Going Beyond "Not Enough Time": Barriers to Preparing Manuscripts for Academic Medical Journals

Phenomenon: Many researchers have difficulty transforming raw data into publishable full-length manuscripts. Among studies presented at professional meetings, registered as clinical trials, or declined from specific journals, nonpublication rates are estimated to range from 25% to 60%. We aimed to characterize major barriers to manuscript preparation, beyond lack of time, for academics from a broad range of specialties at a tertiary academic medical institution. We explored whether major barriers evolved with increasing publishing experience. Approach: We surveyed registrants of 12 noncompulsory workshops on scientific publishing (April 2009-November 2015). Survey respondents indicated how many of their coauthored papers were accepted for publication in peer-reviewed journals in the past 5 years and stated what they found most difficult about preparing a manuscript, other than lack of time. Two investigators performed a content analysis of the reported barriers; mean agreement between coders was 98% (SD = 2%), and the mean Scott π coefficient for interrater reliability was 0.81 (SD = 0.26). We used a multimethod analytic approach to determine whether the perceived barriers varied with level of publishing experience. Findings: Surveys were returned by 201 of 256 registrants (79%). Thirty-eight percent of respondents had lower publishing experience (0-4 papers published in peer-reviewed journals in the past 5 years), 26% had medium experience (5-10 papers), and 35% had higher experience (>10 papers). Many respondents (57%) listed multiple barriers, but 5% listed zero barriers. The content analysis of the 370 reported barrier items identified 8 categories covering 38 concepts. The most common concerns (i.e., organization, writing, following journal format, defining the article scope, disliking writing, responding to reviewers) were not affected by author experience level. However, significantly more academics with higher experience expressed concerns about data presentation. Insights: Academics commonly reported barriers such as uncertainty about how to organize content, difficulty with developing succinct text, and frustration about meeting journal-specific formatting requirements. Greater experience in scientific publishing did not appear to mitigate these barriers. Academic institutions can provide targeted support for persistent challenges to scholarly productivity.