Although we have, as scholars, long enjoyed supervising and mentoring emerging researchers and colleagues (many of whom have gone on to enjoy successful academic careers), we have no secret formula for mentoring and indeed we have very different ways of working. However, we have found that we are asked the same questions, and that these questions come around again and again.

The purpose of this new column is to attempt to answer the kinds of knotty problems and dilemmas about theory, methods, and the practicalities of research with which many of us grapple in studying health professions education. In so doing, we also hope to address the often “semi-isolationist” nature of research. Only a few people are lucky enough to work in environments or communities of practice where they have sufficient and timely opportunities to ask questions and receive answers that can keep their students’ and their own research on track.

To that end, the ‘Questions and Quandaries’ column will offer scholarly answers to common questions about aspects of the use of theory, methodology, and methods as well as about the practicalities of research. We hope that this column will establish a useful library of shared advice that can be accessed by researchers looking for insights as well as by mentors looking to help their individual mentees. We invite members of our community to suggest either questions and dilemmas which they have themselves or those which they have answered for their mentees (and would like to address for a broader audience by writing an article for this series). Suggestions can be sent to AHSEQandQ@gmail.com.

So, in this first ‘Questions and Quandaries’ article, we turn to a common question we hear from both learners and colleagues: My paper was returned to me with a request for major revisions. I’m trying to revise it but the reviewers have said conflicting things. What do I do?

Well, first of all, you should take a minute to be proud of yourself! You made it through initial screening by one or more editors and then had your work scrutinized by two or more reviewers – and they think it is worth their effort to help you improve it so it can be considered for publication in their journal. Now comes the hard work. Revising your work can be challenging at the best of times, and conflicting feedback definitely makes it harder. Ideally the editor(s) who received those reviews should have noticed and helped you out. So, our first advice is to have a detailed look at what the editor(s) wrote. The editor(s) who wrote back to you will have the final say, so be sure to pay close attention to what they tell you to do (and not do). Did they highlight certain revisions suggested by the reviewers? Did they disagree with some of the reviewers’ comments? Did they suggest that some comments must be addressed or that other comments could be treated as optional? If they’ve already done some of the hard work of curating the reviewers’ comments for you and clearly steering you as to what they would like you to prioritise in your revisions, so much the better. An example of an editor resolving the issue of conflicting feedback is illustrated in Table 1.

Table 1 An Example of a Clear Editorial Steer (received for Cleland and MacLeod, 2022)
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This feedback from the editor encouraged us to provide more clarity as to the aim of our paper and to include two detailed examples of how to use digital ethnography in health professions education.

If, however, you have comments that are in opposition to each other and the editor hasn’t given you sufficient direction, you will have to make some decisions on your own. In other words, you must figure out how you want to resolve the issue of conflicting reviews.

This can be freeing, since you can use the fact that the reviewers disagreed to open the way to different possible revision strategies. There are three main ways of doing this. First, if one reviewer asks you to expand on a particular point whereas another tells you to delete it entirely, you could argue that you should take the middle ground by leaving that section as is! Second, if you had really wanted to write more about that point but had limited yourself because of word count, you could use the opportunity to add another few sentences. The third option, of course, is to remove the content! This is possibly the most difficult option: it is always painful to delete words that you toiled over. However, removing words, sentences, or sections can often improve a paper – and by doing so, you free up space to expand on other points raised by the reviewers or editor.

You must then write back to the editor justifying your revisions. You will need to politely point out the contradictory nature of some of the suggestions received (without, we would advise, implying that the editor(s) should have done their job and told you what to do about them, and also without criticising the reviewers), clearly indicating which ones are in opposition to each other. You should then describe how you resolved each contradiction. If you took the middle ground, say so; if you chose one reviewer over the other, explain why you thought that was the right thing to do. If you can justify your choice(s) with a reference or two, that can add some weight.

You can take heart in the likelihood that if an editor hasn’t given you clear direction about potential contradictions in your revisions, they will probably be willing to accept your resolution as long you can make a coherent argument for it. It is also likely that, if that editor really disagrees with your resolution but you have made a reasoned and polite argument for it, they will either accept your proposal or use the opportunity to give guidance on further, specific revisions rather than rejecting the paper after your revisions. In this way, revisions can become a negotiation between the author(s) and editor (albeit a negotiation where the editor has most of the power).

We take this opportunity to also make three more general points which are important when revising a paper after review. The first is that a lot of feedback, particularly contradictory feedback, does suggest that some of your messages were not sufficiently clear, precise, or engaging. Take a long, hard look at your revised paper or ask a colleague to review it with clarity in mind before resubmission. The second is that it is okay to push back on some feedback points, particularly those which cannot be addressed without carrying out another, different study! The trick is to be pleasant yet assertive. We give examples of this in Table 2.

Table 2 Two Examples of Pushing Back
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In the upper example (received for Young et al., 2021), the reviewer is suggesting a different, atypical approach to the analysis. To step around the issue, the authors highlight that the reviewer’s point raises important considerations and explain that they have taken several steps to clarify language and to be consistent with the conventional statistical approach taken.

In the lower example (received for Paton et al., 2020), the reviewer suggests that the authors expand on a minor point in their paper that the reviewer finds interesting and proposes a number of complex theoretical directions they could take to do so. The authors politely agree that the point is interesting but that it is extraneous to their main point and that expanding upon it is beyond the scope of their paper, so they indicate that they will instead remove the minor point entirely.

Our third, more general suggestion is a practical one. If you haven’t written responses to revisions before, you may want to ask colleagues for copies of successful responses to revisions they submitted for now-published papers. This can help both with understanding the niceties of the genre (e.g., the importance of thanking the reviewers and and acknowledging when they have made “interesting points”) and with getting a handle on the general format. You should be aware, however, that every journal has different, specific formatting requirements for responses to revisions; these are usually specified in the revision letter from the journal and/or on the journal website. Some of the common requirements you may encounter are listed in Table 3. Be sure to follow these requirements so you don’t get your revision returned to you for reformatting!

Good luck! Although the revision process may be frustrating, remember that reviewers and editors really do want to help improve your paper – and take heart that this work will probably lead to a published paper.

Table 3 Common Requirements for Formatting Responses to Revisions
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