Duplicate Publication or Communicating Findings Responsibly?

“Duplicate Publication in the Nursing Literature” by Suzanne Blancett, Annette Flanagin, and Roxanne Young (Image, Spring 1995) is deserving of comment. First and foremost, the purpose of publishing research findings is to communicate the findings to target groups that will benefit the most. In randomized clinical trials testing delivery of a model of nursing care, such as my own work for example, the data are far too extensive to be reported in a single article.

In addition, the audiences that would benefit from the findings range from researchers to staff nurses, insurers to policy makers. While there may be some overlap in journal readership, these are quite disparate audiences.

In communicating such a study’s findings, it is conceivable that 10% of an article’s narrative may be repeated in similar form based solely upon the introduction, literature review or citing of important points in the discussion. I would suggest that the authors’ standard of lo%, as an indicator of duplicative publishing, is too low. Second, the authors refer to “peel off’ articles negatively as “salami slicing.” Reporting, in detail, secondary analysis of important clinical findings are all but impossible to report with any depth or meaning in a study’s major findings. They are, however, important. The same is true of the psychometric properties of instruments (yet another slice of the salami). To not make use of the data gathered with significant investigator, taxpayer, or foundation resource is irresponsible!

Failure to cite the original work is unethical. But, let us please remain focused on the major purpose for publishing research findings. The reason is not to further one’s academic career or to avoid editors being scooped by another journal. As noted, the purpose is to communicate the findings to audiences that will most benefit and an use the findings to improve the health care of the nation’s citizenry. And that often takes communicating portions of study findings to more than one group.

Based on my activities as a member of the Institute of Medicine and a member of its recent committee to investigate career paths in clinical research, the authors’ article reminded me of another point. Nurses need to communicate the research training that is a formal part of each of their educational programs from the undergraduate through the doctoral level. This education and training in research is mandated by our academic accrediting bodies and is very different from that of many other health professions including medicine. Too often an uniformed stereotype of our educational preparation, in many areas, surfaces in unexpected ways.

Dorothy Brooten, PhD, FAAN Overseers Professor and Director Center

for Low Birthweight Research School of Nursing

University of Pennsylvania

Insights for Improving Patient Care We are writing to compliment Baigis-Smith, Coombs, and

Larson for their article “HIV Infection, Exercise, and Immune Function” published in the Winter 1994 edition of Image.

They summarized research on a vital topic in the field of HIV/ AIDS research. Exercise is something HIV-infected patients can do for themselves, so it is important to get the most current facts in the practice arena. The authors reported HIV-infected individuals “are getting conflicting messages from health-care providers about the role of exercise for well-being.” Therefore, this article assembles the information needed to help us counsel patients on this subject. One can see how the findings that “exercise programs have been shown safe for the chronically ill” may be inappropriately transferred to HIV-infected persons who were included in those studies. We applaud the authors for illuminating the fact that current research with HIV-infected persons is inconclusive.

The synopsis of the quantitative research was compelling. It had us searching through our nursing textbooks to be sure we understood the implications of the studies. We found the Image article informative and motivating. Perhaps the most enlightening feature was the section on “Implications for Research.” There are so many areas yet to be explored in the study of HIV infection. The information cited in this article points to many avenues of research addressing the physiological and psychological well-being of HIV-infected individuals.

Finally, we want to thank the authors for bringing nurses to the cutting edge in this area of research. The insights they provide enable us to continue to work at improving patient care. Thank you!

Rhonda Deines, RN Connie Mount, RN

Lori S. Peppard, RN Nicole L. Skinner, RN

Beth-El College of Nursing Colorado Springs, CO

There is a Place for Nurses in Medical Schools I was delighted to read “Voices From Different Places: But

Why A Medical School Faculty?’ by Margaret Comerford Freda and Mary Lou Moore (Image, Spring 1995). This article helps to show how diverse and significant the nursing profession is. Because so much of health care is done by nurses in collaboration with physicians, mutual respect is needed. What a wonderful way to start gaining this respect early in the physicians’ careers.

I agree that there is a place for nurses as faculty in medical schools. Nurses bring unique contributions to health care. As discussed in the article, I agree that providing care today is a major challenge that requires broad knowledge beyond a single profession. With shorter hospital stays, I think it is essential that medical students learn to treat more than just the patient’s medical problem. Treating the whole person, as nurses strive to

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