Editorial: Impact factors and clinical specialty nursing journals

Impact factors (IFs) continue to be used as an indicator of a journal’s quality despite extensive criticism about their value for this purpose. IF is a measure of the frequency with which articles in a journal are cited in a particular time period; it is the ratio of citations to articles in a journal in the current year to the articles published in that journal during the previous two years (Thomson Reuters 2010a). There are many reasons why IF is not a good indicator of the quality of nursing journals or importance of the author’s work. Considering the hundreds of nursing journals, few (n = 89) are indexed by Thomson to even generate an IF, and the most relevant journal for an author’s particular article may not be on the list. IFs are based on the frequency of citations and thus vary based on the citing behaviours within a field. Journals in rapidly growing areas of research with a large number of references per article have higher IFs compared with nursing (Owlia et al. 2011). Journals that publish review articles, which are cited frequently and contain many citations, have higher IFs (Cameron 2005), and journals can boost their own IFs by publishing more articles that cite the journal. Other characteristics of the journal such as the number of times the journal is published in a year, number of articles in it, restrictions on their page length and limits on the number of references to include with an article also influence IF (Johnstone 2007).

Nursing journals have low IFs, ranging from a high of 2·103 to a low of 0·034. For comparison, there are 23 critical care medicine journals indexed, and their IFs range from 10·191–0·232. Psychology journals (n = 73) range from 18·288, for an annual review journal, to 0·161 for a psychology journal from France. In the general medicine category with 153 journals, the New England Journal of Medicine has an IF of 53·486 (Thomson Reuters 2010b). As can be seen with these few examples, there is a wide variation in IFs across and within disciplines. The same is true in nursing. In earlier citation analysis studies, Oermann et al. (2008, 2010) categorised broadly the journal nursing literature as academic research journals with articles directed towards scientists and clinical specialty journals with articles written for clinicians. In nursing, the clinical specialty journals tend to have low IFs, and few of these journals are even indexed.

Impact factors measure the frequency of citations to a journal but not to an individual article in that journal. They do not reflect the importance of an article and the information it disseminates nor its use by readers. An article published in a low-impact nursing journal such as a study describing the effects on patient outcomes of hourly rounding on a unit may be an influential article to clinical practice yet have few citations to it. Many articles intended for clinicians and that improve patient care may never be cited or will receive a small number of citations (Cameron 2005). IFs are increasing as demonstrated in Smith’s recent report of a 722% increase in citations to seven core nursing journals, over 32 years (Smith 2010). However, it is unlikely that the clinical specialty nursing journals will enjoy a similar increase because while researchers write manuscripts for peer-reviewed journals and thus can influence IFs, clinicians are less likely to do so. As such, clinicians do not contribute towards the IF of a journal (Jette 2005).

The aim of dissemination is to reach an audience likely to be interested in the topic, read the article and consider the information for their own practice or research. This needs to be a primary consideration when choosing a journal for submission of an article regardless of IF (Oermann & Hays 2011). Disseminating research findings in clinical specialty journals is an effective strategy to reach clinicians who can use the information in their practice. Clinical specialty journals publish original research reports on topics of interest to their readers, and articles frequently cite other research studies, transferring the findings of studies published elsewhere to reach clinicians (Oermann et al. 2008, 2010). Although it is not known how many nurses actually read research reports published in clinical journals, it is more likely that they will read those articles than they would articles written for scientists published in journals that might have a high IF. There is scant literature on the reading habits of clinicians, but Leasure et al. (2008) found that none of the clinicians they surveyed read academic nursing research journals, but 64% read a clinical specialty journal.

Bibliometric studies of the nursing literature are needed to better understand citation patterns across all types of nursing literature and how they influence IFs of nursing journals. IFs vary widely across disciplines because of differences in citation practices, lag time between publication of an article and subsequent citations, proportion of citations to publications not indexed and other factors (Althouse et al. 2009). Not enough is known about citation patterns in the nursing literature. With more studies in nursing, normalised IFs might be determined for nursing journals. Owlia et al. (2011) developed a method for calculating normalised IFs that corrects for different citing behaviors in a field and allows for comparisons across fields; the normalisation significantly increased the IFs of nursing journals.

More studies such as these would benefit nursing faculty members in settings where publication in journals with a certain IF has been adopted as a criterion for assessing performance. IFs were never intended for use in judging the performance of faculty members, for promotion and tenure decisions, and for evaluating departments within an institution or for use in funding decisions. Within a nursing department, IFs should not be used to measure the quality of a faculty member’s research and publications. Until we know more about citation patterns in nursing literature, in settings where IF is used for comparison of faculty across fields or for making judgments about the quality of journals, nursing faculty members should explain the current state of IFs in nursing and why a particular journal was the best one to disseminate their work. They can review the types of articles that have cited their work, even if few in number, and examine how their research findings and ideas have been used in clinical practice, in teaching, for developing policies, and by other researchers. This type of review would provide evidence of the impact of the author’s work in contrast to the IF of the journal in which the work is published. Reaching the ‘right audience’ has to remain a primary consideration in choosing a journal, not its IF.