1. How to hold a successful Journal Club ? J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

2. J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

3.  First journal club St. Bartholomew’s Hospital in London, mid-1800s St. Bartholomew’s Hospital in London, mid-1800s Sir James Paget, a British surgeon: Sir James Paget, a British surgeon: "a kind of club... a small room over a baker's shop near the Hospital- gate where we could sit and read the journals.“  First formal journal club Mc Gill University, 1875 Mc Gill University, 1875 Sir. William Osler Sir. William Osler The goal was to purchase & distribute periodicals he could not afford to subscribe as an individual The goal was to purchase & distribute periodicals he could not afford to subscribe as an individual J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

4. Journal club Evolution Historically: Help participants keep up to date with the latest published literature Recently: Teach critical appraisal skills, research design, medical statistics, clinical decision theory, clinical epidemiology and encourage “evidence-based” medical practices J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

5.  Is a method of learning  A group of individuals who meet regularly to critically evaluate recent articles in scientific literature  Usually organized around a defined subjects in basic or applied research J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

6. Types of journal club  E VIDENCE -B ASED J OURNAL C LUBS  J OURNAL C LUBS B ASED ON C RITICAL A PPRAISAL  J OURNAL C LUBS B ASED ON K NOWLEDGE T RANSMISSION  T HE N O P REPARATION J OURNAL C LUB  I NTERNET -B ASED J OURNAL C LUBS Medical education journal clubs  Article based journal club presentation  Article based journal club presentation  Topic based journal club presentation  Journal club with back references J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

7.  Faculty members 1. Keep current with new knowledge 2. Learn to critically appraise research 3. Promote implementation of new knowledge ex. in practice 4. Increase interest in research and generation of research ideas 5. Increase awareness of own research and appraisal skills  Students 1. Learn scientific reading & summarizing articles 2. Learn how to criticize & give comments politely 3. Promote better understanding of the research process 4. Improve presentation skills  From slides to eye contact! 5. Learn how to socialize J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

8. C ATALOGUING C RITICALLY A PPRAISED A RTICLES FROM J OURNAL C LUB A database is created of current evidence for access by residents, fellows and faculty J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

9.  Objectives J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

10. Journal Club Objectives

11.  Objectives  Presentation Guide J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

12. Journal club presentation guide

13.  Objectives  Presentation Guide  Journal Club Presenter Responsibilities J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

14. Journal Club Presenter Responsibilities

15.  Objectives  Presentation Guide  Journal Club Presenter Responsibilities  Journal Club Format J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

16. Journal Club AgendaResponsible Party I. Concept Overview (≤10 minutes)Faculty II. Article Presentation (~10 minutes)Resident III. EBM Exercise (≤15 minutes)Faculty & Resident IV. Open Discussion (~15 minutes)Resident Journal Club Format Journal Club Format Journal club is held the 1 st wednasday of each month, 3:00-4:00 pm Journal club is held the 1 st wednasday of each month, 3:00-4:00 pm 2 fellows will present each session 2 fellows will present each session Each fellow will receive a copy of JAMA’s Users’ Guide to the Medical Literature: A Manual for Evidence-Based Clinical PracticeEach fellow will receive a copy of JAMA’s Users’ Guide to the Medical Literature: A Manual for Evidence-Based Clinical Practice Fellows are to work with assigned mentor to chose and analyze an appropriate article. Fellows are to work with assigned mentor to chose and analyze an appropriate article. Articles may be chosen from Gastroenterology, Hepatology, NEJM, JAMA, The Lancet, Science, Nature, Annals of Internal Medicine Articles may be chosen from Gastroenterology, Hepatology, NEJM, JAMA, The Lancet, Science, Nature, Annals of Internal Medicine Fellows are encouraged to critically appraise the literature, and develop their own Fellows are encouraged to critically appraise the literature, and develop their own independent criticisms independent criticisms J.Modaresi. - MD, PhD– Alborz University of Medical Sciences

17.  Objectives  Presentation Guide  Journal Club Presenter Responsibilities  Journal Club Format  Assessment & Evaluation Tools  Student presentation assessment  Annual assessment of the journal club J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

18. Annual Journal Club Evaluation

19.  Objectives  Presentation Guide  Journal Club Presenter Responsibilities  Journal Club Format  Assessment & Evaluation Tools  Journal Club Schedule & Important Dates J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

20. Journal Club Schedule

21.  You have been recently appointed as deputy for research of department. There are 10 MSc students / residents in the department working under supervision of 5 faculty members. One of your assignments is to establish journal club for students / residents with active participation of faculty members. Design a complete journal club plan for the first six months. One of your assignments is to establish journal club for students / residents with active participation of faculty members. Design a complete journal club plan for the first six months. J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

22. Ten steps to develop a successful journal club

23.  Step 1 Identify a leader Identify a leader  It correlates with the effectiveness Members may take turns (with one person with overall responsibility) Members may take turns (with one person with overall responsibility) J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

24.  STEP 1 (CONT.)  The facilitator may be a senior student who… Is appointed for a 6 month period Is appointed for a 6 month period The JC starts & finishes on time The JC starts & finishes on time Breaks are signaled well in advance Breaks are signaled well in advance Papers are distributed properly Papers are distributed properly The designated room is welcoming The designated room is welcoming Helps the junior students to prepare slides, … Helps the junior students to prepare slides, …  The supervisor/s may be faculty members who… Prepares a JC plan (ex. 6 month) for the students Prepares a JC plan (ex. 6 month) for the students Supervises the whole process Supervises the whole process Work with the students to prepare Work with the students to prepare J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

25.  Step 2 Identify goals / Learning objectives J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

26.  Step 2 (cont.) Identify goals: 1. Inexperienced group: Critique the same article, discuss how to critique an article Critique the same article, discuss how to critique an article 2. Mixed : Teach & mentor inexperienced members Teach & mentor inexperienced members 3. More experienced group: Identify a clinical problem & critique several articles relating to that problem Identify a clinical problem & critique several articles relating to that problem J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

27.  Step 3 Identify target audience (based on your goals) ex.:  Open to all  All faculty members / students on a specific unit  Microbiology MSc students  Interested faculty members / students  Nutrition PhD students  A cross section of faculty members / students  All nurses in a particular specialty J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

28.  Step 4 Set a time & place : A convenient meeting time (ex, monthly) A convenient meeting time (ex, monthly) A convenient meeting place A convenient meeting place  Sit in a circle or horse shoe Provide free food Provide free food Ample free parking Ample free parking J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

29.  Step 5 Select article(s), based on your goals: Select article(s), based on your goals:  A specific process (apoptosis detection, bariatric surgery, upper GI endoscopy) (apoptosis detection, bariatric surgery, upper GI endoscopy)  Care of a specific population (diabetics,obese,pregnants,…) (diabetics,obese,pregnants,…)  A topic of general interest to the audience J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

30.  Step 5 (cont.) For article selection choose an interesting & well-written paper For article selection choose an interesting & well-written paper J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

31. McMaster Online Rating of Evidence (MORE) system  Developed to help define the best research to support evidence-based clinical practice, tailored to the individual interests of clinicians/nurses. J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

32. Reliable sources J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

33.  Step 6 Develop / select forms One to summarize each article read & discussed One to summarize each article read & discussed One to summarize all of the article discussed by the group One to summarize all of the article discussed by the group J.Modaresi. - MD, PhD – Alborz University of Medical Sciences

34. 1. Definition of the problem 2. Specification of the research question 3. Definition of the variables 4. Selection of the subjects 5. Selection of an appropriate research design 6. Analysis of the data 7. Interpretation of the results J.Modaresi. - MD, PhD – Alborz University of Medical Sciences