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Top-Cited Articles in Medical Professionalism: a Bibliometric Analysis Versus Altmetric Scores

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Top-Cited Articles in Medical Professionalism: a Bibliometric Analysis Versus Altmetric Scores Open access Research BMJ Open: first published as 10.1136/bmjopen-2019-029433 on 31 July 2019. Downloaded from Top-cited articles in medical professionalism: a bibliometric analysis versus altmetric scores Samy A Azer, 1 Sarah Azer2 To cite: Azer SA, Azer S. ABSTRACT Strengths and limitations of this study Top-cited articles in Introduction Citation counts of articles have been used medical professionalism: a to measure scientific outcomes and assess suitability ► Four searches were conducted in the web of Science bibliometric analysis versus for grant applications. However, citation counts are not altmetric scores. BMJ Open database and the altmetric tracks. without limitations. With the rise of social media, altmetric 2019;9:e029433. doi:10.1136/ ► The analysis explored a range of bibliometric scores may provide an alternative assessment tool. bmjopen-2019-029433 parameters. Objectives The aims of the study were to assess ► The study was limited to top-cited articles in the ► Prepublication history and the characteristics of highly cited articles in medical English language. additional material for this paper professionalism and their altmetric scores. are available online. To view Methods The Web of Science was searched for top-cited please visit the journal (http:// articles in medical professionalism, and the characteristics dx. doi. org/ 10. 1136/ bmjopen- of each article were identified. The altmetric database the higher quality of work and the more likely 2019- 029433). 3 was searched to identify report for each identified article. that other researchers cite the work. While Received 25 January 2019 A model to assess the relationship between the number these claims may not necessarily be true, Revised 26 April 2019 of citations and each of the key characteristics as well as there is a substantial body of evidence that Accepted 1 July 2019 altmetric scores was developed. the number of citations correlates with other Results No correlations were found between the number research achievements including research of citations and number of years since publication awards, honours, nomination for Nobel laure- (p=0.192), number of institutes (p=0.081), number of ateship,3 4 prestigious research positions5 authors (p=0.270), females in authorship (p=0.150) or and academic ranking.6 7 However, there are number of grants (p=0.384). The altmetric scores varied from 0 to 155, total=806, median=5.0, (IQR=20). Twitter factors other than scientific quality that may 8 http://bmjopen.bmj.com/ (54%) and Mendeley (62%) were the most popular affect the decision to cite. For example, there altmetric resources. No correlation was found between the is evidence that early interest in a research number of citations and the altmetric scores (p=0.661). publication reflected by online access within However, a correlation was found for articles published in a week of publication predicts citations up to 2007 and after (n=17, p=0.023). To further assess these 15 years later.9 Also, scientific citations favour variables, a model was developed using multivariate positive results and authors tend to cite analysis; did not show significant differences across primarily works by authors with whom they subgroups. The topics covered were learning and teaching know and personally acquainted.10 11 professionalism, curriculum issues, professional and With these limitations in mind, there is a on October 6, 2021 by guest. Protected copyright. unprofessional behaviour. continuous search for alternatives or metres © Author(s) (or their Conclusions Altmetric scores of articles were significantly employer(s)) 2019. Re-use correlated with citations counts for articles published in that can complement the citation counts. permitted under CC BY-NC. No Currently, there is a rising interest in the commercial re-use. See rights 2007 and after. Highly cited articles were produced mainly and permissions. Published by by the USA, Canada and the UK. The study reflects the altmetric scores. Contrary to traditional cita- BMJ. emerging role of social media in research dissemination. tion-based analysis, the altmetrics reflect the 1Professor of Medical Education, Future studies should investigate the specific features of widespread attention to published scien- Department of Medical highly cited articles and factors reinforcing distribution of tific articles and the rise of social media for Education, King Saud University, research data among scholars and non-scholars. dissemination and discussion of scientific College of Medicine, Riyadh, information. Therefore, it is possible to quan- Saudi Arabia 2 tify discussion of an article on blogs, news Senior Robotic Fellow, 12 Department of Urology, INTRODUCTION media or other social media platforms. Southmead Hospital, Bristol, Citation counts have been used by universi- Considering these two tools, it was decided United Kingdom ties and funding bodies to measure scientific to assess highly cited articles on medical outcomes, make decisions about professional professionalism.13 14 The top-cited arti- Correspondence to Professor Samy A Azer; promotion and assess suitability for grant cles were selected because an earlier study 1 2 azer2000@ optusnet. com. au, applications. In this context, it was claimed revealed a number of attributes of articles mcqsmcqs@ hotmail. com that the higher number of citations received, on medical professionalism.14 The use of the Azer SA, Azer S. BMJ Open 2019;9:e029433. doi:10.1136/bmjopen-2019-029433 1 Open access altmetric scores in this study in particular is thought to be different resources contributing to altmetrics. At the end, BMJ Open: first published as 10.1136/bmjopen-2019-029433 on 31 July 2019. Downloaded from useful since articles on professionalism are usually shared we compared these findings with those obtained from the on social media. citation analysis.15–17 A description of the steps used in the Therefore, the present study aims at the following: search is discussed below. first, identify the most-cited articles in medical profes- sionalism and evaluate their characteristics, and study any Searching the web of science database using keywords correlations between the number of citations and each Searching the Web of Science database was carried out in of their biliometric characteristics. Second, assess the the 5 April 2017 by two researchers (SAA is a professor of impact of such articles on social media by calculating the medical education with a 20-year experience in research altmetric scores and conducting an exploratory analysis in the field of medical education and professionalism, examining the altmetric findings compared with citation and SA a surgical registrar and researcher). The search analysis. The conduction of multivariate analysis model words used were the following: ‘Medical professionalism’, may provide additional insight into such evaluation. The ‘Patient safety’, ‘Professional behavior’, ‘Unprofessional findings from this study may enable researchers to iden- behavior’, ‘Role modeling’, ‘Accountability’, ‘Faculty tify common features of articles behind the progress of training in professionalism’, ‘Altruism’, ‘Physician code’, medical professionalism and key topics discussed over the ‘Physician charter’, ‘Medical ethics’, ‘Integrity’, ‘Consent’, last two to three decades. The study may provide more ‘Defining medical professionalism’, ‘Empathy’, ‘Compas- insight into any relationships between citation analysis sionate doctor’, ‘Professional conduct’, ‘Collaborative and the altmetric scores. The identified list of publi- doctor’, ‘Self-assessment’, ‘Professional development’, cations may be useful to medical educators and those ‘Resilient doctor’, ‘Social justice’, ‘Patient autonomy’, teaching medical professionalism or doing masters or ‘Patient Welfare’, ‘Professional responsibility’, ‘Managing research in these areas. conflict’, Patient confidentiality’, ‘Quality of care’, ‘Social contract’, ‘Team work and professionalism’, ‘Personal development’, ‘Public professionalism’, ‘Interpersonal METHODS professionalism’ and ‘Intrapersonal professionalism’. Study design These keywords were identified from the terminology To achieve the objectives of this study, it was decided to and themes used in defining medical professionalism in search the Web of Science database of Clarivate Analytics six resources including.18–23 We also looked at conference for highly cited articles and track the citation records of proceedings in the field and websites of organisations and publications identified. Although Scopus and Google agencies responsible for accreditation of medical educa- Scholar databases also provide citation tracking, it was tion worldwide including: The World Federation for decided to limit the search to the Web of Science. This Medical Education, the UK’s General Medical Council, is because the Web of Science is regularly updated and the Association of American Medical Colleges, the Austra- http://bmjopen.bmj.com/ its 2016-Journal Citation Reports reported over 59 million lian Medical Council, the Liaison Committee on Medical citations in its Science Edition and 7 million from its Education, and the Quality Assurance of Basic Medical Social Science Edition. In the area of medical educa- Education, and documents such as: Tomorrow’s doctors, tion, medical ethics and bioethics, general medicine and 2003; The New Doctor, 2004; and General Medical Prac- surgery, the Web of Science has included 16, 49, 457 and tice, 2001. 180 peer-reviewed journals, respectively. Google
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