70th anniversary issue: after braving the waves and troughs of seven decades, where is our small craft now?
In this issue Dr David Nicholls, a physiotherapist with a strong interest in the history of our profession, begins a series of articles surveying the seventy-year history of the New Zealand Journal of Physiotherapy (Nicholls 2009). In the following Guest Editorial, Dr Nicholls walks us briskly along the path of the past seventy years. This series will continue, with one article per year focussing on an epoch in the Journal's history, until 2013, in which year the 75th anniversary of the Journal coincides with the 100th anniversary of the physiotherapy profession in New Zealand. It promises to be enchanting reading, and we owe a debt of thanks to Dr Nicholls for his commitment to keeping the history of our profession fresh and alive.
So, after seventy years of history, where we are today? Assessing the health and performance of a professional scientific journal is a multi-faceted exercise that no simple summary measure can encompass (Benitez-Bribiesca 1999, Martyn 2007, Rennie 1998, Tobin 2004). In the most comprehensive and considered account of this I have yet seen, Tobin (2004) proposed eleven domains of performance (Table 1). Many of these are not readily measurable, so serve mainly as qualitative, internal benchmarks. Others, such as number of submitted manuscripts, are readily quantified, provided records are taken and kept. So let us assess the state of the New Zealand Journal of Physiotherapy as we embark on or eighth decade.
The number of manuscripts submitted for peer-review has stayed fairly constant through my term as Editor, at 22-25 per year, of which we publish around 50%. It is notable that we have seen higher proportions of submissions from overseas authors. There are several perspectives to this: it is positive that our members/readers are getting the benefit of international perspectives; but correspondingly, it is disappointing that New Zealand authors appear to be submitting more work to overseas journals. However, it is apparent that the output of local authors has risen in both quantity and quality (see our Out of Aotearoa section, towards the rear of this issue), and despite various imperatives such as the Performance Based Research Funding (PBRF) system driving many local authors to publish in higher profile, international journals, I am confident that both the quantity and quality of content in our Journal is also steadily rising.
As a 'barometer of change in the profession' (Nicholls 2009), the content of the Journal's current epoch reflects the values of the profession today. It took our Journal 26 years before it published the first original research report (Morley 1964), then it was another 15 years before the first randomised clinical trial (RCT) appeared in the pages of the Journal (Glendining 1975). The profession of today is active in research and scholarly publication (as reflected in our annual Out of Aotearoa section), reads original research and scholarly reviews critically, and values research-informed clinical perspectives. In 2008, over a third of feature articles in the Journal were original research reports. Every issue of the Journal has included at least one research report for many years. Other feature articles are primarily evidence-based reviews of the literature, and newly introduced categories of Journal content focus on new original research that informs practice and advances scientific understanding (Critically Appraised Papers; In Other Journals).
To see if we are serving the needs of our members/readers, we regularly contribute to the NZSP (New Zealand Society of Physiotherapists Inc.) member survey. In 2008, 44% of respondents reported that they "find something of interest or relevance in most issues", with another 21% finding "something of interest or relevance in every issue". Overall, around 78% 'agree' or 'strongly agree' that the Journal is interesting and relevant. Only 6% "hardly ever" find anything interesting or relevant, with only 1.3% reporting they don't look at the Journal content at all.
This represents a considerable improvement over the survey of 2002--from 61% rating 'interest' the Journal content 3 or higher (out of 5) then to 98.5% in 2008, and 'relevance' rising from 65% to 98%--results we are very proud of. To some extent the results may have been influenced by the context and methods of the survey and--as acknowledged above--there has been a general increase in recognition in the importance of scholarship and evidence-based practice profession-wide which may have influenced respondents' ratings. However, we certainly hope that a large proportion of this >50% jump in 'interest' rating can be attributed to improvement in the content, quality, readability and presentation of the Journal. We have strived to make the journal relevant to the values of the profession today, and our ratings seem to reflect that. For a profession with such a diverse range of specialisms and sub-specialty fields, we feel that this is an excellent result.
In the 2002 survey, the vast majority of written comments reflected disappointment with the Journal, with remarks such as 'quality not up to other international journals', "not much of relevance', and the acutely dispiriting: 'coloured ads are the best part' (Lord 2003). Many readers expressed a preference for overseas journals that offered stronger coverage of their own clinical specialty field. Overall the 2002 respondents indicated that they wanted more clinical content and more original research. We responded to that feedback by restructuring our content sections, and taking a variety of steps to increase submissions of original research and clinical content.
As a result, in 2008 our readers report that 'original research' is the section they read most (80% of respondents) followed by our Clinical Perspective and Professional Perspective sections (67% of respondents). Invited Clinical Commentaries and Critically Appraised Papers have been successful new regular features, with 45% and 51%, respectively, of readers reporting they 'usually read' these sections. Many thanks to the authors and Editorial Committee members who have made these two latter sections such a success. As one respondent wrote: "Well done ... for all the effort".
It is therefore gratifying to see so many positive written responses in the 2008 survey, such as "happy with the way it is", "I think it's great, keep it up", "Journal is an excellent professional publication (a credit to NZSP)" and "Regarded as a sound, scholarly publication". The change in the general flavour of feedback from the reader survey respondents is like music to the ears of the Editorial Committee, particularly those members who were a part of the "navel gazing" that resulted from the 2002 survey (Lord 2003), and is a credit to the changes begun under the leadership of then Editor, Sue Lord.
So, where to from here? As well as more of the same, respondents to the 2008 survey suggest "more case studies", "summaries of recent evidence-based guidelines", "articles that challenge our traditional practices", "encourage member opinion!", "new ideas for clinical practice", "more overseas articles", "demystify writing for journals", "skills needed for critical appraisal" and the very acutely observed: "More variety, but that is up to us to provide it."
Readability of professional journals is undergoing a revolution over recent years, owing much to the influence of Richard Smith's reign as editor of the British medical journal BMJ. On the way out is the passive voice, long tortuous sentences and jargon. Now, we encourage the active voice, first-person pronouns, and concise clarity (Walker 2000, Cooter 2003). Improving readability requires more editorial time and effort, but is worth it to keep readers reading. Because ultimately, if the content is too difficult, 'academic', or boring to read, it's ineffective. Many thanks to our tireless copy editor, Bryan Paynter, for his assistance in this important aspect of serving our readers.
Another index of readership satisfaction is the involvement of readers, in particular as letters to the editor (Tobin 2004). This has been an area I have worked to encourage in my time as Editor, and appears to be on the rise judging by the past few issues, including a topical and important one in this issue (Laslett 2009). Not all letters received are published--some I redirect to the NZSP Newsletter Physio Matters--but I do encourage readers to submit more ("encourage member opinion!"). Refer to our 'guidelines for contributors' at the rear of this issue.
Editorial independence is considered the sine qua non of a professional medical journal (Tobin 2004, Davis 2002). The role of a journal editor is "to attract, select, improve, and publish the best manuscripts" (Rennie 1998), and editors must have the freedom to do so with impartiality, open-mindedness, and intellectual integrity (Kassirer 1999). They must try to select material for its merit, validity, interest to readers, and originality (Kassirer 1999, WAME 2009a). When the content of a journal is influenced by extraneous factors, the journal loses the trust, credibility and respect of its readers (Kassirer 1999). The editor's responsibility to readers is greater than his or her responsibility to the owners (or the authors, or any individual or group), so as a former editor of the JAMA once wrote "If they are doing their jobs well, they [editors] should give no favors, and they should have no friends". (Tobin 2004, Kassirer 1999). Editorial independence therefore requires journal owners who understand that the role of the journal differs from the role of the national organisation, and who "believe unequivocally and irrevocably" that complete editorial freedom is the essential to maintain a vigorous, dynamic, intellectually free profession (Kassirer 1999). It requires that the owner organisation understands that the journal may, from time to time, publish content that expresses views that differ from the positions of that organisation (Kassirer 1999), because those positions are formed by the considered, critical opinions of its members, which require a forum for the debate of differing views.
To ensure integrity of contents, the journal must have in place sound editorial processes. This is primarily in the form of peer review, which we apply in the form of internal (Associate Editors, Editor) and external peer review (WAME 2009b). At the New Zealand Journal of Physiotherapy, we aim to send all research report, case report, review and perspective manuscripts to at least one internal and one external peer reviewer. Other categories undergo at least one internal peer review; Invited Clinical Commentaries at least two. We seek external peer reviewers who are experts in the content area and/or research methods of the manuscript, and who have published at least one article in a peer-reviewed journal--hence they are the peers of the author: not a superior power. The role of peer reviewers is to advise the Associate Editor and Editor of the strengths, weaknesses, validity and importance of the manuscript; and to make recommendations to the authors on how the manuscript might be improved. While we ask peer reviewers to make a recommendation whether a manuscript is suitable for publication in the Journal, that decision is the responsibility of the Editor. It is generally made on the basis of recommendations from an Associate Editor as well as the Editor's own assessment.
Fairness to authors is an unquantifiable criterion that straddles editorial value judgements regarding "the originality, validity and importance" of authors' submissions; editorial responsibility to optimise readability; and timeliness (Kassirer 1999, Tobin 2004). Criticism of one's labours can cut deep, so I have been working to ensure that reviewers' comments conform to the values of peer respect and a spirit of genuine assistance. Work on the part of the Editor and copy-editor to improve the quality and readability of submissions is generally invisible to readers. Happily, it is usually appreciated by authors, as it is always done in the interests of improving the manuscript for the benefit of both the readers and the authors. But from time to time it can be a thankless and reproachable task. To help prepare authors for the expectations of the Journal and the rigours of peer review, we have begun to offer short seminars for new authors and reviewers at NZSP conferences, and have affirmed our commitment to supporting new authors in our Editorial Committee statements of mission, vision and values (Tables 2 & 3).
This decade has seen a rapid rise in electronic publishing. Where once 'internet journals' were looked upon with suspicion and disdain, now almost all of the most respected major journals have a substantive web presence, e-publishing ahead of print is a valued means of reducing publication lag, and there are internet-only publications of the highest repute. The use of advances in technology (internet, pdf, email) has enormous benefits in timeliness, decreased resource use (photocopying), cost savings (printing, postage), accessibility (publicly accessible digital archiving), circulation and exposure. Since 2003 we have taken the Journal on-line, providing free, unrestricted international access to download PDF files of all Journal content. We prefer email submission of electronic files over postage of multiple hard copies. The Journal is currently listed and linked through a number of internet sources, primarily via the NZSP website, and also including the Directory of Open Access Journals, HighBeam Research, freemedicaljournals.com and Die Elektronische Zeitschriftenbibliothek. Our Journal is indexed in a range of searchable databases (Table 4), most notably CINAHL and Google Scholar. We have a plan of action in place to get the Journal listed on more of the most widely searched online databases, but the criteria for listing on the world's most widely-used database, PubMed, are a real struggle for a small, regional, association-owned, member-focused journal to achieve. We believe free, unrestricted web-based access to Journal content has lead to greater readership of the Journal, and more submissions from overseas authors, which have risen sharply since 2006. Currently, however, we have no means of counting hits or downloads of Journal content from the website.
But, of course, the ultimate purpose of a professional scientific journal is to contribute toward improvement in the patients' outcomes. If the Journal succeeds in facilitating that through publishing quality scholarship, clinically-relevant, evidence-based content, critical analysis and challenging debate, all of our efforts will be worthwhile. This is the most important measure, but perhaps the most difficult to assess.
So these are the challenges for the Journal to respond to in the coming years. With the rise in availability of on-line content, general rise in the quality of overseas physiotherapy journals, and various forces influencing where authors seek to publish, this is no time to rest on our laurels. We are already working on some of the areas we and our readers have noted (see Tables 2 & 3), and have tweaked some of the existing sections to appeal more to what our readers value.
Thank you to the respondents of the 2008 reader survey, and please be assured that your comments do influence the content and direction of the Journal. I point to the changes made since the 2002 reader survey as evidence of this. My goal is to ensure that the current and future Editorial Committee members shepherd the Journal well: anticipating, leading and responding to the values of the profession today. If we can continue to be viewed as relevant and interesting by an increasing proportion of our profession in New Zealand, we will be doing well. You can expect to see more original research and more clinically relevant, research informed, and innovative content. We hope to expand the international content and reach of the Journal further. On the most common request from respondents, I agree entirely: I'd love to see more case reports and case studies published in the Journal, as would the readers. Get writing!
J. Haxby Abbott, PhD, MScPT, FNZCP Editor, New Zealand Journal of Physiotherapy
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Table 1: Assessing the performance of a professional scientific journal * 1. number of submitted manuscripts 2. profitability, distribution & circulation 3. indexing & citation ([dagger]) 4. serving needs of readers 5. readability 6. involvement of readers (letters to the editor) 7. use of advances in technology (internet, pdf, email) 8. editorial processes to ensure integrity of contents 9. fairness to authors 10. publication lag 11. editorial independence 12. improve human health outcomes * After Tobin (2004): Assessing the performance of a medical journal. American Journal of Respiratory and Critical Care Medicine. 169:1268-1272 ([dagger]) From Rennie (1998): The present state of medical journals. Lancet. 352(S2):18-22 Table 2: Mission of the New Zealand Journal of Physiotherapy The mission of the New Zealand Journal of Physiotherapy is to serve the members of the New Zealand Society of Physiotherapists by publishing content that reflects excellence in research and professional issues relevant to the New Zealand and international physiotherapy communities. (Revised 2005) Table 3: The vision and values of the New Zealand Journal of Physiotherapy Vision for the NZJP: * All publications in the NZJP will be of a high academic standard * NZJP is considered by authors to be the journal of first choice for publications relating to NZ context * NZJP nurtures new, talented researchers and scholarly clinicians * To maintain and enhance availability of the journal through free on-line access. Values of the NZJP * To nurture and support authors * To advocate for patients and the health of communities * To be receptive and responsive to members wants/ needs * To foster a good relationship with NZSP and the office staff * To support NZSP in its strategic goal of promotion of evidence-based practice. (Revised 2005) Table 4: Facts about the New Zealand Journal of Physiotherapy (from Urlich's Periodicals Directory 2008)* ISSN: 0303-7193 Title: New Zealand Journal of Physiotherapy Publishing Body: New Zealand Society of Physiotherapists (Inc.) Country: New Zealand Status: Active Start Year: 1938 Frequency: 3 times a year Document Type: Journal; Academic/Scholarly Refereed: Yes Media: Print Language: Text in English Circulation: 2500 controlled Price: Free subscription per year to members Subject: Medical Sciences--Physical Medicine and Rehabilitation Dewey #: 615.8 LC#: RM695 Abstracted/Indexed: Yes ** CINAHL (Cumulative Index to Nursing & Allied Health Literature) (1981-) ** AMED (Allied and Complementary Medicine Database) ** Pharmacoeconomics and Outcomes News ** Inpharma Weekly ** Reactions Weekly ** EBSCOhost ** CINAHL: indexed, 1981-01-01--present ** CINAHL Plus: indexed, 1981-01-01--present ** CINAHL Plus with Full Text: indexed, 2004-03-01--present ** CINAHL with Full Text: indexed, 2004-03-01--present ** Ovid ** CINAHL: indexed, 1981-01-01--present ** Thomson Gale (Gale Group) ** Academic OneFile: indexed, 2003-03--present ** Health Reference Center Academic: indexed, 2003-03--present ** InfoTrac Custom: indexed, 2003-03--present ** Information Express ** IngentaConnect ** Te Puna CD-ROM ** British Library Document Supply Centre (6094.640000) * (Ulrich's Periodicals Directory 2008)
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|Publication:||New Zealand Journal of Physiotherapy|
|Date:||Mar 1, 2009|
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