Perceived Barriers to Getting Published: Results of the JANAC Survey Janice Bell Meisenhelder, DNSc, RN; Jeanne Kalinoski, MA, RN; and Judith M. Saunders, DNSc, RN, FAAN
In order to identify strategies to promote the publication of A N A C members" knowledge and expertise, the authors conducted a survey of
JANAC readers. Twenty-four respondents, almost all clinicians, identified 25 areas of interest they want to develop for publication. Barriers to getting published fell into four categories: lack of time, writing skills, selfconfidence, and motivation or ideas. Suggestions for facilitating scholarship focused mainly on collaboration with writing experts and learning through educational workshops. The results of this study can serve as a guide in the development of services to readers interested in their own development as scholars.
Key words: Barriers to publication, facilitating nurse scholarship, JANAC survey
Janice Bell Meisenhelder, DNSc, RN, is Associate Professor, MGH Institute of Health Professions, Boston, MA. Jeanne Kalinoski, MA, RN, is Associate Director of Nursing, Child Health Clinics of New York City. Judith M. Saunders, DNSc, RN, FAAN, is Assistant Professor, USC School of Nursing, Los Angeles. O n e of the major goals of JANAC has been to disseminate the extensive knowledge base and clinical expertise of " the members of the Association of Nurses in AIDS Care (ANAC). This wealth of members' insight needs to be shared among HIV clinicians and researchers so that the sdence base of nursing practice in AIDS care may advance. Previously identified strategies to promote scholarship in clinical settings include collaboration between researchers and clinicians, research development workshops, brown-bag lunches, research presentations, and newsletters (Nail, 1990; Ponte, 1992; Rosswurm, 1992; Smeltzer & Hinshaw, 1988; Tyler, Clark, Winslow, & White, 1990). Staff nurses also have suggested creating networks of clinicians and university faculty and special interest groups to nurture collegial relationships among nurses with like interests who are in different practice settings (Funk, Champagne, Wiese, & Tornquist, 1991). In order to identify strategies by which JANAC can facilitate the publication of such clinical knowledge, the authors conducted a survey of the journal's readers. The purpose of this survey was to identify: (a) barriers to publication for readers; and (b) strategies for facilitating scholarly writing of ANAC members. Methods
Through conference calls, the authors developed a 12item questionnaire, combining demographic and shortanswer items with open-ended questions. The focus of the questionnaire was to determine the barriers to submitting manuscripts for publication and what, if anything, JANAC could do to lessen these barriers. A subquestion was: Is it possible to team up clinical experts with writing experts in order to foster articles from cliniJANAC Vo|.6, No. 6, November-December,1995
P e r c e i v e d Barriers to G e t t i n g P u b l i s h e d : R e s u l t s o f t h e
cians? All items were created by the authors for the purpose of this survey (See Table 1.) The survey was published twice: in the July-August and September-October 1994 issues of JANAC. Readers were invited to fill out the survey and return it by mail to the ANAC headquarters. To encourage participation, one of the a u t h o r s wrote an editorial e m p h a s i z i n g JANAC's determination to "know what it is that's getting in your way and, most importantly, what we can do to help remove the obstacles to your contributing to the journal" (Kalinoski, 1994, p. 13). All questionnaires were coded with a three-digit number to ensure confidentiality during the data analysis.
Sample T w e n t y - f o u r p e o p l e r e s p o n d e d to the s u r v e y . Eighteen were clinical/patient-care nurses, four were t e a c h e r s , three w e r e a d m i n i s t r a t o r s , five w e r e in research, a n d one n u r s e practitioner. Twelve were employed in the ambulatory care setting, eight were in acute care, one was in a school of nursing, and five were in other assorted settings, including a school of medicine or extended care (survey items 5 & 6).
Results Writing Interests In regard to their writing interests and needs, only one person self-identified as a writing expert, while 14 respondents identified themselves as clinical experts (survey item 3). Eighteen people identified 25 specific topics for development into articles, all widely varied. The range of subjects covered the gamut from psychosocial issues to cellular biology. While most of these items wei'e chosen by one p e r s o n each, three areas were selected by two people with related, but not identical, interests: family needs, T-cell development, and nutrition (survey items 7 & 8). Six people indicated they wanted some help in developing their topic, but most respondents left this question
JANAC S u r v e y
unanswered (survey item 9). Question 11 was aimed at people with writing expertise. Since only one respondent claimed such knowledge, the results of question 11 probably indicate areas of clinical expertise in which people feel comfortable writing (See Table 2).
Perceived Barriers Questions I and 2 contained the heart of the survey. Out of 24 open-ended responses to the first item, 18 people i d e n t i f i e d barriers to publication. M a n y of the r e s p o n d e n t s i n d i c a t e d m o r e t h a n one barrier. All answers fell into four categories: (a) lack of time (n = 11); (b) lack of writing skills (n = 9); (c) lack of self-confidence (n -- 5); and (d) lack of motivation/ideas (n = 4). Lack of time clearly was the leading hindrance to writing. Two respondents delineated the conflicting demands of family, college, work, and ANAC meetings, which left them no time to write or think. Lack of writing skills (n = 9) reflects perceived deficits in these skills. This problem is similar to lack of self-confidence. These two categories have been s e p a r a t e d because most people cited a lack of skill, while some people expressed feelings of intimidation, which the authors interpreted as lack of self-confidence. Some respondents were specific about the writing skill areas in which they needed help: "development of ideas, guidelines for structure, actual writing; .... knowledge of the process; .... need to improve editing skills; statistics consultation." Others simply stated "writing skills" or "inexperience" as the barrier. Two people specifically requested that JANAC. "pair writers with content e x p e r t - - a research bank approach," and "mentors." It was clear from the responses that the area of need was in writing skills, not content knowledge. Lack of self-confidence (n = 5) often centered on the research nature of the journal. Some of the comments included: "being intimidated by the research-oriented nature of the articles in the JANAC;.... JANAC seems more interested in research and traditional, descriptive formats; .... intimidation by certain journals." Others simply stated "fear of rejection" or "worry about my ability
JANAC Vol.6, No. 6, November-December,1995
Table 1. JANAC Survey Dear Colleague, We are interested in your ideas about how we can facilitate getting more people published without compromising quality. Please take a few minutes to give us your opinion on the following questions. 1. What are the barriers to getting your ideas into a manuscript?
2. How can &e JANAC editorial board help people with expertise write their ideas for publication ?
6. What is your employment setting? (circle one') 1. Acute care 2. Ambulatory care 3. School of nursing 4. Other 7. Do you have a specific topic you are interested in developing? 1. Yes 2. Not at the moment 8. If yes, what is that topic?
We are interested in creating writing dyads of a person with clinical expertise and a person with advanced writing skills. Please answer the following if you fit one of the descriptions: 3.1 am willing to work with someone and share authorship in exchange for assistance in content and~or writing. Name: Address: Phone #: Fax, E-Mail: What capacity to serve? (citvle one) l. Writing expert 2. Clinical expert 4. If you have an idea Nat you want to share, where in the princess do you need the most help? (circle all that apply) 1. Beginning, at concept clarification 2. Library search 3. Overcoming writer's block 4. End, editing 5. Time management, getting time to write 6- Other 5. What is your current primary professional responsibility? (circle one) 1. Teaching 2. Administration/management 3. Clinical/patient care 4. Research 5. Other
9. Can someone be helpful to you in developing this topic? Who?
10. What kind of workshop would be helpful at an A N A C confergnce? 1. How to write for publication 2. How to review articles and critique for publication 3. Other 11. ff you are interested in being a writing expert for a team, in what major areas would you be able to help? (citvle all that apply) 1. Education 2. Clinical interventions 3. Management/administration 4. Data-based research articles 5. Epidemiology 6. Primary care 7. Writing style 8. Other 12. What else would you like" to share with us about how we can help more members develop manuscripts for publication ?
Thank you for your response. Please copy this page and mail to: ANAC, 704 Stony Hill Road, Suite 106, Yardley, PA 19067. Jeanne Kalinoski, Editor By returning this survey, you are giving the surveyors permission to publish the results. The colffidentialityof all participants will be maintained.
Vol. 6, No. 6, November-December, 1995
Barriers to Getting
II"~IIU:I i i
of Responses 6 5 1 1 1 3 0 1
i 7 84184184184184 ! P! ! iiii21iii!ilii i IIQ!IGPIII,:I~284184184184184184 84184 ui ! i84184 !ii!ilPiiii84iii i ii ii i ii ill Q%:~. ~"~iu~ /
to write at that level." This barrier seems to suggest more of a need to preserve self-esteem. These respondents not only perceive a lack of skill, but are fearful of the damage to their self-concept that risking rejection might bring. Lack of motivation/ideas (n = 4) was the last category. Entries in this category included: "motivation," "getting started," and "creative energy." These statements seem to reflect a lack of perceived reward for putting in the extensive time and effort to complete a manuscript for publication. Writing Assistance Thirteen p e o p l e r e s p o n d e d to question 2, but one respondent said, "I really don't know." Therefore, the analysis reflects r e s p o n s e s f r o m 12 people, s o m e of w h o m gave more than one answer or suggestion. All answers reflected the need for writing assistance, which is the overall category for this analysis. Within the concept of writing assistance, three sub-themes emerged: (a) published materials; (b) pairing/consultation; and (c) solicitation. Two respondents looked for written materials to help them with their writing. These requests included: "an a n n u a l JANAC m a n u s c r i p t p a m p h l e t or d i r e c t i o n s page;" and "publish a list of helpful hints." Six respondents looked for consultation in some form: "Provide editorial assistance at reasonable rates; .... pairing people u p might help; .... co-authorship; .... offer consultants to help with developing ideas; .... share their experience and 60
expertise in publishing; .... I believe 1:1 feedback (in person preferably) is always of value." Five respondents felt JANAC should take a different a p p r o a c h to solicitation of articles. Their r e s p o n s e s included: "Ask people to solicit a manuscript;" "be more approachable; .... through solicitation of manuscripts, possibly picking a topic for particular issues; .... offer an incentive." One respondent elaborated:
Table 2. Major Areas of Expertise Areas of Expertise Number 1, Education 2. Clinical interventions 3. Management/administration 4. Data-based research 5. Epidemiology 6. Primary care 7. Writing style 8. Other: "Nutrition in HIV"
Focus more on practice and a bit less on research; nurses need to know and understand more about the diseases, medications, psychosocial issues, and long-term survival issues that PWAs experience daily. Include "stories" by nurses w h o are living with AIDS. Articles by nurses about their personal, enriching experiences in the care of a person with AIDS are interesting and educational. Question 4 aimed at soliciting specific areas of need in writing skill (see Table 3). Suggestions Q u e s t i o n 10 focused on specific content areas for future workshops. Nineteen people indicated an interest in a t t e n d i n g a w o r k s h o p on writing for publication, while 12 respondents w a n t e d to k n o w how to review articles. T h r e e o t h e r s u g g e s t i o n s i n c l u d e d : (a)
Table 3. Areas of Greatest Learning Needs Greatest Learning Needs 1. Beginning, at concept clarification 2. Library search 3. Overcoming writer's block 4. End, editing 5. Time management, getting time to write 6. Other "Courage to try" "Collection of data" "All of the above"
Number of responses 12 6 10 9 11 3
JANAC Vol.6, No. 6, November-December, 1995
"Explaining how the entire process works at JANAC/ will my rejection notice be kind?" (b) (providing a) "motivational w o r k s h o p - - W e are already so overworked. I go home exhausted--need some ooumph!" and (c) "overcoming writer's block; efficient library searching, time management." The last question, item 12, allowed the respondents to share whatever they wanted on how JANAC can be of assistance in the writing process. Nine people wrote in answers that fell into three categories: (a) providing education; (b) clinical focus; and (c) solicitation. Four people made suggestions for ways ANAC can provide education for them to advance their writing skills. Responses included: "sessions at Congress to help consult on manuscripts; .... yearly review of what has been already published; .... articles in the journal about writing and regional educational seminars held quarterly;.... I would be most interested in taking classes in how to write and develop manuscripts for publication." Three other respondents suggested including more articles with a clinical rather than a research focus. One respondent said: Organize focus group discussions with ANAC conference; then have a writing expert synthesize and summarize the most useful discussions around: (1) practice setting--nurse managers of HIV units, nurse educators, staff nurses in acute/ambulatory or home care. (2) topics--working with IDUs, resuscitation issues, pain management, etc. Another entry: i feel ]ANAC needs to begin to focus on the changing face of the epidemic, to reflect all populations affected and possibly solidt a better balance between data-based research articles and clinical issues artides. I am a clinician who really wants to learn more about data-based research. I also feel we need to express through our nursing literature exactly what is an HIV nursing intervention, what do people do, how do they do it, and why do they do it. JANAC Vol. 6, No. 6, November-December, 1995
The last category was solicitation. Two people suggested ways for JANAC to solicit articles: by asking presenters at the conference to submit their papers; and by asking faculty members to encourage graduate students to submit papers. A third respondent stated, "This month's 'The View From Here' helped spark the determ i n a t i o n . . . My staff has helped me to realize that I really do have a lot to contribute to their knowledge base and their well-being at the present time." This last entry implies the importance of peer support and affirmation in helping people realize their potential for writing. Discussion
The majority of the people who responded to this survey are clinicians who have ideas to develop, but lack time, skills, motivation, and confidence to do so. Of these four categories, the ones most likely to be changed by an intervention am writing skills and self-confidence, both of which could be influenced by collegial mentoring or consultation. Lack of time appears to be an area amenable only to individual determination, and might be related to lack of motivation, since people make time for what is most important to them. In reality, leaders of the academic world expect their faculty members to publish and reward them by promotion and tenure (Ragsdale, 1993). This last barrier seems to be one that may not be possible to overcome by the journal's efforts, unless the journal is willing to motivate them through monetary reward. Highly esteemed, scientific journals avoid such a practice. Rather, ANAC might continue its efforts to promote scholarship as a norm within the organization, as it has done in the annual conferences. ANAC also might encourage clinicians to create a work atmosphere that values research and to build a recognition system for scholarship within their own practice settings (Martin, 1993; Meisenhelder, 1994; Swanson, Albright, Steim, Schaffner, & Costa, 1992) Eighteen people had specific topics of interest they would like to develop. Some of them had several topics, all different from each other. The overwhelming theme of how to decrease the barrier to getting published was the provision of education on writing skills, with many 61
Perceived Barriers to Getting Published: Results of the JANAC Survey
options listed. The responses seemed to confirm the importance of individual interaction in developing people's writing skills (Meisenhelder, 1994; Nail, 1990; Rosswurm, 1992; Tyler et al., 1990) A few thoughts on solicitation of articles emerged from the analysis. One was to include more articles on clinical intervention and fewer on research, which was suggested by two people. Three others offered suggestions on soliciting articles, most of which are already in practice at JANAC. One of the severe and serious limitations of this survey is the small sample size. C o m m e n t s by one or two respondents reflect only individuals' opinions. The research nature of the journal renders it highly respected in its field and with other disciplines. Making any changes in the journal based on one or two opinions would be a misuse of this data. The results of this study are best used as a guide to provide services to the readers that may advance their own development as scholars.
Acknowledgment.The authors thank the JANACreaders who participated in this survey.
References Funk, S., Champagne, M., Wiese, R., & Tornquist, E. (1991). Barriers to using research findings in practice: The clinicians perspective. Applied Nursing Research,4, 90-95. Kalinoski, 1. (1994). It's your turn. JANAC, 5(4), 13. Martin, P. (1993). Clinical settings need organizational s u p p o r t for research. Applied Nursing Research,6, 103-104.
Recommendations The results of this study provide evidence for the need to pair nurses with clinical knowledge and writing experts in order to promote individual growth in scholarship. Such a pairing also would allow the unique experiential learning of clinical experts to be shared for the advancement of nursing science. Along with individual attention, group sessions, such as conferences or chapter meetings, might be another vehicle for learning. The results also indicated a need for a medium to publish more experiential or option articles. Perhaps ANACDOTES, the newsletter of ANAC, could provide the medium for manuscripts focussed on sharing clinical experiences and stories. Thus, the readers would have the opportunity to publish less scholarly works while the integrity of JANAC remains intact.
Summary Only a small portion of JANAC readers responded to the survey, but those people were eager, expressed cre62
ative ideas, had strong clinical knowledge, and seemed frustrated at the lack of their own progress. Barriers to publishing were identified as lack of time, lack of writing skill, lack of self-confidence, and lack of motivation. Requests for assistance were mainly in the area of education on writing skills, focusing both on individual consultation and group workshops. The results confirmed many previous observations on ways to nurture scholarship among clinical experts.
Meisenhelder, J. (1994). Cultivating scholarship in the clinical setting. Iournal of Nursing Staff Development, lO(2), 87 90. Nail, L. (1990). Involving clinicians in nursing research. Ontology Nursing Forum, 17, 621 - 623. Ponte, 1~. (1992, June/July). Enabling professional nursing staff to conduct research. Massachusetts Nurse, 6. Ragsdale, D. (1993). A call for help: Collaborative nursing research. JANAC, 4(2), 48-52. Rosswurm, M. (1992). A research-based practice model in a hospital setting. Journal of Nursing Administration, 22(3), 57-60. Smeltzer, C., & Hinshaw, A. (1988). Research: Clinical integration for excellent patient care. Nursing Management, 19(1), 38-44. Swanson, J., Albright, J., Steirn, C., Schaffner, A., & Costa, L. (1992). Strategies for teaching nursing research: Program efforts for creating a research environment in a clinical setting. Western Journal of Nursing Research, 14, 241 -245. Tyler, D., Clark, A., Winslow, E., & White, K. (1990). Strategies for cond u c t i n g clinical n u r s i n g research in critical care. Critical Care Quarterly, 12(4), 30-38.
Vol. 6, No. 6, November-December, 1995