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Many cultural factors influence the ethics of authorship. Each disciplinary (e.g. sociology) context will have unique cultural dimensions that influence what is considered appropriate or common. Beyond academic disciplines, individual organizations (e.g. the university for which you work) and countries will also add cultural dimensions to the complexity of authorship decision-making.

In our Canadian health sciences context, we have observed three cultural factors that we will discuss here: interdisciplinarity, types of research (quantitative or qualitative), and academic promotions.


Health sciences education is an interdisciplinary field (Kuper et al, 2010), wherein the different disciplines that comprise it bring their own norms and expectations for authorship practices.

In the health sciences education research context:

  • first author tends to connote the primary thinker, doer, and writer behind the work
  • last author tends to connote a potentially equally, or at times more prominent, thinker behind the work. For example, where the first author is a student, the last author may have been their supervisor. The last author may have written significant portions of various drafts and revised the submission carefully.
  • the authors in between tend to be ordered according to contribution (from most to least)

Yet, scholars from various disciplines may not agree with the above norms. As they become more integrated into the health professions education field, they may begin to adopt these norms.

Long authorship lists are another byproduct of the frequent need for a mix of clinical, educational, and research expertise on teams in our interdisciplinary field. While excessively long lists of authors raise questions about just how deserving each author can be of authorship, there are many occasions where moderately long lists are appropriate.

However, in some of the disciplines that converge to form our interdisciplinary fields, single author works are common (e.g. English). When multiple disciplines, or knowledge communities, come together, authors must pay attention to these interdisciplinary differences in understanding and practicing authorship. Ideally, these interdisciplinary differences would be discussed at the outset of a collaboration, and re-visited throughout. If not, we risk making false assumptions. For example, a humanities collaborator closely leading a project conceptually might deserve the last author position, but from their disciplinary perspective, might also deserve and prefer the second author position.

Type of research

In our fields, both qualitative and quantitative research are common. While only performing data collection, according to authorship guidelines, would not constitute authorship, we must note that in qualitative studies, data collection often occurs alongside analysis, and data collection itself may entail significant intellectual contribution. In these cases, we suggest offering the person conducting data collection the opportunity to contribute to writing, and thus an opportunity to be a co-author.

Academic promotions

In our context, faculty members are often promoted based on research excellence, marked by research publications and their impact. The expectations of promotion and tenure committees may also include first or “senior” (last) author positions on many publications, while collaborator positions (e.g. middle author positions) may not “count” as much. These workplace pressures may also contribute to the overall culture within which authorship ethics must be practiced.


Kuper A, Albert M, Hodges BD. The origins of the field of medical education research. Academic Medicine. 2010 Aug 1;85(8):1347-53.

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