It has long been said that information is power. It is only with information that understanding can occur and decisions made in light of one's comprehending of the question can be encountered. In today's society, we call this “making an informed decision”. And information is readily available at the fingertips of anyone with a keyboard and an internet connection. In theory, because information is so readily available, all decisions made should be occurring in an informed state for those who care to seek the information in answering their query. Today's patients are more active and informed than ever when it comes to searching information concerning their health, symptoms, and even diagnostic criteria. But how does one without formal training make sense of all that information available to them? A recent study of the literature suggested that patients tend to have more trust in patient management websites that were easy to navigate and had authors with multiple medical credentials, despite being laden with suboptimal information and yielding a correct diagnosis with symptom checkers less than 35% of the time.1
Another societal shift over the past 2 decades has been a public demand for transparency in decision making for those in positions of authority. People want to know how their money paid in taxes is being spent, what decisions have been made by the authority figure (good or bad) in the past, what experiences and ties does a person have to one or more groups, and what other possible conflicts or perceived conflicts of interest may exist that could have an effect on one's decision making. Cities are even hiring transparency officers to ensure that sunshine laws are upheld.2
Most recently, the push for transparency has been growing in scientific publication. The reasons for this quest toward open record publishing have been due to several reasons. The reason initially cited was because of the typical lengthy delay of dispersion of study results due to a laborious peer review system. The call for change was also due to the unscrupulous behavior by a few; mismanagement of data, falsification of results, or even “pay-to-print” predatory journals. As a result, the publication industry “invented” a market where a researcher can publish their results before peer review and called the process “preprint”.
First launched in 1991, arXiv (pronounced “archive”) servers began formatting rough draft papers from scientists in their raw form, assigning a citable digital object identifier, which is a unique alphanumeric string assigned to a work by a publisher or registration agency, and then housing a copy of this work for open public view.3 Typically, readers are able to comment and provide feedback on the work posted to these communal servers.4 What this ruthless sharing of information offers authors is the opportunity to accelerate the dissemination of scientific findings.5,6 Today, preprint servers are plentiful, and a researcher can “publish” their results almost instantly on one of these servers, generally for a one-time fee of approximately $10.00. With this arrival of transparency for others to view writings openly, now science is readily available for everyone in its initial form. This advantage of nearly instantaneous access to study results must be weighed against the obvious disadvantages that occur in the absence of peer review. Is there an appropriate level of rigor of research methods? Appropriate statistical analyses? Application of ethical principles?—to name just a few.7 Available, yes. Reviewed by someone other than the author, not likely. The debate of the usefulness of transparency such as preprint publishing is ongoing.
At the 2018 Educational Leadership Conference in Jacksonville, FL, Lieutenant General Michael K Nagata (director of strategic operational planning at the National Counterterrorism Center, US Army, and physical therapist by training) delivered the keynote address at the Geneva R. Johnson Forum on Innovation in Physical Therapy Education. The title of his talk “Leadership in a Rapidly Changing World,” Nagata suggested that there are three questions that all leaders should ask themselves. One of those three questions was “How ruthlessly do we share information?” His message was that decisions cannot be made without everyone in the organization knowing everything that they can possibly know. Everyone knowing everything is how informed decisions can be made and made quickly. As editors of the Journal, we recognized how implicit this message was to us in our role. Everyone at the Journal, editors, associate editors, reviewers, etc., should know as much as they can know about what we are attempting to accomplish with our publication. We subscribe to the expectation that to publish, scholarly work should only be made available to our readers after it has been thoroughly vetted through a rigorous peer review process. But we believe that there are some lessons to learn here. Lessons of what people, our members, are likely to want. Although preprints afford rapid dissemination of research and a forum of dialog within the scientific community, this cannot be the end point.
Dissemination of scholarly work is the foundation of advancing knowledge and practice across all professions. As Coeditors of JOPTE, we regularly think about this question in the context of the researchers and authors who “ruthlessly share” the practices at their respective institutions to provide insights into their own best practices or to share experiences that inform our educational community. Although intrinsic and extrinsic factors drive the motivation to publish, this sharing of information serves to expand the knowledge base to advance practice. Articles presented in this issue exploring best practices in physical therapist education are but a few examples of this.
Technology continues to afford evolving means for the “ruthless sharing of information.” As members of a scientific community, we have the responsibility of not only understanding the context in which information is shared but also how it is applied. As consumers of the literature, know that these preprint servers are becoming more plentiful, and the future seems to support the climate of continued growth. So, buyers beware. That article you read yesterday and plan to implement into your plan today may not have been reviewed and subjected to the rigors, which you believe it has. But we do know for certain, if you read it in the Journal of Physical Therapy Education, it was blind peer reviewed before one single word made it to the typesetter. Read our material with the confidence that such review allows.
2. Trubey JS. Atlanta Mayor Bottoms to appoint city's first transparency officer. Atlanta Journal-Constitution. December 21, 2018.
3. Teixira da Silva JA. The pre-print debate: What are the issues? Med J Armed Forces India. 2018;74:162–164.
4. Elmore SA. Preprints: What role do these have in communicating scientific results? Toxicol Pathol. 2018;46:364–365.
5. Johansson MA, Reich NG, Meyers LA, Lipsitch M. Preprints: An underutilized mechanism to accelerate outbreak science. PLoS Med. 2018;15:e1002549.
6. Peiperl L, on behalf of the PLOS Medicine Editors. Preprints in medical research: Progress and principles. PLoS Med. 2018;15:e1002563.
7. Berg JM, Bhalla N, Bourne PE, et al. SCIENTIFIC COMMUNITY: Preprints for the life sciences. Science. 2016;352:899–901.