Peer-reviewed Reports in Medical Education Research (PRiMER) publishes research briefs of original research relevant to education in family medicine and closely related areas (primary care, preventive medicine, public health, etc.). As a companion to other STFM-sponsored journals, PRiMER is focused on medical education and health workforce policy. The journal does not publish clinical reviews, clinical research, or other articles that are not related to primary care education or workforce development. However, the journal will consider non-educational research, including clinical research, if the research has a family medicine focus and the first author is a medical student or family medicine resident. In addition to original research, PRiMER will also publish editorially – reviewed letters to the editor, as well as invited short reviews, commentaries, and editorials. Case reports will not be accepted.
The main focus of PRiMER is to publish research briefs (1,000 words or less) that succinctly present research. Submitted manuscripts may evolve from recent conference presentations, or may be based upon studies or projects that are smaller in scope, exploratory, confirmatory, or in an early stage of development (e.g. pilot studies).
PRiMER is designed to serve as a bridge between the presentation of research results at conferences (such as those hosted by the Society for Teachers of Family Medicine [STFM] or the North American Primary Care Research Group [NAPCRG]), and the development of full-length articles that would be suitable for submission to the journal Family Medicine. The goals of PRiMER are to:
- Provide an outlet for the scholarly exchange of new knowledge and educational innovations that would otherwise not be disseminated after a conference presentation.
- Facilitate scholarly productivity and writing skills development of early-stage scholars, including researchers, residents, students, and clinical faculty focused on teaching and educational practice.
- Engage and develop early-stage scholars as manuscript reviewers under the guidance of the editorial team.
PRiMER accepts manuscript submissions in the following categories:
Research Briefs are scholarly manuscripts describing original research, rigorous analyses, or brief systematic reviews germane to the broad disciplines of family medicine and primary care education in the United States and other nations.
The editorial team will consider non-educational research, including clinical research, if (and only if) the first author is a medical student or family medicine resident AND the research has a family medicine focus. The instructions for Research Brief should be followed for these manuscripts as well. Non-educational, student/resident-led manuscripts should be submitted using the Learner Research category in the manuscript submission system.
Letters to the Editor:
Letters to the editor must be brief (500 words or less), written in professionally appropriate parlance, and referenced appropriately (maximum 5 references). Letters to the Editor may not include tables or figures, unless requested by the editor.
Occasionally, the editor may request, invite, or call for review articles, commentaries, or editorials. These will, in all cases, be invited by the editor, and will in all cases be submitted for editorial or peer review as appropriate.
- All submissions to PRiMER should be composed in Microsoft Word in a manner consistent with the uniform instructions for authors as published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: www.icmje.org.
- Authors should only be listed on the title page
- All reports of original research must have approval by an appropriate institutional review board (IRB), and this approval must be explicitly confirmed in the paper (preferably in the Methods section).
- Manuscripts should be clear, succinct, and well documented. Manuscripts must be well written and correctly use syntax, grammar, spelling, and symbols to assure accurate transmission of information. Text should avoid sexual and racial bias and use gender inclusive language whenever possible. In general, passive construction should be avoided.
- Abbreviations and acronyms should be kept to a minimum and spelled out on first reference.
- All drug names should be generic.
- HEADINGS should use all capital letters, centered and underlined, for major section headings.
- Subheadings are encouraged and should be left-justified and underlined.
- Justify only the left-hand margin. Do not hyphenate words at the margin. Use one space, not two, following the period at the end of each sentence. The manuscript should not include a running header or footer.
- Page Numbers: All pages should be numbered, including the title pages, abstract, main text, references, tables and figures. Although it is preferred for the tables and figures to be uploaded in a file separate from the main text, the table and figure page numbers should coincide with their approximate placement within the manuscript.
- All submissions should be written in a journal-style format, adhering to all the above guidelines. The manuscript preparation tab will provide you with details.
The entire manuscript should be double-spaced in an 8 1/2" x 11" portrait layout format with one-inch (1") margins and a 12-point font. Note: Tables and Figures may be single-spaced. All manuscripts should be formatted with the following sections:
- Title of 75 characters or less
- Name, professional degree, and institutional affiliation of each author,
- Name, address, telephone number, fax number, and e-mail address of the corresponding author,
- Date of submission
- Word count for the main text (ie, excluding abstract, references, tables, figures, and legends)
- Financial support for the project being reported, if applicable
- Presentations: the name, date, and location of any professional meetings at which the content of the manuscript has been presented or will be presented before publication
- Conflict Disclosure: disclosure of all conflicts of interest for any and all authors
- Key Words: two to six key words, using standard Index Medicus terminology
Abstract (Research Briefs, Learner Research, Special Articles):
All research and review articles require an abstract of no more than 250 words. The abstract should have four sections: Introduction, Methods, Results, Conclusion.
Main Text (All Manuscripts):
Maximum Length 1,000 Words
- Introduction: The introduction section of manuscripts reporting research or educational interventions should generally include a brief review of relevant literature to establish the need for the research project and/or the educational intervention being reported. The Introduction section should always address the following questions:
1. What issue is being addressed?
2. Why is the issue important?
3. How will the discipline of family medicine and/or medical education benefit from having addressed the issue?
4. What have others done to address the issue?
5. What were your objectives for the research or educational intervention?
- Methods: For both qualitative and quantitative research, the methods should be described in sufficient detail to permit readers to fully understand how the research was performed. This should include a complete description of sampling methods, instruments used, methods of data collection and data analysis, and steps taken to avoid or adjust for bias and confounding.
1. All manuscripts reporting research that involves human subjects (both educational research and clinical research) should include a statement indicating that the research has been reviewed and approved, or granted an exemption from formal review, by an appropriate human subjects protection committee (institutional review board).
2. Manuscripts reporting educational methods, curricula, or interventions should include a description of the educational method, curricula, or intervention, in sufficient detail to permit readers to understand how the activity might be reproduced at their own institutions.
3. Research on educational methods, curricula, or other interventions must include an evaluation of the effect of the intervention. A description of the techniques used for evaluation should be described in the methods section of the manuscript.
4. For manuscripts reporting non-interventional work, it is important that authors carefully describe methods, curricula, and other aspects of their work to provide a full sense of the scope and nature of the project.
- Results: Results should be presented in coherent fashion and should be specifically tied to the objectives and methods presented earlier in the manuscript.
- Conclusions: This section should:
1. State the principal findings of the research or educational intervention.
2. Explain why those findings are important.
3. Comment on methodological weaknesses of the study.
4. Provide an overall conclusion.
5. Discuss potential next steps for further research or educational intervention.
Authors should not draw conclusions or make inferences that are not specifically supported by the data reported in the study.
Tables and Figures: Authors should follow the AMA Manual of Style guidelines for the Visual Presentation of Data when preparing tables and figures. Provide no more than a total of 5 tables or figures. Figures should be provided in their original form (ie, jpg, tif, etc)
References (All Manuscripts):
Use of a reference management software package is strongly recommended (such as Mendeley.com, RefWorks.com, Endnote, etc.).
Acknowledgments (All Manuscripts): Acknowledgments should be brief and appear on a separate page, following the references. All contributors who do not meet the criteria for authorship should be listed under acknowledgments. Authors should obtain permission from persons being acknowledged before including their names in the work.
Some material is more appropriate to be placed in an appendix than in the body of a manuscript. PRiMER handles appendix material via the STFM Resource Library (http://resourcelibrary.stfm.org/home
). The following items should be included as Appendices:
- Full Curricular Descriptions
- Survey or Questionnaire tools
- Standardized Patient Case Descriptions
- Assessment Tools
- Similar items that the authors or editors deem appropriate as an appendix
- Note: Editor-in-Chief makes final decisions about appendices
Items intended to serve as appendices to a manuscript should be:
- Submitted to the STFM Resource Library as a "General Resource"
- Once the resource is created, the manuscript should then cite the resource (along with all other citations to journal articles, in the reference section).
Submit a Manuscript
Submit manuscripts using our Online Manuscript Submission System. If you already have an user account with Family Medicine, you can login using that same account.
Quality Guidelines for Authors and Reviewers
Manuscript Quality—PRiMER seeks to publish papers that rigorously evaluate educational interventions and learning outcomes or test for behavioral changes resulting from an educational intervention. While we will consider manuscripts that the Annals of Family Medicine or Family Medicine might reject, this is not because we lower the level of rigor expected in the study design or execution. PRiMER will consider small studies, pilot projects, single-institution studies, work that seeks to replicate or confirm findings that are already known, or research that explores a broadly known construct in a new context. Print journals may be less likely to accept these manuscripts due to printing costs and concerns that they are not sufficiently impactful in the field. Published papers in PRiMER must still contribute knowledge that incrementally adds to what is known about a topic or phenomenon. We will consider quantitative, qualitative, and mixed methods submissions that are sufficiently rigorous.
We generally will not publish “reactions” to new curricula or interventions (eg, surveys of learners about satisfaction with a course) unless the learning modality or instructional content is new, there is generalizable knowledge to be gained by instructors at other institutions, and key portions of the instructional materials are made available (typically by references to a stable format for publication of online content, such as the STFM Resource Library).
Manuscripts outside the scope of medical education may also be considered for PRiMER publication if the first author is a medical student or a family medicine resident, and the content is pertinent to family medicine as a broad discipline. Resident and student manuscripts will be held to the same quality standards outlined below.
For a general overview of research methods, consider this free online methods guide: The Research Methods Knowledge Base (https://www.socialresearchmethods.net/kb/)
The following elements should be included in all submissions when applicable:
- Data sources must be fully identified
- Human subject recruitment procedures must be described, if applicable, including:
- Institutional Review Board (IRB) interactions (see statement below)
- Consent processes
- Participation Incentives
- Recruitment procedures, description of outreach, etc.
- Description of the sample characteristics, and as appropriate, a comparison of the sample to the population the sample should represent, or from which it is drawn
- Limitations: Given the nature and mission of PRiMER, we expect that submissions will generally have extensive limitations. Rather than aiming for flawless studies, we prefer to have a comprehensive description of all limitations, to allow complete assessment of quality by reviewers, and fully informed interpretation by readers. The statement of limitations is included as part of the Discussion section, as it is in most scientific journals.
- A statement about an interaction with an IRB should be present in most studies, except as noted below. As a general rule, studies that utilized publically available data (eg, public CDC data sets, reviews of published literature, observation of public activity, opinion or theory pieces, etc) do not require any IRB interaction. All other studies require IRB interaction. All manuscripts that require an interaction with an IRB should stipulate which type of interaction occurred:
- IRB determination that a project is “not research” (eg, quality improvement or assurance) or “not human subjects research” (eg, biological samples of deceased individuals).
Example: “This project was determined by #### IRB to constitute a quality improvement activity, and not human subjects research.”
- IRB determination that a project is research, but exempt from review
Example: “As an anonymous survey, this project was determined to be exempt from review by ### IRB, citing exemption #2.”
- IRB review (expedited or full review). Example: “This project was reviewed and approved by ### IRB.”
Manuscripts are expected to consist of the following structural elements, in order:
- An Introduction and literature review should lead to the study question(s). The literature review should include and refer to appropriate literature. There should be a description of the research question(s) and hypotheses to be tested or problems to be solved by the project
- A Methods section should be appropriate to answer the study questions. The methods should predict all reported results (eg, if the authors say they conducted a t-test, the results of the t-test should appear in the results).
- A Results section should be directly tied to all steps in the methods section.
- A Discussion section should explain the meaning of the results and help readers place the research findings in appropriate context. The discussion section should not take “flights of fancy.” More information on writing an effective discussion section is available at: http://www.rcjournal.com/contents/10.04/10.04.1238.pdf. The Discussion section should also contain a clear and complete description of study limitations.
- References should be listed in standard format, and follow AMA style. (consistent with Family Medicine).
- Appendices (optional): Material that might go into an appendix should be handled by having the author submit the item (a curricular description, survey form, etc) to the STFM Resource Library, and then cite the resource (along with all other citations). Reference #7 in this article is a good example: https://journals.stfm.org/primer/2017/prunuske-0002/.
Use of the Kirkpatrick Model of Assessment
Although manuscripts do not need to refer directly to the Kirkpatrick Model (KM) of Assessment, it is helpful for reviewers, associate editors, and authors to have a basic understanding of the four levels at which outcomes might be assessed, according to KM. Briefly, the four KM levels are:
- Level 1: Reaction—The degree to which participants find the training favorable, engaging and relevant to their jobs.
- This level might be thought of as the typical conference feedback form, eg, a “post-only” assessment of how the learner “liked” or experienced a training or educational event.
- For PRiMER, we will only rarely publish “reactions”, and then only if the learning modality or instructional content is new, there is generalizable knowledge to be gained by instructors at other institutions, and key portions of the instructional materials are made available (typically by references to a stable format for publication of online content, such as the STFM Resource Library). Level 1 (reaction) studies are more likely to be considered if done as a rigorous qualitative process.
- Level 2: Learning—The degree to which participants acquire the intended knowledge, skills, attitude, confidence and commitment based on their participation in the training.
- This is often measured by a “pre/post” design, where students complete a process (such as a test or survey), are exposed to an intervention, and then resubmit the same test or survey immediately after. This model is often affected by maturation, by quick reinforcement or “teaching to the test,” and other threats to validity.
- For PRiMER, learning MUST be assessed beyond simple pretest followed by nearly immediate posttest. Examples of acceptable forms of learning assessment may include:
- Performance on a standardized process (eg, United States Medical Licensing Examination [USMLE], Family Medicine Computer-Assisted Simulations for Educating Students [fmCASES], a regularly administered institutional examination, a periodic and regular survey, etc), and comparison with a nonexposed or differently exposed cohort (eg, comparison of students exposed to an intervention, vs unexposed, on board scores or an Objective Structured Clinical Examination [OSCE])
- Posttest at an extended interval, on a test or instrument that measures a construct that was intended to be affected by the intervention (ie, assessment of long-term retention of knowledge).
- Level 3: Behavior—The degree to which participants apply what they learned during training when they are back on the job. For example, if residents and faculty were given comprehensive education and feedback about opioid prescribing in a family medicine office, a decreased number of opioid prescriptions would be a change in behavior.
- Level 4: Results—The degree to which targeted outcomes occur as a result of the training and the support and accountability package. For example, if residents and faculty were given comprehensive education and feedback about opioid prescribing in a family medicine office, a decrease in patient emergency room visits for opioid overdose would be considered a result.
Although researchers should use a rigorous approach to educational assessment, some educational interventions will not achieve their goals, or will have unintended consequences. Performance, behavior, and results should be measured, but they may not improve. The journal welcomes submissions with unexpected or negative results.
For quantitative studies, consider:
- Is the number of units used in the sample study (N) very small? Manuscripts that try to do “too much” with a very small sample may be problematic. We do accept small studies, but they should be handled appropriately for their sample size. Examples of good practices are:
- The reliance on purely descriptive statistics if inferential (ie P-value generating) procedures would be underpowered
- The use of statistical procedures that are intended for small samples (eg Fisher’s Exact Test)
- Emphasizing qualitative analyses and results for studies that have them
- Is the statistical test appropriate?
- Have the authors utilized the best procedures (not just appropriate), and have they controlled, either experimentally or statistically, for confounding factors?
- Is a comparison group appropriate, and if so, was a comparison group (of any sort) used? A comparison with self (eg, a time series), or a simple descriptive study, may not require a separate comparison group.
- Are the instruments employed valid and reliable? How do the authors know?
For qualitative studies, consider:
- Methods across qualitative studies can vary extensively. This is appropriate. Ideally, a qualitative study will describe a broad type of study (eg, “grounded theory”, “phenomenological”, “content analysis”, etc)
- There are basic components that should be present in all qualitative studies:
- Data collection procedures or sources
- Sampling methods
- Analytic processes
- Transcription procedures
- Some statements about control or consideration of biases
- A general sense that the authors have not selectively identified only quotes that fit their research question
- Additionally, the issues that apply to quantitative studies (described above) may be applied to qualitative study assessment, with appropriate consideration for how those requirements fit the qualitative model described.
Download a PDF of the Quality Guidelines