EBM Tools : Ten Ways of Improving Journal Clubs

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Our department has been conducting evidenced based journal clubs for its orthopedic staff since last year. We implemented a relatively standard, EBM style “format” of presentation that encourages thorough, analytical and critical thinking among our residents. This was also to prepare these residents for a better, EBM acceptable researches in the future. Indeed during the initial sessions of our journal club, we seem to have made a good impact.

After attending our latest journal club however, a few reports were drifting back and there’s still room for improvements. I’m not dampening the efforts of some residents in preparing their presentations. I can see potential in their reports. But a resident (you know who you are) simply made it appear he has been in the dark ages of EBM. His report pales in comparison to a known, acceptable format for a lively, critical and learning-conducive journal club reporting.

In this, many (if not all) of our consultant staff would agree. So I’m making some suggestions to improve some more our  journal club presentations. I know I may sound like a broken record but  consultants do feel sad when residents perform below their potentials .

To help you out, here are these suggestions.

  1. Prepare ahead (weeks, not an hour!) of the journal club schedule. Think (or look back) for an case/problem/dilemma that affected you and your orthopedic training
  2. Problems in orthopedics can be broadly classified into whether it is a clinical,  diagnostic, therapeutic, technical or surgical dilemmas, outcomes etc. Identify where your case/problems falls and then read the appropriate EBM guidelines in critiquing journals for those. Use them as guides.
  3. Search for an appropriate journal. Appropriate means the journal relevance to your case/dilemma/problem/question. The journal should be able to make you decide for an appropriate EBM based action on your case/problem on hand.
  4. Read first these general guidelines (I will enumerate them below) before during and after you read your journal. This will definitely guide you on sifting out weeds on your journal!
  5. Make sure you can answer these questions and knew your journal by heart before even trying to write/prepare your presentation slides.
  6. Prepare a 10-15 minute presentation that could answer these same general guidelines. Stick to the basic presentation format, slide color presentation and brevity of words.
  7. Presentation should be concise, short but should answer all the relevant questions. Relevance should be at the first level. Cut those unrelated words and phrases and don’t mention or drag in concepts your not familiar with. This will save you (and us) a lot of time.
  8. Wait for questions at the end of your presentations. Answer questions with first level relevant answers. Yes or no (or I don’t know) answers are pretty much better than strings of unrelated phrases.
  9. Take note (or ask someone to do it for you)  of questions you haven’t answered. or suggestions for your improvement.That will actually gauge your proficiency and how well you prepared for this journal club.
  10. Try to answer those unanswered questions in number nine after the journal club by either, going through the journal again and searching for appropriate material to read (books,journals researches etc). Just don’t leave any questions hanging for you and your colleagues.

I’m reprinting this outline from this journal and so all credits goes to the authors

  • DESCRIBE THE CASE OR PROBLEM THAT ATTRACTED YOU TO THIS PAPER
  • EXPLAIN HOW YOU CAME ACROSS THIS ARTICLE
  • DESCRIBE THE STUDYAND THE RESEARCH QUESTION
  • STATE THE IMPORTANCE/RELEVANCE/CONTEXT OF THIS QUESTION
  • DESCRIBE THE METHODS BY GIVING MORE DETAIL ON THE QUESTION COMPONENTS
  • STATE YOUR ANSWERS TO THE CRITICAL APPRAISAL QUESTIONS ON VALIDITY
  • SUMMARIZE THE PRIMARY RESULTS
  • DESCRIBE WHY YOU THINK THE RESULTS CAN ORCANNOT BE APPLIED TO YOUR PATIENTS/SITUATION
  • CONCLUDE WITH YOUR OWN DECISION ABOUT THE UTILITY OF THE STUDY IN YOUR PRACTICE—RESOLVE THE CASE OR QUESTION WITH WHICH YOU BEGAN
  • FINALLY, PREPARE A 1 PAGE SUMMARY OF THE OUTLINE ABOVE AS A HANDOUT

You can also freely download the file and reproduce or distribute them. Hope these suggestions will all improve our journal clubs in the coming months! I, for one will be expecting more from the presenter.

  • Mark D Schwartz, Deborah Dowell, Jaclyn Aperi and Adina L Kalet. Improving journal club presentations, or, I can present that paper in under 10 minutes Evid. Based Med. 2007;12;66-68
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Dr. Remo-tito Aguilar co-founded #HealthXPh. A board certified orthopedic surgeon, he is previously Chief of Clinics at St. Louis Hospital in Tacurong City and a consultant in Orthopedics at the Southern Philippines Medical Center in Davao City. Dr. Aguilar is a healthcare social media evangelist and writes his medical musings at The Cast & Curious (www.remomd.com).

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