AJN, American Journal of Nursing:
Why this should matter to all nurses.
Maureen Shawn Kennedy, MA, RN, AJN Editor-in-Chief, E-mail: firstname.lastname@example.org
As an editor, I often feel like a scavenger, trolling meetings and scanning news reports for potential topics and authors. I ask the nurses I meet lots of questions: “What are you doing at work these days?” “What do you need to know more about?” and “In your area of practice, who's doing something new and interesting?” I ask because we need nurses in all areas of clinical practice to write about their work, about the innovative projects and practices they're implementing in an ever-changing health care environment. We need to know what works and what doesn't. It's incredibly gratifying to receive an informative manuscript that adheres to the tenets of good writing, supports its statements with relevant references, and addresses an issue or practice change that will matter to nurses.
But in the last few years, we've received an increasing number of unpublishable papers. According to my network of fellow editors, this is a widespread trend. Some of the papers we receive are poorly written, illogical, lacking clear purpose and organization, ineptly sourced. Many come from students hoping to publish their thesis papers, which are often about “capstone” projects required by master's or doctoral programs.
For some students, submission for publication is a course requirement; after all, dissemination of work is a common tenet of graduate programs in nursing. The American Association of Colleges of Nursing's curriculum guide, The Essentials of Doctoral Education for Advanced Nursing Practice, suggests that a final project “could include manuscripts submitted for publication, systematic review, research utilization project, practice topic dissemination…” That's a reasonable objective. The guide also notes, “The final DNP project produces a tangible and deliverable academic product that is derived from the practice immersion experience and is reviewed and evaluated by an academic committee” (italics mine). But what's unclear is how such works should be evaluated.
Writing for publication is a skill that must be developed, along with all the other skills educators aim to build in those who will advance our profession. The manuscripts I see show that most students aren't receiving adequate coaching in this area on many levels. Their papers demonstrate a lack of knowledge about basic aspects of writing—sentence and paragraph structure, logical progression of facts and ideas. They also show a lack of awareness about the difference between submitting a paper for class and submitting it for publication. References are often missing or from inappropriate sources; formatting isn't systematic; length requirements are ignored. Well-established guidelines and formats for writing and submitting various types of scholarly papers for professional publication (such as the CONSORT, PRISMA, and SQUIRE guidelines) aren't followed.
This matters, for several reasons. Nurses’ work itself—those innovative interventions and quality improvement projects that get tested and retested—must be rigorously done if it is to provide useful evidence that can influence practice. Documentation of processes and evaluation of outcomes must be objective and without bias. And knowing how to present and report on what we learn in a rigorous and balanced manner is an essential part of that work. Adherence to standard research reporting guidelines helps to ensure that. The quality of what we write also influences our reputation. A nurse who serves on the institutional review board of a major medical center told me many of the project applications it's received showed that the authors didn't know how to write a proposal. She was embarrassed because it reflects badly on our profession if nurses can't communicate clearly and on par with other health care professionals. She's right.
AJN can offer some immediate help, at least for one type of paper—the systematic literature review, which involves a focused search of the literature using a specific question. Beginning with this issue, we're bringing you a new series, Systematic Reviews, Step by Step, to guide you through the process. The authors hail from the Joanna Briggs Institute, a leader in “the synthesis, transfer and utilization of evidence through identifying feasible, appropriate, meaningful and effective healthcare practices.”
If nursing is to take its rightful place at policy tables, in boardrooms, and on research teams, we need to present ourselves—in person and on the page—as the competent, thoughtful leaders we are.