- "Race in the U.S.A.," a faculty and student discussion (pg. 10)
- Faculty present their research on issues of public health (pg. 12)
- "Experiencing Vietnam," a discussion among alumni veterans of the conflict (pg. 14)
- "Battle Plans," students take up swords in Jason Asprey's "Theater Skills: Stage Combat" class (pg. 26)
- Dr. Philip Landrigan's presentation "Public Health and the University" (pg. 45)
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Meet the critics
The process of publishing one’s work in an academic journal is, by design, tortuous. The editorial cycle for a manuscript, from submission through reviews and revisions to final publication, can take three years. Sometimes, such as when the topic involves improving health care through technology, and lives as well as a great deal of money are at stake, that’s simply too long.
Rob Fichman is an associate professor in Boston College’s information systems department and a senior editor of a forthcoming special issue of the journal Information Systems Research on the potential roles for the field in health care. Together with co-editors Rajiv Kohli of the College of William and Mary and Ranjani Krishnan of Michigan State, Fichman hosted a writing workshop at Boston College on September 19 for the authors of 10 papers under consideration. The objective, says Fichman, was to compress the normal review process by providing face-to-face “constructive, developmental, and actionable criticism” in between rounds of the customary anonymous, long-distance peer review. If successful, they might speed the issue’s publication to late 2010, cutting the journal cycle by at least a year.
Early that Saturday morning, some two dozen authors and reviewers clad in business casual gathered in the anteroom of the Lynch Conference Center for coffee, bagels, and juice. The participants had come from universities relatively near (Carnegie Mellon and Johns Hopkins) and far (the University of Hawaii, the University of British Columbia, and the University of London). Each of the 10 papers, the cream of 53 submissions, had already been through an editorial screening and a first cycle of anonymous peer review.
The format of the workshop before them would be familiar to any English major who ever dabbled in creative writing. In four sessions throughout the day, the whole group, with laptops aglow, gathered around a horseshoe conference table to hear individual 15-minute PowerPoint presentations on two or three of the papers, which had been made available in advance on an invite-only website. Topics included “Electronic Patient Record Use in Multidisciplinary Care”; “Examining Patient Contact Tracing in Epidemic Outbreak Management”; and “The Clinical Impact of eHealth on the Self-Management of Diabetes.”
For all the technology on display, Fichman and his fellow editors chose a primitive information system to hold presenters to their time limit: They raised handwritten placards to count down the minutes. Following each general session, the group split up for more in-depth discussions of the individual studies.
Jerry Kane is an assistant professor in Boston College’s information systems department and an associate editor for the special issue. Because his duties are administrative and not editorial, he was allowed to submit a paper, which made the first cut. The session on Kane’s paper, which carries the working title “Dissent Within the Clan: Assessing the Impact of System Avoidance on the Performance of Health Care Groups,” drew a crowd of 12 critics to the long classroom tables in Fulton 453.
Kane’s study explores what happens when different members of health care teams—doctors, nurses, administrators—decline to use electronic systems that track scheduling, lab and radiology results, and administrative tasks within the team. Kane started by outlining some of the concerns raised by his two early reviewers. Both wanted to see a stronger connection to existing health care literature; Kane and his coauthor, Joe Labianca of the University of Kentucky, had obliged. Before Kane could finish discussing the reviewers’ reports, Brian Butler of the University of Pittsburgh interjected that the manuscript lacked a bottom-line reckoning of the real-world consequences of information system avoidance. “You have no ‘this is something that kills 10 million people a year,’ or ‘this much money is spent,'” said Butler. Kane nodded, jotting down notes at his place in the front of the classroom.
Shortly after that, Butler reminded Kane that in a hospital setting resisting the use of an information system isn’t necessarily a bad thing. “One of the characteristics of health care is the complete acceptability of making do, or doing something an alternative way,” he said. “If it saves the patient, you’re allowed to do just about anything.” Kane continued to take notes. “It seems like the thing that’s unifying a lot of these comments is that in health care, avoidance is a different phenomenon, and I need to explain that,” he responded.
Much of the discussion centered on recondite technical matters or the parsing of theoretical issues. Kane, for example, noted an initial reviewer’s opinion that social network theory, an evaluative technique common to the social sciences, isn’t suited to the analysis of quantitative data. Butler sided with Kane, saying this assertion was “just wrong.” Molly Wasko of Florida State University brought up the difference between information technology avoidance and information systems avoidance. “You use the terms interchangeably. The teams you studied are using information systems, just not the technology,” she said, noting that taking notes with paper and pen technically constitutes an information system. “I’m wondering which one you’re interested in studying,” she said. Kane admitted to the imprecision in language.
After the workshop, Kane spoke about the value of his critics’ input. “They raised issues that frankly, I never would have thought about,” he said, “assumptions that I made that I probably shouldn’t have made.” The revisions he planned for the paper based on the workshop were “major, but doable.” The original research and analysis are sound, he said, but “I need to do a better job of explaining what I did and why it’s important.”
After the business of the workshop wrapped up, shortly before 7 p.m., most of the group reconvened for dinner. “No shop talk on my end of the table, just catching up with friends,” Fichman said. He was pleased how the workshop turned out. “Many participants,” he said, “made note of the constructive, collegial atmosphere that pervaded the breakout sessions, which was a contrast to some of the workshops they had attended [elsewhere] that were more adversarial.”
The time and money required to assemble 20 or so scholars in the same place likely will prevent the workshop model from being adopted more broadly by peer-review journals. Fichman and Kane are working on another solution. They’re currently writing a paper exploring the use of wikis—collaborative websites that allow a group of people to add and critique content—in the editorial process.
“You learn much more in a conversation than you do in monologues,” says Kane. “One of the reasons we’re proposing this wiki-based approach is you can have a conversation without the difficulties of getting everybody face to face.”
Read more by Tim Czerwienski