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Background: There are well-recognized challenges to delivering specialty health care in rural settings. These challenges are particularly evident for specialized surgical health care due to the lack of trained operators in rural communities. Telerobotic surgery could have a significant impact on the rural-urban health care gap, but thus far, the promise of this method of health care delivery has gone unrealized. With the increasing adoption of telehealth over the past year, along with the maturation of telecommunication and robotic technologies over the past 2 decades, a reappraisal of the opportunities and barriers to widespread implementation of telerobotic surgery is warranted. Here we report the outcome of a rural telerobotic stakeholder workshop to explore modern-day issues critical to the advancement of telerobotic surgical health care. Materials and Methods: We assembled a multidisciplinary stakeholder panel to participate in a 2-day Rural Telerobotic Surgery Stakeholder Workshop. Participants had diverse expertise, including specialty surgeons, technology experts, and representatives of the broader telerobotic health care ecosystem, including economists, lawyers, regulatory consultants, public health advocates, rural hospital administrators, nurses, and payers. The research team reviewed transcripts from the workshop with themes identified and research questions generated based on stakeholder comments and feedback. Results: Stakeholder discussions fell into four general themes, including (1) operating room team interactions, (2) education and training, (3) network and security, and (4) economic issues. The research team then identified several research questions within each of these themes and provided specific research strategies to address these questions. Conclusions: There are still important unanswered questions regarding the implementation and adoption of rural telerobotic surgery. Based on stakeholder feedback, we have developed a research agenda along with suggested strategies to address outstanding research questions. The successful execution of these research opportunities will fill critical gaps in our understanding of how to advance the widespread adoption of rural telerobotic health care. 

Journals play a critical role in the scientific process because they evaluate the quality of incoming papers and offer an organizing filter for search. However, the role of journals has been called into question because new preprint archives and academic search engines make it easier to find articles independent of the journals that publish them. Research on this issue is complicated by the deeply confounded relationship between article quality and journal reputation. We present an innovative proxy for individual article quality that is divorced from the journal's reputation or impact factor: the number of citations to preprints posted onarXiv.org. Using this measure to study three subfields of physics that were early adopters of arXiv, we show that prior estimates of the effect of journal reputation on an individual article's impact (measured by citations) are likely inflated. While we find that higher‐quality preprints in these subfields are now less likely to be published in journals compared to prior years, we find little systematic evidence that the role of journal reputation on article performance has declined.