Wednesday, August 20, 2014

Shifting Paradigms from Traditional Models to New Ways of Disseminating Research: “Who gives a tweet”?





General Description of Each Paradigm

The paradigm shift associated with dissemination of research and new knowledge continues to be an ongoing process characterized by movement from a relatively closed system to one of openness, broader access, and wider acceptance of innovative interactive ways of communicating. Previously, research dissemination consisted primarily of traditional print journal manuscripts that were published in professional / trade journals typically read by other scholars and sometimes practitioners who were interested in a specific topic. While online access was available, it was predicated upon costly journal subscriptions that were purchased by institutions and healthcare organizations. The current paradigm shift consists of movement toward innovative means of communicating, such as social media, and an emphasis on openness in access of materials that were previously only available to a limited audience.

Common Assumptions

Examining the underlying assumptions related to research dissemination can provide insight into the current shift. Previously, the purpose of dissemination was essentially to cast knowledge out into the practice world with the assumption that a good idea would eventually be used. Under the common dissemination models of that time, the flow of knowledge was considered a linear, one-way top-down process of information flow from the “experts” to a passive audience. In many ways, research and development of knowledge was in itself a focused objective that culminated with a linear process of dissemination. However, with the shifting focus on knowledge / research utilization and translation into practice, new models of dissemination have emerged. The interactive complex nature of dissemination and information flow is recognized as foundational and shifts the focus to include users of research and information with particular consideration on how they mediate that knowledge and give it meaning in their specific settings. These new assumptions view research and new knowledge not as an object sent and received, but as fluid understandings that are molded by those who create it as well as those who use it. The user is no longer considered a passive receiver of information or expertise, but as an active learner who will use the knowledge and information to solve problems and create their own knowledge. In addition, assumptions regarding who the users are have shifted. In the new paradigm, end users consist of other researchers and scholars, clinicians, policy makers, administrators, and patients and families.  Both the old assumptions and the new ones provide a particular perspective of dissemination and therefore, inform how researchers communicate their studies and what strategies are selected for dissemination.

Examples from Old and New Dissemination Paradigms

Traditional Dissemination Model
Transition Dissemination Model

Print Based Journals, Textbooks
Research Conferences Poster/Podium
Reader “pulls” out information
Subscriber Pays for Access
Private Peer Review and Feedback Process
Focused Impact Factor of the Journal
Fixed Formatting
Primarily text per journal standards

Slower Dissemination
History of prolonged delay before
integration into clinical practice
Viewed and upheld as more rigorous due to referee/peer review process
Limited access
Oriented to the Scientific Community

Hybrid of Print with Increasing Digital Availability
Social Media, Open Access
Researcher “pushes” out information
Researcher Pays to allow Access
Public Feedback/Response Process
Increased Focus on Article Metrics
Customizable Format
Increased Pictorial/Graphic Format with Language Translation opportunity
Rapid Dissemination
Anticipated to hasten the time
to integration into clinical practice
Viewed by some as less scholarly with concern for the peer review process
Global access
Oriented to a broader audience


This table provides some examples of key differences between the traditional and transition models of research dissemination.

The shifting paradigm of dissemination is a process that will not necessarily eliminate traditional print journals but will push the boundaries of traditional methods to be more open and accessible. The example of a traditional model of publishing a scientific manuscript involved sending it to the journal and having the journal manage the review process, typesetting, printing, and distribution of one’s work. This process was costly and slow. Journal subscriptions were and still are expensive, yet the journals do not employ the authors of the manuscripts or the peer reviewers who do the bulk of the work. Other examples of traditional dissemination include paper and poster presentations at professional conferences, publication of books and chapters, and publications of monographs.

Online formatting with social media removes the cost of producing a physical copy of the journal and research article and increases the interactive experience of reviewing and discussing the literature. The authors and reviewers still are not compensated for their work-in fact the authors pay a fee for open access publication.

Driving Forces Leading to the Shift




A number of driving forces have precipitated the paradigmatic shift related to research dissemination. These forces have occurred in different arenas, however converge to create the context for the shift away from traditional methods of scientific dissemination. The development and ongoing improvements in digitization and networked technology has dramatically changed the communications environment and availability of information across the world. Concurrently, the increasing cost of traditional journal subscriptions has outpaced inflation by 50% and made ongoing subscriptions prohibitive for some organizations; making the use of open access more feasible and cost effective.  In addition, the prevalent individual use of technologies such as personal computers and smart phones has increased access to information for healthcare professionals as well as consumers. Technology and digitization provides near-immediate access in comparison to the lengthy time-lines required for publication processes in the traditional model of dissemination. The new technologies and web 2.0 services found on the internet have brought about changing practices in communicating and producing information, emphasizing a type of decentralization and collective generation. Information and knowledge can be co-created.  Involving the original developer, other researchers, and end users, in some ways similar to crowdsourcing,  brings into question whether traditional peer review is an outdated process. Given the protracted timeframe for translation of research into practice, the ability to disseminate quicker and more broadly provides a means to address problems through a type of open science that develops collaborative solutions for those who would benefit the most (patients and families).

The overarching emphasis on research utilization and evidence-based practice has elevated the need for information and research access for the clinician. Over the last decade, the focus on patient and family centered care has shifted the view from a provider-centric perspective to one that values the consumer and their preferences to care. This framework considers the patient as an equal partner, valuing their perspective in decision-making processes, thus requiring they have access to current information and research.

From a global perspective, in many countries access and availability to research and information is often too costly even for institutions of higher learning and require resources that are simply not available. Therefore, student education is significantly compromised due to lack of access. The common need across the world in a number of academic institutions to gain access to the most current information and research is an additional driving force toward a more open model of dissemination.

Sources that provide much needed funding for research are additional stakeholders in the dissemination process as their interest in equity and access encompasses policy-makers, governmental agencies, professional organizations, and consumers. In the case of government sponsored research, tax dollars often provide the resources for grants and other funding mechanisms, adding the public interest as an additional stakeholder and driving force for a more open dissemination model.

Conflict, Controversy, and Tension between the Paradigms



Study findings can be viewed as an intellectual commodity and researchers are voicing their concerns that the open access format is not as well regulated as print journals to handle this commodity and this creates tension in moving from the old paradigm of dissemination to the new paradigm. The perception is that the regulation of the quality of the manuscripts is managed through feedback of peer reviewers, who are regarded as experts in their fields and trained for the responsibility. The concern is that in moving to an open access model there will be a loss of this regulatory mechanism and instead the reading audience will take on this responsibility and they may be unequipped to fill this role. Relying on the reading audience for content regulation can become increasingly problematic in an open digital forum if the comments become a distraction from the manuscript because they are off subject or malicious in nature.

Also, tensions exist over the best way to determine the quality and influence of research journals and articles. Traditional models emphasize impact factors (IF), a measure of citation frequency which was intended to rate journals http://admin-apps.webofknowledge.com/JCR/help/h_impfact.htm.  However, academic settings have used IFs in their evaluation of researchers / faculty and institutions. While impact factors (IF) assume the most cited journals are the higher quality, IFs can be manipulated, distorting the reliability of this metric. Open access and social media provide new and different evaluation strategies at the article level.  The digital environment provides the ability to collect information on more than just citations as an indicator of quality of the research product. Altmetrics (article level metrics) quickly captures social media references not available in traditional metrics and reflect a broader more public engagement. Despite these advantages, altmetrics are not yet fully understood or utilized, hindering their widespread adoption. Here is an example of one article’s metrics:


Source: The Current Landscape of Open Access by Heather Joseph (ALA Midwinter Meeting Seattle, WA

Controversy also exists over the publication of fabricated studies in OA journals which can contribute to the perception that the peer review process used by OA journals is less structured and rigorous than in traditional print journals. The recent “sting” operation involving the acceptance of a spoof study in a number of OA journals was described in Science as a definite indication of poor peer review processes in OA journals. This led to a concern about the preponderance of poor quality studies that may dilute or overwhelm the scholarly articles that are present in OA journals or social media sites. OA and social media dissemination avenues can overcome the perception of poor quality through increased representation of high quality research articles becoming dominant over all others to improve the reputation of these avenues; otherwise the perception will persist.

Journals attempt to increase their impact factor which may increase publication of articles that focus on popular topics over other important works. Conflicts of interest for the editors may create unfair bias for acceptance of articles based on the relationship of the editors to the contributor.



Source: Brazilian Citation Scheme Outed by Richard Van Noorden (Nature News 27 August 2013). http://www.nature.com/news/brazilian-citation-scheme-outed-1.13604


Controversy may develop over copyright issues and bring into question who owns the research information. In traditional models of dissemination, authors sign over copyright to the publishing journal. However, in OA, the public is free to use and re-use the materials and often a creative commons license is developed, see https://creativecommons.org/licenses/ for information on these licenses. Other conflicts can develop as the funding agency may establish that the knowledge generated becomes their own intellectual property and not that of the researcher. This information may be considered proprietary and legal ramifications that can follow dissemination outside of contractual agreements of who owns the information and how it should be disseminated.

There is concern about misinterpretation of information that becomes readily available in social media and Open Access articles. The audience becomes very broad and will include researchers and non-researchers alike. The ability to critically appraise the information presented in research articles may be much more difficult for the lay person who is less practiced in understanding all of the finer points of evaluating the information which creates the space in which misunderstanding can occur.

Barriers to Adoption of New Model

While progress continues toward a more open, accessible, and interactive model of dissemination; barriers to adoption include time constraints, misconceptions and lack of understanding of new strategies, bureaucratic and organizational limitations, prevailing attitudes and policies in academia, and lack of resources. Certainly, time and prioritization of time for academics and researchers is an ongoing challenge and will vary depending on the familiarity and comfort level with the new dissemination strategies. The time and effort required to learn new methods and maintain social media strategies such as blogs and twitter may be perceived as an additional responsibility and add a sense of burden to an already heavy workload.

Perceptions related to the business model associated with Open Access and lack of understanding of the related peer review processes can also serve as barriers. The shift of cost from subscribers to the publishing authors in Open Access journals maybe be perceived as a kind of quid-pro-quo and be considered unethical and distasteful. This new business model is particularly difficult to socialize in an environment such as academia given the objective scientific focus and attention to avoidance of conflicts of interest.

Prevailing attitudes in academia surrounding issues of tenure and promotion are often founded on traditional methods of dissemination with special consideration given to publishing in high impact journals. Editors of high impact journals may be less likely to feel the need to publish in Open Access, thus affecting faculty dissemination and publication plans. Researchers may be concerned about the prevailing attitudes among their peers related to Open Access and use of social media and be less inclined to use these strategies based on these concerns. In addition, while the benefits of using Open Access and social media include broader and timelier dissemination, the associated sense of exposure and vulnerability may be a barrier. Having a broader audience who can respond interactively to one’s work certainly requires a kind of openness to public peer review and criticism on a considerably larger scale. 

Finally, while Open Access repositories are growing and use of social media continues to trend upward, these strategies and formats remain relatively new for academic environments. New quality assurance measures and intellectual property (copyright) methods are under development. University resources may not be available to support faculty’s social media work. Given that some questions and lack of understanding remain for a number of researchers and academics and acknowledging the slow movement of the scientific community to adopt new methods, some individuals remain disinclined to progress toward new models of dissemination.

Current Outcome 

A direct outcome of open access and use of social media for dissemination is that the work of researchers and other academics reaches more people in a faster timeframe. Researchers are able to connect and collaborate with others outside of their usual networks, thus increasing the potential for working groups and multi-authored, multisite work. Participating in an academic online community provides opportunities to publicize studies, exchange ideas, and provide timely feedback and interaction regarding publications and research. For practicing clinicians and consumers (patients and families), having the most current research and information available allows for faster, more efficient translation as the user has direct access to the information and the source.



Source: Tweet and Download Trends by Kaisa Puustinen and Rosalind Edwards (LSE Impact Blog, CC BY

While traditional dissemination requires end users to “pull” or intentionally search out information or research evidence, social media-based strategies “push” out information or knowledge based on interests previously identified and indicated by participants in specific blogs, twitter, or other web-based approaches. This means researchers have a better chance of having their studies disseminated to those most interested in their work and users are able to receive the latest information based on their own identified requirements.

Status of the Shift and Unintended Consequences

The current status of open access and use of social media in research dissemination has progressed to include over 8600 OA journals with a number of related repositories and publishing organizations. Several prominent organizations include:
Directory of Open Access Journals (DOAJ) http://doaj.org - a database of indexed and accessible peer-reviewed OA journals covering a variety of subjects;
Public Library of Science (PLOS) http://www.ploscollections.org/- a nonprofit open access scientific publishing project aimed at creating a library of open access journals and other scientific literature under an open content license;
SPARC (the Scholarly Publishing and Academic Resources Coalition) http://www.sparc.arl.org - an international collaboration of academic and research libraries that support the emergence of new scholarly communication models that expand dissemination and reduce financial burden on libraries.

Online services such as Mendeley http://www.mendeley.com/provide free reference manager and academic social networks with the ability to showcase researcher’s studies and collaborate with others to follow their research and share feedback. Similarly, Pub Med Commons is a pilot project that allows researchers to comment on other Pub Med abstracts, providing a forum for scientific discourse http://www.ncbi.nlm.nih.gov/pubmedcommons/.

From a policy perspective, significant progress has been made toward a more open accessible system of dissemination. NIH has public access policies requiring authors to submit their journal publications that result from NIH funded research to PubMed Central which is openly accessible. Other consumer groups are petitioning similar requirements for all federal agencies that fund research.

Future Directions, Implications, and Unanswered Questions

 The paradigm shift of research dissemination is happening and although the traditional dissemination research model is not completely abandoned as an antiquated system, there remains considerable concern about jumping into the transition model as discussed above. Technological advances are improving the efficiency of getting our research findings out into the world where they can be usable and can be integrated into our clinical knowledge base to improve patient care.  

Consumers have increasing interest in being actively involved in their own health care decisions and becoming active participants in the process.  Making research findings accessible to the end user is an important part of creating a dialogue on what options exist or should be addressed. Electronic access to medical records through secured health portals is a requirement of policy and as individuals become more accepting of this they are going to look for answers to their burning questions. The barriers to understanding the content are going to come to the forefront of the dissemination issue as there will be increasing demand for reader friendly content.

The idealized formatting for the “Journal of the Future” can be beneficial in bridging the gap between the lay and scientific communities. The potential capabilities of clicking a button for instant language translation, hovering over scientific jargon and getting a definition, accessing imbedded links to images and related content can make this information more obtainable regardless of the knowledge base or formal training of the reader. The articles become adaptable in ways that books have become when converted to an electronic reading format. Examples of these articles can be explored at these links:



As we look to the future, there are many unanswered questions to consider as this paradigm shift occurs. Some to think about should include the following:

How does the scientific community create a system of checks and balances that can address the critical need of evaluating the methods of research dissemination? And also how are the needs and interests of the public best addressed through improved dissemination processes?

How does the scientific community increase global collaboration and research dissemination without out-pricing developing countries or extending existing language barriers?

How do we continue to keep up with the all of the new options for research dissemination created by social media and the internet without being overwhelmed in the sea of choices?



Recommended Readings /Links

Developing a Dissemination Plan
Beyond Scientific Publication: Strategies for Disseminating Research Findings http://www.yale.edu/bioethics/contribute_documents/CARE_Dissemination_Strategies_FINAL_eversion.pdf
  
Open access
Open access explained
The Current Landscape of Open Access
What’s new in open access
Open Access Scholarly Publications Association
Public Library of Science
Directory of Open Access Journals: http://doaj.org
Global editorial board members discuss open access
Frances Collins and teen scientist discuss open access http://www.youtube.com/watch?v=G55hlnSD1Ys&feature=youtu.be
The Berkeley Blog: My take on Science’s peer review sting http://blogs.berkeley.edu/2013/10/04/open-access-is-not-the-problem/
SHERPA/RoMEO: publisher copyright & self-archiving policies

The Journal of the Future
Kevin Sea from the ACS  (American Chemical Society): discussion of desirable features for the future https://www.youtube.com/watch?v=XRaafZxitQc&feature=youtu.be
Articles of the Future – prototype articles to view

Social Media, the web, impacts on research dissemination:
Spreading the word: Disseminating research findings
The future of academic impacts: Social media tools
Who gives a “tweet”?
Social Media Release Increases Dissemination of Original Articles in the Clinical Pain Sciences; http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0068914
Social media: a guide for researchers (Case studies) Research Information Network:  file:///C:/Users/u0919504/Downloads/case_studies%20(1).pdf
If you build it, will they come? How researchers perceive and use web 2.0: file:///C:/Users/u0919504/Downloads/web_2.0_screen%20(2).pdf

Analytics: Impact factor and Google scholar
Polit & Northam’s article: http://www.ncbi.nlm.nih.gov/pubmed/21256359

Citation managers and collaboration
UlrichsWeb Global Serials Directory:

Created by Participants in Nursing 7106 Context for Advancing Science (and Improving Health)
University of Utah College of Nursing PhD Program Summer 2014 
Submitted by: Catherine Dingley PhD and Mandy Snyder  MSN
(Lead Authors)




              



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