Brief Report
Journal Club Experience in a Postgraduate
Psychiatry Program in Chile
Rodrigo A. Figueroa, M.D., Sergio Valdivieso, M.D.
Marı́a Turpaud, M.D., Paulina Cortes, M.D.
Jorge Barros, M.D., Catalina Castaño, M.D.
Objective: Literature about journal clubs in postgraduate psy-
chiatry programs is scarce, and there is no reference to resi-
dents' preferences.
Methods: Residents were asked to respond to a survey about
their general satisfaction with the current journal club format
and paper preferences, according to subject, scope, and type.
Results: Residents' general satisfaction was high. Residents
preferred clinically relevant meta-analyses and randomized con-
trolled trials about mood and psychotic disorders, neuroscience,
and biological therapies.
Conclusion: There is a trend to prefer articles related to bio-
logical aspects of psychiatry, centered in evidence-based medi-
cine methodology. An effort should be made to broaden the scope
of selection of papers, incorporating, for instance, humanistic
views, psychotherapy, and other methodologies.
Academic Psychiatry 2009; 33:407– 409
Received December 27, 2007; revised April 22, September 12, and
December 29, 2008; accepted January 12, 2009. The authors are affiliated
with the Department of Psychiatry at Pontificia Universidad Católica de
Chile in Santiago, Chile. Address correspondence to Sergio Valdivieso,
Pontificia Universidad Católica de Chile, Psiquiatria, Camino El Alba
12351, Las Condes, Santiago, Región Metropolitana, 7550000, Chile;
svaldivi@med.puc.cl (e-mail).
Copyright © 2009 Academic Psychiatry
Academic Psychiatry, 33:5, September-October 2009
D ue to the amount of publications in basic science and
clinical care, it is hard for psychiatric residents to
keep up-to-date with literature (1). Journal clubs are be-
coming a popular strategy to overcome this problem (2). In
the United Kingdom and Ireland, 97% of all tutors in-
volved in psychiatry training stated that their academic
programs included a journal club (3).
A journal club can be defined as a group of people who
meet periodically to discuss papers. A variety of reviews
have analyzed the educational objectives and the most
appropriate methodology for the efficient operation of a
journal club. The objectives are to stimulate residents to
keep up with recent literature, to practice evidence-based
medicine, to demonstrate continuing medical education
abilities, to learn critical appraisal skills, and to promote
social contact. The methodology includes compulsory at-
tendance, application of the basic principles of adult learn-
ing, an experienced moderator, and a regular venue. Shar-
ing food is also recommended (4).
According to a MEDLINE search we carried out in
December 2007 using the terms “psychiatry” [MeSH]
AND “journal club,” only a few published papers are
devoted to journal clubs in psychiatry training (3–5), and
none of them explore the preferences of the residents
involved. This lack of information can affect optimal post-
graduate program planning.
In this article we describe the main article characteris-
tics preferred by our residents as well as the structure of
our journal club, the papers presented over the past 3
years, and the general satisfaction of the residents. Our
aim is to give ideas to residency directors for implement-
ing a journal club in a postgraduate psychiatry program.
Methods
Our psychiatry postgraduate program lasts 3 years, with
three residents in each year. After the exclusion of one
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JOURNAL CLUB EXPERIENCE

TABLE 1. Resident Survey on Journal Club Satisfaction scope (neurosciences, biological therapies, psychology,
(Nⴝ7) psychotherapies, or psychiatric epidemiology), type of pa-
per (reviews and meta-analyses, randomized-controlled
Preferred Article Subject n (%)
Mood disorders 5 (71.4) trials, observational studies, or clinical guidelines), and
Psychotic disorders 2 (28.6) reason for selection (methodological quality, clinical ap-
Anxiety disorders 0 (0) plicability, personal interest, or novelty). Residents had to
Personality disorders 0 (0)
Substance use disorders 0 (0)
choose only one option according to their preference.
Other disorders 0 (0) All articles discussed in journal clubs between 2002 and
Preferred Article Scope n (%) 2005 were reviewed and classified according to main sub-
Neurosciences 5 (71.4)
ject, scope, and type.
Biological therapies 1 (14.3)
Psychology 0 (0)
Psychotherapies 0 (0)
Results
Psychiatric epidemiology 1 (14.3)
Preferred Article Type n (%)
Reviews and meta-analyses 5 (71.4) One hundred thirty-one articles were reviewed, and
Randomized and controlled trials 2 (28.6) seven residents were surveyed. The general satisfaction
Observational studies 0 (0)
average score was 6.3 (SD⫽0.35). The most frequent sug-
Clinical guidelines 0 (0)
Reasons for Choosing an Article n (%) gestion was to give more flexibility in the selection of
Clinical utility 4 (57.1) journals and articles. Results obtained from the residents’
Personal interest 2 (28.6) surveys and articles review are detailed in Table 1 and
Novelty 1 (14.3)
Methodological rigor 0 (0) Table 2, respectively.

Discussion
resident who had left the program and another resident
who is also an author (RF), only seven residents were To our knowledge, this is the first paper that explores
eligible to participate in the study. psychiatric residents’ preferences for a journal club in a
The residents in our postgraduate program participate in postgraduate psychiatry program.
a journal club moderated by the director of the program.
The meetings take place weekly in cycles of 9 weeks. TABLE 2. Results of Reviewing 131 Articles in Journal
First- and second-year residents can propose two articles Club Satisfaction Survey
from Archives of General Psychiatry, American Journal of
Psychiatry, or British Journal of Psychiatry, and third- Journal of Origin n (%)
American Journal of Psychiatry 61 (46.6)
year residents can propose two articles from any journal. Archives of General Psychiatry 54 (41.2)
At the first meeting, eight papers are selected by vote. In British Journal of Psychiatry 4 (3.0)
a 1-hour weekly meeting with compulsory attendance, one The Journal of Nervous and Mental Disease 3 (2.3)
Other 9 (6.9)
resident must present the selected article to the audience.
Main Article Subject n (%)
The meetings begin with a quiz on the article, and then a Mood disorders 56 (42.8)
resident is randomly selected to comment on the article’s Psychotic disorders 32 (24.4)
strengths and weaknesses and impact on patient care. After Anxiety disorders 18 (13.7)
Personality disorders 9 (6.9)
this introduction, the resident in charge of the presentation Substance use disorders 5 (3.8)
gives a slide show with the key issues of the paper, a Other 11 (8.4)
critical appraisal of the methodology, and its main find- Main Article Scope n (%)
Neurosciences 31 (23.7)
ings. Breakfast is provided to the participants. Biological therapies 34 (26.0)
The general satisfaction was evaluated on a scale of 1 to Psychology 10 (7.6)
7 (1⫽least satisfactory, 7⫽most satisfactory). Open sug- Psychotherapies 8 (6.1)
Psychiatric epidemiology 48 (36.6)
gestions were encouraged.
Main Article Type n (%)
To find out residents’ preferences when selecting a pa- Reviews and meta-analyses 53 (40.5)
per, we distributed a multiple-choice questionnaire that Randomized and controlled trials 17 (12.9)
included four questions regarding preferred subject (mood Observational studies 61 (46.6)
Clinical guidelines 0 (0)
disorders, psychotic disorders, anxiety disorders, etc.),

408 http://ap.psychiatryonline.org Academic Psychiatry, 33:5, September-October 2009


Mood disorders was the most frequent subject chosen in
both residents’ surveys and articles reviewed. This may be
related to the high prevalence of mood disorders; in Chile
the lifetime prevalence of major depressive episodes in the
general population is 9.2% (6). The second most popular
subject was psychotic disorders, probably because schizo-
phrenia is one of the most challenging disorders in psy-
chiatry from a historical and psychopathological point of
view. The low preference for articles related to personality
disorders and psychotherapy is remarkable and might re-
flect residents' preference for issues related to neuro-
science and pharmacotherapy, but might also relate to
difficulties for the discussion of more humanistic subjects
in the current journal club format. Participants of Taylor
and Warner’s (3) survey complained about the lack of
flexibility in evidence-based journal clubs, which excluded
from discussion psychodynamic issues. This fact has to be
addressed, considering that psychotherapy is an important
part of general psychiatry training.
Residents also preferred meta-analyses and randomized
controlled trials, which may reflect a growing interest in
evidence-based psychiatry, although this trend is debatable
(7). It is remarkable that although residents did not prefer
observational studies, they selected them most frequently
(almost 50%). We do not have any documented hypothesis
to explain this yet.
The great interest in articles with biological approaches
matches the strong development of biology in psychiatry.
In a recent survey of 77 directors of psychiatry training
programs (1), 86% of directors reported that they had
increased their neuroscience curriculum and expected to
increase it further. The high interest in clinically useful
articles highlights the clinical emphasis of our program.
This study has important limitations. The number of
residents surveyed was small, and the study was conducted
Academic Psychiatry, 33:5, September-October 2009
FIGUEROA ET AL.
in only one postgraduate program, so any generalization of
the results must be taken with caution. If we want to come
to general conclusions, it is necessary to include larger
programs from different countries. Furthermore, we only
surveyed preferences about journal type. We did not ad-
dress resident preferences related to the structure of the
journal club or how junior residents felt about the limita-
tion of journals available to them. We only had one global
measure of resident satisfaction, so we could not know
what factors explain the high satisfaction obtained in this
survey. These limitations could be addressed in a fol-
low-up study.
At the time of submission, the authors declared no competing
interests.
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