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HOW TO CONDUCT A

JOURNAL CLUB SESSION

Dr. Farooq Ahmed


Student of Masters in Health Professions
Education
AIM OF A JOURNAL
CLUB
To expand our knowledge of the
subject studied

NO
1. WHAT IS A JOURNAL CLUB?

A Journal Club is a teaching program


that supports clinical staff to
develop their understanding of the
evidence based
principles of
practice and increase
critical appraisal skills.
The content of the presentation is
the critical appraisal of a research
paper with the aim of determining
the reliabilityhttp://en.wikipedia.org/wiki/Journal_club
and validity of the
research evidence.
HISTORY
ADVANTAGES OF A JOURNAL CLUB

Help people to learn and improve their critical


appraisal skills

Encourage evidence based medicine

Promote awareness of research skills

Encourage use of research


2. HOW IS THE JOURNAL CLUB ORGANIZED ?

Usually a rota is prepared


indicating the date individuals
are required to present in
Journal Club.

Staff who are familiar with


the process could be allocated
first on the rota to
enable others an opportunity
to look and learn.
STEPS OF THE
PROCESS
Formulate a clinical question for
the Journal Club to address

Search the literature and retrieve


article(s)

Appraise the evidence

Prepare the presentation

Presentation and feedback from


the group
FORMULATE A CLINICAL
QUESTION

Patient
(Problem)

Intervention PICO
Comparison

Outcome
PI CO

Comparison of the efficacy


of Rifaxamin vs traditional
therapy in patients with
hepatic encephalopathy
THE LEADER AND CHAIRPERSON

Consultants with interests in


medical education, such as
tutors, take the role of leaders

Senior trainees such as


senior registrars take the role
of the chair.

One person can have both


WHAT IS CRITICAL
APPRAISAL?

Balanced assessment of the


benefits/strengths and
flaws/weaknesses of a study
Assessment of research
process and results
Consideration of quantitative
and qualitative aspects
WHY CRITICAL APPRAISAL
IS NEEDED

The purpose of appraising a paper is to


discover if the methods and results of
the research are sufficiently valid to
produce useful information.
A principal goal of appraisal is to
establish whether research objectives
have been met?
HOW TO CRITICALLY APPRAISE A
PAPER

Purpose of research
Methodology
Statistical aspects
Results
Discussion
Conclusions / summary /
recommendations
References
RVR PURPOSE OF STUDY
A
RELEVANCE Need of the study

VALIDITY
Is there a clear description of the problem

REPRODUCIB Is the study useful and relevant to general


ILITY practice
APPLICABILITY
Is the study done in a hospital based
setting be interpreted in a community
based setting

Is the study design appropriate to the field


of research

Type of study

Ethical issues

Literature review

PAPER METHODOLOGY
Study design
Consistency
Originality
Perspective
Sample is representative of the
population?
Subjects recruitment
Inclusion and exclusion criteria
Questionnaires and Proforma
authenticity
Was the study adequately controlled
Were the groups comparable
Were outcome measured and how?
Sources of bias in the study
Have confounding variables been
removed

STATISTICAL ASPECTS OF A PAPER

Groups comparing

Data

Statistical tests

Data analysis

Were outliers analyzed

Correlation and regression analysis

Probability / confidence / degree of significance

P values etc.
RESULT ASPECTS OF A PAPER

Missing data such as drop outs,


non-responders are accounted for
Sample size
Clarity
Bars / charts / tables used
correctly?
DISCUSSION ASPECTS OF A PAPER

The study is discussed critically


The results are discussed with
reference to other important
literature
The discussion and conclusions do
not speculate too far beyond what
has been shown in the study.
OUTLINE OF PRESENTATION

Topic selection----------------------1
month ahead
Distribution by e-mail / paper
format--7 days ahead.
Presentation of paper------------10-
15 minutes
Discussion---------------------------20-
30 minutes
Feedback-----------------------------10
minutes
REFERENCES
Kleinpell RM. Rediscovering the value of the journal club.American Journal
of Critical Care 2002;11:42.
Linzer M. The journal club and medical education; over one hundred years
of unrecorded history. Postgraduate Medical Journal 1987;63:475-8.
Swift G. How to make journal clubs interesting.Advances in Psychiatric
Treatment 2004;10:67-72.
Hill A, Spittle house C.What is critical appraisal? London: Hayward
Medical Communications, 2006. (www.evidence-based-medicine.co.uk
Rosenberg W, Donald A. Evidence based medicine; an approach to clinical
problem solving.BMJ 1995;310:1122-6.
Hallas P. Tips onChoosing an interesting paper for the journal club.BMJ
Careers 2005;331:252.http://careerfocus.bmj.com/cgi
/content/full/331/7529/252
Phillips R, Glasziou P. What makes evidence based journal clubs
succeed?Evidence Based Medicine 2004;9:36-7.