May/June Supplement 2001, Volume 5, Number 3

Submitting the Manuscript for Review

Rose Mary Carroll-Johnson, MN, RN

Once an author writes a manuscript, he or she must choose the most appropriate journal for submission. Between submission and publication, the author will need to respond to a peer review, revise the paper, and assist with the production process. Each step requires attention to detail and collaboration between the author and the editor to achieve successful publication and make the process a positive one for all concerned.

Although writing a manuscript for publication is the most difficult and time-consuming part of the process, the steps involved in submitting the manuscript to a journal, as well as the journey through the subsequent steps of the process, are critical to achieving success. A lack of attention to detail at any point will not mean failure, but care in planning and executing the submission and revision process can save time and unnecessary confusion on the part of the author, editor, and journal staff.

Once a manuscript has been prepared, the author must attend to a number of considerations, including selecting a journal, submitting the manuscript, undergoing and responding to peer review, revising and finalizing the manuscript as requested, and cooperating in the production process.

Matching your manuscript to the right journal is worth some careful consideration. There is one hard and fast rule about submitting a manuscript to a professional journal: A manuscript can be submitted to only one journal at a time. Because of this rule, you will want to avoid wasting time by submitting to an inappropriate journal. This also minimizes the chance of outright rejection.

Authors often decide which journal to submit to before writing their manuscripts, although this decision does not have to be made first. Choosing the most appropriate journal is best done by following certain steps, regardless of where you are in the writing process.

References exist to expose potential authors to the wide variety of nursing and biomedical publications available today. Although compilations of information about journals are available (e.g., Daly, 2000), you should read the journal's specific author guidelines for a description of its mission, audience, and the types of articles published. Spend some time really looking at possible target journals. Even if you want to submit to a journal you read regularly, look again at the journal with the following in mind.

• Make note of what kind of articles the journal publishes. You would not want to send a first-person account to a journal that only publishes research reports.
• What is the tone of the journal? Is it light and informal (e.g., use of first person), or is it serious and scientific? (Grant, 1998). Is the tone of your paper consistent with that of the target journal?
• Note the breadth and depth of the topic coverage. Do the articles cover topics narrowly and superficially with only four or five references, or is the information presented in-depth and comprehensively with extensive referencing? Does your manuscript match the journal's style?
• Can you find examples in the target journal of the type of article you want to write (e.g., case reports)?
• Does the journal reach the audience you want to reach?

Negative responses to these questions or answers that indicate your paper deviates from what the journal usually publishes should raise suspicion that you may not be choosing wisely. Choosing the wrong journal can result in outright rejection or, worse, rejection only after a lengthy peer review that reveals the paper is just not suitable.

A query letter, which can be directed to multiple journals simultaneously, may do some of the work for you. A well-written query letter will contain specifics about the manuscript: who you are writing for, the scope of the content (including a content outline or detailed description), the approximate length, and your planned timeline for completion/submission. If you have questions about certain aspects of the manuscript (e.g., length, scope of coverage), use a query letter to ask the editor's advice. Some journal editors require a query letter as part of the submission process, whereas others may respond to a query letter but do not require one. The journal's author guidelines usually specify the editor's preference. You also may consider contacting the editor more informally via phone or e-mail. You should be prepared to describe your manuscript during this contact.

Just prior to sending the manuscript to the editor, reconfirm that you have chosen the right journal, especially if your manuscript turned out to be substantially different than you originally envisioned or you made the journal decision prior to actually writing the paper.

The journal's author guidelines will give you the specifics of how to submit your manuscript, including where to send it and how many copies to include. You may want to prepare a checklist for yourself based on the author guidelines. A sample generic checklist is presented in Figure 1. Be sure to add any journal-specific requirements. Attention to detail will convey to the editor that you are professional and pay attention. This will not make up for any serious deficiencies in the manuscript, but it will foster a professional atmosphere and help to establish good working relationships between you, the editor, and journal staff.

Most journals acknowledge receipt of manuscripts. If you have not received a response in three weeks, contact the editorial office. Once a manuscript is "in the system" (see Figure 2), weeks or months may pass before you receive further information from the journal (Benner, 1998; Grant, 1998). Be patient. Follow up on the status of your manuscript if you have not heard anything in three to four months.

Most nursing journals today have a system of peer review. Peer review is a process to help evaluate the quality and desirability of a manuscript (King, McGuire, Longman, & Carroll-Johnson, 1997). Usually the manuscript is submitted to two or three peer reviewers. They are usually content experts, experienced authors themselves, representative of journal readership, and anonymous. In addition, peer reviewers typically are not told the name of a manuscript's author. This system, known as blind peer review, is believed to improve manuscripts (Goodman, Berlin, Fletcher, & Fletcher, 1994). Reviewers comment on the following.

• Suitability for the journal
• Timeliness
• Accuracy
• Originality
• Quality of presentation

Reviewer feedback is shared with authors in a variety of ways, depending on the journal. Editors may share direct reviewer feedback (e.g., copies of completed review forms), or they may synthesize the reviews and paraphrase them for the author.

Reviewers often offer divergent opinions about a manuscript or address different aspects. The editor is responsible for sorting out the comments for the author, helping to determine the real nature of the problem at the root of the reviewers' comments, and helping authors understand what to fix and how to fix it (Johnson, 1996).

The Psychology of Peer Review

Whether you are a seasoned author or writing your first paper for publication, reviewer feedback is likely to generate some negative feelings (Woodford, 1986). This will be the case regardless of whether the critique is supportive and constructive or perceived to be petty and rude. Often, authors initially respond to criticism by bristling and being defensive. The secret to success in publishing is to find a way to move beyond those negative feelings and look at the feedback with as objective an eye as possible. Some strategies that are helpful may be to (a) set the manuscript aside for a short time to get some distance from it, (b) ask a colleague for his or her opinion about the reasonableness of the feedback, or (c) address the issues point-by-point rather than looking at the feedback as a whole.

If your paper is rejected, do not just give up. Look at the reason for the rejection as objectively as possible. If the reason had nothing to do with the quality of the paper per se (e.g., another paper on the topic may have just been accepted or the paper is judged inappropriate for the journal), reformat it (as necessary) for another journal and submit it elsewhere. If the paper is rejected because it simply has too many problems, look at the critiques carefully, fix the problems, and submit it to another journal. Do not accept a rejection with no stated reasons. Contact the editor for more information and for suggestions about what to do next.

Do not wait too long to get started, no matter what you need to do. If the editor has given you a deadline, work hard to respond in the time allotted. Set up a timeline for doing your revisions, and stick to it. The faster you turn the paper around, the more likely you are to do the work. The longer you wait, the more likely it is that you will never revise the paper.

With regard to the feedback from the peer review, your responsibilities as an author include the following.

• Consider and acknowledge each major issue. You do not necessarily need to take every piece of advice or change everything a reviewer says to, but consider each point. Argue your case to the editor if you believe that reviewers' advice is not in the best interest of the paper.
• Remember that reviewers are representative readers. If a reviewer has missed the point or has not understood something that you feel is quite evident, others also may have trouble. Be as clear and detailed as possible to explain your points.
• Realize that reviewers make mistakes. Do not be afraid to argue your position. This advice pertains to the substance of your article. Once your mansuscript is accepted, it will be edited--copyedited, substantively edited, and content edited. As an author, you need to focus on the accuracy of the content and not whether aspects of the manuscript are changed to conform to journal style.
• Be prepared for reviewers to disagree. Often times, one reviewer may be quite critical and another offers glowing recommendations. The truth usually lies somewhere in between these opposing views. The editor's job is to help authors sort it all out. Do not hesitate to call and ask for help reconciling differing points of view.
• Remind yourself about the paper you wanted and intended to write. A fine line exists between critiquing the paper in hand and offering opinions about the paper that reviewers wish had been written. Some reviewers have difficulty toeing that line. Do not let yourself be forced into writing a paper that you had no intention of writing.

If you cannot reconcile the reviews or are unwilling to make the requested changes, talk with the editor. Perhaps the paper should be submitted elsewhere. You will need the editor to release the paper before you are free to submit it to another journal.

When you have completed the revisions and are ready to resubmit the manuscript to the editor, retrace all the steps you followed with the first submission. Prepare a cover letter describing the changes you made, justifying your decisions regarding reviewer suggestions, and stating your case if you chose not to make requested adjustments. Do this even if you spoke to the editor. If your manuscript needs to be re-reviewed, enclose the appropriate number of copies and be prepared to wait for a response just as you did after the first submission. Whether the original reviewers review the revised paper will be a matter for the editor to decide.

If your paper was accepted with revisions, a few extra steps are in order.

• Review the editor's letter carefully to determine how many copies of the manuscript you need to send, how you should prepare the computer disk (see Johnson, 1997), what form any artwork should be in, what forms (e.g., copyright assignment) you may need to sign, and any specific journal requests.
• Gather the necessary letters for permission to reprint tables and figures from other sources. Send the original permission letter(s) to the editor and keep a copy for your files.
• Recheck your references. Ensure that each reference cited is in the reference list and vice versa. Ensure that names are spelled correctly and that years of publication are accurate.
• List any acknowledgments you may have. Include correctly spelled names and full credentials, and acknowledge the contribution each person made to the manuscript.

Once the editor accepts your revisions, he or she will set a tentative date for publication. The editor must consider many factors, including how many manuscripts are in the publication queue, how often the journal is published, how many editorial pages are available, how timely and time-dependent your manuscript is, and whether pairing your manuscript with others that have been scheduled for publication would be advantageous. Time to publication can range from three months to two years. Remember that the dates you are given are tentative. The editor may need to bump your paper to a later issue or may be able to move up the schedule depending on circumstances. Do not hesitate to discuss scheduling with the editor if you want more specific information about a particular journal's schedule.

Manuscripts that are "in production" (i.e., being prepared for publication) undergo some fairly routine processes regardless of the journal. At some point, the editor will address editorial concerns. Although some editors are more hands-on than others, all will provide some degree of input. Second, the manuscript will be copyedited. Copy editors address the technical details of the paper (e.g., spelling, punctuation, sentence structure, clarity of headings, consistency of format, correspondence between references and reference lists, adherence to journal style, reference formats).

Copy editors may input all of the changes, including any author queries (i.e., questions you need to answer), or they may return a marked-up copy of the paper to you with a request that you input the changes. Scrutinize all changes carefully to ensure that the editing did not change meaning or introduce inaccuracies into the text (Johnson, 1998). Answer every question. Adhere strictly to the deadlines given to you because production schedules offer little flexibility. If you are asked to turn a manuscript around in three days, drop everything and do it. If you have the type of schedule that makes that difficult, ask ahead of time for some indication of when to expect the manuscript so you can plan around it. If you anticipate being away from home or work during a critical time, plan for a way to be contacted (e.g., by phone, fax, or e-mail) so that your manuscript does not hold up journal production or get postponed to a later issue.

Some journals will elect to change some manuscripts more than others. The journal staff may delete content, rearrange text, and devise different methods to deliver information (e.g., taking text out to create a table or sidebar). The editing stage may seem as unpleasant as the peer review. Again, you must develop perspective, understand that a journal basically treats all papers alike (from both new and seasoned authors), and understand that learning how to work with an editor and copy editor through this stage is a valuable skill if you want to continue your writing activities. Discuss your concerns with the editor, whose job is to bridge the gap between you--the content expert--and the production staff--the information-delivery experts. Publication is a partnership, with each partner contributing his or her expertise. Clarity about these roles will facilitate the process.

Finalized versions of the manuscript may be returned to the author in computerized form, as page layouts, or as galleys (long columns of typeset material). Read every word from the title to the references to ensure that nothing was unintentionally missed. Review the tables and figures carefully, particularly with respect to line and column alignment. Remember, this is not the time for substantive changes. If a major change is warranted because of the availability of new information, call the editor for advice.

Nothing is quite so daunting or gratifying as seeing your manuscript successfully published. It is a difficult job but can be made easier with attention to detail and an understanding of each step of the process and how each step contributes to the final product. Once your article is published, you may receive requests for reprints, feedback to the points you made, or questions to answer. If these communications occur formally via the editor, work to respond professionally and reasonably. Just as you did when writing the paper, work with the editor to complete the cycle. Last, but never least, begin to plan your next publication. You are well on your way to a successful writing career.

Benner, J. (1998). 10 tips for successful and fun publishing. Nurse Author and Editor, 8 (3), 8.

Daly, J. (2000). Writer's guide to nursing publications. Thousand Oaks, CA: Sage.

Goodman, S.N., Berlin, J., Fletcher, S.W., & Fletcher, R.W. (1994). Manuscript quality before and after peer review and editing at Annals of Internal Medicine. Annals of Internal Medicine, 121, 11-21.

Grant, J.S. (1998). Writing manuscripts for clinical journals. Home Healthcare Nurse, 16, 813-822.

Johnson, S.H. (1996). Dealing with conflicting reviewers' comments. Nurse Author and Editor, 6 (4), 1-3.

Johnson, S.H. (1997). Submitting your manuscript on disk. Nurse Author and Editor, 7 (4), 1-4, 7-8.

Johnson, S.H. (1998). The proofing challenge: Finding hidden errors. Nurse Author and Editor, 8 (3), 1-4, 7.

King, C.R., McGuire, D., Longman, A., & Carroll-Johnson, R.M. (1997). Peer review, authorship, ethics, and conflict of interest. Image, 29, 163-167.

Woodford, F.P. (Ed.) (1986). Scientific writing for graduate students. Bethesda, MD: Council of Biology Editors.

Rose Mary Carroll-Johnson, MN, RN, is the editor of Oncology Nursing Forum and Nursing Diagnosis: The International Journal of Language and Classification. She resides in Santa Clarita, CA.

Author Contact: Rose Mary Carroll-Johnson, MN, RN, can be reached at P.O. Box 801360, Santa Clarita, CA 91380-1360 or at rose_mary@earthlink.net.

Submitting a Manuscript for Review

• Attention to detail at the time of manuscript submission can facilitate the process.
• Choosing the right journal for the manuscript you have written is a critical part of the process.
• Following some simple rules of etiquette can foster development of a professional relationship with the editor and editorial staff.
• The editor's role involves helping the author sort through reviewer comments, designating what changes need to be made, and content editing of the manuscript.
• Even though the production process is technical in nature, the author has an important role to play to ensure a quality publication.
• Publishing success is the result of collaboration among the author, editor, peer reviewers, and production staff.

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