How much effort is needed to keep up with the literature relevant for primary care?

OBJECTIVES: Medicine must keep current with the research literature, and keeping current requires continuously updating the clinical knowledge base (i.e., references that provide answers to clinical questions). The authors estimated the volume of medical literature potentially relevant to primary care published in a month and the time required for physicians trained in medical epidemiology to evaluate it for updating a clinical knowledge base. METHODS: We included journals listed in five primary care journal review services (ACP Journal Club, DynaMed, Evidence-Based Practice, Journal Watch, and QuickScan Reviews). Finding little overlap, we added the 2001 "Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library." We counted articles (including letters, editorials, and other commentaries) published in March 2002, using bibliographic software where possible and hand counting when necessary. For journals not published in March 2002, we reviewed the nearest issue. Five primary care physicians independently evaluated fifty randomly selected articles and timed the process. RESULTS: The combined list contained 341 currently active journals with 8,265 articles. Adjusting for publication frequency, we estimate 7,287 articles are published monthly in this set of journals. Physicians trained in epidemiology would take an estimated 627.5 hours per month to evaluate these articles. CONCLUSIONS: To provide practicing clinicians with the best current evidence, more comprehensive and systematic literature surveillance efforts are needed.     

The evaluation of peer-review quality

This paper discusses the role of peer review in the decision-making processes of scientific journals. It outlines the objectives of peer review and some of the problems. It then goes on to describe research into the quality of peer review, in particular the BMJ's programme of research to date, the results obtained, and consequent changes in practice. It also looks briefly at future possibilities for research into the peer-review process.     

Listening to our Students: Understanding the factors that affect Aboriginal and Torres Strait Islander students' academic success

While the number of Aboriginal and Torres Strait Islander students in higher education in Australia has doubled in recent years, the gap between their attainment and the attainment of other Australians has remained consistent. It is essential to elucidate the factors that promote Aboriginal and Torres Strait Islander students' academic success, not in order to justify the exclusion of these students from tertiary education, but to refine and develop curriculum and management strategies which promote their academic success. This study focuses on Aboriginal and Torres Straight Islander students' experiences in a diploma program offered in block mode, in order to better understand the ‘on-’ and ‘off-’ campus experiences which are related to academic success and the factors which challenge or enhance students' study. The research yields important findings related to students' motivations to enrol and their definitions of academic success; the challenges they experience in making the transition to tertiary study; the vulnerability of our students' determination to succeed; the effects of being in a program for Aboriginal and Torres Strait Islander students; and the ways in which minor challenges, if unresolved, can accumulate to interfere with students' study.