Journal club

A journal club is a recurring meeting to critically appraise recent literature relevant to a particular discipline (e.g., medicine). The tradition is traced to the need to share journal articles, which were historically a limited resource. The modern journal club has since shifted from a resource-sharing activity to a fundamental educational component of medical training programs. A successful journal club keeps clinicians informed of new publications, cultivates critical appraisal skills, and facilitates the translation of research into clinical practice while consistently attracting engaged participants, fostering critical discussion of relevant literature, and providing clear, lasting value through inclusivity, regularity, and practical takeaways.

See also "Interpreting medical evidence."

• Primary objectives may include: ^[1]
  • Staying current with new literature
  • Honing skills in critical appraisal, biostatistics, and research methods ^[2]
  • Applying new knowledge to inform clinical practice
  • Fostering consistent reading habits
• The focus of a journal club can be adapted over time to suit the needs of its participants. ^[1]
  • Early-stage trainees
    • Acquiring foundational knowledge in biostatistics and epidemiology
    • Developing presentation skills
  • Advanced trainees and clinicians
    • Practice-based learning and improvement
    • Evaluating literature that addresses specific clinical questions

Traditional ^[1]

• Description: A trainee presents a preselected article, and then the group discusses the article with commentary from senior faculty.
• Pros
  • Efficient method for sharing clinical updates
  • Requires little advance preparation from attendees
• Cons
  • Variable quality of selected articles
  • Possibility of unprepared and/or disengaged participants

Evidence-based ^[1]

• Description: Articles are selected to address specific clinical questions, and discussion focuses on a critical appraisal of the study's methodology and statistics.
• Pros: actively builds and refines critical appraisal and research skills
• Cons: requires a baseline understanding of biostatistics and research design

Flipped ^[1]

• Description: Faculty choose a clinical topic and a key article, while trainees select related background papers and prepare for a detailed discussion beforehand.
• Pros: encourages in-depth learning and high engagement from all members
• Cons: requires more preparation than other formats

Virtual ^[1]

• Description: Discussion is hosted through social media, blogs, or video conferencing software. ^[2]
• Pros ^[3]
  • Highly accessible, removing barriers of time and location
  • Facilitates wide communication between different institutions
• Cons: may offer less opportunity for spontaneous interaction compared to in-person meetings

Different journal club formats offer distinct benefits and limitations; a flexible approach can address diverse goals.

Leadership ^[1]

• A designated host or leader is essential for success. ^[4]
• An effective approach combines trainee leadership with active faculty mentorship. ^[2]
• Leader responsibilities ^[3]
  • Coordinate meeting logistics
  • Guide article selection
  • Facilitate discussions

Combining trainee-led sessions with active faculty mentorship improves the quality and structure of journal clubs.

Sessions

• Typically last 30–60 minutes ^[1]
• Components associated with success (e.g., higher attendance, longevity, and satisfaction) include: ^[1][2][3]
  • Monthly meetings held at a regular, predictable time ^[2][4]
  • Meetings held in the evening and outside of the hospital setting
  • Refreshments at the meeting
  • Mandatory attendance

Article selection

• Involve participants in choosing topics and articles to boost engagement. ^[2]
• Choose articles that are relevant to the audience's clinical work and educational objectives. ^[1][3]
  • Original research is ideal for practicing critiquing skills.
  • Review articles are effective for building background knowledge.

The educational quality of a session depends heavily on the choice of article and preparation of the facilitator and participants. ^[2]

Preparation

• Circulate articles 1–2 weeks before the meeting. ^[1][2]
• Provide a structured critical appraisal tool to guide participants' reading. ^[2][3]
• See "Tips and Links" for a link to tools from the Critical Appraisal Skills Programme.

Using a checklist increases learner satisfaction and the educational value of the session. ^[2][4]

Approach ^[5]

• Introduction: Address the clinical question that prompted the article selection.
• Background
  • Examine the research question using, e.g.:
    • PICO criteria
    • FINER criteria
  • Determine the type of research question. ^[6]
    • Descriptive: Summarize data to understand patterns or characteristics.
    • Predictive: Apply data to calculate the probability of an outcome based on specific inputs.
    • Causal inference: Estimate the results of different scenarios or interventions.
• Methods
  • Appraise the appropriateness of the study design to answer the research question.
  • Assess inclusion and exclusion criteria.
  • Evaluate the methodology for potential sources of bias (e.g., selection bias, information bias) and confounding.
  • Assess the appropriateness of the statistical methods used.
• Results
  • State the primary outcomes and their significance.
  • Review key data from tables and graphs.
• Discussion
  • Discuss the main findings.
    • Differentiate between statistical significance and clinical relevance.
    • Discuss whether the authors' conclusions are supported by the data, and what limitations are acknowledged.
  • Analyze the study's strengths and weaknesses.
  • Provide context on the authors, their institutions and funding, and the journal's impact factor.
  • See also "Questions to ask when critically appraising a research paper."
• Clinical context: Conclude by summarizing how the paper's findings might change or reinforce current clinical practice.

Best practices ^[2]

• Foster a safe learning environment that promotes participation from all members, particularly junior learners.
• Apply principles of adult learning theory, e.g.:
  • Center discussions on problem-based topics relevant to clinical work.
  • Promote active participation over passive listening.
• After the presentation, consider submitting insightful critiques or comments as a letter to the editor of the publishing journal. ^[5]

Confirm local expectations for format and timing, as these vary significantly. ^[5]