Just Rewards: Continuing Medical Education Credit for Peer Review of Manuscripts

THE NATIONAL KIDNEY Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide Continuing Medical Education (CME) for physicians in the United States. Effective December 1, 2005, the National Kidney Foundation will offer Category 1 credit for the peer review of manuscripts submitted to the American Journal of Kidney Diseases. Why?

Why peer review? Peer review generally is considered to be a critical underpinning of scientific inquiry. Because science is by definition the forefront of knowledge, only peers can judge the importance of a scientific study. This critical appraisal serves a number of purposes. First and foremost, it prevents mistakes from being made. It also improves the quality of scientific reporting by selecting studies that are of sufficient quality to warrant publication and by ensuring that appropriate manuscript revisions are made.

Peer review also is important for authors. It gives authors valuable direction in their scientific studies and teaches them how best to communicate their results to others. Importantly, peer review contributes to the social fabric of academia by providing the benchmark (publication of peer-reviewed articles) for promotion, tenure, and academic standing.

Why do peers peer review? Few journals pay for peer review. Many reviewers list in their curriculum vitae the journals for which they have reviewed and thereby possibly gain recognition that may be important for their academic careers. However, the spirit of voluntarism should not be underestimated. Many have chosen a career in academic medicine for reasons other than economic or social gain, and peer review can similarly be performed for altruistic reasons. Of course, peer review also is educational. By critically appraising the work of others, we learn to critically appraise our own work.

It is the educational nature of peer review that creates the rationale for offering CME credits to peers who review. However, implicit in offering CME credit is having a method for judging the quality of the reviews and for offering feedback to reviewers. Amazingly, what constitutes a good review is poorly defined. Recently, semiquantitative scoring systems have been developed in an attempt to reproducibly measure the quality of peer reviews. We have adopted a method developed and tested by van Rooyen et al1 that asks the following questions: (1) Did the reviewer discuss the importance of the research question? (2) Did the reviewer discuss the originality of the report? (3) Did the reviewer clearly identify the strengths and weaknesses of the methods (study design, data collection, and data analysis)? (4) Did the reviewer make specific useful comments on the writing, organization, tables, and figures of the manuscript? (5) Were the reviewer’s comments constructive? (6) Did the reviewer supply appropriate evidence, using examples from the report to substantiate his or her comments? (7) Did the reviewer comment on the author’s interpretation of the results?

Reviewers who return their review on time, apply for CME credit by answering 5 questions on the review form, and submit a review that meets a minimum overall-quality score will be awarded up to 3 hours of Category 1 CME credit (maximum of 15 credits per year). Our hope is that offering CME credit will help validate and strengthen the importance and educational nature of peer review and will offer a small token of our appreciation for the valuable role that our peer reviewers play.