Nursing

During the 2010 Grammy Awards, country singer Taylor Swift performed with her idol Stevie Nicks the classic Fleetwood Mac song, “Rhiannon.” Within hours, pundits began giving scathing reviews of Swift’s performance and attacking her both personally and professionally. At the time, Swift stated, “There’s constructive criticism, there’s professional criticism—and then there’s just being mean. And there’s a line that you cross when you just start to attack everything about a person” (Songfacts, 2010). Although what happened to Swift took place in the music industry, it could very well have taken place in a health care setting and involved nurses. This incident demonstrates a growing incivility trend in our society and one that also may manifest itself in the professional work environment and the peer review process.

Swift’s release in 2011 of the album Speak Now featuring the hit single “Mean” was her response to those 2010 Grammy critics. The song was her way of addressing what she perceived to be bullying in her industry. As nurses, how would we respond to similar less than constructive criticism? Ideally, we should begin with turning around incivility through positive actions that optimize the process of giving and receiving feedback. Applying constructive principles to the peer review process makes giving and receiving that feedback much more meaningful. But where do we begin?

Smith (2006) suggests that “the most important question with peer review is not whether to abandon it, but how to improve it” (p. 180). One way of improving the peer review process entails training and mentoring in the REVIEW framework (Alexandrov, Hennerici, & Norrving, 2009), which means “Responsibly Evaluate, Verify and Improve the manuscript, Educate the authors and editors, and Weigh your expert opinion against the submitted work” (p. 243). The REVIEW framework lends itself well to integrating sound tips for giving and receiving feedback (The Nursing Centre, 2010).

To Responsibly Evaluate a manuscript and give feedback requires reviewers to pursue the assignment with a conscientious, balanced, and thorough approach that is timely and concisely highlights the work’s strengths, limitations, and appropriateness. This requires focusing on content accuracy, clarity, and logical presentation within the context of the particular journal and its standards. In receiving reviewer comments, manuscript authors have an obligation to remain open to the feedback. Not immediately becoming defensive allows authors to hear the reviewer’s suggestions and to grow from the peer review experience. Although staying calm and collected in the absence of praise may be extremely difficult, taking a deep breath and walking away from the feedback only to return with a clear mind could be helpful.

To Verify and Improve a manuscript, reviewers must read with focus and intention, providing both positive and corrective feedback. Instead of making sweeping generalizations, feedback must be fact based, specific, and actionable. To benefit most from the feedback, the recipient should maintain perspective regarding the feedback and seek to understand what it will take to make the product better and enhance its publication likelihood. Most journal editors are generous with their time and by appointment would be willing to discuss improvement strategies.

To Educate authors, a reviewer uses a positive tone and a respectful approach, providing a numbered list of limitations and suggesting ways to improve the limitations. In educating both authors and editors, reviewers delineate specific next steps, which can help to visualize the revision trajectory. Making this part of the REVIEW framework more tangible may entail pointing authors to exemplars that will assist them in visualizing what the recommended improvements could look like. Once thoughtful constructive feedback is given, authors have a duty to assume responsibility and take ownership for improving their work. Embracing continual learning through peer review opportunities may sometimes be painful, but these experiences ultimately make both reviewers and authors stronger.

To Weigh in as a reviewer involves first understanding expectations of this role. A common misconception among reviewers (especially novice ones) is that they must focus on grammar and spelling; these two areas are the domain of the editor and the publishing staff. The primary focus of an expert review is in addressing three key questions and making recommendations for revisions to answer the following in the affirmative (Kazdin, 2003):

1. Does the manuscript make an important substantive contribution to this phenomenon of interest?

2. Does the methodology used permit drawing conclusions the author wishes to make?

3. Is the manuscript well organized and complete in explaining what was done and why and how it was done?

As part of Weigh in, reviewers must be cautious to not abuse the peer review process. Avoiding potential conflicts of interest and remaining objective while evaluating the work of various contributors represent important considerations and may require recusing yourself from a review assignment. Conversely, from the standpoint of individuals receiving feedback, they have the option to suggest reviewers for their work. Regardless of the author–reviewer pairings, each individual would do best to recognize that both writing and reviewing are voluntary activities and individuals who pursue these endeavors generally do so with the best intentions.

Putting all the pieces of the REVIEW framework together and keeping these in the forefront position all parties well for giving and receiving valuable feedback. Although the peer review process may not always be perfect, if done right using the REVIEW approach, it can be most meaningful. In keeping with the nursing profession’s altruistic values and desired professional behaviors, giving and receiving feedback does not have to be mean.