HE EXPECTATION THAT academics publish and detrimental effects on creativity, morale, and output
T disseminate research findings, information, andknowledge is increasingly becoming a component ofnursing and academic practice. This can be seen as anoverwhelming responsibility in the absence of a support-ive framework and arbitrary expectations to “publish orperish” within academic and professional life. InAustralia, universities receive funding based on academicpublication rates, and the likelihood of promotion isincreased by publication output (McGrail, Rickard, &Jones, 2006). The pressure to publish is identified in theliterature across disciplines and has been associated with
ation Coordinator, Research Lead, Changing Workforcer, School of Nursing, The University of Adelaide, 5005 Australiaoordinator, Lecturer, School of Nursing, The University oAustralia.ol of Nursing, The University of Adelaide, 5005 Australia.er, Postgraduate Coursework Team Lead, School of Nursingof Adelaide, 5005 Australia.
Contributions: AW, SS, JK, and PR contributed to the study design, datacollection, and article preparation; data analysis was conducted by AWand SS.
Address correspondence to Philippa Rasmussen: School oNursing, The University of Adelaide, 5005 Australia. [email protected]/12/$ - see front matter
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(De Rond & Miller, 2005). In addition, without dissemi-nation, there is a risk that the professional body ofknowledge does not evolve sequentially with the researchand enquiry undertaken (Clapham, 2005).
This article describes an initiative by a school ofnursing to develop a supportive framework to assistacademics, nurse–clinicians, and multidisciplinary col-leagues to publish by promoting a cultural changethrough focusing on the benefits of publishing. Throughthe implementation of a strategic plan acknowledgingfour incremental stages, “promote, prepare, polish and
proliferate”, the enormity of the task of publishing wasdemystified, the skills required were outlined, and theincentive of incorporating these strategies into practicewere highlighted.
BackgroundIn nursing, written communication is an integral part ofprofessional conduct; however, this does not alwaysconvert to publication output (Taylor, Lyon, & Harris,2005). The increasing expectation to publish may createbarriers and anxiety affecting productivity rather thanpromoting publishing as an opportunity to discuss anddisseminate nursing knowledge. As a result, clinicalresearch and new knowledge are often lost to the widernursing and other health disciplines (Taylor et al., 2005).Consequently, clinicians and nurse academics need todevelop skills and knowledge on how to contribute tonursing and professional literature. Unfortunately, clini-cians and nurse academics often feel unprepared andunderqualified to contribute to the nursing and healthliterature (Driscoll & Aquilina, 2011). As such, writingfor publication is frequently not considered part of theireveryday work but additional workload (Happell, 2008).Despite this, the requirement to publish remains anintegral and unavoidable part of nursing scholarship andcan be viewed as encompassing educational, political, andprofessional concepts (Taylor et al., 2005).
EducationalAs an education tool, publications are instrumental inpromoting the dissemination of information, which addsto the body of nursing knowledge (Driscoll & Aquilina,2011; Driscoll & Driscoll, 2002). The secondary effects,from an educational perspective, are that nursingliterature provides a foundation for teaching andpromoting validated evidence-based practice. The devel-opment of writing skills within academe has beendemonstrated not only to benefit staff but also thestudents they teach (Keen, 2007). Clear, well-articulatedwriting leads to good communication and improvedunderstanding in all facets of writing, including essaysand research reports. In today's information-rich world, itis vital to communicate clearly, concisely, and effectively.
PoliticalPublications are considered direct measures of individualand institutional performance and credibility (Rickardet al., 2009). Higher education institutions are increas-ingly required to demonstrate academic performancethrough evaluation of research quality.
In Australia, research excellence in universities ismeasured using the Excellence in Research for Australia(ERA) process, an initiative by the federal government(Australian Research Council, 2011). The process uses acombination of measures on researchers, research out-puts, research income, reputation, and other measures,one of which is publication output, to assess researchquality. Universities receive extra funding based on theirpublication rates, and this influences accessibility to
funding, resource opportunities, and consequently trans-lates to competitiveness in the marketplace, as reflectedby the coalition of leading universities (Group of Eight[Go8] Australia, 2011). The Go8 is a coalition of the eightleading Australian universities, which are intensive inresearch and education. Enhancing and extending thecontribution of the Go8 members to Australia's social,economic, cultural, and environmental knowledge base isa fundamental aim of the group, and quality publicationsare avenues in which to ensure this aim.
ProfessionalPublication output as a professional obligation is notmandated by regulatory and professional nursing bodiesin Australia. However, the Australian Nursing andMidwifery Accreditation Council standards for bothregistered nurses and nurse practitioners identify theneed for critical thinking and analysis (AustralianNursing and Midwifery Council, 2006a, 2006b). Thisextends to an expectation for contribution to researchand practice innovation, including the construct ofnursing knowledge through publication. Consequently,job and person specifications for nurse practitioners,advanced practice nurses, and leadership roles oftenrequire productivity in this area.
In academe, there is a clearly defined expectation ofpublication, which is directly associated with tenure andpromotion. Without a good publication record, nurseacademics may find it difficult to be promoted (McGrailet al., 2006). Because of the traditional focus on provisionof clinically relevant and focused nurse education, manyemployees of schools of nursing may not have undertak-en a traditional academic pathway and learned the art ofwriting to publish.
Promoting Publication OutputBarriers to publishing have been identified as follows:inadequate time, lack of resources, and lack of confidence(De Rond & Miller, 2005; Driscoll & Aquilina, 2011;Keen, 2007; Rickard et al., 2009; Taylor et al., 2005).Increasingly, strategies for overcoming these issues arebeing identified and tested. A search of the literatureidentified multiple programs for promoting publicationoutput, including step-by-step guides (Happell, 2008)and formal training programs that involved multiplesessions over extended time frames with formal curri-culum (Rickard et al., 2009), to the development ofwriting support groups and mentorship relationships(Taylor et al., 2005). The framework, for the reportedstrategic plan, was adapted from the work of Rickard et al.and included strategies utilized by Morss and Murray(2001) to promote confidence and focus on writingthrough incremental writing.
Rickard et al. (2009) developed a “writing forpublication course” aimed specifically at increasingexposure and productivity within a small group ofacademic staff. This initiative incorporated a 1-weekcourse and subsequent monthly writers' support group of4-hour duration. The implementation of this intensive
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program is described to have had positive effects seenthrough an increase in academic publication rates.Although Rickard et al.'s structure was deemed effectiveby the authors, the model, as described, was not suitablefor our purposes. Consequently, Rickard et al.'s structurewas adapted to meet the culturally specific nature of theUniversity of Adelaide's School of Nursing and multi-disciplinary colleagues.
MethodsOverview of the Design
The “building publications” strategy is a professionaldevelopment activity to develop the skills and knowledgeof staff, students, and clinicians in publishing their workin peer-reviewed scientific journals. The strategy com-menced in March 2009 and continued for 19 months(until September 2010).
The design of the strategy was informed by literature(Rickard et al., 2009; Rolfe, 2009; Taylor et al., 2005), andan initial scoping study to ascertain the needs of staff wasconducted by the publication team (the authors). Thedesign and application of individual activities wasinfluenced by postworkshop evaluations and modifiedby the team. The primary aim of the strategy was topromote publications in the school; prepare staff,students, and affiliated clinicians for publication; enablethem to polish their skills; and proliferate the researchoutput of the school. Considered development was fromthree broad approaches: knowledge, confidence, andmotivation. The strategy had four phases and two cycles,whereby first, a workshop for “neophyte writers” wasconducted, followed 6 months later by a workshop aimedat participants having developed some knowledge andexperience and building on the earlier workshop content.Subsequently, the series was repeated.
SettingThe University of Adelaide is an Australian leader inresearch and ranked in the top eight universities inAustralia. With a focus on excellence in research, theschool of nursing at the University of Adelaide is one ofseven schools in the Faculty of Health Sciences.Publication output in the school of nursing wasrepresented by a minority; hence, to achieve the highestERA rating possible and maintain that rating, the schooldeveloped a strategy to promote publication output inranked, peer-reviewed journals.
Through close alignment with the acute care andcommunity health sectors, the school of nursing at theUniversity of Adelaide brings together an energetic,enthusiastic group of clinicians and academics whosemain interest is in furthering nursing as a practice, as ascience, and as a discipline.
In order to acknowledge and address the issues ofpublishing for nurse academics and clinicians, thepublication team was formed in 2009 as part of theschool's strategic plan. Thus, we initiated a strategy thatwould support the showcasing of our research, educationinitiatives, and clinical outcomes.
To facilitate this strategy, we devised a strategic planfor staff, students, and title holders, which incorporatedworkshops on the practicalities of publishing, how towrite manuscripts, strategies for success, and processes ofsubmission and where to publish.
Phase 1: Scoping Study and Literature ReviewAn initial search of the literature identified a few keyarticles reporting on similar initiatives (Rickard et al.,2009; Taylor et al., 2005). Such information assisted thepublication team in constructing a survey to apply tostaff, students, and clinicians who worked closely withthe school. The survey sought participants' perspectiveson what they needed to support their personal develop-ment in publishing. The anonymous survey was distrib-uted by e-mail to 25 faculty and doctoral students withfollow up in 2 weeks. A 92% (n = 23) response rate wasachieved. Survey data were managed in an SPSS database,and frequency and descriptive analyses were performed.Free-form responses were grouped in meaningful units toidentify common perspectives.
Phase 2: Development of the Strategic PlanFindings from the analysis of the scoping survey directedthe structure of the strategic plan (Appendix A). Aplanning exercise was undertaken using an affinitydiagram as a framework (Florida Department of Health,2011). Affinity diagramming is a tool that helps toorganize large amounts of data from brainstorming and isuseful in planning situations where a new team forms orwhere knowledge is incomplete. Team groups gatheredinformation such as ideas, opinions, and issues intonatural relationships, developing groups. Groups areassigned a name or heading that captures the essentiallink among the ideas and conveys the meaning of thegroup. If there are relationships between two or moregroups, a “superheader” can be assigned (FloridaDepartment of Health, 2011). The activity is completedwith a drawn diagram preceded by a problem statement.
Phase 3: ImplementationThe strategy aimed to provide professional developmentfor those who had never published to those with somepublishing experience. As such, a series of four workshopswere designed, whereby the first activity was aimed as anintroduction to some of the many facets of publishing(why publish, manuscript formats, using search engines,etc.) and the second at building upon that knowledge.
At each workshop, a keynote address by an experi-enced publisher in or editor of scholarly journals wasprovided. Sessions on other pertinent aspects of publish-ing and article added depth. Writing groups and buddypairs were encouraged to form and write papers on acommon interest. Each workshop was concluded with aparticipant satisfaction questionnaire, which indicatedthat the workshops were rated highly (agree/stronglyagree that they were most useful) by participants. Allworkshops were held in the university and closely locatednext to an acute care facility, which allowed clinicians
Box 1. Electronic Survey Questions
Questions1. Demographics; in which professional capacity
did you attend the workshop? (lecturer, researchstaff, student, nurse–clinician, and other clinician)
2. Have you attended any of the workshops held bythe school of nursing? If yes, please indicate whichof the workshops you attended:
a. 21 September 2009b. 9 February 2010c. 15 April 2010d. 29 September 2010
3. My knowledge in publishing has increased as aresult of attending the publication workshop/s.
4. My confidence in publishing has increased as aresult of attending the publication workshop/s.
5. My motivation in publishing has increased as aresult of attending the publication workshop/s.
6. Have you prepared amanuscript for publication? Ifyes, please indicate the number.
7. Have you had a manuscript published? If yes,please indicate the number.
8. If you have had a manuscript published in ajournal, which type of journal was it:
a. Peer reviewedb. Professional
9. Have you revised a book chapter? If yes, pleaseindicate the number.
10. Have you reviewed a book chapter? If yes, pleaseindicate the number.
11. Have you written a book chapter? If yes, pleaseindicate the number.
12. Have you reviewed a manuscript for a journal? Ifyes, please indicate the number.
13. Please indicate your future plans for publishing(open text).
14. Please outline any suggestions you have for thecontent of future publication workshop/s.
213PUBLISH OR PERISH
easy access. Workshops ran for up to 5 hours in length,the initial workshop being the longest.
Phase 4: EvaluationEvaluation of professional development programs isneeded for the successful continuation of such programsand, also, so that they may be adapted to meet thechanging needs of participants. Following completion ofthe implementation of the publication strategy, anevaluation to determine the effectiveness of the strategywas undertaken. In developing the evaluation protocoland the data collection tools, three considerationsinfluenced the final choice of approach: busy lifestyle ofparticipants, access to participants, and known contactdetails. The approach taken was needed to balance theknown problems of low response in survey research andthe benefits of direct access to the sample. Subsequently,a Survey Monkey™ electronic survey was undertaken.Four main outcome measures were considered: knowl-edge, motivation, confidence, and experience in publish-ing activities. Workshop participants were e-mailed thehyperlink to the tool, which was completed andsubmitted on-line. The e-mail requested each participantto complete the on-line survey in a predetermined timeframe of 2 weeks. On the due date, a second e-mail wassent to the participants either thanking them for theirparticipation or providing them with an extension tocomplete the survey.
ResultsThe electronic survey comprised 14 questions (Box 1)and was distributed to 37 participants, and 17 completedthe survey resulting in a response rate of 46%.
Descriptive analysis of the survey data provided thefollowing information: Academic lecturers comprised29.4% (n = 5) of respondents, 17.6% (n = 3) were clinicallecturers, 11.8% (n = 2) were research-only staff, and5.9% (n = 1) were clinicians. The largest proportion ofrespondents were students who made up 35.3% (n = 6) ofrespondents. The respondents were required to provideinformation about the number of publication workshopsattended. Five participants (33.3%) attended both thefirst workshop, conducted on 21 September 2009, andthe second workshop, conducted on 9 February 2010,26.7% (n = 4) of the respondents attended the workshopconducted in April 2010, and 73.3% (n = 11) attended thefinal workshop in September 2010. Two of the re-spondents did not provide a response to this item.
One of the aims of the publication workshop series wasto increase the participants' knowledge in publishing.Four respondents (26.7%) strongly agreed that knowl-edge in publishing had increased, 66.7% (n = 8) agreedthat their knowledge had increased, and 6.7% (n = 1) ofrespondents suggested that they were uncertain whethertheir knowledge in publishing had increased. Howeveragain, in this item, two respondents chose not to respond.
A second aim of the series of publication workshopswas to increase participants' confidence in publishing.Fear and anxiety are cited as barriers to publishing by
Dies (1993) and Lee and Boud (2003), and a lack of con-fidence is cited by Keen (2007). Of the 15 respondents,13.3% (n = 2) strongly agreed that personal confidencehad increased as a result of attending the workshops.More than half of the respondents, that is, 53.3% (n = 8),agreed that personal confidence in publishing hadincreased. However, 26.7% (n = 4) of respondents wereuncertain, and 6.7% (n = 1) disagreed that by attendingthe publication workshops, personal confidence hadincreased. Two respondents did not complete this item.
The strategic plan formulated at the outset of thisproject addressed the issue of motivation for publishing.Motivation for publishing is crucial to increase publica-tion output (Keen, 2007). Attendance at the publicationworkshops implied that participants had intrinsic moti-vation for publishing at the outset. However, 28.6% (n = 4)strongly agreed that motivation for publishing had
214 WILSON ET AL
increased since attending the workshops. The majority ofrespondents, that is, 64.3% (n = 9), agreed that theirmotivation had increased. One respondent or 7.1% ofrespondents disagreed that personal motivation hadincreased as a result of attending the publicationworkshops. Three respondents did not complete this item.
During the series of publication workshops, a templatefor manuscript development was demonstrated by akeynote presenter and subsequently distributed to allparticipants. The template was provided to participants togive novice writers structure and a framework formanuscripts. Of the 17 respondents, 53.3% (n = 8) hadprepared a manuscript for publication, and 46.7% (n = 7)had not. Two respondents neglected to respond to thisitem. Further to the development of a manuscript,respondents reported that 20% (n = 3) had previouslyhad a manuscript published, whereas 80% (n = 12) hadnot. Of the 20% who had published a manuscript, 100%were published in a peer-reviewed journal.
Although the impetus for publishing in peer-reviewedjournals is prominent (Rickard et al., 2009) revising,writing or reviewing a book chapter was encouraged fornovice writers by the publication team. Of the partici-pants, 14.3% (n = 2) had revised a book chapter, 15.4%(n = 2) had reviewed a book chapter, and 21.4% (n = 3)had authored a book chapter. The publication team alsoencouraged participants to review manuscripts as analternative strategy for increasing knowledge, confidence,and motivation for publishing. Thus, 20% (n = 3) ofrespondents stated that they had reviewed a manuscriptfor a journal.
Finally, the participants were asked to indicate theirpersonal future plans for publishing and to makesuggestions for the content of future publication work-
Table 1. Change in Knowledge, Confidence, and Motivation
shops. Fifteen respondents added a comment about theirpersonal plans. A typical response was “Publish my PhDproject in a reputable international journal.” Suggestionsfor the content of future publication workshops includedcomments like “Develop a specific focus, for example,publishing from research, publishing from clinicalpractice, and conducting/identifying systematic reviews.”All comments provided by respondents have been collatedfor future reference.
To measure the impact of how the publication strategychanged participants' knowledge, motivation, and con-fidence in publishing, we compared data from theoriginal preworkshop survey and the final electronicsurvey. As shown in Table 1, there were positive changesin all elements.
DiscussionThe series of publication workshops conducted weresuccessful in increasing knowledge, confidence, andmotivation of university staff and affiliates to publish.Ongoing monitoring and evaluation will identify wheth-er publication output of the school increases. The resultsof the reported initiative alluded to some interestingissues. The publication team set out to enable staff,students, and affiliates of a small school of nursing topublish. However, most of the respondents of the surveywere students of the school. Staff of the schoolrepresented the second largest proportion of partici-pants. This is not surprising given the impetus to publishor perish. Despite the fact that the publication team didaim to include clinicians equally, they were not wellrepresented as participants because only one cliniciancompleted the on-line survey. Perhaps, this strategy didnot resonate well with clinicians, or publication of theirwork is not deemed important. Only further investiga-tion will clarify the reasons for their lack of represen-tation. Students undertaking post graduate studies have agreater opportunity to realize the importance of publi-cation and are afforded encouragement by universitylecturers and supervisors. The support for the publica-tion strategy indicates that doctoral education is asignificant place to intervene if we are to improve thelow level of publication output. Almost all academic staffare aware of the academic and promotional imperativesto publish.
Interestingly, the greatest number of participantsattended the workshop conducted on 29 September2011. This workshop was at the end of the strategyrather than at the beginning. Each workshop wasadvertised widely. An e-mail with an attached flyer wasdistributed to all school of nursing staff; all faculty staff;all students, postgraduate and undergraduate; and allclinical title holders of the school. Each workshop flyerwas concurrently displayed on the school of nursingWeb site and distributed by academic staff to affiliatedclinical environments. However, perhaps, it was “wordof mouth” that most facilitated the greatest attendance atthe final workshop. Only one survey respondent dis-agreed that his or her confidence and motivation for
215PUBLISH OR PERISH
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ublishing increased. For all other respondents, atten-ance at the workshop(s) resulted in an increase innowledge, confidence, and motivation for publishing.erhaps, this message was the one conveyed by word ofouth and translated to a greater participation at thenal workshop.More than half of the respondents reported that theyad prepared a manuscript for publication. However, itecame obvious that a minority of this group had beenuccessful in having their manuscripts published.lthough the workshops addressed issues of manuscriptubmission and how to manage the feedback fromeviewers, understanding why so few manuscripts hadeen published would warrant further investigation. Ofhe manuscripts that had been published, all had beenublished in peer-reviewed journals. Targeting peer-eviewed journals is consistent with the impetus toublish in reputable journals, which carry a higherpact factor and citation rates. However, the authors
lso suggest that targeting professional journals is a goodtrategy for novice writers to gain knowledge, confi-ence, and motivation to publish and, more importantly,o be able to disseminate new knowledge generated fromesearch and clinical activity.An alternative strategy to encourage novice writers toarticipate in publishing was to engage them in revising;eviewing or writing a book chapter or reviewinganuscripts was not successful. Most, that is, at least0%, of respondents did not undertake any of thesectivities. Emphasis on peer-reviewed publications mayave negatively impacted on this strategy. The reasonsr not adopting this alternative strategy were notvestigated by the publication team.Overall, the publication team concluded that partic-ants had reported a positive shift in knowledge,onfidence, and motivation to publish. This was aleasing result because it satisfied the original aims andbjectives of the formulated strategic plan and positive-addressed the well-cited barriers to publishing.
ecause this strategy proved useful to us as a smallchool of nursing, it may also prove useful to othermall schools and, in fact, other disciplines who findhemselves in a similar situation where publishing is
not a priority and publication output is less thandesired. Other schools and disciplines may be able toreplicate or adapt the strategic plan, workshopsstructure, and content.
LimitationsUnfortunately, participant response in this study wasrelatively small, and generalizability is not possible.Survey research is known for its low response rate,although research has shown that response rates arehigher with electronic surveys than with paper surveys orinterviews (Colorado State University, 2011). Neverthe-less, the strategy offers useful information for thosewishing to implement a similar activity. The descriptiveanalysis suggests that the sample of participants wasrepresentative of the publication strategy population interms of baseline characteristics, and hence, results areapplicable to all participants. Although participants hadbeen encouraged to form writing groups, and informa-tion had been provided on how to do this, the evaluationdid not explore whether participants had done so.However, it was known that some participants formedbuddy pairs, and these were continuing at the time ofevaluation. Exploration of the benefits of “buddy”writingwould be worthwhile. The publication strategy requiredevaluation of its effectiveness from the workshopsconducted over 18 months. However, the original designdid not consider the possibility that the majority ofparticipants would change at each function.
ConclusionThere is strong pressure in all higher education in-stitutions to improve publication output. Writing forpublication requires skill development, support, andpractice. Strategies, such as the one reported, can beeffective in increasing academic publication output.Further research that investigates the effectiveness
of writing buddies/pairs/groups would contribute tothe developing body of knowledge around writingfor publication.Further investigation by the publication team in the
future would be able to assess the change in publicationoutput and publication destination.
216 WILSON ET AL
Appendix A. School of Nursing Publication Team
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