In clinical clerkship (CC), medical students can practice evidence-based medicine (EBM) with their assigned patients. Although CC can be a valuable opportunity for EBM education, the impact of EBM training, including long-term behavioral changes, remains unclear. One hundred and nine fourth- and fifth-year medical students undergoing CC at a medical school in Japan attended a workplace-based learning program for EBM during CC (WB-EBM), which included the practice of the five steps of EBM. The program\'s effect on the students\' attitudes toward EBM in CC was assessed through questionnaires. A total of 88 medical students participated in the program. Responses to the questionnaire indicated high satisfaction with the WB-EBM program. The most common theme in students\' clinical problems with their assigned patients was the choice of treatment, followed by its effect. Based on the responses in the post-survey for the long-term effects of the program, the frequency of problem formulation and article reading tended to increase in the \'within six months\' group comprising 18 students who participated in the WB-EBM program, compared with the control group comprising 34 students who did not. Additionally, the ability to self-assess problem formulation was significantly higher, compared with the control group. However, among 52 students who participated in the WB-EBM program more than six months later, EBM-related behavioral habits in CC and self-assessments of the five steps of EBM were not significantly different from those in the control group. The WB-EBM program was acceptable for medical students in CC. It motivated them to formulate clinical questions and enhanced their critical thinking. Moreover, the WB-EBM program can improve habits and self-evaluations about EBM. However, as its effects may not last more than six months, it may need to be repeated across departments throughout CC to change behavior in EBM practice.

BACKGROUND: the peer-review process, which is the foundation of modern scientific production, represents one of its essential elements. However, despite numerous benefits, it presents several critical issues.
OBJECTIVE: to collect the opinions of a group of researchers from the epidemiological scientific community on peer-review processes.
METHODS: cross-sectional study using a questionnaire evaluation.
METHODS: a 29-question survey was administered to 516 healthcare professionals through the SurveyMonkey platform. The questions focused on the individual characteristics of the respondents and their perceived satisfaction with some characteristics of the review process as well as their propensity of changing some aspects of it. In addition, three open-ended questions were included, allowing respondents to provide comments on the role that reviewers and the review process should play. Descriptive statistics were produced in terms of absolute frequencies and percentages for the information collected through the questionnaire. Secondly, a multiple logistic regression analysis was conducted to assess the willingness to change certain aspects of peer review, adjusting for covariates such as age, sex, being the author of at least one scientific work, being a reviewer of at least one scientific work, and belonging to a specific discipline. The results are expressed as odds ratios (ORs) and their 95% confidence intervals (95%CI). Text analysis and representation using word cloud were also used for an open-ended question.
METHODS: level of satisfaction regarding some characteristics of the peer-review process.
RESULTS: a total of 516 participants completed the questionnaire. Specifically, 87.2% (N. 450) of the participants were the authors of at least one scientific publication, 78.7% were first authors at least once (N. 406), and 71.5% acted as reviewers within the peer-review process (N. 369). The results obtained from the multiple logistic regression models did not highlight any significant differences in terms of propensity to change for age and sex categories, except for a lower propensity of the under 35 age group towards unmasking, defined as the presence of reviewers and editorial boards names on the publish article (OR <35 years vs 45-54 years: 0.51; 95%CI 0.29-0.89) and a higher propensity for post-formatting proposals, defined as the possibility of formatting the article following journal guidelines after the acceptance, among those under 45 (OR <35 years vs 45-54 years: 1.73; 95%CI 0.90-3.31; OR 35-44 years vs 45-54 years: 2.02; 95%CI 1.10-3.72). Finally, approximately 50% of respondents found it appropriate to receive credits for the revision work performed, while approximately 30% found it appropriate to receive a discount on publication fees for the same journal in which they acted as reviewers.
CONCLUSIONS: the peer-review process is considered essential, but imperfect, by the professionals who participated in the questionnaire, thus providing a clear picture of the value that peer-review adds rigorously to each scientific work and the need to continue constructive dialogue on this topic within the scientific community.

The world of publication can seem intimidating and closed to the newcomer. How then does one even begin to get a foot in the door? In this paper, the authors draw from the literature and their recent lived experience as editorial interns to consider this challenge under the theme of access, and how it overlaps with the various components of academic publication. The main three components of the publication \'machine\' are discussed in this article, authoring, reviewing, and editing. These are preceded by the first, and arguably foundational, interaction with academic journal publishing-reading. Without reading articles across different journals, and even in different disciplines, understanding the breadth of scholarship and its purpose is impossible. The subsequent components of authoring, reviewing, and editing, which are all enhanced by ongoing familiarity with current literature through further reading, are considered in further detail in the remainder of this article, with practical advice provided as to how to gain access and experience in each of these areas, for example, writing non-research article manuscripts, engaging in collaborative peer review, and applying for editorial opportunities (with perseverance) when the opportunity presents itself. Medical education publication can seem daunting and closed to entry-level academics. This article is written to dispel this view, and challenges the notion that the world of publication is reserved for experts only. On the contrary, newcomers to the field are essential for academic publications to retain relevance, dynamism, and innovation particularly in the face of the changing landscape of medical education.

BACKGROUND: Quality measurement in the German statutory program for quality in health care follows a two-step process. For selected areas of health care, quality is measured via performance indicators (first step). Providers failing to achieve benchmarks in these indicators subsequently enter into a peer review process (second step) and are asked by the respective regional authority to provide a written statement regarding their indicator results. The statements are then evaluated by peers, with the goal to assess the provider\'s quality of care. In the past, similar peer review-based approaches to the measurement of health care quality in other countries have shown a tendency to lack reliability. So far, the reliability of this component of the German statutory program for quality in health care has not been investigated.
METHODS: Using logistic regression models, the influence of the respective regional authority on the peer review component of health care quality measurement in Germany was investigated using three exemplary indicators and data from 2016.
RESULTS: Both the probability that providers are asked to provide a statement as well as the results produced by the peer review process significantly depend on the regional authority in charge. This dependence cannot be fully explained by differences in the indicator results or by differences in case volume.
CONCLUSIONS: The present results are in accordance with earlier findings, which show low reliability for peer review-based approaches to quality measurement. Thus, different results produced by the peer review component of the quality measurement process may in part be due to differences in the way the review process is conducted. This heterogeneity among the regional authorities limits the reliability of this process. In order to increase reliability, the peer review process should be standardized to a higher degree, with clear review criteria, and the peers should undergo comprehensive training for the review process. Alternatively, the future peer review component could be adapted to focus rather on identification of improvement strategies than on reliable provider comparisons.

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BACKGROUND: Peer-review of teaching materials (PRTM) has been considered a rigorous method to evaluate teaching performance to overcome the student evaluation\'s psychometric limitations and capture the complexity and multidimensionality of teaching. The current study aims to analyze the PRTM practices in Canadian and Australian universities in their faculty evaluation system.
METHODS: This is a qualitative content analysis study in which all websites of Canadian and Australian universities (n = 46) were searched based on the experts› opinion. Data related to PRTM were extracted and analyzed employing an integrative content analysis, incorporating both inductive and deductive elements iteratively. Data were coded and then organized into subcategories and categories using a predetermined framework including the major design elements of a PRTM system. The number of universities for each subcategory was calculated.
RESULTS: A total of 21 universities provided information on PRTM on their websites. The main features of PRTM programs were organized under the seven major design elements. Universities applied PRTM mostly (n = 11) as a summative evaluation. Between half to two-thirds of the universities did not provide information regarding the identification of the reviewers and candidates, preparation of reviewers, and logistics (how often and when) of the PRTM. Almost all universities (n = 20) defined the criteria for review in terms of teaching philosophy (n = 20), teaching activities (n = 20), teaching effectiveness (n = 19), educational leadership (n = 18), teaching scholarship (n = 17), and professional development (n = 14).
CONCLUSIONS: The major design elements of PRTM, categories and subcategories offered in the current study provide a practical framework to design and implement a comprehensive and detailed PRTM system in the academic setting.

The potential of artificial intelligence (AI) in the field of medical research is unquestionable. Nevertheless, the scientific community has raised several concerns about a possible fraudulent use of these tools that might be used to generate inaccurate or, in extreme cases, erroneous messages that could find their way into the literature. In this experiment, we asked a generative AI program to write a technical report on a non-existing Magnetic Resonance Imaging technique called Magnetic Resonance Audiometry, receiving in return a full seemingly technically sound report, substantiated by equations and references. We have submitted this report to an international peer-reviewed indexed journal, passing the first round of review with only minor changes requested. With this experiment, we showed that the current peer-review system, already burdened by the overwhelming increase in number of publications, might be not ready to also handle the explosion of these techniques, showing the urgent need for the entire community to address both the issue of generative AI in scientific literature and probably a more profound discussion on the entire peer-review process. CLINICAL RELEVANCE STATEMENT: Generative AI models are shown to be able to create a full manuscript without any human intervention that can survive peer-review. Given the explosion of these techniques, a profound discussion on the entire peer-review process by the scientific community is mandatory. KEY POINTS: • The scientific community has raised several concerns about a possible fraudulent use of AI in scientific literature. • We asked a generative AI program to write a technical report on a non-existing technique, receiving in return a full technically sound report, substantiated by equations and references, that passed peer-review. • This experiment showed that the current peer-review system might be not ready to handle the explosion of generative AI techniques, advising for a profound discussion on the entire peer-review process.

Bullying and misconduct in the realm of scientific and scholarly publishing have the potential to jeopardize the transparency and integrity of academic discourse. While misconduct issues among authors have been extensively discussed, the role of editors in perpetuating or mitigating such problems has garnered less attention. Scientific publishing serves as the gateway for disseminating innovative research findings globally, and the role of editors, especially Editor/s-in-chief, is pivotal in safeguarding the rigor and credibility of published research. Editor bullying and misconduct involve behaviors that undermine the scientific process, compromise research integrity, and harm the careers and wellbeing of individuals. These actions may manifest as biased decision-making, suppression of dissenting voices, or the exploitation of power dynamics in the peer review process. To address these issues, preventive and therapeutic approaches are suggested, including enhancing awareness, recognizing and mitigating exacerbating factors, and upholding professionalism. Moreover, the importance of a conflict-of-interest declaration for editors is highlighted to ensure transparency and integrity in the editorial process. The present mini-review aims to shed light on editor bullying, illuminating its gravity and the urgency to address these issues within the academic publishing domain/s. This review underscores the more subtle, yet equally significant, issue of professional misconduct in the editorial realm of scientific journals.

BACKGROUND: Preprints are increasingly used to disseminate research results, providing multiple sources of information for the same study. We assessed the consistency in effect estimates between preprint and subsequent journal article of COVID-19 randomized controlled trials.
METHODS: The study utilized data from the COVID-NMA living systematic review of pharmacological treatments for COVID-19 (covid-nma.com) up to July 20, 2022. We identified randomized controlled trials (RCTs) evaluating pharmacological treatments vs. standard of care/placebo for patients with COVID-19 that were originally posted as preprints and subsequently published as journal articles. Trials that did not report the same analysis in both documents were excluded. Data were extracted independently by pairs of researchers with consensus to resolve disagreements. Effect estimates extracted from the first preprint were compared to effect estimates from the journal article.
RESULTS: The search identified 135 RCTs originally posted as a preprint and subsequently published as a journal article. We excluded 26 RCTs that did not meet the eligibility criteria, of which 13 RCTs reported an interim analysis in the preprint and a final analysis in the journal article. Overall, 109 preprint-article RCTs were included in the analysis. The median (interquartile range) delay between preprint and journal article was 121 (73-187) days, the median sample size was 150 (71-464) participants, 76% of RCTs had been prospectively registered, 60% received industry or mixed funding, 72% were multicentric trials. The overall risk of bias was rated as \'some concern\' for 80% of RCTs. We found that 81 preprint-article pairs of RCTs were consistent for all outcomes reported. There were nine RCTs with at least one outcome with a discrepancy in the number of participants with outcome events or the number of participants analyzed, which yielded a minor change in the estimate of the effect. Furthermore, six RCTs had at least one outcome missing in the journal article and 14 RCTs had at least one outcome added in the journal article compared to the preprint. There was a change in the direction of effect in one RCT. No changes in statistical significance or conclusions were found.
CONCLUSIONS: Effect estimates were generally consistent between COVID-19 preprints and subsequent journal articles. The main results and interpretation did not change in any trial. Nevertheless, some outcomes were added and deleted in some journal articles.

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