Promoting Nurses’ Critique of the Scholarly Literature

Introduction

A recent interview with medical writer Ivan Oransky, Co-Founder of Retraction Watch (retractionwatch.com), addresses the ongoing problems of quality peer review, flawed research, and subsequent retraction (Flight, 2022). He specifically spoke about nonspecialist readers of scientific literature and their need to be cautious and skeptical about what they read (Flight, 2022). In fact, all readers of JAPNA, regardless of their specialization and scientific background, are consumers of the information they read and should ALWAYS be critical of the research. The information taken from journal manuscripts has the potential to influence patient care. This editorial will focus on the importance of understanding a scholarly journal’s editorial process, including peer review, and critically evaluating the quality of the information presented in the publication. Specifically, this editorial will focus on promoting all nurses’ educated critique of scholarly literature.

Misinformation in scholarly literature pertaining to patient care is not a new concept. Historically, there has been notable erroneous published research that has influenced care practices long after retraction. One of the most influential research studies involved Andrew Wakefield’s assertion that vaccines might be linked to symptoms of autism (Wakefield et al., 1998). He made this assertion with research characterized by a small sample size, uncontrolled design, and speculations that fueled fear in parents and dropped the vaccine rates of children (Eggertson, 2010). It took years for the retraction process to be implemented (Eggertson, 2010) and for correction of the scientific literature to restore the publics’ trust in the safety of vaccines (Rao & Andrade, 2011).

More recently, numerous research papers on the COVID virus have been questioned and retracted. Oransky (Flight, 2022) noted that, as of February 2022, 209 COVID-19 papers had been retracted. He speculated there would likely be more papers retracted in the future as past manuscripts are scrutinized for validity. There is currently less rush to publication for COVID papers and overall more careful review of these published manuscripts. Notably, the rate of retraction of papers relating to COVID is not higher than the retraction rate of all other scientific literature topics (Flight, 2022).

JAPNA has received numerous submissions of papers concerning COVID management, nursing care, and the effects on staff. These papers have received the same diligent editor review and peer review (if they haven’t been rejected by the editor) and decision-making that are applied to all journal submissions. (See “Review Process” at https://us.sagepub.com/en-us/nam/journal-of-the-american-psychiatric-nurses-association/journal201684#submission-guidelines.) Many papers have been rejected. Those accepted have met the quality standards and the goal of adding to nursing knowledge.

Oransky noted the importance of readers evaluating whether a journal does what it says it will do (Flight, 2022). He noted, in Flight’s interview, that “the difference between a journal you can have confidence in and one you shouldn’t have any confidence in, is far less clear than a lot of people, particularly those in large publishing houses, would like you to think” (Flight, 2022, p. 2). This raises the ongoing question around the risk of predatory journals and being wary of the information they present in published research (Flight, 2022).

Critical thinking skills are essential to nursing practice (Papathanasiou et al., 2014). Critical thinking skills, taught in nursing education, allow nurses to specifically and creatively find solutions to problems encountered in clinical practice. Teaching nurses specific research appraisal skills results in an improved view of research that is relevant to patient care (Jelsness-Jørgensen, 2014). Critical thinking is essential in reading, understanding, and applying clinical research to practice.

Nurses need to critically evaluate all the research they read, even those published in “reputable journals.” Certainly, JAPNA adheres to ethical principles such as double-anonymous peer review and assessment of cross-check statistics, and JAPNA’s editors and reviewers evaluate submissions for methodological standards, human subjects approvals, reporting guidelines, and other elements of scientific rigor, but even with this careful attention to detail, it is possible that research is inadvertently published that is flawed or incorrect. The reader is the last step in verifying the ethical and scientific validity of a manuscript. This requires employing a level of questioning while reading an article, regardless of the source where the article is found.

Parse (2017) cited the editorial challenges involved with maintaining the quality of published manuscripts. She advocates for teaching the art of scholarly writing and the development of nursing knowledge in students at all levels of nursing education. Having this knowledge early in a nursing career will assist in judging the validity of research encountered in scholarly journals (Parse, 2017).

How can nurses critically evaluate professional literature? Ask the questions/do the below:

The authors, reviewers, and editors of JAPNA consistently strive to publish information that is timely, professionally considered, and accurate. The process is imperfect and under constant re-evaluation to ensure the highest quality. Your job as a reader of the scholarly literature, as a consumer of health care information, is to ask critical questions and constantly query whether what you read has validity and applicability to your practice. Ultimately, patients will benefit.