a research article that is peer reviewed means

Finding Scholarly Articles: Home

What's a Scholarly Article?

Your professor has specified that you are to use scholarly (or primary research or peer-reviewed or refereed or academic) articles only in your paper. What does that mean?

Scholarly or primary research articles are peer-reviewed , which means that they have gone through the process of being read by reviewers or referees  before being accepted for publication. When a scholar submits an article to a scholarly journal, the manuscript is sent to experts in that field to read and decide if the research is valid and the article should be published. Typically the reviewers indicate to the journal editors whether they think the article should be accepted, sent back for revisions, or rejected.

To decide whether an article is a primary research article, look for the following:

• The author’s (or authors') credentials and academic affiliation(s) should be given;
• There should be an abstract summarizing the research;
• The methods and materials used should be given, often in a separate section;
• There are citations within the text or footnotes referencing sources used;
• Results of the research are given;
• There should be discussion   and  conclusion ;
• With a bibliography or list of references at the end.

Caution: even though a journal may be peer-reviewed, not all the items in it will be. For instance, there might be editorials, book reviews, news reports, etc. Check for the parts of the article to be sure.   

You can limit your search results to primary research, peer-reviewed or refereed articles in many databases. To search for scholarly articles in  HOLLIS , type your keywords in the box at the top, and select  Catalog&Articles  from the choices that appear next.   On the search results screen, look for the  Show Only section on the right and click on  Peer-reviewed articles . (Make sure to  login in with your HarvardKey to get full-text of the articles that Harvard has purchased.)

Many of the databases that Harvard offers have similar features to limit to peer-reviewed or scholarly articles.  For example in Academic Search Premier , click on the box for Scholarly (Peer Reviewed) Journals  on the search screen.

Review articles are another great way to find scholarly primary research articles.   Review articles are not considered "primary research", but they pull together primary research articles on a topic, summarize and analyze them.  In Google Scholar , click on Review Articles  at the left of the search results screen. Ask your professor whether review articles can be cited for an assignment.

A note about Google searching.  A regular Google search turns up a broad variety of results, which can include scholarly articles but Google results also contain commercial and popular sources which may be misleading, outdated, etc.  Use Google Scholar  through the Harvard Library instead.

About Wikipedia .  W ikipedia is not considered scholarly, and should not be cited, but it frequently includes references to scholarly articles. Before using those references for an assignment, double check by finding them in Hollis or a more specific subject  database .

Still not sure about a source? Consult the course syllabus for guidance, contact your professor or teaching fellow, or use the Ask A Librarian service.

• Last Updated: Oct 3, 2023 3:37 PM
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Introduction

Peer-reviewed journals (also called scholarly or refereed journals) are a key information source for your college papers and projects. They are written by scholars for scholars and are an reliable source for information on a topic or discipline. These journals can be found either in the library's online databases, or in the library's local holdings. This guide will help you identify whether a journal is peer-reviewed and show you tips on finding them.

What is Peer-Review?

Peer-review is a process where an article is verified by a group of scholars before it is published.

When an author submits an article to a peer-reviewed journal, the editor passes out the article to a group of scholars in the related field (the author's peers). They review the article, making sure that its sources are reliable, the information it presents is consistent with the research, etc. Only after they give the article their "okay" is it published.

The peer-review process makes sure that only quality research is published: research that will further the scholarly work in the field.

When you use articles from peer-reviewed journals, someone has already reviewed the article and said that it is reliable, so you don't have to take the steps to evaluate the author or his/her sources. The hard work is already done for you!

Identifying Peer-Review Journals

If you have the physical journal, you can look for the following features to identify if it is peer-reviewed.

Masthead (The first few pages) : includes information on the submission process, the editorial board, and maybe even a phrase stating that the journal is "peer-reviewed."

Publisher: Peer-reviewed journals are typically published by professional organizations or associations (like the American Chemical Society). They also may be affiliated with colleges/universities.

Graphics:  Typically there either won't be any images at all, or the few charts/graphs are only there to supplement the text information. They are usually in black and white.

Authors: The authors are listed at the beginning of the article, usually with information on their affiliated institutions, or contact information like email addresses.

Abstracts: At the beginning of the article the authors provide an extensive abstract detailing their research and any conclusions they were able to draw.

Terminology:  Since the articles are written by scholars for scholars, they use uncommon terminology specific to their field and typically do not define the words used.

Citations: At the end of each article is a list of citations/reference. These are provided for scholars to either double check their work, or to help scholars who are researching in the same general area.

Advertisements: Peer-reviewed journals rarely have advertisements. If they do the ads are for professional organizations or conferences, not for national products.

Identifying Articles from Databases

When you are looking at an article in an online database, identifying that it comes from a peer-reviewed journal can be more difficult. You do not have access to the physical journal to check areas like the masthead or advertisements, but you can use some of the same basic principles.

Points you may want to keep in mind when you are evaluating an article from a database:

• A lot of databases provide you with the option to limit your results to only those from peer-reviewed or refereed journals. Choosing this option means all of your results will be from those types of sources.  
• When possible, choose the PDF version of the article's full text. Since this is exactly as if you photocopied from the journal, you can get a better idea of its layout, graphics, advertisements, etc.  
• Even in an online database you still should be able to check for author information, abstracts, terminology, and citations.
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What is peer review.

Peer review is ‘a process where scientists (“peers”) evaluate the quality of other scientists’ work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already know.’ You can learn more in this explainer from the Social Science Space.  

Peer review brings academic research to publication in the following ways:

• Evaluation – Peer review is an effective form of research evaluation to help select the highest quality articles for publication.
• Integrity – Peer review ensures the integrity of the publishing process and the scholarly record. Reviewers are independent of journal publications and the research being conducted.
• Quality – The filtering process and revision advice improve the quality of the final research article as well as offering the author new insights into their research methods and the results that they have compiled. Peer review gives authors access to the opinions of experts in the field who can provide support and insight.

Types of peer review

• Single-anonymized  – the name of the reviewer is hidden from the author.
• Double-anonymized  – names are hidden from both reviewers and the authors.
• Triple-anonymized  – names are hidden from authors, reviewers, and the editor.
• Open peer review comes in many forms . At Sage we offer a form of open peer review on some journals via our Transparent Peer Review program , whereby the reviews are published alongside the article. The names of the reviewers may also be published, depending on the reviewers’ preference.
• Post publication peer review can offer useful interaction and a discussion forum for the research community. This form of peer review is not usual or appropriate in all fields.

To learn more about the different types of peer review, see page 14 of ‘ The Nuts and Bolts of Peer Review ’ from Sense about Science.

Please double check the manuscript submission guidelines of the journal you are reviewing in order to ensure that you understand the method of peer review being used.

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Articles: Finding (and Identifying) Peer-Reviewed Articles: What is Peer Review?

• What is Peer Review?
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Peer Review in 3 Minutes

What is "Peer-Review"?

What are they.

Scholarly articles are papers that describe a research study. 

Why are scholarly articles useful?

They report original research projects that have been reviewed by other experts before they are accepted for publication, so you can reasonably be assured that they contain valid information. 

How do you identify scholarly or peer-reviewed articles?

• They are usually fairly lengthy - most likely at least 7-10 pages
• The authors and their credentials should be identified, at least the company or university where the author is employed
• There is usually a list of References or Works Cited at the end of the paper, listing the sources that the authors used in their research

How do you find them? 

Some of the library's databases contain scholarly articles, either exclusively or in combination with other types of articles. 

Google Scholar is another option for searching for scholarly articles. 

Know the Difference Between Scholarly and Popular Journals/Magazines

Peer reviewed articles are found in scholarly journals.  The checklist below can help you determine if what you are looking at is peer reviewed or scholarly.

• Both kinds of journals and magazines can be useful sources of information.
• Popular magazines and newspapers are good for overviews, recent news, first-person accounts, and opinions about a topic.
• Scholarly journals, often called scientific or peer-reviewed journals, are good sources of actual studies or research conducted about a particular topic. They go through a process of review by experts, so the information is usually highly reliable.

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Understanding Peer Review in Science

Peer review is an essential element of the scientific publishing process that helps ensure that research articles are evaluated, critiqued, and improved before release into the academic community. Take a look at the significance of peer review in scientific publications, the typical steps of the process, and and how to approach peer review if you are asked to assess a manuscript.

What Is Peer Review?

Peer review is the evaluation of work by peers, who are people with comparable experience and competency. Peers assess each others’ work in educational settings, in professional settings, and in the publishing world. The goal of peer review is improving quality, defining and maintaining standards, and helping people learn from one another.

In the context of scientific publication, peer review helps editors determine which submissions merit publication and improves the quality of manuscripts prior to their final release.

Types of Peer Review for Manuscripts

There are three main types of peer review:

• Single-blind review: The reviewers know the identities of the authors, but the authors do not know the identities of the reviewers.
• Double-blind review: Both the authors and reviewers remain anonymous to each other.
• Open peer review: The identities of both the authors and reviewers are disclosed, promoting transparency and collaboration.

There are advantages and disadvantages of each method. Anonymous reviews reduce bias but reduce collaboration, while open reviews are more transparent, but increase bias.

Key Elements of Peer Review

Proper selection of a peer group improves the outcome of the process:

• Expertise : Reviewers should possess adequate knowledge and experience in the relevant field to provide constructive feedback.
• Objectivity : Reviewers assess the manuscript impartially and without personal bias.
• Confidentiality : The peer review process maintains confidentiality to protect intellectual property and encourage honest feedback.
• Timeliness : Reviewers provide feedback within a reasonable timeframe to ensure timely publication.

Steps of the Peer Review Process

The typical peer review process for scientific publications involves the following steps:

• Submission : Authors submit their manuscript to a journal that aligns with their research topic.
• Editorial assessment : The journal editor examines the manuscript and determines whether or not it is suitable for publication. If it is not, the manuscript is rejected.
• Peer review : If it is suitable, the editor sends the article to peer reviewers who are experts in the relevant field.
• Reviewer feedback : Reviewers provide feedback, critique, and suggestions for improvement.
• Revision and resubmission : Authors address the feedback and make necessary revisions before resubmitting the manuscript.
• Final decision : The editor makes a final decision on whether to accept or reject the manuscript based on the revised version and reviewer comments.
• Publication : If accepted, the manuscript undergoes copyediting and formatting before being published in the journal.

Pros and Cons

While the goal of peer review is improving the quality of published research, the process isn’t without its drawbacks.

• Quality assurance : Peer review helps ensure the quality and reliability of published research.
• Error detection : The process identifies errors and flaws that the authors may have overlooked.
• Credibility : The scientific community generally considers peer-reviewed articles to be more credible.
• Professional development : Reviewers can learn from the work of others and enhance their own knowledge and understanding.
• Time-consuming : The peer review process can be lengthy, delaying the publication of potentially valuable research.
• Bias : Personal biases of reviews impact their evaluation of the manuscript.
• Inconsistency : Different reviewers may provide conflicting feedback, making it challenging for authors to address all concerns.
• Limited effectiveness : Peer review does not always detect significant errors or misconduct.
• Poaching : Some reviewers take an idea from a submission and gain publication before the authors of the original research.

Steps for Conducting Peer Review of an Article

Generally, an editor provides guidance when you are asked to provide peer review of a manuscript. Here are typical steps of the process.

• Accept the right assignment: Accept invitations to review articles that align with your area of expertise to ensure you can provide well-informed feedback.
• Manage your time: Allocate sufficient time to thoroughly read and evaluate the manuscript, while adhering to the journal’s deadline for providing feedback.
• Read the manuscript multiple times: First, read the manuscript for an overall understanding of the research. Then, read it more closely to assess the details, methodology, results, and conclusions.
• Evaluate the structure and organization: Check if the manuscript follows the journal’s guidelines and is structured logically, with clear headings, subheadings, and a coherent flow of information.
• Assess the quality of the research: Evaluate the research question, study design, methodology, data collection, analysis, and interpretation. Consider whether the methods are appropriate, the results are valid, and the conclusions are supported by the data.
• Examine the originality and relevance: Determine if the research offers new insights, builds on existing knowledge, and is relevant to the field.
• Check for clarity and consistency: Review the manuscript for clarity of writing, consistent terminology, and proper formatting of figures, tables, and references.
• Identify ethical issues: Look for potential ethical concerns, such as plagiarism, data fabrication, or conflicts of interest.
• Provide constructive feedback: Offer specific, actionable, and objective suggestions for improvement, highlighting both the strengths and weaknesses of the manuscript. Don’t be mean.
• Organize your review: Structure your review with an overview of your evaluation, followed by detailed comments and suggestions organized by section (e.g., introduction, methods, results, discussion, and conclusion).
• Be professional and respectful: Maintain a respectful tone in your feedback, avoiding personal criticism or derogatory language.
• Proofread your review: Before submitting your review, proofread it for typos, grammar, and clarity.
• Couzin-Frankel J (September 2013). “Biomedical publishing. Secretive and subjective, peer review proves resistant to study”. Science . 341 (6152): 1331. doi: 10.1126/science.341.6152.1331
• Lee, Carole J.; Sugimoto, Cassidy R.; Zhang, Guo; Cronin, Blaise (2013). “Bias in peer review”. Journal of the American Society for Information Science and Technology. 64 (1): 2–17. doi: 10.1002/asi.22784
• Slavov, Nikolai (2015). “Making the most of peer review”. eLife . 4: e12708. doi: 10.7554/eLife.12708
• Spier, Ray (2002). “The history of the peer-review process”. Trends in Biotechnology . 20 (8): 357–8. doi: 10.1016/S0167-7799(02)01985-6
• Squazzoni, Flaminio; Brezis, Elise; Marušić, Ana (2017). “Scientometrics of peer review”. Scientometrics . 113 (1): 501–502. doi: 10.1007/s11192-017-2518-4

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How to know if an article is peer reviewed [6 key features]

Features of a peer reviewed article

How to find peer reviewed articles, frequently asked questions about peer reviewed articles, related articles.

A peer reviewed article refers to a work that has been thoroughly assessed, and based on its quality, has been accepted for publication in a scholarly journal. The aim of peer reviewing is to publish articles that meet the standards established in each field. This way, peer reviewed articles that are published can be taken as models of research practices.

A peer reviewed article can be recognized by the following features:

• It is published in a scholarly journal.
• It has a serious, and academic tone.
• It features an abstract at the beginning.
• It is divided by headings into introduction, literature review or background, discussion, and conclusion.
• It includes in-text citations, and a bibliography listing accurately all references.
• Its authors are affiliated with a research institute or university.

There are many ways in which you can find peer reviewed articles, for instance:

• Check the journal's features and 'About' section. This part should state if the articles published in the journal are peer reviewed, and the type of reviewing they perform.
• Consult a database with peer reviewed journals, such as Web of Science Master Journal List , PubMed , Scopus , Google Scholar , etc. Specify in the advanced search settings that you are looking for peer reviewed journals only.
• Consult your library's database, and specify in the search settings that you are looking for peer reviewed journals only.

➡️ Want to know if a source is scholarly? Check out our guide on scholarly sources.

➡️ Want to know if a source is credible? Find out in our guide on credible sources (+ how to find them).

A peer reviewed article refers to a work that has been thoroughly assessed, and based on its quality has been accepted to be published in a scholarly journal.

Once an article has been submitted for publication to a peer reviewed journal, the journal assigns the article to an expert in the field, who is considered the “peer”.

The easiest way to find a peer reviewed article is to narrow down the search in the "Advanced search" option. Then, mark the box that says "peer reviewed".

Consult a database with peer reviewed journals, such as Web of Science Master Journal List , PubMed , Scopus , etc.

There are many views on peer reviewed articles. Take a look at Peer Review in Scientific Publications: Benefits, Critiques, & A Survival Guide for more insight on this topic.

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• What Is Peer Review? | Types & Examples

What Is Peer Review? | Types & Examples

Published on 6 May 2022 by Tegan George . Revised on 2 September 2022.

Peer review, sometimes referred to as refereeing , is the process of evaluating submissions to an academic journal. Using strict criteria, a panel of reviewers in the same subject area decides whether to accept each submission for publication.

Peer-reviewed articles are considered a highly credible source due to the stringent process they go through before publication.

There are various types of peer review. The main difference between them is to what extent the authors, reviewers, and editors know each other’s identities. The most common types are:

• Single-blind review
• Double-blind review
• Triple-blind review

Collaborative review

Open review.

Relatedly, peer assessment is a process where your peers provide you with feedback on something you’ve written, based on a set of criteria or benchmarks from an instructor. They then give constructive feedback, compliments, or guidance to help you improve your draft.

Table of contents

What is the purpose of peer review, types of peer review, the peer review process, providing feedback to your peers, peer review example, advantages of peer review, criticisms of peer review, frequently asked questions about peer review.

Many academic fields use peer review, largely to determine whether a manuscript is suitable for publication. Peer review enhances the credibility of the manuscript. For this reason, academic journals are among the most credible sources you can refer to.

However, peer review is also common in non-academic settings. The United Nations, the European Union, and many individual nations use peer review to evaluate grant applications. It is also widely used in medical and health-related fields as a teaching or quality-of-care measure.

Peer assessment is often used in the classroom as a pedagogical tool. Both receiving feedback and providing it are thought to enhance the learning process, helping students think critically and collaboratively.

Prevent plagiarism, run a free check.

Depending on the journal, there are several types of peer review.

Single-blind peer review

The most common type of peer review is single-blind (or single anonymised) review . Here, the names of the reviewers are not known by the author.

While this gives the reviewers the ability to give feedback without the possibility of interference from the author, there has been substantial criticism of this method in the last few years. Many argue that single-blind reviewing can lead to poaching or intellectual theft or that anonymised comments cause reviewers to be too harsh.

Double-blind peer review

In double-blind (or double anonymised) review , both the author and the reviewers are anonymous.

Arguments for double-blind review highlight that this mitigates any risk of prejudice on the side of the reviewer, while protecting the nature of the process. In theory, it also leads to manuscripts being published on merit rather than on the reputation of the author.

Triple-blind peer review

While triple-blind (or triple anonymised) review – where the identities of the author, reviewers, and editors are all anonymised – does exist, it is difficult to carry out in practice.

Proponents of adopting triple-blind review for journal submissions argue that it minimises potential conflicts of interest and biases. However, ensuring anonymity is logistically challenging, and current editing software is not always able to fully anonymise everyone involved in the process.

In collaborative review , authors and reviewers interact with each other directly throughout the process. However, the identity of the reviewer is not known to the author. This gives all parties the opportunity to resolve any inconsistencies or contradictions in real time, and provides them a rich forum for discussion. It can mitigate the need for multiple rounds of editing and minimise back-and-forth.

Collaborative review can be time- and resource-intensive for the journal, however. For these collaborations to occur, there has to be a set system in place, often a technological platform, with staff monitoring and fixing any bugs or glitches.

Lastly, in open review , all parties know each other’s identities throughout the process. Often, open review can also include feedback from a larger audience, such as an online forum, or reviewer feedback included as part of the final published product.

While many argue that greater transparency prevents plagiarism or unnecessary harshness, there is also concern about the quality of future scholarship if reviewers feel they have to censor their comments.

In general, the peer review process includes the following steps:

• First, the author submits the manuscript to the editor.
• Reject the manuscript and send it back to the author, or
• Send it onward to the selected peer reviewer(s)
• Next, the peer review process occurs. The reviewer provides feedback, addressing any major or minor issues with the manuscript, and gives their advice regarding what edits should be made.
• Lastly, the edited manuscript is sent back to the author. They input the edits and resubmit it to the editor for publication.

In an effort to be transparent, many journals are now disclosing who reviewed each article in the published product. There are also increasing opportunities for collaboration and feedback, with some journals allowing open communication between reviewers and authors.

It can seem daunting at first to conduct a peer review or peer assessment. If you’re not sure where to start, there are several best practices you can use.

Summarise the argument in your own words

Summarising the main argument helps the author see how their argument is interpreted by readers, and gives you a jumping-off point for providing feedback. If you’re having trouble doing this, it’s a sign that the argument needs to be clearer, more concise, or worded differently.

If the author sees that you’ve interpreted their argument differently than they intended, they have an opportunity to address any misunderstandings when they get the manuscript back.

Separate your feedback into major and minor issues

It can be challenging to keep feedback organised. One strategy is to start out with any major issues and then flow into the more minor points. It’s often helpful to keep your feedback in a numbered list, so the author has concrete points to refer back to.

Major issues typically consist of any problems with the style, flow, or key points of the manuscript. Minor issues include spelling errors, citation errors, or other smaller, easy-to-apply feedback.

The best feedback you can provide is anything that helps them strengthen their argument or resolve major stylistic issues.

Give the type of feedback that you would like to receive

No one likes being criticised, and it can be difficult to give honest feedback without sounding overly harsh or critical. One strategy you can use here is the ‘compliment sandwich’, where you ‘sandwich’ your constructive criticism between two compliments.

Be sure you are giving concrete, actionable feedback that will help the author submit a successful final draft. While you shouldn’t tell them exactly what they should do, your feedback should help them resolve any issues they may have overlooked.

As a rule of thumb, your feedback should be:

• Easy to understand
• Constructive

Below is a brief annotated research example. You can view examples of peer feedback by hovering over the highlighted sections.

Influence of phone use on sleep

Studies show that teens from the US are getting less sleep than they were a decade ago (Johnson, 2019) . On average, teens only slept for 6 hours a night in 2021, compared to 8 hours a night in 2011. Johnson mentions several potential causes, such as increased anxiety, changed diets, and increased phone use.

The current study focuses on the effect phone use before bedtime has on the number of hours of sleep teens are getting.

For this study, a sample of 300 teens was recruited using social media, such as Facebook, Instagram, and Snapchat. The first week, all teens were allowed to use their phone the way they normally would, in order to obtain a baseline.

The sample was then divided into 3 groups:

• Group 1 was not allowed to use their phone before bedtime.
• Group 2 used their phone for 1 hour before bedtime.
• Group 3 used their phone for 3 hours before bedtime.

All participants were asked to go to sleep around 10 p.m. to control for variation in bedtime . In the morning, their Fitbit showed the number of hours they’d slept. They kept track of these numbers themselves for 1 week.

Two independent t tests were used in order to compare Group 1 and Group 2, and Group 1 and Group 3. The first t test showed no significant difference ( p > .05) between the number of hours for Group 1 ( M = 7.8, SD = 0.6) and Group 2 ( M = 7.0, SD = 0.8). The second t test showed a significant difference ( p < .01) between the average difference for Group 1 ( M = 7.8, SD = 0.6) and Group 3 ( M = 6.1, SD = 1.5).

This shows that teens sleep fewer hours a night if they use their phone for over an hour before bedtime, compared to teens who use their phone for 0 to 1 hours.

Peer review is an established and hallowed process in academia, dating back hundreds of years. It provides various fields of study with metrics, expectations, and guidance to ensure published work is consistent with predetermined standards.

• Protects the quality of published research

Peer review can stop obviously problematic, falsified, or otherwise untrustworthy research from being published. Any content that raises red flags for reviewers can be closely examined in the review stage, preventing plagiarised or duplicated research from being published.

• Gives you access to feedback from experts in your field

Peer review represents an excellent opportunity to get feedback from renowned experts in your field and to improve your writing through their feedback and guidance. Experts with knowledge about your subject matter can give you feedback on both style and content, and they may also suggest avenues for further research that you hadn’t yet considered.

• Helps you identify any weaknesses in your argument

Peer review acts as a first defence, helping you ensure your argument is clear and that there are no gaps, vague terms, or unanswered questions for readers who weren’t involved in the research process. This way, you’ll end up with a more robust, more cohesive article.

While peer review is a widely accepted metric for credibility, it’s not without its drawbacks.

• Reviewer bias

The more transparent double-blind system is not yet very common, which can lead to bias in reviewing. A common criticism is that an excellent paper by a new researcher may be declined, while an objectively lower-quality submission by an established researcher would be accepted.

• Delays in publication

The thoroughness of the peer review process can lead to significant delays in publishing time. Research that was current at the time of submission may not be as current by the time it’s published.

• Risk of human error

By its very nature, peer review carries a risk of human error. In particular, falsification often cannot be detected, given that reviewers would have to replicate entire experiments to ensure the validity of results.

Peer review is a process of evaluating submissions to an academic journal. Utilising rigorous criteria, a panel of reviewers in the same subject area decide whether to accept each submission for publication.

For this reason, academic journals are often considered among the most credible sources you can use in a research project – provided that the journal itself is trustworthy and well regarded.

Peer review can stop obviously problematic, falsified, or otherwise untrustworthy research from being published. It also represents an excellent opportunity to get feedback from renowned experts in your field.

It acts as a first defence, helping you ensure your argument is clear and that there are no gaps, vague terms, or unanswered questions for readers who weren’t involved in the research process.

Peer-reviewed articles are considered a highly credible source due to this stringent process they go through before publication.

In general, the peer review process follows the following steps:

• Reject the manuscript and send it back to author, or
• Lastly, the edited manuscript is sent back to the author. They input the edits, and resubmit it to the editor for publication.

Many academic fields use peer review , largely to determine whether a manuscript is suitable for publication. Peer review enhances the credibility of the published manuscript.

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What Does "Peer-reviewed" or "Refereed" Mean?

Peer review is a process that journals use to ensure the articles they publish represent the best scholarship currently available. When an article is submitted to a peer reviewed journal, the editors send it out to other scholars in the same field (the author's peers) to get their opinion on the quality of the scholarship, its relevance to the field, its appropriateness for the journal, etc.

Publications that don't use peer review (Time, Cosmo, Salon) just rely on the judgment of the editors whether an article is up to snuff or not. That's why you can't count on them for solid, scientific scholarship.

Note:This is an entirely different concept from " Review Articles ."

How do I know if a journal publishes peer-reviewed articles?

Usually, you can tell just by looking. A scholarly journal is visibly different from other magazines, but occasionally it can be hard to tell, or you just want to be extra-certain. In that case, you turn to Ulrich's Periodical Directory Online . Just type the journal's title into the text box, hit "submit," and you'll get back a report that will tell you (among other things) whether the journal contains articles that are peer reviewed, or, as Ulrich's calls it, Refereed.

Remember, even journals that use peer review may have some content that does not undergo peer review. The ultimate determination must be made on an article-by-article basis.

For example, the journal  Science  publishes  a mix  of peer-reviewed and non-peer-reviewed content. Here are two articles from the same issue of  Science . 

This one is not peer-reviewed:  https://science-sciencemag-org.ezproxy.lib.utexas.edu/content/303/5655/154.1  This one is a peer-reviewed research article:  https://science-sciencemag-org.ezproxy.lib.utexas.edu/content/303/5655/226

That is consistent with the Ulrichsweb  description of  Science , which states, "Provides news of recent international developments and research in all fields of science. Publishes original research results, reviews and short features."

Test these periodicals in Ulrichs :

• Advances in Dental Research
• Clinical Anatomy
• Molecular Cancer Research
• Journal of Clinical Electrophysiology
• Last Updated: Aug 28, 2023 9:25 AM
• URL: https://guides.lib.utexas.edu/journalarticles101

Peer Reviewed Literature

What is peer review, terminology, peer review what does that mean, what types of articles are peer-reviewed, what information is not peer-reviewed, what about google scholar.

• How do I find peer-reviewed articles?
• Scholarly vs. Popular Sources

Research Librarian

For more help on this topic, please contact our Research Help Desk: [email protected] or 781-768-7303. Stay up-to-date on our current hours . Note: all hours are EST.

This Guide was created by Carolyn Swidrak (retired).

Research findings are communicated in many ways.  One of the most important ways is through publication in scholarly, peer-reviewed journals.

Research published in scholarly journals is held to a high standard.  It must make a credible and significant contribution to the discipline.  To ensure a very high level of quality, articles that are submitted to scholarly journals undergo a process called peer-review.

Once an article has been submitted for publication, it is reviewed by other independent, academic experts (at least two) in the same field as the authors.  These are the peers.  The peers evaluate the research and decide if it is good enough and important enough to publish.  Usually there is a back-and-forth exchange between the reviewers and the authors, including requests for revisions, before an article is published. 

Peer review is a rigorous process but the intensity varies by journal.  Some journals are very prestigious and receive many submissions for publication.  They publish only the very best, most highly regarded research. 

The terms scholarly, academic, peer-reviewed and refereed are sometimes used interchangeably, although there are slight differences.

Scholarly and academic may refer to peer-reviewed articles, but not all scholarly and academic journals are peer-reviewed (although most are.)  For example, the Harvard Business Review is an academic journal but it is editorially reviewed, not peer-reviewed.

Peer-reviewed and refereed are identical terms.

From  Peer Review in 3 Minutes  [Video], by the North Carolina State University Library, 2014, YouTube (https://youtu.be/rOCQZ7QnoN0).

Peer reviewed articles can include:

• Original research (empirical studies)
• Review articles
• Systematic reviews
• Meta-analyses

There is much excellent, credible information in existence that is NOT peer-reviewed.  Peer-review is simply ONE MEASURE of quality. 

Much of this information is referred to as "gray literature."

Government Agencies

Government websites such as the Centers for Disease Control (CDC) publish high level, trustworthy information.  However, most of it is not peer-reviewed.  (Some of their publications are peer-reviewed, however. The journal Emerging Infectious Diseases, published by the CDC is one example.)

Conference Proceedings

Papers from conference proceedings are not usually peer-reviewed.  They may go on to become published articles in a peer-reviewed journal. 

Dissertations

Dissertations are written by doctoral candidates, and while they are academic they are not peer-reviewed.

Many students like Google Scholar because it is easy to use.  While the results from Google Scholar are generally academic they are not necessarily peer-reviewed.  Typically, you will find:

• Peer reviewed journal articles (although they are not identified as peer-reviewed)
• Unpublished scholarly articles (not peer-reviewed)
• Masters theses, doctoral dissertations and other degree publications (not peer-reviewed)
• Book citations and links to some books (not necessarily peer-reviewed)
• Next: How do I find peer-reviewed articles? >>
• Last Updated: Feb 12, 2024 9:39 AM
• URL: https://libguides.regiscollege.edu/peer_review

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• The Right Source For Your Need-Authority
• Finding Subject Specific Sources: Research Guides
• Understanding Peer Reviewed Articles
• Understanding Peer Reviewed Articles- Arts & Humanities
• How to Read a Journal Article
• Locating Journals
• How to Find Streaming Media

The Peer Review Process

So you need to use scholarly, peer-reviewed articles for an assignment...what does that mean? 

Peer review  is a process for evaluating research studies before they are published by an academic journal. These studies typically communicate  original research  or analysis for other researchers. 

The Peer Review Process at a Glance:

Looking for peer-reviewed articles?  Try searching in OneSearch or a library database  and look for options to limit your results to scholarly/peer-reviewed or academic journals. Check out this brief tutorial to show you how:   How to Locate a Scholarly (Peer Reviewed) Article

Part 1: Watch the Video

Part 1: watch the video all about peer review (3 min.) and reflect on discussion questions..

Discussion Questions

After watching the video, reflect on the following questions:

• According to the video, what are some of the pros and cons of the peer review process?
• Why is the peer review process important to scholarship?
• Do you think peer reviewers should be paid for their work? Why or why not?

Part 2: Practice

Part 2: take an interactive tutorial on reading a research article for your major..

Includes a certification of completion to download and upload to Canvas.

Social Sciences

(e.g. Psychology, Sociology)

(e.g. Health Science, Biology)

Arts & Humanities

(e.g. Visual & Media Arts, Cultural Studies, Literature, History)

Click on the handout to view in a new tab, download, or print.

For Instructors

• Teaching Peer Review for Instructors

In class or for homework, watch the video “All About Peer Review” (3 min.) .

Video discussion questions:

• According to the video, what are some of the pros and cons of the peer review process

Assignment Ideas

• Ask students to conduct their own peer review of an important journal article in your field. Ask them to reflect on the process. What was hard to critique?
• Have students examine a journals’ web page with information for authors. What information is given to the author about the peer review process for this journal?
• Assign this reading by CSUDH faculty member Terry McGlynn, "Should journals pay for manuscript reviews?" What is the author's argument? Who profits the most from published research? You could also hold a debate with one side for paying reviewers and the other side against.
• Search a database like Cabell’s for information on the journal submission process for a particular title or subject. How long does peer review take for a particular title? Is it is a blind review? How many reviewers are solicited? What is their acceptance rate?
• Assign short readings that address peer review models. We recommend this issue of Nature on peer review debate and open review and this Chronicle of Higher Education article on open review in Shakespeare Quarterly .

Proof of Completion

Mix and match this suite of instructional materials for your course needs!

Questions about integrating a graded online component into your class, contact the Online Learning Librarian, Rebecca Nowicki ( [email protected] ).

Example of a certificate of completion:

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• Last Updated: Apr 26, 2024 10:45 AM
• URL: https://libguides.sdsu.edu/WhichSource

Evaluating Information Sources: What Is A Peer-Reviewed Article?

• Should I Trust Internet Sources?

What Is A Peer-Reviewed Article?

Anali Perry, a librarian from Arizona State University Libraries, gives a quick definition of a peer-reviewed article.

The Library Minute: Academic Articles from ASU Libraries on Vimeo .

How Do Peer-Reviewed Articles Differ From Popular Ones?

This 3 minute video from the Peabody Library at Vanderbilt University talks about the differences between popular and scholarly articles.  It also mentions trade publications. 

What Is Peer Review?

In academic publishing, the goal of peer review is to assess the quality of articles submitted for publication in a scholarly journal. Before an article is deemed appropriate to be published in a peer-reviewed journal, it must undergo the following process:

• The author of the article must submit it to the journal editor who forwards the article to experts in the field. Because the reviewers specialize in the same scholarly area as the author, they are considered the author’s peers (hence “peer review”).
• These impartial reviewers are charged with carefully evaluating the quality of the submitted manuscript.
• The peer reviewers check the manuscript for accuracy and assess the validity of the research methodology and procedures.
• If appropriate, they suggest revisions. If they find the article lacking in scholarly validity and rigor, they reject it.

Because a peer-reviewed journal will not publish articles that fail to meet the standards established for a given discipline, peer-reviewed articles that are accepted for publication exemplify the best research practices in a field.

Features of a Peer-Reviewed Article

When you are determining whether or not the article you found is a peer-reviewed article, you should consider the following.

Does the article have the following features?

Also consider...

• Is the journal in which you found the article published or sponsored by a professional scholarly society, professional association, or university academic department? Does it describe itself as a peer-reviewed publication? (To know that, check the journal's website). 
• Did you find a citation for it in one of the  databases that includes scholarly publications? (Academic Search Complete, PsycINFO, etc.)?  Read the database description to see if it includes scholarly publications.
• In the database, did you limit your search to scholarly or peer-reviewed publications? (See video tutorial below for a demonstration.)
• Is the topic of the article narrowly focused and explored in depth ?
• Is the article based on either original research or authorities in the field (as opposed to personal opinion)?
• Is the article written for readers with some prior knowledge of the subject?
• If your field is social or natural science, is the article divided into sections with headings such as those listed below?

How Do I Find Peer-Reviewed Articles?

The easiest and fastest way to find peer-reviewed articles is to search the online library databases , many of which include peer-reviewed journals. To make sure your results come from peer-reviewed (also called "scholarly" or "academic") journals, do the following:

• Read the database description to determine if it features peer-reviewed articles.
• When you search for articles, choose the Advanced Search option. On the search screen, look for a check-box that allows you to limit your results to peer-reviewed only.
• If you didn't check off the "peer-reviewed articles only" box, try to see if your results can organized by source . For example, the database Criminal Justice Abstracts will let you choose the tab "Peer-Reviewed Journals."

Video tutorial

Watch this video through to the end. It will show you how to use a library database and how to narrow your search results down to just peer-reviewed articles.

• << Previous: Should I Trust Internet Sources?
• Last Updated: Aug 21, 2019 2:00 PM
• URL: https://guides.lib.jjay.cuny.edu/evaluatingsources

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• Confirm an article is peer-reviewed

What is a scholarly, peer-reviewed journal?

Confirm that an article is peer-reviewed -- part 1:, confirm that an article is peer-reviewed -- part 2:, primary research articles vs review articles.

• Cite sources properly

First, determine whether the article is published in a peer-reviewed journal. There are two ways to determine whether a journal has a peer-review process in place (which means that it is a scholarly source):

Next, look at the article to see what elements it has in it, and consult the table below to make your final determination:

Why are some of the articles in a peer-reviewed journal NOT peer-reviewed?

The peer-review process take a lot of time and effort, so it's reserved for articles where accuracy is essential -- reports of new and original research, or summaries of research. Other researchers are going to use and build upon the data and information reported in those articles, so it's important that it is accurate.

For articles such as book reviews, accuracy is not as important (after all, book reviews and editorials are highly influenced by personal opinions). Therefore, these articles are checked for grammar by an editor but don't undergo the rigorous peer-review process.

A primary research article presents a first report of original research. It's written by the people who performed the research, and it's usually written for other researchers in the same field. 

Example of a primary research article:  Bramhanwade, K.; Shende, S.; Bonde, S.; Gade, A.; Rai, M. Fungicidal activity of Cu nanoparticles against Fusarium causing crop diseases. Environmental Chemistry Letters 2016 , 14, 229-235.

The structure is designed to be a practical and efficient means of delivering information. It also ensures that key points will be covered in the article, including:

A scholarly review article is a special type of peer-reviewed article that provides an overview of an area of research; it describes major advances, discoveries, and ongoing debates in that field. It can be very useful to look for review articles if you are new to an area of research.

Example of a scholarly review article:  Kasana, R. C.; Panwar, N. R.; Kaul, R. K.; Kumar, P. Biosynthesis and effects of copper nanoparticles on plants.  Environmental Chemistry Letters  2017 ,15, 233-240.

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• Last Updated: Mar 8, 2024 2:04 PM
• URL: https://libguides.du.edu/health-medical

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TCOM 101 Critical Media Literacy -- Moore: What does peer-reviewed mean?

Peer-reviewed articles.

A peer-reviewed (or refereed) article has been read, evaluated, and approved for publication by scholars with expertise and knowledge related to the article’s contents.   Peer-reviewing helps insure that articles provide accurate, verifiable, and valuable contributions to a field of study.

• The peer-review process is anonymous, to prevent personal biases and favoritism from affecting the outcomes.   Reviewers read manuscripts that omit the names of the author(s).   When the reviewers’ feedback is given to the author(s), the reviewers’ names are omitted.
• Editors of journals select reviewers who are experts in the subjects addressed in the article.   Reviewers consider the clarity and validity of the research and whether it offers original and important knowledge to a particular field of study.

How do I know if an article is peer reviewed?

• Most scholarly journal articles also have symbols next to their record in the library catalog. 
• Search the journal title in Ulrichsweb Global Serials Directory.

• In general, book reviews, opinion pieces/editorials, and brief news articles are not peer-reviewed. 
• Published peer-reviewed articles name their author(s) and provide details about how to verify the contents of the articles (such as footnotes and/or a list of “literature cited” or “references”).   If the article does not name its author(s), it is not peer-reviewed.
• Some articles provide specific information about the peer-review process, such as dates of review and approval for publication.  
• Some journals list peer-reviewed articles as “research” or “articles” in the table of contents to distinguish them from other materials like “news” or “book reviews”.

What is a scholarly peer reviewed journal article?

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Evidence-Based Health Care

• Learning About EBP
• The 6S Pyramid
• Forming Questions
• Identifying Peer-Reviewed Resources
• Critical Appraisal

What is Peer Review?

If an article is peer reviewed , it was reviewed by scholars who are experts in related academic or professional fields before it was published. Those scholars assessed the quality of the article's research, as well as its overall contribution to the literature in their field. 

When we talk about peer-reviewed journals , we're referring to journals that use a peer-review process.

Related terms you might hear include: 

• Academic: Intended for academic use, or an academic audience. 
• Scholarly:  Intended for scholarly use, or a scholarly audience. 
• Refereed: Refers to a specific kind of peer-review process. 

National University Library System. (2018). "Find Articles: How to Find Scholarly/Peer-Reviewed Articles". Retrieved from: http://nu.libguides.com/articles/PR.

How Peer Review Works

 Here's how it typically works:

• Submission : An author submits their research paper or article to a scholarly journal for publication consideration.
• Editorial Assessment : The journal's editor(s) review the submission to determine if it meets the journal's scope, standards, and criteria for publication. They may reject it outright if it doesn't meet these criteria.
• Peer Review : If the submission passes the initial editorial assessment, it is sent out to experts in the field, known as "peers" or "referees," for thorough evaluation. These experts are typically researchers or scholars who have expertise in the subject matter of the submitted work but are not directly affiliated with the author.
• Peer Feedback : The peer reviewers carefully examine the submission for its originality, significance, methodology, accuracy, and overall quality. They provide detailed feedback, critiques, and suggestions for improvement to the journal's editor(s).
• Editorial Decision : Based on the feedback from the peer reviewers, the editor(s) make a decision on whether to accept the submission for publication, request revisions from the author(s) to address specific concerns, or reject it if it does not meet the journal's standards.
• Revision and Resubmission (if applicable): If revisions are requested, the author(s) revise their work in response to the reviewers' feedback and resubmit it to the journal. The revised version may undergo further rounds of peer review until it meets the journal's requirements.
• Publication : Once the submission has successfully passed peer review and any necessary revisions, it is accepted for publication and included in the journal's forthcoming issue.

Peer review serves as a critical checkpoint in the academic publishing process, helping to ensure that only high-quality, rigorously researched, and credible scholarly work is disseminated to the academic community and the public. It helps to uphold standards of academic integrity, accuracy, and reliability.

How Do I Know If a Journal is Peer-Reviewed?

The easiest way to find out if a journal is peer-reviewed is to search for the title in a serials directory like UlrichsWeb:

• UlrichsWeb Global Serials Directory Includes in each record: ISBN, title, publisher, country of publication, status (Active, ceased, etc.), start year, frequency, refereed (Yes/No), media, language, price, subject, Dewey #, circulation, editor(s), email, URL, brief description Also known as: Ulrichs

How to Use Ulrichs

1. Type the name of the journal in the search bar and click the search button. NOTE : you need to use the full name of the journal, not an abbreviation.

2. Locate the journal in the results list. You may see multiple entries for one journal because Ulrichs lists print, electronic, and international version separately.​​​​​​​

Other Techniques for Determining Peer Review Status

Determining whether an article has been peer-reviewed without a service like Ulrichs typically involves a few steps:

• Journal Reputation: Look at the journal where the article is published. Reputable academic journals usually have a peer-review process in place. Check the journal's website or databases like PubMed, Scopus, or Web of Science to see if it's peer-reviewed.
• Article Information: Sometimes, journals explicitly state whether articles undergo peer review. This information can usually be found on the journal's website, alongside other details about submission and publication processes.
• Author Guidelines: Journals often provide authors with guidelines that include information about the peer-review process. Authors are usually instructed to submit their work for peer review as part of the publication process.
• Editorial Policies: Review the journal's editorial policies. Peer-reviewed journals typically have detailed descriptions of their review processes, including how they select reviewers, criteria for acceptance, and timelines for review.
• Check the Article Itself: While this is not always conclusive, some peer-reviewed articles will include a statement indicating that the article has undergone peer review. Look for phrases like "peer-reviewed" and "refereed."
• Indexing Databases: Many indexing databases only include peer-reviewed journals in their listings. If you find the article indexed in databases like PubMed, you can generally assume it has been peer-reviewed.

Remember that while these methods can help you determine whether an article has undergone peer review, it's always good practice to critically evaluate the content of the article regardless of its peer-review status.

How Do I Know If an Article is Peer-Reviewed?

Even if an article was published in a peer-reviewed journal, it may not necessarily be peer-reviewed itself; for example, a commentary article may undergo editorial review instead, meaning it was only reviewed by the journal editor.

There are some clues you can look for to help you identify if an article is peer-reviewed:

• Does the abstract discuss the author's/authors' research process?
• Does the abstract include a variation of the phrase "This study..."?
• Is there a Methodology or Data header in the text of the article?
• Does the paper discuss related research in a literature review?
• Is there an analysis of a need for further research, or gaps in the literature?
• Are the references for scholarly articles and books?

If an article published in a verified peer-reviewed journal includes these elements, it is most likely a peer-reviewed article.

• National University Library: Scholarly Checklist Use this printable checklist to help you identify scholarly, research-based articles

Identifying Peer Reviewed Materials in Scholarly Databases

Peer reviewed material in pubmed and medline.

Good news! Most of the journals in Medline and PubMed are peer reviewed.  Generally speaking, if you find a journal citation in Medline and PubMed you should be just fine. However, there is no way to limit your results within PubMed or the Medline EBSCO interface to knock out the few publications that are not considered refereed titles.

However, EBSCO (a third-party vendor) does provide a list of all titles within Medline and lets you see which titles are considered peer reviewed. You can check if your journal is OK - see the "Peer Review" tab in the report below to see the very small list of titles that don't make the cut.

• Medline: List of Full-Text Journals These journals cover a wide range of subjects within the biomedical and health fields containing information needed by doctors, nurses, health professionals, and researchers engaged in clinical care, public health, and health policy development. Information on peer-reviewed status available within table of titles.

Peer Reviewed Material in CINAHL & PsycINFO

In CINAHL and PsycINFO, there is a "Peer Reviewed" box in the advanced search, which allows you to limit your search results to those that have been identified as peer reviewed.

• View the Title List for CINAHL Complete This page links to the full title list for CINAHL Complete in both Excel and HTML formats.
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Peer-reviewed journal articles

• Overview of peer review
• Scholarly and academic - good enough?
• Find peer-reviewed articles

Using Library Search

Is a journal peer reviewed, check the journal.

Resources listed in  Library Search that are peer reviewed will include the Peer Reviewed icon.

For example:

If you have not used Library Search to find the article, which may indicate if it's peer reviewed, you can use Ulrichsweb to check.

• Go to Ulrichsweb

Screenshot of search box in UlrichsWeb  © Proquest

•  Enter the journal title in the search box.

Screenshot of results list in UlrichsWeb  © Proquest

•  If there are no results, do a search in Ulrichsweb to find journals in your field that are peer reviewed.

Be aware that not all articles in peer reviewed journals are refereed or peer reviewed, for example, editorials and book reviews.

If the journal is not listed in Ulrichsweb :

• Go to the journal's website
• Check for information on a peer review process for the journal. Try the Author guidelines , Instructions for authors  or About this journal sections.

If you can find no evidence that a journal is peer reviewed, but you are required to have a refereed article, you may need to choose a different article.

• << Previous: Find peer-reviewed articles
• Last Updated: Dec 6, 2023 2:42 PM
• URL: https://guides.library.uq.edu.au/how-to-find/peer-reviewed-articles

What is peer-reviewed?

What does “peer reviewed” mean, how do academic articles improve the quality of your work, how can you tell if an academic journal article is peer reviewed or not, how can you use the library databases to find “peer reviewed” articles, for further information.

Watch this   short video  for a brief overview of the subject.

Alternatively, have a look at the below presentation or read the full article.

You have no doubt seen the mention of “peer reviewed” academic articles in your project outlines and heard your faculty requiring you to base your research on “peer reviewed” articles. But what exactly does the term “peer reviewed” mean? How does using “peer reviewed” articles improve the quality of your work? How can you tell if an article is peer reviewed or not? How can you use the library databases to find “peer reviewed” articles?

A simple definition would be “read thoroughly and checked by fellow experts”. The peer review process guarantees the validity, reliability, and credibility of the article.

In practice, before an article is published in an academic journal, it is sent to a panel of experts in the same field or discipline. These experts read the article carefully, checking for weaknesses or gaps in the arguments, research methodology or results and discussion. The experts also consider whether the article is contributing something new to the field of knowledge and not just repeating information already known. They give feedback to the authors of the article suggesting improvements or changes. The authors improve their article according to the feedback and then resubmit the article for publication. The article is peer reviewed again. If it now reaches the required standard, it will be published. If not, it will be rejected and will not appear in the journal. The peer review process usually takes several months.

Since the academic journal guarantees the validity, reliability, and credibility of the information it publishes, you can be sure that when you base your work on peer reviewed articles you are using the most authoritative sources. This in turn gives your work an air of authority and credibility. The very fact of citing the work of experts demonstrates the seriousness of your own work.

Most, but not all, academic journals use the peer review process to check the quality of articles before publication. There are several ways to check if the article you are interested in has been peer reviewed. One way is to go to the home page of the journal, where you will usually find information about the journal’s peer review process. Here is an example from the Journal of Hospitality and Tourism Management (select “Guide for authors”)

Peer review

This journal operates a double anonymized review process. All contributions will be initially assessed by the editor for suitability for the journal. Papers deemed suitable are then typically sent to a minimum of two independent expert reviewers to assess the scientific quality of the paper.

Source: https://www.elsevier.com/journals/journal-of-hospitality-and-tourism-management/1447-6770/guide-for-authors

If you cannot find this type of statement, then you should begin to have doubts about whether the articles in the journal are peer reviewed or not.

Another way to check if an academic journal uses the peer review process is to visit Ulrichsweb Global Serial Directories . Enter the name of the journal in the search bar and you will see if it is peer reviewed. This is the example for Journal of Hospitality and Tourism Management

How to find out the ranking of an academic journal

When you access the main search bar on the library database, make sure you check the “peer reviewed” box on the left-hand side:

Please consult the library produced document How to identify reliable sources?

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Biomedical Research

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• NIH Peer Review

NIH announces the Simplified Framework for Peer Review

The mission of NIH is to seek fundamental knowledge about the nature and behavior of living systems and to apply that knowledge to enhance health, lengthen life, and reduce illness and disability . In support of this mission, Research Project Grant (RPG) applications to support biomedical and behavioral research are evaluated for scientific and technical merit through the NIH peer review system.

The Simplified Framework for NIH Peer Review initiative reorganizes the five regulatory criteria (Significance, Investigators, Innovation, Approach, Environment;  42 C.F.R. Part 52h.8 ) into three factors – two will receive numerical criterion scores and one will be evaluated for sufficiency. All three factors will be considered in determining the overall impact score. The reframing of the criteria serves to focus reviewers on three central questions they should be evaluating: 1) how important is the proposed research? 2) how rigorous and feasible are the methods? 3) do the investigators and institution have the expertise/resources necessary to carry out the project? 

•        Factor 1: Importance of the Research  (Significance, Innovation), scored 1-9

•        Factor 2: Rigor and Feasibility  (Approach), scored 1-9

•        Factor 3: Expertise and Resources  (Investigator, Environment), to be evaluated with a selection from a drop-down menu

o             Appropriate (no written explanation needed)

o             Identify need for additional expertise and/or resources (requires reviewer to briefly address specific gaps in expertise or resources needed to carry out the project) 

Simplifying Review of Research Project Grant Applications

NIH Activity Codes Affected by the Simplified Review Framework.

R01, R03, R15, R16, R21, R33, R34, R36, R61, RC1, RC2, RC4, RF1, RL1, RL2, U01, U34, U3R, UA5, UC1, UC2, UC4, UF1, UG3, UH2, UH3, UH5, (including the following phased awards: R21/R33, UH2/UH3, UG3/UH3, R61/R33).

Changes Coming to NIH Applications and Peer Review in 2025

•        Simplified Review Framework for Most Research Project Grants (RPGs )

•        Revisions to the NIH Fellowship Application and Review Process

•        Updates to NRSA Training Grant Applications (under development)

•        Updated Application Forms and Instructions

•        Common Forms for Biographical Sketch and Current and Pending (Other) Support (coming soon)

Webinars, Notices, and Resources

Apr 17, 2024 - NIH Simplified Review Framework for Research Project Grants (RPG): Implementation and Impact on Funding Opportunities Webinar Recording & Resources

Nov 3, 2023 - NIH's Simplified Peer Review Framework for NIH Research Project Grant (RPG) Applications: for Applicants and Reviewers Webinar Recording & Resources

Oct 19, 2023 - Online Briefing on NIH’s Simplified Peer Review Framework for NIH Research Project Grant (RPG) Applications: for Applicants and Reviewers. See  NOT-OD-24-010

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• NATURE INDEX
• 01 May 2024

Plagiarism in peer-review reports could be the ‘tip of the iceberg’

• Jackson Ryan 0

Jackson Ryan is a freelance science journalist in Sydney, Australia.

You can also search for this author in PubMed   Google Scholar

Time pressures and a lack of confidence could be prompting reviewers to plagiarize text in their reports. Credit: Thomas Reimer/Zoonar via Alamy

Mikołaj Piniewski is a researcher to whom PhD students and collaborators turn when they need to revise or refine a manuscript. The hydrologist, at the Warsaw University of Life Sciences, has a keen eye for problems in text — a skill that came in handy last year when he encountered some suspicious writing in peer-review reports of his own paper.

Last May, when Piniewski was reading the peer-review feedback that he and his co-authors had received for a manuscript they’d submitted to an environmental-science journal, alarm bells started ringing in his head. Comments by two of the three reviewers were vague and lacked substance, so Piniewski decided to run a Google search, looking at specific phrases and quotes the reviewers had used.

To his surprise, he found the comments were identical to those that were already available on the Internet, in multiple open-access review reports from publishers such as MDPI and PLOS. “I was speechless,” says Piniewski. The revelation caused him to go back to another manuscript that he had submitted a few months earlier, and dig out the peer-review reports he received for that. He found more plagiarized text. After e-mailing several collaborators, he assembled a team to dig deeper.

Meet this super-spotter of duplicated images in science papers

The team published the results of its investigation in Scientometrics in February 1 , examining dozens of cases of apparent plagiarism in peer-review reports, identifying the use of identical phrases across reports prepared for 19 journals. The team discovered exact quotes duplicated across 50 publications, saying that the findings are just “the tip of the iceberg” when it comes to misconduct in the peer-review system.

Dorothy Bishop, a former neuroscientist at the University of Oxford, UK, who has turned her attention to investigating research misconduct, was “favourably impressed” by the team’s analysis. “I felt the way they approached it was quite useful and might be a guide for other people trying to pin this stuff down,” she says.

Peer review under review

Piniewski and his colleagues conducted three analyses. First, they uploaded five peer-review reports from the two manuscripts that his laboratory had submitted to a rudimentary online plagiarism-detection tool . The reports had 44–100% similarity to previously published online content. Links were provided to the sources in which duplications were found.

The researchers drilled down further. They broke one of the suspicious peer-review reports down to fragments of one to three sentences each and searched for them on Google. In seconds, the search engine returned a number of hits: the exact phrases appeared in 22 open peer-review reports, published between 2021 and 2023.

The final analysis provided the most worrying results. They took a single quote — 43 words long and featuring multiple language errors, including incorrect capitalization — and pasted it into Google. The search revealed that the quote, or variants of it, had been used in 50 peer-review reports.

Predominantly, these reports were from journals published by MDPI, PLOS and Elsevier, and the team found that the amount of duplication increased year-on-year between 2021 and 2023. Whether this is because of an increase in the number of open-access peer-review reports during this time or an indication of a growing problem is unclear — but Piniewski thinks that it could be a little bit of both.

Why would a peer reviewer use plagiarized text in their report? The team says that some might be attempting to save time , whereas others could be motivated by a lack of confidence in their writing ability, for example, if they aren’t fluent in English.

The team notes that there are instances that might not represent misconduct. “A tolerable rephrasing of your own words from a different review? I think that’s fine,” says Piniewski. “But I imagine that most of these cases we found are actually something else.”

The source of the problem

Duplication and manipulation of peer-review reports is not a new phenomenon. “I think it’s now increasingly recognized that the manipulation of the peer-review process, which was recognized around 2010, was probably an indication of paper mills operating at that point,” says Jennifer Byrne, director of biobanking at New South Wales Health in Sydney, Australia, who also studies research integrity in scientific literature.

Paper mills — organizations that churn out fake research papers and sell authorships to turn a profit — have been known to tamper with reviews to push manuscripts through to publication, says Byrne.

The fight against fake-paper factories that churn out sham science

However, when Bishop looked at Piniewski’s case, she could not find any overt evidence of paper-mill activity. Rather, she suspects that journal editors might be involved in cases of peer-review-report duplication and suggests studying the track records of those who’ve allowed inadequate or plagiarized reports to proliferate.

Piniewski’s team is also concerned about the rise of duplications as generative artificial intelligence (AI) becomes easier to access . Although his team didn’t look for signs of AI use, its ability to quickly ingest and rephrase large swathes of text is seen as an emerging issue.

A preprint posted in March 2 showed evidence of researchers using AI chatbots to assist with peer review, identifying specific adjectives that could be hallmarks of AI-written text in peer-review reports .

Bishop isn’t as concerned as Piniewski about AI-generated reports, saying that it’s easy to distinguish between AI-generated text and legitimate reviewer commentary. “The beautiful thing about peer review,” she says, is that it is “one thing you couldn’t do a credible job with AI”.

Preventing plagiarism

Publishers seem to be taking action. Bethany Baker, a media-relations manager at PLOS, who is based in Cambridge, UK, told Nature Index that the PLOS Publication Ethics team “is investigating the concerns raised in the Scientometrics article about potential plagiarism in peer reviews”.

How big is science’s fake-paper problem?

An Elsevier representative told Nature Index that the publisher “can confirm that this matter has been brought to our attention and we are conducting an investigation”.

In a statement, the MDPI Research Integrity and Publication Ethics Team said that it has been made aware of potential misconduct by reviewers in its journals and is “actively addressing and investigating this issue”. It did not confirm whether this was related to the Scientometrics article.

One proposed solution to the problem is ensuring that all submitted reviews are checked using plagiarism-detection software. In 2022, exploratory work by Adam Day, a data scientist at Sage Publications, based in Thousand Oaks, California, identified duplicated text in peer-review reports that might be suggestive of paper-mill activity. Day offered a similar solution of using anti-plagiarism software , such as Turnitin.

Piniewski expects the problem to get worse in the coming years, but he hasn’t received any unusual peer-review reports since those that originally sparked his research. Still, he says that he’s now even more vigilant. “If something unusual occurs, I will spot it.”

doi: https://doi.org/10.1038/d41586-024-01312-0

Piniewski, M., Jarić, I., Koutsoyiannis, D. & Kundzewicz, Z. W. Scientometrics https://doi.org/10.1007/s11192-024-04960-1 (2024).

Article   Google Scholar  

Liang, W. et al. Preprint at arXiv https://doi.org/10.48550/arXiv.2403.07183 (2024).

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• Published: 02 May 2024

Risk factors and long-term outcomes of oropharyngeal dysphagia in persons with multiple sclerosis: a systematic review protocol

• Zahra Sadeghi 1 ,
• Mohamadreza Afshar 2 ,
• Asefeh Memarian 3 &
• Heather L. Flowers   ORCID: orcid.org/0000-0001-6742-9459 3  

Systematic Reviews volume  13 , Article number:  121 ( 2024 ) Cite this article

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Metrics details

Oropharyngeal dysphagia (OPD) can be functionally debilitating in persons with multiple sclerosis (pwMS). OPD induces alterations in safety and efficiency of food and/or liquid ingestion and may incur negative sequalae such as aspiration pneumonia or malnutrition/dehydration. Early detection and timely management of OPD in pwMS could prevent such complications and reduce mortality rates. Identifying risk factors of OPD relative to its onset or repeat manifestation will enable the development of care pathways that target early assessment and sustained management. The aims of this systematic review are to compile, evaluate, and summarize the existing literature reporting potential risk factors and associated long-term outcomes (e.g., aspiration pneumonia, malnutrition, dehydration, and/or death) of OPD in pwMS.

We will undertake a systematic review to identify studies that describe patterns and complications of OPD in pwMS. Variables of interest include predictors of OPD along with long-term outcomes. We will search MEDLINE, Embase, CINAHL, AMED, the Cochrane Library, Web of Science, and Scopus. We will consider studies for inclusion if they involve at least 30 adult participants with MS and report risk factors for OPD and/or its long-term outcomes. Studies will be excluded if they refer to esophageal or oropharyngeal dysphagia induced by causes other than multiple sclerosis. Study selection and data extraction will be performed by two independent assessors for abstract and full article review. We will present study characteristics in tables and document research findings for dysphagia-related risk factors or its complications via a narrative format or meta-analysis if warranted (e.g., mean difference and/or risk ratio measurements). All included studies will undergo risk-of-bias assessment conducted independently by two authors with consensus on quality ratings.

There is a lacune for systematic reviews involving risk factors and long-term outcomes of dysphagia in pwMS to date. Our systematic review will provide the means to develop accurate and efficient management protocols for careful monitoring and evaluation of dysphagia in pwMS. The results of this systematic review will be published in a peer-reviewed journal.

Systematic review registration

PROSPERO CRD42022340625.

Peer Review reports

Oropharyngeal dysphagia (OPD) is common in multiple sclerosis (MS) [ 1 ] due to injury to the corticobulbar tracts, potentially involving the brainstem, the cerebellum [ 2 , 3 ], and the cortex [ 4 ]. There may be a differing clinical course across types of MS, classified based on disease onset and progression over time [ 5 ]. The most frequent includes relapsing–remitting MS (RRMS), usually beginning with acute exacerbation and detrimental impacts that recover fully or partially over time. The other forms of MS are all defined as progressive, including secondary progressive MS (SPMS), primary progressive MS (PPMS), and progressive relapsing MS (PRMS). Patients with RRMS develop SPMS within 10 years of the onset of RRMS. PPMS is the least frequent type of MS and is characterized by deteriorating neurological function from disease onset coupled with a lack of remittance. Nevertheless, superimposed relapses are also evidenced in this type. Overall, the course of MS is unpredictable, and depending on the severity, the diversity of anatomic impacts, and the onset of associated lesions, its clinical manifestations are also heterogeneous.

Symptoms of OPD in MS may include coughing and/or choking on saliva or other liquid and food boluses, feelings of bolus sticking in the throat, the need to swallow multiple times per bolus, difficulty initiating a swallow (accompanied by drooling), and alterations to usual eating patterns (such as viscosity or texture changes) [ 3 , 4 , 6 ]. Oropharyngeal dysphagia may incur severe and multifaceted poor outcomes, such as aspiration pneumonia, malnutrition/dehydration [ 3 , 4 , 6 ], increased psychosocial comorbidities [ 7 , 8 ], and even death during periods of medical instability [ 9 ]. Identifying risk factors for OPD in pwMS will provide the means to develop accurate and efficient management protocols for careful monitoring and evaluation by dysphagia experts. By extension, sustained management will permit timely and comprehensive care to mitigate potential serious complications.

In two recent systematic reviews, the authors provided an estimate of the pooled frequency of dysphagia in pwMS based on a range of evaluation methods, whether screening, clinical, or instrumental examination [ 1 , 10 ]. Guan et al. [ 1 ] reported a pooled frequency estimate of 36% based on subjective screenings or cursory evaluations (such as the Dysphagia in Multiple Sclerosis Questionnaire, the water swallowing test, and various dysphagia checklists from individual clinical swallowing centers) and 81% based on objective measurements (such as videofluoroscopy or fiber-optic nasoendoscopy). More specifically, the frequency of dysphagia was 46% in pwMS when Expanded Disability Status Scale (EDSS) scores were stratified as 4.5 or higher and 40% for those below 3.0. Similarly, patients with longer disease duration (over 10 years) were more likely to have dysphagia symptoms compared with shorter disease duration.

Various individual studies have also shown a higher frequency of dysphagia with greater disability [ 11 , 12 , 13 , 14 , 15 ] and/or disease duration [ 15 , 16 ]. Nevertheless, a few studies have reported that pwMS with low EDSS scores still had dysphagia [ 15 , 17 , 18 ]. To illustrate, Abraham et al. [ 18 ] reported that 43% of pwMS in their sample had dysphagia including 17% with low levels of disability (EDSS score lower than 2.5). Aghaz et al. [ 10 ] estimated the pooled frequency of dysphagia as 37% based on subjective evaluations or cursory checklists versus 47% for objective instrumental evaluations respectively. In contrast to the findings of Abraham et al. [ 18 ], they failed to demonstrate associations for the presence of dysphagia according to EDSS-based disease severity, duration of disease, or MS stage.

Taken together, reported frequencies of dysphagia hover around one-third of pwMS at a given point in time [ 1 , 10 ], whereby varied frequencies relate primarily to evaluation methods, whether screening, clinical assessment, or instrumental evaluation. The most common patient-report tool used to identify dysphagia in pwMS is the Dysphagia in Multiple Sclerosis Questionnaire (DYMUS) [ 1 , 10 , 19 ], involving 10 items with very good reliability and internal consistency. However, frequencies of reported dysphagia based on questionnaires are lower than those based on standardized tools or instrumental evaluations [ 1 ]. In general, instrumental assessment remains the gold standard for dysphagia and aspiration detection, whether by videofluoroscopy or fiber-optic nasoendoscopy rather than various types of screening tools, bedside evaluations, or patient-reported questionnaires. Some pwMS may underestimate their dysphagia severity due to altered sensory appreciation of symptoms, despite instrumental evidence to the contrary.

In addition to our poor understanding of the frequency of dysphagia in pwMS, gaps exist regarding patterns of associations between disease severity, duration, or stage. Notwithstanding, certain predictive factors may well routinely accompany the expression of dysphagia in pwMS. Elucidating such information would require a comprehensive profile of patient groups with known disease severity, duration, and stage alongside MS type, neuroanatomical impacts, and concomitant deficits or disorders. For example, dysphagia may be precipitated by coexisting psychological or cognitive impairments [ 11 , 18 , 20 ]. Therefore, continual monitoring for risk of dysphagia in pwMS who also experience negative mental health symptoms or cognitive disorders [ 4 , 20 ] is warranted. Furthermore, speech impairments (e.g., dysarthria) may provide good and readily identifiable clinical indicators for the presence of dysphagia in persons with neuromuscular diseases [ 21 ]. A systematic appraisal of the literature is required to identify the best available evidence for risk factors of dysphagia along with ensuing long-term sequelae in pwMS.

A systematic review constitutes the highest level of research evidence, especially if there is a quality evaluation and meta-analysis. Therefore, a comprehensive systematic review, aimed at establishing the predictors of dysphagia in pwMS, ideally identified with gold standard evaluation methods (such as instrumental assessment), could facilitate the development of new tools for screening or assessing dysphagia and inform practice guidelines. In addition, a close consideration of associated outcomes over the long term (e.g., pneumonia, poor social participation, death) could contribute to our understanding of prognostic indicators for particular patient groups. Consequently, our purpose is to search the existing literature to systematically identify the risk factors and associated outcomes of oropharyngeal dysphagia over the long term in persons with pwMS.

The protocol of this systematic review has been registered in PROSPERO (registration number: CRD42022340625). We have applied PRISMA-P guidelines to develop this review protocol further. It served to direct our search strategy of databases and the gray literature as well as our data extraction and compilation methods. We will document our article selection results using the PRISMA flow diagram to delineate reasons for abstract and article exclusion until the final set of articles is identified. Our investigation of risk factors is in keeping with recommendations from the Cochrane Prognostic Methods Group ( https://methods.cochrane.org/prognosis/ ) [ 22 ]. We are submitting the protocol prior to undertaking the full search or any subsequent processes such as abstract screening and full article evaluation.

Operational definitions

Oropharyngeal dysphagia is defined as body and structure impairment [ 23 ] in swallowing physiology evidenced by expert clinical or instrumental assessment of function from the anterior aspect of the lips to inferior aspect of the upper esophageal sphincter. Diagnosis of multiple sclerosis is based on accepted criteria for both definite and probable MS, according to a classification scheme that involves expert clinical and objective evaluations (such as neuroimaging) [ 24 ].

Data sources

We will conduct an electronic search in the following databases for abstracts in languages that the co-authors can read (English, French, German, Persian, Portuguese, Spanish, and Turkish). No publication date or study design restrictions will be imposed. Relevant databases will include MEDLINE, Embase, CINAHL, AMED, the Cochrane Library (CENTRAL), Web of Science, and Scopus. The MeSH and search terms used in the search strategy were developed a priori (Table  1 ). A research librarian will consult to enable valid adaptations of the MEDLINE terms into the other databases. Our MEDLNE search was conducted in OVID, revealing 189 citations (April 2023). We will also search international gray literature sources (e.g., OpenGrey and Dissertation Abstracts) and review the bibliographies and citations for all included articles in a reiterative manner until no further possible references are identified.

Eligibility criteria

Studies will be considered for inclusion if they have observational intent and involve retrospective or prospective consecutive or randomly selected sampling (either from a particular cohort or population). Study designs may include case series, cross-sectional, longitudinal, case–control, and/or other observational investigations as well as the control arm (i.e., participants who are not receiving trial-related interventions for MS or dysphagia) of randomized controlled trials. We will consider studies with at least 30 adults (18 years or older) with MS. Studies must include an aim to identify risk factors (e.g., MS subtype, disease duration, EDSS score, age, gender, smoking or alcohol use, psychological symptoms, cognitive impairments, and/or dysarthria) that may precipitate oropharyngeal dysphagia (OPD). We have chosen not to prespecify all possible risk factors as we seek to identify new potential risk factors. The body of evidence is small, and risk factors are likely underrepresented at present. Any potential new risk factors will provide a path for future researchers to investigate them in a comprehensive way and thus extend the literature and knowledge base in this respect.

Corresponding studies that include follow-up time points will contribute to our interest in long-term outcomes (e.g., detrimental medical, activity/participation, or quality-of-life outcomes). Ideally, such studies would have comparable follow-up periods (e.g., yearly) that span the course of the disease and document the outcomes relative to the absence/presence and/or severity classifications of OPD. However, we will not exclude any studies based on their follow-up points or overall time horizon.

During our review of abstracts and full articles, we will apply pre-defined exclusion criteria. That is, we will exclude studies involving convenience samples, those without extractable data (e.g., studies involving aggregate results for multiple etiologies rather than pwMS alone) for our outcomes of interest, and those reporting duplicate data. Any abstracts without corresponding full study publications will be excluded. We will also exclude articles without a clear sample of at least 30 pwMS and corresponding OPD (for at least a declared portion of the sample), identified by clinical or instrumental swallowing assessments. Finally, articles will be excluded if they do not conform to our operational definitions of OPD and MS or if they refer to oropharyngeal dysphagia induced by causes other than multiple sclerosis. We will contact authors when we cannot find full articles or when we wish to elucidate study characteristics such as method of dysphagia assessment. Our full systematic review reporting will conform to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist [ 27 ].

Data collection

Study selection from primary articles will be performed in two stages:

Initial screening and coding of titles and abstracts whereby relevant abstracts (stage 1) will undergo full article review (stage 2) (Table  2 )

Evaluation and coding of full articles for inclusion in the final sample (Table  2 )

The review process will be conducted by two independent reviewers (blind to each other’s coding) across the two stages. Any discrepancies will be resolved by consensus discussion between the two reviewers, and, when agreement is not possible, a third reviewer (also a member of the research team) will read the abstract or article independently and contribute to a decision. All references for the excluded articles will be retained for documentation purposes.

One data extractor will identify pertinent information from the final set of included articles and compile it into a table or spreadsheet. Extracted data will be verified by a second independent reviewer to ensure the accuracy of information from the following categories:

Study characteristics: First author’s name, year of publication, country in which the study was conducted, study design, and size of the sample

Study population and participant characteristics: Age, gender, MS type, disease duration, and EDSS score

Diagnostic assessments for MS and dysphagia

Risk factors for dysphagia whether related to MS (e.g., MS type, disease duration, and EDSS score), to patient characteristics (e.g., age, gender, and smoking or alcohol abuse), and/or to comorbidities (e.g., psychological symptoms, cognitive impairments, or dysarthria)

Follow-up assessments of dysphagia in terms of type and timing

Frequency and impact (e.g., severity) of detrimental medical (e.g., aspiration pneumonia, dehydration, malnutrition, institutionalization, and mortality), activity/participation (e.g., fewer social engagements around meals), or quality-of-life outcomes.

Risk of bias in individual studies

We will apply appropriate risk-of-bias evaluations [ 22 , 28 ] such as the Newcastle–Ottawa scale (NOS) [ 29 ] as a quality evaluation of included obserervational studies. To illustrate, the NOS contains grading for categories of selection (e.g., sample representativeness), comparability (e.g., evaluation of confounders), and outcome (adequacy of follow-up period). Further, if warranted, the Cochrane Collaboration’s risk-of-bias tool will be used for randomized controlled trials, based on the domains: sequence generation, blinding of participants, blinding of outcome measurement, allocation sequence concealment, missing data, selective outcome reporting, and other biases such as sources of funding and conflicts of interest [ 30 ]. Additionally, the Quality in Prognosis Studies (QUIPS) tool will facilitate assessment for the risk factor studies [ 22 ]. For any type of quality appraisal (observational study quality scale, Cochrane’s risk-of-bias tool, or QUIPS), two authors will independently review the included studies and resolve discrepancies by discussion and consensus agreement within the review team.

Data analysis

We will provide a descriptive synthesis of the findings from the included studies, structured around target population characteristics, type of assessments, and outcomes of interest. We will consider meta-analyses if there is an adequate number of studies and homogeneity of study populations and assessment methods. Otherwise, we will present a narrative synthesis of the results. We anticipate that there will be restricted scope for meta-analysis due to differing study populations and/or assessment methods along with a paucity of existing literature. Where studies have similar sample characteristics (including potential comparison groups), assessment methods, and corresponding outcomes, we will pool the results and apply various types of meta-analyses such as mean difference, standard mean difference, or Cox regression for continuous outcomes and risk ratio measurement or logistic regression for categorical outcomes depicted in forest plots along with their 95% confidence intervals (CIs). Finally, we will evaluate the overall strength of the evidence based on discussion among authors through application of a tool such as GRADE.

Assessment of heterogeneity

If there is reason to consider meta-analysis, analyses will be performed using Cochrane’s Review Manager tool (Review Manager: RevMan [computer program]. The Cochrane Collaboration, 2024). We plan to assess study features such as participant age and sex, MS subtype, time course for follow-up, and primary outcome measures as the basis for determining if data pooling for meta-analysis is warranted. Subsequently, if meta-analysis is undertaken, we will apply and interpret the I 2 statistic [ 30 ] as an indictor of heterogeneity relative to the number of studies and direction of effect using the following guide: mild (between 0 and < 25%), moderate (between 25 and < 50%), severe (between 50 and < 75%), and highly severe (between 75 and 100%). If there is moderate heterogeneity, we will present a supplementary qualitative synthesis of the findings.

Analysis of subgroups or subsets

If sufficient data are available, subgroup analyses may be conducted for different OPD assessment methods (e.g., clinical bedside evaluation, fiber-optic nasoendoscopic evaluation, and/or videofluoroscopic evaluation) relative to MS type and risk factors. Similarly, long-term outcomes based on dysphagia status or severity levels will be analyzed according to follow-up periods or comparable overall time horizon.

Assessment of publication bias

Publication bias will be evaluated using a funnel plot (i.e., plots of study results against precision) and Begg’s [ 31 ] and Egger’s [ 32 ] tests if an adequate number of studies (≥ 10) are identified. Additionally, we will incorporate Deek’s asymmetry test [ 33 ] to mitigate overestimation of effects when predictive modeling with odds ratios is applied for the determination of OPD across studies that involve low event proportions. However, if meta-analysis is not possible, publication bias will be assessed descriptively and involve documentation of direction of results across risk factors (whether significant or not) as well as potential follow-up time lags across studies.

Our search strategy is extensive compared to other recent systematic reviews in the field of multiple sclerosis [ 1 , 34 ] given the inclusion of numerous sources and comprehensive search terms. We believe that it will yield a broad capture of abstracts internationally, but that many articles will derive from western or developed countries. This may be an important limitation because many underrepresented countries, such as Iran, have a high and increasing prevalence of pwMS in certain regions [ 35 , 36 ].

Other systematic reviews have undertaken different lines of inquiry such as investigating the prevalence of dysphagia in pwMS without considering risk factors [ 1 ] or long-term outcomes [ 1 , 10 ]. Thus, we will extend the knowledge base in a new content area (involving predictors and long-term outcomes of dysphagia in pwMS). Our identification of literature in the field of MS will provide new insights into the repercussions of dysphagia and offer direction for the development of screening protocols, assessment methods, and improved therapeutic management in pwMS. In the event that our findings elucidate multiple predictors (e.g., related to MS, patient characteristics, and/or comorbidities) and varied outcomes (e.g., medical, activity/participation, or quality of life), they may warrant publication in multiple peer-reviewed papers.

We anticipate that various limitations will result during our search of the literature. First, studies may not report the timeframe between dysphagia onset, assessments, and associated outcomes. Second, dysphagia identification in specific studies might be based on cursory screenings, patient self-report (and potentially non-standardized) questionnaires, and/or subjective clinical assessments rather than on instrumental reference tests such as videofluoroscopy and fiber-optic nasoendoscopy. Finally, it may be difficult to pool results from the existing literature for some of the risk factors or outcomes if investigations restrict enrolment to particular types of pwMS, involving subsamples of larger studies, or if they fail to incorporate shared definitions and research methods in the field of multiple sclerosis [ 36 ].

Although the frequency of dysphagia in pwMS has been a topic of inquiry within the past two decades [ 1 , 10 ], a poor understanding of associations to disease-related risk factors and negative outcomes remains. Our proposed systematic review will address such a gap in the literature, as we will attempt to elucidate risk factors of dysphagia and long-term outcomes from observational studies reporting frequencies of dysphagia over the long term. Where relevant, we will pool results across studies or extract individual-level data that may permit us to model risk factors of dysphagia and/or its associated long-term outcomes in pwMS. Our inquiry will offer the means to inform best practices in the early detection of dysphagia and provide information that can be incorporated into guidelines and clinical practice initiatives for the management of dysphagia in pwMS.

Availability of data and materials

Not applicable.

Abbreviations

• Oropharyngeal dysphagia

Persons with multiple sclerosis

• Multiple sclerosis

Expanded Disability Status Scale

Dysphagia in Multiple Sclerosis Questionnaire

Strengthening the Reporting of Observational Studies in Epidemiology

Newcastle-Ottawa scale

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Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

Zahra Sadeghi

Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran

Mohamadreza Afshar

School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, ON, K1S 5S9, Canada

Asefeh Memarian & Heather L. Flowers

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ZS conceptualized, designed, and wrote much manuscript. HF conceptualized, designed, wrote, and edited the manuscript. MA conceptualized, designed, and wrote parts of the manuscript. AM developed the search terms and wrote parts of the manuscript.

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Sadeghi, Z., Afshar, M., Memarian, A. et al. Risk factors and long-term outcomes of oropharyngeal dysphagia in persons with multiple sclerosis: a systematic review protocol. Syst Rev 13 , 121 (2024). https://doi.org/10.1186/s13643-024-02530-3

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The risk of falls in older people prescribed antihypertensives … and other research

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Ann Robinson reviews the latest research

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Competing interests: None declared

Provenance and peer review: Not commissioned; not peer reviewed

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The effect of scenario-based training versus video training on nurse anesthesia students’ basic life support knowledge and skill of cardiopulmonary resuscitation: a quasi-experimental comparative study

• Vahid Saidkhani 1 ,
• Masoumeh Albooghobeish 1 ,
• Zahra Rahimpour 1 &
• Mohammad Hosein Haghighizadeh 2  

BMC Medical Education volume  24 , Article number:  488 ( 2024 ) Cite this article

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Performing CPR (Cardiopulmonary Resuscitation) is an extremely intricate skill whose success depends largely on the level of knowledge and skill of Anesthesiology students. Therefore, this research was conducted to compare the effect of the scenario-based training method as opposed to video training method on nurse anesthesia students’ BLS (Basic Life Support) knowledge and skills.

This randomized quasi-experimental study involved 45 nurse anesthesia students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran in 2022–2023. The practical room of the university formed the research environment. The participants were randomly divided into three groups of scenario-based training, video training, and control. Data were collected by a knowledge questionnaire and a BLS skill assessment checklist before and after the intervention.

There was a significant difference between the students’ scores of BLS knowledge and skill before and after the educational intervention in both SG (scenario group) ( p  < 0.001) and VG (video group) ( p  = 0.008) ( p  < 0.001). However, no significant difference was observed in this regard in the CG (control group) ( p  = 0.37) ( p  = 0.16). Also, the mean scores of BLS knowledge and skills in the SG were higher than those in the VG ( p  < 0.001).

Given the beneficial impact of scenario-based education on fostering active participation, critical thinking, utilization of intellectual abilities, and learner creativity, it appears that this approach holds an advantage over video training, particularly when it comes to teaching crucial subjects like Basic Life Support.

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Introduction

Cardiopulmonary arrest refers to the sudden cessation of breathing and blood circulation and resuscitation to restore life to a person who has experienced clinical death [ 1 ]. The theoretical concept of CPR (Cardiopulmonary Resuscitation) involves establishing ventilation and blood circulation until spontaneous circulation is restored [ 2 ]. In practice, CPR aims to revive the heart and lungs, the two vital organs, in order to restore life. CPR consists of two main components: BLS (Basic Life Support) and ACLS (Advanced Cardiac Life Support) [ 3 ]. Cardiovascular disease remains the leading cause of death worldwide [ 2 ]. Disciplines such as emergency medicine, cardiology, and anesthesia play a crucial role in managing patients with cardiac arrest. Therefore, it is vital and highly important for individuals in these fields to possess knowledge and familiarity with the principles of cardiopulmonary resuscitation [ 4 ]. Cardiopulmonary arrest may happen anywhere, in hospital or outside it, and if CPR is performed adequately and correctly, the patient’s survival rate increases [ 5 ]. Performing CPR is an extremely intricate skill whose success depends largely on the level of knowledge and skill of the health care workers [ 6 ]. The significance of CPR training for healthcare professionals has been highlighted in a study examining the skills and motivation of residents in fields related to cardiopulmonary resuscitation, such as anesthesia and nursing [ 7 ]. It is obvious that efficient and appropriate training can help them in the successful rescue process [ 8 ]. Tragic deaths can be prevented through a few hours of theoretical and practical CPR training [ 7 ].

Simulation-based training is an effective strategy for teaching CPR and teamwork [ 9 ]. Simulation has emerged as one of the most effective learning methodologies in clinical nursing education programs [ 10 ]. Unlike conventional teaching methods such as lectures, simulation actively engages learners, promoting a more interactive and participatory learning experience [ 11 ]. Simulation has the potential to enhance patient safety by providing a safe and controlled environment for practice [ 12 ]. Moreover, the use of simulation can significantly improve the knowledge, skills, and performance of nursing students, enabling them to develop high levels of critical thinking and acquire new professional skills without compromising patient safety [ 13 ].

The use of educational videos is the other relatively new method, which is claimed to provide positive results ranging from superficial learning to comprehensive learning. Therefore, it is necessary to assess the effectiveness of new methods such as video education [ 14 ]. One of its advantages is the possibility of storing and continuity of information, ease of use, and cost-effectiveness. Also, video speeds up learning and recall and strengthens long-term memory [ 15 ]. The findings of Ahn et al. showed that repeated viewing of CPR videos through mobile phones increased retention of the CPR skills of the studied group [ 16 ]. Each of the mentioned educational methods have different effects on the trainees, and it is important that right decisions be made in order to avoid possible problems and costs and to put patient safety on priority of care in the health and treatment system. However, the literature lacks sufficient studies regarding the use of an effective educational method to improve the performance and ability of nurse anesthesia students in terms of performing BLS on the injured. Therefore, the present study aims to compare the effect of scenario-based training versus video training on nurse anesthesia students’ BLS knowledge and skills. Finding the preferred teaching method and providing suggestions to be useful for professors of medical sciences are other objectives of this study.

Type of study and setting

The research design employed in this study was a quasi-experimental pre-test-post-test intervention design. The study was conducted at Jundishapur University of Medical Sciences in Ahvaz, Iran. Participants consisted of second and third-year Bachelor of anesthesia students. According to the obtained statistics, a total of 21 s-year students and 24 third-year students were studying in the university.

Sample size and sampling

All students studying in the second and third years were assessed based on the entry criteria. These criteria included being a second- or third-year anesthesia student, providing consent to participate, and not having completed a basic cardiopulmonary resuscitation (CPR) course within the last few months. Additionally, students who did not complete the questionnaires, were absent or did not attend the training sessions, and those who opted out of continued participation were excluded from the study. The sample size for this study was determined based on a previous study [ 17 ] and utilizing the sample size formula outlined below.

In the final analysis, a total of 45 students were included in the study, accounting for a 10% dropout rate. These participants were then randomly assigned to three groups: two intervention groups (scenario-based training group and video training group) and a control group. Random allocation was achieved using a table of random numbers, wherein each student was assigned a number. Students with numbers 1 to 3 were allocated to the scenario group, those with numbers 4 to 6 were assigned to the video group, and students with numbers 7 to 9 were placed in the control group. Randomization was solely applied in the distribution of samples between the intervention and control groups. Consequently, this research project, like many others in the field of medical education, was conducted in a semi-experimental manner. As a result, 15 individuals were allocated to each group. The students were blinded to their group assignment, meaning they were unaware of whether they were placed in the scenario-based training group, the video training group, or the control group. Additionally, the individual selected by the research team as an examiner to evaluate the resuscitation skills was unaware of the specific training method assigned to each group. This study was conducted between 2022 and 2023. The sampling process began on November 6 and continued for a duration of one week.

Data collection tools

The data collection tool included three sections: demographic information questionnaire, cardiopulmonary resuscitation knowledge assessment questionnaire and cardiopulmonary resuscitation skill assessment checklist.

1- Demographic information questionnaire

The questionnaire encompassed inquiries regarding age, gender, marital status, academic semester, and prior participation in similar training courses.

2- Cardiopulmonary resuscitation knowledge Assessment Questionnaire

For the preparation of the resuscitation knowledge questionnaire, references such as basic pre-hospital medical emergencies and an introduction to pre-hospital emergency management in the scene of rescue operations and the 2021 guidelines of the European Resuscitation Council were utilized [ 18 ]. These sources provided the necessary information and guidance to develop the questionnaire. The knowledge questionnaire consists of 15 four-choice questions, in which correct answers are scored one. The total score ranges from 0 to 15.

3- Cardiopulmonary Resuscitation Skill Assessment Checklist : This checklist contains 13 items that are scored based on a 5-point Likert scale (very poor: 1, poor: 2, average: 3, good: 4, very good: 5). The maximum score in this section is 65.

To create the resuscitation skill checklist, various sources were consulted, including references such as pre-hospital primary medical emergencies, an introduction to pre-hospital emergency management at the scene of rescue operations and the 2021 guidelines of the European Resuscitation Council [ 18 ]. Additionally, Chegeni et al.‘s study was also utilized as a valuable resource [ 19 ].

A panel of experts was used to validate the data collection tool. To this aim, the opinions of ten faculty members who were experts in face and content validity were sought and the required amendments were made. To determine the reliability of the knowledge questionnaire, the test-retest method was used at an interval of ten days, and the obtained Pearson correlation coefficient was 0.87. Internal consistency method was used for the skill checklist, and the obtained Cronbach’s alpha coefficient was 0.74.

CVR: The content validity ratio was calculated using the Lavshe table, resulting in a value of 0.62. It was found that all the items in both the knowledge questionnaire and skill checklist had values higher than 0.62, indicating their necessity and confirming their content validity [ 20 ].

CVI: In this study, the content validity index was used to assess the relevance and necessity of the items in the knowledge questionnaire and skill checklist. A CVI score higher than 0.79 was considered suitable, between 0.70 and 0.79 was deemed questionable and in need of correction and revision, and a score less than 0.70 was considered unacceptable and resulted in the removal of the respective items. It was found that all the items in both the knowledge questionnaire and skill checklist had a CVI higher than 0.7, indicating their appropriateness in terms of relevance and necessity [ 20 ].

Data collection

This study was conducted following the acquisition of necessary permits from the Ethics Committee of Jundishapur University of Medical Sciences, Ahvaz, and relevant authorities. The researcher visited the study environment, explained the research objectives to the participants, and obtained written informed consent from them. Subsequently, eligible participants were randomly assigned to three groups: scenario-based training (15 participants), video training group (15 participants), and control group (15 participants). Prior to implementing the intervention, demographic information questionnaires and cardiopulmonary resuscitation knowledge assessments were completed by all participants across the three groups. Additionally, to assess the participants’ cardiopulmonary resuscitation skills before the intervention, each participant underwent individual practice sessions, and their performance was evaluated using a designated checklist. To minimize potential biases, an examiner was selected by the research team to evaluate the participants’ resuscitation skills. The examiner was blinded to the intervention groups and had received training from the researcher on utilizing the checklists. The examiner’s scientific and practical competence was validated by the research team. Subsequently, participants in the first intervention group received scenario-based training, while those in the second intervention group received video training.

In the intervention group of scenario-based education, a two-hour session was conducted wherein theoretical material was presented using a lecture method and PowerPoint slides. Following this, students were divided into several groups, with each group assigned predetermined scenarios corresponding to the educational topic covered in the session. Within their respective groups, students were tasked with identifying the most correct and appropriate scientific and practical actions based on the information acquired during the training session. They collaborated to integrate their answers while utilizing a mannequin to simulate real-life scenarios. Subsequently, one member from each group presented the solutions and fundamental actions related to their assigned scenario to the audience for discussion. Throughout the session, the coach played a pivotal role in monitoring the execution of first aid and resuscitation techniques, as well as providing essential feedback regarding the quality of care delivered by the students.

In the video training intervention group, a two-hour session was conducted with a similar format to the scenario-based education group. The session began with the presentation of theoretical material through lectures and PowerPoint slides, similar to the previous group. Following this, an educational video on basic cardiopulmonary resuscitation, selected by the researcher to align with the session’s content, was shown to the participants.

The educational content presented in both groups included the following: defining and introducing the history of basic cardiopulmonary resuscitation, explaining the importance and functioning of vital systems such as the central nervous system, blood circulation, and breathing, defining and introducing the types of death, symptoms of cardiorespiratory arrest, and cerebral arrest. Additionally, the content covered examining the importance and methods to maintain the safety of oneself and the injured person at the scene of the accident, checking the alertness, pulse, and breathing of the injured person, opening the airway, establishing ventilation, establishing blood circulation and performing extracardiac massage. Moreover, it included introducing the side effects of extracardiac massage and methods for preventing these complications, as well as introducing various resuscitation cases.

The main researcher, a senior student of intelligence education, served as the trainer and led all training activities. The educational materials used in this intervention were derived from basic pre-hospital medical emergency textbooks and provided an introduction to pre-hospital emergency management at the scene of rescue operations.

It should be noted that no educational intervention was performed in the control group. Two weeks after the intervention, the knowledge questionnaire was completed again for all three groups. Additionally, the checklist was individually filled out by the examiner for each participant. Subsequently, the data were collected and subjected to final analysis.

Data analysis

Data were reported using descriptive statistics. Kolmogorov-Smirnov test has shown the normality of the data. Chi-square test was used to compare qualitative results. Data were analyzed using paired t-test (for pre- and post-test), analysis of covariance, and one-way analysis of variance in SPSS version 20. In all stages of the research, the significance level was considered less than 0.05.

A total of 45 students participated in the present study. The mean age of the participants was 21.5 ± 3.42 years (minimum 19 and maximum 43 years). In the scenario, video and control groups, the mean age was 20.8 ± 0.99, 22.8 ± 5.68, and 21.0 ± 1.03 years, respectively. One-way analysis of variance was used to compare the mean age in three groups, and the difference was not significant ( p  = 0.23). The three groups were similar in terms of gender, marital status, and academic year (Table  1 ).

Paired t-test was used to compare the mean knowledge scores of pre-test and post-test in three groups. The results showed that there was a statistically significant difference between the mean knowledge scores of the pre-test and post-test in the SG (Scenario Group) ( p  < 0.001) and VG (Video Group) ( p  = 0.008), with a significant increased being observed in the mean knowledge scores obtained at the post-test. However, this difference was not statistically significant in the CG (control group) ( p  = 0.37). One-way analysis of variance was used to compare the mean knowledge scores of the pre-test and post-test between the three groups. The results showed that there was no statistically significant difference between the mean knowledge scores of the pre-test in the three investigated groups ( p  = 0.29), but a significant difference was observed between the mean knowledge scores of the post-test in the three groups ( p  < 0.001), with the mean knowledge scores in the SG being higher compared with the VG and CG (Table  2 ).

The results also showed that there was a significant difference between the mean skill scores of pre-test and post-test in the SG ( p  < 0.001) and VG ( p  < 0.001), with a significant increase being observed in the mean skill scores of the post-test. However, this difference was not significant in the CG ( p  = 0.16). There was no statistically significant difference between the mean skill scores of the pre-test in the three investigated groups ( p  = 0.89). However, a significant difference was observed between the mean skill scores of the post-test in the three groups ( p  < 0.001), with the mean skill scores in the SG being higher than that in the VG and CG (Table  3 ).

The ANCOVA (analysis of covariance) was used to examine the combined effect of time and group, while also controlling for the potential influence of pre-test knowledge and skill scores. the results indicated a statistically significant difference between the two case groups in terms of their mean knowledge and skill scores at the post-test ( p  < 0.001). This means that the intervention had a noticeable impact on the participants’ knowledge and skill levels. Additionally, the effect size was calculated to provide an estimate of the practical significance of the intervention. For knowledge, the effect size was 0.54, indicating a moderate effect. For skill, the effect size was 0.79, suggesting a larger effect. These effect sizes indicate the magnitude of the difference between the groups and provide insights into the practical significance of the intervention. Overall, these findings suggest that the intervention was effective in improving participants’ knowledge and skill levels, with a notable impact observed in both areas.

In the present study, there was a significant difference between the students’ scores of BLS knowledge and skill, before and after the educational intervention based on the scenario and video methods. However, this difference was not significant in the CG, so the training interventions in this study were effective in increasing the students’ BLS knowledge and skills. Laco et al. showed that BLS and urgent care clinic scores of the participants in their study increased after simulation training [ 21 ]. Also, Toubasi et al. found that BLS simulation training sessions were associated with a significant improvement in the skills of Jordanian nurses. They also maintained that a BLS training session is highly recommended for nurses to ensure their preparation in real CPR scenarios [ 22 ]. In Boada et al.‘s study, the use of a game called LISSA (life support simulation activities) used as a teaching method led to higher scores in acquisition and retention of skills among nursing students trained by LISSA compared to the group that was trained by the traditional method [ 23 ]. The results of another study by Ackermann et al. indicate that the use of educational videos leads to enhanced awareness and skills of the participants in terms of CPR [ 24 ].

With the unprecedented advancements in science and technology in the last few years, the use of electronic content and educational videos provides an opportunity for the learners to manage their learning according to their personal interests, preferences, and needs. They can also repeat the learning experience as many times as they wish, and by changing the speed at which the video is played they can facilitate their learning and better acquire the details [ 25 ]. In the studies cited above, various simulation methods were used for clinical training, which ultimately led to the improvement and promotion of clinical efficiency. Of course, measuring the effectiveness of each educational method alone or in combination with each other in clinical learning requires further research. In the present study, two simulation methods were compared, and a significant difference was observed after both educational interventions. However, the mean scores of knowledge and BLS skills in the SG were significantly higher compared with the VG. This indicates the greater effectiveness of the scenario method which involves the active participation of learners and the use of interactive discussions in this educational method. As Haugland et al. showed in their study, scenario-based simulation is a useful approach to prepare nursing students to be more aware of difficult situations and how to handle them. According to their results, with active participation, learners remember the materials better, and when teaching is based on simulation and theoretical principles, learning is significantly enhanced [ 26 ]. Falahinia et al. compared practical training with video training as two educational methods and found that both methods are equally effective, but using training videos can offer advantages such as easy use, cost-effectiveness, repeatability of the content, and no need for student presence in class [ 25 ]. In Erenel et al., it was shown that although the scenario-based simulation method was used by educators to increase students’ preparation for practice, it led to a decrease in clinical satisfaction, decreased the students’ stress, and had no effect on the students’ self-confidence level [ 27 ]. The findings of Baek et al.‘s study showed that this educational method helps to develop nursing competence in nursing students without experience in nursing internship, and the authors recommended inclusion of developing scenario learning in the nursing curriculum to promote initial adaptation to clinical environments [ 28 ]. Based on the results of these studies, it can be concluded that given the nurse anesthesia students’ dire need for preparation and effective performance of CPR, a novel and efficient teaching method should be adopted for teaching these students. Quality and effective training methods, such as the scenario-based method, will lead to the learners’ enhanced level of knowledge, self-confidence, and courage during resuscitation operations, giving them the ability to act independently and more successfully in saving the lives of thousands of patients. Of course, it should be noted that in case it is not possible to use more effective methods such as scenario-based training, video training seems to be the best alternative.

This study has several strengths worth mentioning. Firstly, it stands out for its inclusion of a control group, setting it apart from other similar studies. Additionally, unlike previous research that primarily compared simulation methods with traditional lecture-based teaching, this study specifically compares two simulation-based teaching methods. This approach provides a more comprehensive understanding of the effectiveness of different instructional techniques. Lastly, while many studies solely focus on the impact of simulation-based teaching methods, this study also investigates their effect on student learning outcomes.

Limitations of the study

Due to our limited educational facilities and space, as well as the less active participation of students in research, it was not possible to design and implement stronger crisis scenarios. In this study, only the components of knowledge and skills were examined, and factors such as the effect of educational methods on the level of satisfaction, stress, and self-confidence of students were not examined, which can be addressed in future studies. Also, a larger sample size can be used to achieve more accurate results with greater generalizability.

According to the results of the present study, the increase in the nurse anesthesia students’ level of scientific knowledge and practical skills of BLS after intervention was higher in the SG compared with the VG. Therefore, it can be concluded that the educational method based on the scenario is more efficient and effective than the other teaching method. In addition, it should be noted that due to the scarcity of similar research, future studies are recommended to examine the effect of new educational methods and compare them with each other, especially the effect of using different simulation-based teaching methods for teaching basic and advanced CPR and other emergency situations.

Data availability

All data generated or analyzed during this study are included in this published article.

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Acknowledgements

We would like to express our gratitude to the ethics professors and all the students who helped us in this research.

This work was supported by Ahvaz Jundishapur University of Medical Sciences (Ref. ID: IR.AJUMS.REC.1401.475).

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Vahid Saidkhani, Masoumeh Albooghobeish & Zahra Rahimpour

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Z.R collected the data study. Z.R, M.A, V.S & MH.H wrote the article. all of the authors read the articles and made necessary checks for its correction. then all of them approved the article.

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Saidkhani, V., Albooghobeish, M., Rahimpour, Z. et al. The effect of scenario-based training versus video training on nurse anesthesia students’ basic life support knowledge and skill of cardiopulmonary resuscitation: a quasi-experimental comparative study. BMC Med Educ 24 , 488 (2024). https://doi.org/10.1186/s12909-024-05490-3

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Received : 07 August 2023

Accepted : 29 April 2024

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DOI : https://doi.org/10.1186/s12909-024-05490-3

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Cat Ownership and Schizophrenia-Related Disorders and Psychotic-Like Experiences: A Systematic Review and Meta-Analysis

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John J McGrath, Carmen C W Lim, Sukanta Saha, Cat Ownership and Schizophrenia-Related Disorders and Psychotic-Like Experiences: A Systematic Review and Meta-Analysis, Schizophrenia Bulletin , Volume 50, Issue 3, May 2024, Pages 489–495, https://doi.org/10.1093/schbul/sbad168

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It has been proposed that cat ownership may be a risk-modifying factor for schizophrenia-related disorders and psychotic-like experiences (PLE). This study aimed to systematically review and meta-analyze publications that reported the relationship between cat ownership and schizophrenia-related outcomes.

We searched Medline, Embase, CINAHL, Web of Science, and gray literature for publications between January 1, 1980, and May 30, 2023, regardless of geographical location and language. Backward citation search methods were used to locate additional articles. We included studies that reported original data on cat ownership and schizophrenia-related outcomes. We meta-analyzed estimates based on broad definitions (cat ownership, cat bites, and cat contact) with estimates with or without covariate adjustments. We pooled comparable estimates using random-effects models and assessed the risk of bias, heterogeneity, and study quality.

We identified 1915 studies, of which 106 were chosen for full-text review, ultimately resulting in the inclusion of 17 studies. We found an association between broadly defined cat ownership and increased odds of developing schizophrenia-related disorders. For the studies reporting unadjusted odds ratios (OR; n = 10), the pooled OR was 2.14 (95% CI: 1.29–3.55). Exclusion of one outlier study resulted in a pooled OR ( n = 9) of 1.56 (95% CI: 1.27–1.92). For the studies reporting adjusted estimates ( n = 5), the pooled OR was 2.44 (95% CI: 1.59–3.73). After excluding one study with suboptimal exposure/design features, the pooled adjusted OR ( n = 4) was 2.40 (95% CI: 1.50–3.86). We were unable to aggregate the estimates for the PLE outcomes because of the broad range of measures.

Our findings provide support for the hypothesis that cat exposure is associated with an increased risk of broadly defined schizophrenia-related disorders; however, the findings related to PLE as an outcome are mixed. There is a need for more high-quality studies in this field.

PROSPERO 2023 CRD42023426974. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023426974

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