Evidence-based public health: an evolving concept.

Background 
Editorial peer review is universally used but little studied. We examined the relationship between external reviewers' recommendations and the editorial outcome of manuscripts undergoing external peer-review at the Journal of General Internal Medicine (JGIM).


Methodology/Principal Findings 
We examined reviewer recommendations and editors' decisions at JGIM between 2004 and 2008. For manuscripts undergoing peer review, we calculated chance-corrected agreement among reviewers on recommendations to reject versus accept or revise. Using mixed effects logistic regression models, we estimated intra-class correlation coefficients (ICC) at the reviewer and manuscript level. Finally, we examined the probability of rejection in relation to reviewer agreement and disagreement. The 2264 manuscripts sent for external review during the study period received 5881 reviews provided by 2916 reviewers; 28% of reviews recommended rejection. Chance corrected agreement (kappa statistic) on rejection among reviewers was 0.11 (p<.01). In mixed effects models adjusting for study year and manuscript type, the reviewer-level ICC was 0.23 (95% confidence interval [CI], 0.19–0.29) and the manuscript-level ICC was 0.17 (95% CI, 0.12–0.22). The editors' overall rejection rate was 48%: 88% when all reviewers for a manuscript agreed on rejection (7% of manuscripts) and 20% when all reviewers agreed that the manuscript should not be rejected (48% of manuscripts) (p<0.01).


Conclusions/Significance 
Reviewers at JGIM agreed on recommendations to reject vs. accept/revise at levels barely beyond chance, yet editors placed considerable weight on reviewers' recommendations. Efforts are needed to improve the reliability of the peer-review process while helping editors understand the limitations of reviewers' recommendations.

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Editorial peer reviewers' recommendations at a general medical journal: are they reliable and do editors care?

The last decade has witnessed a rapid expansion of biomedical knowledge. Despite this, fashions in medical education over the same period have shifted away from factual (didactic) teaching and towards contextual, or problem-based, learning (PBL). This paradigm shift has been justified by studies showing that PBL improves reasoning and communication while being associated with few if any detectable knowledge deficits. Analysis of the literature indicates that the recent rapid rise of PBL has closely paralleled the timing of the information explosion. The growing dominance of PBL could thus worsen the problems of information management in medical education via several mechanisms: first, by creating the impression that a defined spectrum of core factual knowledge suffices for clinical competence despite ongoing knowledge expansion (quality cost); second, by dissuading teachers from refining the educational utility of didactic modalities (improvement cost); and third, by reducing faculty time for developing reusable resources to impart factual knowledge more efficiently (opportunity cost). These costs of PBL imply a need for strengthening the knowledge base of 21st-century medical graduates. New initiatives towards this end could include the development of more integrated cognitive techniques for facilitating the comprehension of complex data; the design of differentiated medical curricula for producing graduates with defined high-priority skill sets; and the encouragement of more cost-effective faculty teaching activities focused on the prototyping and testing of innovative commercializable educational tools.

/pdf/learning-from-the-problems-of-problem-based-learning-2pg4k0p98h.pdf

Learning from the problems of problem-based learning

The purpose of this paper is to investigate how social media may support information encountering i.e. where individuals encounter useful and interesting information while seeking or browsing for some other information and how this may lead to the facilitation of tacit knowledge creation and sharing. The study employed a qualitative survey design that interviewed 24 physicians who were active users of social media to better understand the phenomenon of information encountering on social media. The data was analysed using the thematic analysis approach. The study found six main ways through which social media supports information encountering. Furthermore, drawing upon knowledge creation theories, the study concluded that information encountering on social media facilitates tacit knowledge creation and sharing among individuals. The study provides new directions for further empirical investigations to examine whether information encountering on social media actually leads to tacit knowledge creation and sharing. The findings of the study may also provide opportunities for users to adopt social media effectively or gain greater value from social media use.

/pdf/information-encountering-on-social-media-and-tacit-knowledge-10nha3kbpf.pdf

Information encountering on social media and tacit knowledge sharing

ing and indexing information management classification electronic publishing online information retrieval knowledge management

Evidence‐based Practice for Information Professionals:A Handbook

Keeping one's personal fund of knowledge current is one of the most formidable challenges that physicians face. This article considers a few strategies that may help physicians as they struggle to keep their knowledge up-to-date. Physicians need to develop their own goals for staying current, systematically and periodically search the literature for high-quality material relevant to the topics on their agendas, become facile with critical appraisal of the literature, and schedule time for reading. One of the responsibilities of any professional is to maintain expertise, and this responsibility is probably nowhere more critical, or more difficult, than in the profession of medicine.

David S. Weinberg

Papers

How can physicians keep up-to-date?