do IhIs, wIIh lIIIle or wIIhouI cosI. Dne oI Ihe
simplest ways is to use hIIp:llabouI.me, which allows you to create a landing page linking to the
socIal medIa sIIes you wanI oIhers Io nd. A more sophIsIIcaIed websIIe IhaI could allow you Io posI
updates is a blogging service, like Wordpress.com. This is a convenient way to help share, and you
can use the about page for your biography. For the really bold, look into a service that allows you to
buy a domaIn name, as well as creaIe and hosI a websIIe lIke hIIp:llsquarespace.com.
Find pIaces tc ccnnect: NexI you can explore dIerenI socIal medIa sIIes Io see whaIs happenIng on
Ihem. For example, II you were on LInkedn search groups Ior HealIh PolIcy Research. UsIng Ihe
buIlI In search IuncIIons Ior a socIal medIa servIce can allow you Io nd Ihe relevanI dIscussIon and
evaluate if a tool might be right for you.
47
Hcw can I create a strcng cnIine presence7
Creating an online presence may seem complicated, but its really about taking simple and deliberate
sIeps. uIldIng a brand Is no longer only a concern Ior a company. Young researchers need Io explore
IheIr InIeresIs and skIlls and be wIllIng Io puI Ihemselves In places where Ihey can nd, parIIcIpaIe, share,
and be found. The Internet landscape will continue to evolve and change. Researchers should choose the
direction they want to go and test the use of new services to help them get there. The following are some
specIc ways you can begIn Io esIablIsh yourselI onlIne.
Where tc begin:
Think about your values, interests and passions - these should drive what you focus your time on and
how you acI onlIne. Any IIme you open your browser you can geI losI In Ihe noIse, spend IIme IhInkIng
about what is important and of interest to you before you go online.
Ccme prepared:
Cather ycur infcrmaticn: Create a document that has an appropriate photo (only you in the picture,
clear enough to recognize you) of you or an avatar (if youre not comfortable create your own avatar
hIIp:llwww.doppelme.com). Write out a short bio (a few sentences, a medium bio, and a longer
versIon}. Use IhIs documenI any IIme you creaIe a prole.
Pick a username: Although its an easy step to skip, usernames are important in social media, its
how others will (or will not) remember you. Try to make it descriptive (name - Rob, profession -
nurserob, and avoId numbers - IIorgeI1586} so oIhers can learn abouI you and remember.
Use hIIp:llnamechk.com Io IesI usernames across mulIIple sIIes so you do noI have a dIerenI
username for every service.
5tart with an end in mind: Think about what you want to accomplish or learn. This is crucial to
remember and its important to routinely evaluate how youre spending time. Hopefully you can
self-identify when youre purposefully investing in your career versus avoiding work you seriously
need to do.
Cet started:
LInkedn Is an excellenI place Io sIarI (www.linkedin.com).
Create a prcIe: SIarI by compleIIng your prole - some people leave II halI nIshed (or worse} lled
with spelling errors, typos, or duplications. If the intent is to create a positive reputation and put your
besI IooI Iorward, you jusI IaIled I Iakes a small upIronI InvesImenI oI IIme Io gaIher and compleIe
this information, however, once this is done you only need review occasionally.
Ccnnect with pecpIe ycu kncw: Build your network by searching for people and groups (e.g. CAHSPR)
that you know. Remember though that sending out blanket invites is strongly discouraged. Indeed,
onlIne Iools are an exIensIon oI oIne socIal norms. How do you Ieel when someone walks up Io
you and makes a request without at least saying hello? Take time to address the individual by name,
remind them who you are, and be polite!
keep it up tc date: Remember Io updaIe your prole quarIerly. A sImple calendar remInder every
/-6 monIhs Io spend 15 mInuIes Io updaIe your prole Is helpIul. ThIs prevenIs IIme rushIng by
and soon your prole says recenIly began a undergraduaIe when youre wrappIng up a posI-
doctorate fellowship.
Another easy service to get started with is Twitter. It requires less information than Linkedin. All you
need is a picture, user name, and a brief bio before you start to look for others and share with people or
organizations that are interesting to you.
48
Participate:
Use the ccmment secticn: Your comments dont have to be long responses or in-depth critiques of
some material. Simply providing feedback to the content creator that their work is valuable can be
encouragIng. A perIecI example oI when Io use Ihe commenI secIIon Is when you wanI Io buIld on an
Idea, ask Ior clarIcaIIon, or conIInue Ihe dIscussIon. ThIs can beneI your own learnIng and expands
dialogue on the topic of interest.
Use ycur name and scciaI infcrmaticn: Many comment sections allow you to login with various social
media accounts (Twitter, LinkedIn, etc.). Using these allows the author and other viewers to link
back Io your prole. ThIs Is helpIul because II allows Ihem Io know your background, InIeresIs and
experIIse. ThIs should also keep you accounIable. UsIng your name or socIal medIa proles Iorces
you to respond in a professional manner. This is important because many people think anonymous
comments allow freedom to ignore general manners and professionalism. As a general rule, if you
wouldnt say it to the person face-to-face than it doesnt have a place online either.
Participate in cnIine discussicns: Social media allows for continual sharing of information and
conversaIIons. AIIer seIIIng up your proles, you should look Ior opporIunIIIes Io engage In onlIne
dIscussIons and conversaIIons relaIed Io your eld. Look Ior oIhers IhaI are Inuencers and IhoughI
leaders In your eld. I you see a research or polIcy leader In your area usIng TwIIIer, Iollow Ihem and
respond to their posts or mention them when reading their articles. You can also use a hashtag, which
Is a Iag used on IwIIIer by puIIIng a In IronI oI a word or accronym. For example, hcsmca Is used
on twitter to discuss issues related to Health Care Social Media in Canada (HCSMCA). There may be a
hashIag Ior a conIerence youre aIIendIng, whIch Is a IerrIc way Io see who and whaI Is beIng saId
about presentations. There may also be scheduled times when discussions are held by a group, like
#hcsmca, which hosts a one hour discussion on topics submitted by participants. If you dont see a
topic that interests you, consider creating one!
Measure ycur ecrt:
TIme Is a scare resource, and Ihere are a loI oI dIerenI ways Io spend II. I you value your IIme, youll
want to know how youre spending it, so look for ways to measure where youre investing your time.
These donI have Io be exacI measuremenIs, only a rough proxy allowIng you Io make comparIsons over
time. Something as uncomplicated as views of a video or presentation you share can work. There are
many Iypes oI daIa, regardless oI whaI you decIde Io use, make a poInI Io reecI on II regularly.
5et gcaIs and pricrities: I you have goals, IIs easIer Io evaluaIe wheIher or noI your eorIs are helpIng
you Io reach Ihem. DveremphasIs on a sIngle measure Is dangerous, because IIs possIble Io deIracI
from the overall goal by focusing on that particular measure. Goal-focused behaviour should use
mulIIple sources oI InIormaIIon Io gauge success. For example, II you share a reIerence lIsI, perhaps
you may not get many return visitors to a web-page, but you might get numerous comments or
sharing of the page through Twitter. Another reason to focus on your goals is that metrics arent
perIecI. For InsIance, you may nd ouI a vIdeo you shared was used In a class. ThaI vIdeo would
only have 1 addIIIonal vIew on Ihe websIIe you shared II, despIIe Ihe IacI Ihere may be 1U-2UU
students in the classroom. Sometimes you might get other forms of feedback, such as an email or
IexI message. These can all valIdaIe your sIraIegy Ior achIevIng your goals, buI mIghI noI be parI oI
regularly scheduled evaluation.
Use buiIt-in metrics: Many social sites now provide account owners some sort of metric, like views
(YouTube, Slideshare, etc.) or Likes (Facebook). These are a perfect start. If you have a website, you
can use a Iree Iool called Coogle AnalyIIcs Io measure your websIIe Irac behavIour. EngagemenI
can also be measured by comments on your site or public discussion on sites like Twitter.
CcIIect the unexpected: As prevIously menIIoned you may geI emaIls, IexI messages, or oIher Iorms oI
Ieedback. Try Io nd a place Io copy and save Ihese. ThaI way as IIme goes by you can keep a record,
and use it as evidence. Perhaps you start a social presence for your organization or your research
group, IhIs can all help jusIIIy Ihe IIme expense and valIdaIe Ihe groups work.
49
FinaI wcrds
DIgIIal and socIal Iools creaIe a sIgnIcanI shIII In communIcaIIon by changIng II Irom one-way Io
mulII-dIrecIIonal conversaIIon. nsIead oI geIIIng losI In Ihe ever-expandIng web oI servIces avaIlable
online, researchers need to focus on the bigger trend. Like it or not, changes to how we can communica
oer new opporIunIIIes Io acceleraIe and enhance parInershIps, collaboraIIon, and knowledge sharIng.
These Iools can oer new possIbIlIIIes and advanIages Io sIudenIs and researchers IhaI learn abouI IheIr
potential early and how to leverage them in order to advance their research and its impacts.
These services are also creating new opportunities to work across traditional professional, institutional,
and geographic boundaries. Hopefully theyll help us continue to evolve our understanding of healthcare
in our country and abroad, perhaps even allowing us to tear down the traditional silos that our system
regularly laments.
This chapter is not a comprehensive guide, only a starting point. These strategies are meant to provide
some basIc perspecIIve on how socIal medIa Is relevanI Io HSPR. AlIhough II may noI oer you a perIecI
road map Ior your own cIrcumsIances, hopeIully II helps you sIarI your journey. Theres a loI Io learn,
and we can all help by sharing the various ways these tools help enhance our research and accelerate
knowledge sharing in health care.
5U
CcncIusicn
When we asked Peter Norton, Professor Emeritus at the University of Calgary, about his early
publIshIng experIences and IacIors relaIed Io hIs success, he responded IhaI early on he someIImes
jusI sIumbled Ihrough IhIngs, learnIng along Ihe way wIIh each new experIence. n readIng IhIs
guidebook, we hope to have provided you with some information and advice that helps you stumble a
bII less on your own journey.
The Idea oI journey Is an ImporIanI one. When we rsI Iumble down Ihe rabbII hole and emerge In an
HSPR-relaIed eld, wheIher IIs as a graduaIe sIudenI, posIdocIoral Iellow or young researcher, we donI
all start at the same place with the same skills and baggage. You neednt worry, however, if you dont
immediately conduct your research and write your papers with the same eloquence as some of the giants
In Ihe eld. There are many resources ouI Ihere Io help you and many opporIunIIIes Ior you Io learn and
evolve. Through each publIshIng experIence, you can learn Ihe IrIcks our Irade, nd your own unIque
voice, and hopefully leave your mark on the health system and the health of Canadians.
51
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