In this issue of Simulation in Healthcare, as in several previous issues, I—the Editor-in-Chief (EIC)—am an author of a paper that is not an editorial. Also in this issue is a paper authored by simulation investigators from the EIC's own School of Medicine. Simulation in Healthcare takes seriously issues of fairness, disclosure, and conflicts of interest. Readers are entitled to wonder how such occurrences are handled by the Journal. This also provides an opportunity to inform readers about the general process of peer review used by this Journal.
The Journal staff uses a computerized (web-based) system—Editorial Manager—for handling manuscripts. This is provided by the Journal's publisher, and it is thus widely used by many other academic journals' staff. It has been customized for Simulation in Healthcare. The managing editor (Beverlee Anderson) ensures that a submission is complete and identifies it for action by the EIC. I select one of the five Associate Editors (Jeffrey Cooper, Michael DeVita, Ronnie Glavin, Barry Issenberg, and Dan Scott) to be the Associate Editor (AE) for that manuscript. I choose an AE based primarily on two factors: 1) the particular expertise of the editor concerning the topic; and 2) how many manuscripts they are currently overseeing. We have chosen experienced simulation experts as our AEs, so any of them can edit any submission, but each has areas of particular knowledge that we attempt to leverage.
The AE chooses three or more additional reviewers using the Journal's database of reviewers from, or nominated by, members of the Editorial Board. Sometimes specific external reviewers with special expertise are sought. The AE may also identify backup reviewers to be automatically promoted by Editorial Manager if one of the primary choices declines or is unavailable. Reviewers are selected by their expertise in the area of the manuscript, and often to represent diversity of professional discipline or domain. Invited reviewers have about 1 week to accept or decline the invitation to review a manuscript, and if they accept they have about a month to complete the review. If they are late (or sometimes earlier if all others have weighed in already), we send them a reminder. Each reviewer is asked to provide an analysis of the strengths and weaknesses of the manuscript and to identify particular issues for revision or for explanation by the authors. They are also asked to provide a recommendation concerning publication from the choices:
- Accept pending minor revisions
- Accept pending moderate revisions
- Revise: likelihood of eventual publication
- Revise: no guarantee of publication
The AE is responsible for synthesizing the comments and recommendations of the different reviewers and providing a recommendation of his own. At this point, the manuscript reenters the work flow of the EIC. Every paper is read by the EIC, usually before the comments and recommendations of the AE and reviewers are seen. The EIC adds any comments of his own and creates specific text for the EIC's letter to the corresponding author detailing the official editorial decision. Thus, each paper is usually read and reviewed by five individuals—sometimes even more. The editors keep track of the quality of reviews submitted by reviewers and we make adjustments in our reviewer roster dropping a few and adding others as time goes on. Thus, we work hard to achieve a reasonably prompt, thorough, and credible review.
Reviewers or AEs can recommend to invite an editorial (and author thereof) related to an accepted paper (or any other topic) and the EIC decides whether to do so. Once a paper has been fully accepted it goes into the preproduction mode. The managing editor ensures that all elements of the paper, including figures and web addenda, are ready for transmission to the production editor. If necessary, the EIC or AE are consulted about production issues that may arise. In production, the paper is copyedited per the unique policies of our Journal and figures and tables are formatted. Preliminary typesetting is performed and page proofs are reviewed by the corresponding author, the managing editor, and the EIC. The EIC chooses the lineup of papers for a given issue, selecting an appropriate mix of paper types and an appropriate order for those papers.
Because the EIC and AEs were selected for the long and broad experience in simulation, it is not surprising that they and their institutional colleagues are active researchers and writers about simulation. As they are keenly interested in the success of the Journal, they have a strong incentive to see the best work of their laboratories and those of their colleagues submitted to Simulation in Healthcare. When an author of a submission is a reviewer or AE, the standard procedures make it easy to assign an AE and reviewers who are not the author and not from his or her institution. Because I, as EIC, typically read every submission, a slightly different procedure is used when I or someone from my institution is an author. In this case, one of the AEs is assigned (typically by the managing editor) to act as the de facto or “acting” EIC and I am not involved at all in the review or decision-making about the manuscript (including whether an editorial is warranted and who should write it). Often another AE also participates in the review. After the manuscript has been fully accepted by the “acting EIC” (if that happens) I do take over the preproduction and production aspects, consulting with the primary AE if needed.
I hope that this explanation of the review process will be useful for readers and especially for those who would like to submit a manuscript but have never done so. Should readers have any questions or comments about the editorial processes of the Journal, they are encouraged to contact the managing editor or to send a Letter to the Editor. The Editorial Board meets annually at the International Meeting on Simulation in Healthcare meeting at which it discusses and decides upon policies that govern the operation of the Journal.