Advancing research integrity: a programme to embed good practice in Africa

In Africa, training programmes as well as institutional policies on research integrity are lacking. Institutions have a responsibility to oversee research integrity through various efforts, including policies and training. We developed, implemented and evaluated an institutional approach to promote research integrity at African institutions, comprising a workshop for researchers ("bottom-up") and discussions with senior faculty on institutional policies ("top-down"). During the first day, we facilitated a workshop to introduce research integrity and promote best practices with regards to authorship, plagiarism, redundant publication and conflicts of interest. We used a variety of interactive teaching approaches to facilitate learning, including individual and group activities, small group discussions and case-based learning. We met with senior faculty on the following day to provide feedback and insights from the workshop, review current institutional policies and provide examples of what other research groups are doing. We evaluated the process. Participants actively engaged in discussions, recognised the importance of the topic and acknowledged that poor practices occurred at their institution. Discussions with senior researchers resulted in the establishment of a working group tasked with developing a publication policy for the institution. Our approach kick-started conversations on research integrity at institutions. There is a need for continued discussions, integrated training programmes and implementation of institutional policies and guidelines to promote good practices.


Introduction
In Africa, efforts to promote research integrity are limited, and policies as well as training initiatives at academic institutions are lacking [1][2][3][4]. While there are some training programmes on research ethics, these generally focus on ethics related to human and animal participants of studies and do not include topics linked to research integrity, responsible conduct of research (RCR) or research reporting, and formal training on RCR is lacking [2,5]. Academic institutions have a responsibility to oversee research integrity, especially in countries where national regulatory bodies and policies are lacking [1,3,6]. Efforts to promote research integrity should be multi-faceted and should include clear policies that outline best practices, handling of allegations of research misconduct, as well as consequences of research misconduct; continued awareness raising and training of all students and researchers [6]. As part of a bigger project to gain more understanding on research integrity in low-and middle-income countries (LMICs), we recently conducted a survey amongst Cochrane authors based in LMICs to analyse the perceived prevalence of poor reporting practices related to authorship, redundant publication, plagiarism and conflicts of interest [7]. Survey participants reported that poor practices were common at their institutions in terms of guest authorship (77% of 198 respondents), ghost authorship (41%), text-recycling (60%), plagiarism of translated text (37%), plagiarism of ideas (43%) and not declaring financial conflicts of interest (40%). In subsequent interviews with selected participants, interviewees reported that lack of training and mentorship contributed to poor practices. In addition, very few participants were aware of the existence of institutional policies and guidelines. We developed an approach that included both training of researchers ("bottom-up") and high-level engagement in institutional policies ("top down"), aiming to embed good practices in institutions.
This report describes our approach to develop, implement and evaluate an institutional approach to promote research integrity at African institutions. We focused on practices related to reporting of research, including authorship practices, plagiarism, redundant publication and conflicts of interest.

Workshop report What is research integrity?
Research integrity can be defined as "honesty in reporting and communicating, reliability in performing research, objectivity, impartiality and independence, openness and accessibility, duty of care, fairness in providing references and giving credits, and responsibility for future science generations" [8]. These values and principles are fundamental to any discipline, in any setting. Research misconduct is often defined as data fabrication, data falsification and plagiarism. However, it includes a much wider spectrum of poor practices ( Table 1) such as guest authorship (adding authors that have not contributed substantially to the work) and ghost authorship (omitting authors that have contributed substantially to the work) or not declaring conflicts of interest that are just as important, more relevant on a day-to-day basis and more common compared to data fabrication and falsification [9][10][11].

What was our approach?
We consulted with senior faculty at two tertiary institutions in Africa to outline the package being offered and to explore opportunities to visit these institutions. Our package included a training workshop to introduce best practices to researchers ("bottom-up") on day 1 and discussions with senior faculty on institutional policies ("top down") on day 2. We developed the workshop "Doing the right thing: A workshop on research integrity and publication ethics" to introduce research integrity and promote best practices in authorship, plagiarism, redundant publication and conflicts of interest (Table 2) Participants completed a pre-workshop survey on perceptions and behaviour related to research reporting practices. The questionnaire, previously developed for the survey of Cochrane authors from LMICs [7], contained scenarios related to authorship practices, plagiarism, redundant publication and conflicts of interest (Table 3).
We asked participants to indicate whether practices portrayed in the scenarios were acceptable or not, whether they themselves or someone they knew had engaged in this behaviour in the past, and whether it occurred at their institution. We used a variety of instructional methods to facilitate learning. Our approach encouraged active engagement of participants and included individual and group activities, as well as case-based instruction, all of which have been found to be effective in training of principles of research integrity [12,13]. Each participant also received a list with important websites and guidelines related to publication ethics and research integrity. We asked participants to complete an evaluation form at the end of the workshop. On the day following the workshop, we had a discussion with senior faculty members, including the deans of Attendees of the meeting felt that this would be an ideal opportunity to include aspects related to research integrity and discussed the possibility of developing a policy at departmental or faculty level as a starting point. As this would be easier to implement and monitor, it could act as a pilot for an institution-wide policy. Participants agreed to form a working group that would provide input into the proposed policy.

Conclusion
Our combined "bottom-up" and "top-down" approach worked well to initiate conversations on research integrity at institutions. Participants  Table 1: research misconduct related to reporting research  Manipulating, omitting or changing research results in order to make the data look better Plagiarism

Tables
Copying text or part of a text, an idea or an image from another source, without properly referencing the source and using it as one's own.

Redundant publication
Republishing one's own work including copying of an entire manuscript (duplicate publication), publication of parts of the results in separate papers (salami publication) and re-using of text in several publications (text-recycling).

Guest authorship
Adding authors to a manuscript who did not contribute substantially to the work.

Ghost authorship
Omitting authors who have contributed substantially to the work.

Conflicts of interest
A financial or non-financial (personal, political, academic, religious, institutional) interest that can potentially influence professional judgement and bias results. To introduce research integrity and its importance in health research and to promote best practice in authorship attribution, conflicts of interest and avoiding plagiarism.

Learning objectives
After the workshop, participants will be able to: Discuss research integrity and how it relates to reporting their research Find and apply current guidelines for good research reporting practice related to authorship, conflicts of interest and plagiarism Participants Junior and senior health researchers, who want to publish in national and international journals including Masters and PhD students as well as postdoctoral researchers Setting Institutions in Sub-Saharan Africa Duration 4 hours Teaching approach Interactive workshop Using scenarios on research reporting practices as a springboard for discussions Small group discussions Programme

Pre-workshop
Complete online questionnaire Workshop Why research integrity isn't just somebody else's problem Authorship, based on questionnaire scenarios Conflicts of interest, based on the questionnaire scenarios Plagiarism, based on the questionnaire scenarios Redundant publication, based on the questionnaire scenarios How to promote integrity at individual level and group level

Guest authorship
A junior researcher, J, adds the head of department, D, as the last author on a research paper. D provided suggestions for direction of J's work that helped her obtain the grant, although he hasn't contributed to the actual research or the publication. A professor, M, who did not contribute to study design, data collection or data analysis but is an expert in the field, reviews the draft manuscript and suggests some minor changes to the English. He asks to be listed as an author on the paper. Ghost authorship A researcher, S, contributes to the design and does most of the data collection in a study but goes on maternity leave as it is being analysed. When she returns to her post she discovers that the research has been published by her supervisor without her name or any acknowledgement of her contributions. Acknowledgement practices A Master's student consults with the resident biostatistician, P, to help with data analysis on her research project. In the manuscript that she submits for publication, she lists P in the "Acknowledgement" section. Text-recycling/redundant publication A PhD student "copies and pastes" nearly all of the introduction from a paper that she has previously published into her next manuscript, since she is doing a series of experiments on the same topic. Plagiarism A researcher in Mozambique wants to submit his manuscript to a journal published in English. He finds a text book in Portuguese that explains an aspect of the background to the disease very well. He translates one paragraph into English, and puts this into his introduction without reference to the book. A researcher from India attends an international conference where a European research study with a novel design is presented. He submits a protocol for an identical study to the ethics committee at his home institution. He does not reference the European study.

Conflicts of interest
A researcher, T, is working on a diagnostic test study. The company manufacturing the test has supplied the kits for free but did not design or fund the research. T was paid for a consultancy for the same company two years ago. In the publication of the study, he declares that he has no conflicts of interest. A researcher, K, writes a review for treatment guidelines of herbal remedies for children's cough. K's wife is employed by the company that manufactures one of these remedies. In the review, K declares that he has no conflicts of interest.