Supplying the pipeline of peer review: A call to engage new practitioners

Peer review is a process in which a proposed body of work is evaluated by a group of experts in the appropriate field.^1-3 Peer review is not only essential to ensuring the integrity of biomedical research—it also encourages authors to improve their work based on feedback from their given discipline, as reviewers are often identified by their content area expertise. Currently, new practitioners typically make up only a small fraction of volunteer journal reviewers as well as those assigned to review articles. This is at odds with prior literature indicating, based on editor comments and evaluations, that younger reviewers (less than 40 years of age) may be associated with stronger, more high-quality peer review.^4-7

In the New Practitioners Forum (NPF) Clinical Practice Advisory Group term during the 2018-2019 American Society of Health-System Pharmacists (ASHP) Volunteer Year (July-June), advisory members conducted an analysis of the availability and need for content and resources focused on research. Members suggested future action steps for gaps identified over the breadth of the research process to address the current state, the availability of content, and whether additional content was needed. Areas assessed included project planning, conducting research, the writing process, peer review, and presenting, with gaps identified in manuscript preparation, publication, and peer review. The gap analysis noted that materials were available to new practitioners, yet additional content and education would add value. NPF leadership used the findings from gap analysis and conversations with ASHP staff to ascertain that additional support was needed for peer review. The authors determined that educational opportunities around peer review should be prioritized for new practitioner members.

During the 2019-2020 ASHP term, NPF leadership collaborated with editorial staff at the American Journal of Health-System Pharmacy (AJHP) to understand new practitioners’ perceptions of peer review. A review of the literature indicated that peer review has previously been discussed at AJHP.^8-10 Leadership was therefore perplexed that volunteer members had identified this as a gap in practice despite resources being available. While the existing content was considered to be helpful, it was determined that there might be better strategies, platforms, and content to support new practitioners in this area. To bridge this gap, NPF leadership decided to conduct an educational webinar presentation.¹¹ Participants’ perceptions of peer review were assessed before and after the webinar event, with the following observations reported:

• • Participants were residency-trained pharmacists who had not participated as peer reviewers.

• • The majority felt that they had never received formal peer review training.

• • The most common reasons given for not previously participating in peer review were that individuals were “unsure how to be a peer reviewer” and “had never published before.”

• • Individuals identified “volunteer opportunity” and “improving their own writing” as the primary benefits from becoming a peer reviewer.

• • Participants agreed that peer review was beneficial for their own professional development and for the profession of pharmacy.

• • Survey results after the webinar indicated that participants felt more confident in acting as a peer reviewer as a result of this programming, although opportunities remain to increase confidence.

• • After the webinar, participants reported being more likely to register as a peer reviewer in the next 2 to 3 months.

The audience’s perceptions of the benefit of a formalized education series on peer review were mixed. Perceptions in the literature of the benefit of formal education are also mixed, with some believing that training for peer review is a continuing process of improvement while others are of the opinion that formalized training would be helpful.¹² In the literature, practicality and timing are identified as barriers to providing quality peer review.^12,13 A study of 609 reviewers found that providing a peer review training program resulted in a short-term benefit in decreasing the learning curve.¹⁴ While formal training may be difficult to incorporate into pharmacy curricula, pharmacy school and residency training, direct exposure, partnering with a mentor to complete a review, and example reviews appear to provide benefit by increasing confidence. Barriers may include limited preceptor and faculty time, experience, and comfort with peer review. Our webinar was a short yet meaningful intervention to help bridge this gap. While the benefits of peer review and peer reviewers’ perceptions have been described, without actually participating in peer review, the process may appear daunting.¹⁵ Mentoring during residency or for new practitioners starting a new role is critical to ensure individuals are aware of how to become a peer reviewer, feel comfortable with this process, and are confident in their ability to provide sound feedback and suggestions. Peer review mentors can utilize various resources such as webinars and provide supportive articles as well as links and instructions for how to sign up.^8,16 A preceptor or mentor could complete a joint review with a resident, learner, or less experienced new practitioner, including a review of the process and direct feedback on the learner’s independent review.

Similarly, new practitioners should better vocalize their aspirations to become peer reviewers. Most initial peer review opportunities are provided by supervisors, mentors, and colleagues.¹² In sharing this interest with residency directors, preceptors, and leaders, an opportunity to be recommended and mentored for peer review is more likely to become available. Additionally, new practitioners should be aware that they can engage in peer review without publication experience.

Overall, our findings provide a unique perspective from new practitioners. New practitioners can obtain qualifications (training, credentials, and education) to provide quality peer review but lack formal training and confidence. In addition, new practitioners may not often be selected to be a reviewer, denying them the opportunity to experience the process and in time become an expert reviewer. If this gap is not overcome, the supply of peer reviewers could be in jeopardy. Residents and other new practitioners would benefit from formal peer review training and practice alongside a mentor.

Disclosures: At the time of writing, Dr. Vest was an associate editor for AJHP. The authors have declared no potential conflicts of interest.

Previous affiliations: At the time of writing, Dr. Martin was employed by ASHP and Dr. Whalen was affiliated with St. Joseph’s Health, Syracuse, NY.

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