I was recently asked if JWOCN had a blind or unblinded review process, and I replied "It is an unblinded review but only one way-the reviewer knows the name of the author, but the author does not know the name of the reviewer." The individual thanked me and said, "You are the first editor I have asked who has openly answered my question". Is blind review an issue?

Would not hiding the author's name from the reviewer make more sense-the reviewer should then be able to provide an objective unbiased review without being influenced by the author's reputation. Unfortunately, at least one study has shown that blinding the reviewer to the author is difficult. The specialty world of continence, ostomy, and wound care is relatively small, and self-citation, as well as an expert knowledge of the content area, means that reviewers can often discover the author identity and will waste time trying to decode author identity.

The peer reviewer is a respected and trusted professional who will ensure a confidential review, not discuss the review with others, and not use the information in the manuscript for personal gain. Manuscript review is seen by most as a professional responsibility and recognition of their own expertise in the field. The process has been an established aspect of publishing in quality journals for decades and, in fact, was formalized by the Royal Society in England in the 17th century. The reviewer provides a pivotal evaluation of the scientific merit of a study, based on the literature review, the sample size, the results, and the interpretation of the results. He or she ensures that the results as presented are congruent with the research questions, that the interpretation of the results does not go beyond what the research questions posed, that the statistical methods appear reasonable, and that there is no overt bias influencing reporting that the authors have not acknowledged in the discussion. For example, industry-sponsored clinical trials can provide valuable treatment information, but they may be limited to select subjects, may have "soft" outcome measures, or do not include a nonintervention arm. Thus, the results may not be generalizable to a typical wound, ostomy, or continence practice. General manuscripts, such as systematic reviews of the literature, are scrutinized for the logical conclusions based on a comprehensive literature review and synthesis of findings. Because reviewers are experts in the clinical field, they can usually spot whether the author has overlooked key or recent articles in the litera ture review or discussion. Occasionally, reviewers will also detect plagiarism or fraudulent submissions.

Fraud detection is not an expected role of the reviewer; committed and determined "fraud artists" are too clever for most reviewers or editors. Expectation that reviewers can detect fraud also places far too much responsibility on the reviewer. What happens to the reviewer if he or she misses a case? Could the reviewer be held somehow responsible? Absolutely not!! If this were the case, it would be impossible for editors to find reviewers. As Mulligan points out, science itself is self-correcting.1 In time, fraudulent research reporting will be detected when other researchers try to replicate results. To at least protect against amateur fraud, nearly all journals require that authors sign a form stating that the manuscript is original and not published elsewhere. Many journals also require that each author describe in detail his or her role in preparation of the manuscript. In an attempt to reduce scholarly misconduct, criteria for authorship have been developed by the International Committee of Medical Journal Editors (ICMJE) and revised several times, most recently in 2004. Although having authors read Uniform Requirements has not necessarily changed unscrupulous practice,2 the document does provide an outstanding guideline on the potential challenges related to authorship. Prospective authors submitting to JWOCN are directed to visit http://www.icmje.org/index.

As an editor or as a reviewer, receipt of a well-written manuscript is a thrill, especially if the material is cutting edge. The peer reviewer helps ensure that the manuscript is, indeed, cutting edge and supplies critical information to the editor, who cannot be a content expert in all fields. Reviewing manuscripts, however, is a time-consuming responsibility that the editor appreciates. To ensure that reviewers are not overloaded, JWOCN has a policy of first contacting a reviewer by e-mail, providing the title of the manuscript, and giving him or her or an opportunity to accept or decline the review. If the author agrees, the manuscript is e-mailed, requesting a review turnaround electronically within 3 weeks. Once the comments are returned (each manuscript has at least 2 peer reviewers), the section editor reviews the manuscript, considers the reviewer responses in the context of his or her own review, and forwards these to the editor. The editor carefully assesses the manuscript and all the responses and contacts the authors, often with suggested revisions to strengthen the manuscript. Decisions to accept or reject are ultimately the editor's, informed directly by the manuscript reviews. The whole process takes approximately 3 months. Quick turnaround is important so that the manuscript does not become outdated; it is important for JWOCN so that manuscripts are current and topical.

It is expected that the editor will ensure that all content fits within the JWOCN mandate and that material is not inaccurate or politically charged. One extreme example of this was an article in Human Immunology where a guest editor,3 whose first language was not English, presented arguments that became politically charged, in part because of poor English expression.4 The effect among readership was so extreme that the journal publisher retracted the article, fired the guest editor, and requested libraries to tear out the offending pages. One of the recommendations by the parties involved was that clear directions be given to peer reviewers and guest editors on their responsibilities as part of a special issue. JWOCN has taken steps to provide reviewers with guidelines that give direction for review.

Editors are in a position of trust and autonomy, but, as with any position of power, the unscrupulous can be tempted to advance their own interests. Richard Smith, Editor of the British Medical Journal, describes Editor Sir Cyril Burt, known for important but often disputed research on intelligence, as a classic in editorial misconduct. Smith writes:

He [Burt] founded a journal called the British Journal of Statistical Psychology and was its editor. He published 63 of his own articles and often altered the work of others without permission, sometimes adding favourable references to his own work. Once he published a letter he wrote himself under a pseudonym and a response he also wrote himself under another pseudonym in order to attack a colleague.^(5p1225)

Should editors publish in their own journals? At a recent International Academy of Nursing Editors (INANE) Conference, there was active discussion on the topic of self-publishing (publishing in one's own journal). The general view, also held by the JWOCN editor, is that even "whiffs" of self-promotion should be avoided and that despite an editor's article going through the peer-review process, on the surface, the publication could be perceived as abusing position.

Editors make every attempt to maintain journal integrity and feel personally affronted in cases of scholarly misconduct. The most common example of this is publishing the same (or extremely similar) article in more than one journal. Judith Krauss, Editor of Archives of Psychiatric Nursing, describes a recent experience of duplicate publishing and the implied blame that the editor of the first article placed on her when the error was not detected.6 Do editors need to do an online check of author publications to ensure duplicate publication does not occur? Is this even realistic given the lag time between publishing and appearance in Medline or CINAHL? What if the order, names, or number of authors has changed? Editors expect scholarly integrity. They fiercely try to protect their journals and are devastated when mistakes occur. Although history is rampant with breaches of publication ethics in the medical field, this is relatively new and, it must be added, rare in nursing. Increased pressure for promotion and tenure, however, and the changing face of nursing research mean that issues historically distanced from nursing are now a more real threat.

There is no perfect peer-review process, and oversights can occur. The editor hopes that the reviewer can provide a balanced and informed critique of the manuscript that will assist the author to revise or will explain, without malice, why the manuscript is being rejected. Such are the reviews received by JWOCN, and without the many WOCN members who assist when called on, JWOCN would not have the high standard of manuscripts it now publishes. Thanks are extended to all the 2004 reviewers (see the list in the November/December issue) and appreciation to those who will assist in 2005.

References