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“A JOURNAL ON A JOURNAL 
CLUB!” 
Dr. Madhusudhan NC 
Resident-Dept. of Orthopaedic Surgery 
Bangalore Baptist Hospital
Planning and executing orthopedic journal clubs
1. Journal Topic: Planning and executing 
orthopedic journal clubs. 
2. Publication: Indian Journal of Orthopaedics. 
3. Year: 2007. 
4. Volume: 41. 
5. Issue: 41. 
6. Page: 47-54
Authors: 
Jaydeep K Moro Mohit Bhandari 
Division of Orthopedic Surgery, 
McMaster University, 
Hamilton, Ontario 
Canada.
History:
Purpose of the Article? 
“ To provide organizers with tools to plan and 
execute successful journal clubs in Orthopedic 
surgery training programs”
PURPOSE AND GOALS OF JOURNAL CLUBS 
1. Keeping abreast with the current literature. 
2. Unfortunately., has become an unrealistic goal-why? 
3. So, the current goals include. 
“promoting Evidence-Based Orthopedics and 
learning general critical appraisal skills for 
Residents.” 
Thus, Journal clubs are the Ideal vehicle for 
Evidence based orthopedic surgery Topic
What others have to say about this? 
1. Greene surveyed 149 North American Orthopedic 
surgery training programs. 
1. 99% included a regularly scheduled journal clubs. 
2. Most important goal – Teaching critical appraisal skills 
to surgical residents. 
2. General Surgery journal clubs in American 
Institutions: 
1. 64% - directors thought their journal club was important 
or very Important to the educational mission . 
2. 87.5% - Learning Literature Review Skills. 
3. 52.9% - Provide training in research education. 
4. 52.4% - Research design.
3. Survey of Hand Surgery fellowship directors: 
* 57 Hand Surgery fellowship directors. 
* Felt- Very Important for Fellowship training. 
Secondary Goals: 
 Increasing Reading Comprehension. 
 Fostering Resident- Faculty relations. 
 Learning Orthopaedics in an alternative manner.
PREVALENCE AND CHARACTERISTICS OF 
ORTHOPEDIC JOURNAL CLUBS 
1. Greene study: 
“ The Role of journal clubs in Orthopedic surgery Residency 
Programs” 
Findings: 
* 161 North Americn Orthopedic training programs. 
* 99% - Regularly scheduled journal clubs. 
* 78% - Once a month. 
* 9% - Twice a month. 
* 82% - More than 1 scientific journals were reviewed. 
* 38% - Designated faculty member. 
* 17% - Chairman of the Orthopedic program. 
* 32% - Rotating faculty. 
* 13% - Chief Resident.
* 50% - Departmental Office. 
* 31% - Home of a Faculty member. 
* 18% - Restaurant. 
* 68% - Evening. 
* 29% - At the start of the work day. 
* 59% - (80-100%) attendance. 
* 36% - (60-80%) attendance. 
* 4% - (40-60%) attendance. 
* 50% - Full meal. 
* 37% - Light Snack. 
Top 3 Goals: 
1. Teaching Orthopedic Residents how to evaluate scientific 
articles. 
2. Instilling a habit of reading scientific journals. 
3. Facilitating Residents learning about current research.
PLANNING AND ORGANIZATION ISSUES
PLANNING AND ORGANIZATIONAL ISSUES 
1. Not all journal Clubs are successful. 
2. Sidorov et all., - Successful journal clubs means- 
*Those that meets the educational objectives. 
*Those that continually promote and maintain 
resident interest. 
3. Jones et all., - Regularly revise their selection of 
journals in order to increase the value of this 
important educational process.
LEADERSHIP
LEADERSHIP 
1. Designated leader. 
* Effective journal clubs are correleted with having 
a designated leader. 
2. Essential attributes of a leader. 
* An interest in medical education. 
* A belief that the journal club is important. 
3. Responsibilities 
* Planning. 
* Execution of the club. 
* Evaluation of the club. 
4. Use of having a skilled Moderator. 
* Adds value to the discussion. 
* Attendance of the club.
ENVIRONMENT
ENVIRONMENT 
1. Maintaining boundaries is important to the success of 
the club. 
2. Thus Trainees should be relieved from clinical duties, 
except Emergency patient care. 
3. This aids the session to start and stop on time. 
4. Room should be comfortable. 
5. Papers to be distributed well in advance to attendees. 
6. Environment should have a sense of security and thus 
allow creative thinking.
AUDIENCE
AUDIENCE 
1. Crucial to the success of journal clubs, unlike traditional 
teaching conferences. 
2. The educational value of the meeting is optimized by the 
interactions of the attendees and the dynamic exchange 
of opinions and ideas. 
3. Mandatory attendance 
4. Continuity is promoted by having a regular group of 
attendees. 
5. On the other hand, trainees may feel attendance is 
imposed on them rather than viewing the club as an 
educational opportunity. 
6. This may be addressed by allowing residents to set their 
own rules such as journal club presenter opportunities 
and participating in choosing papers to discuss.
* Faculty support with independent running 
of the journal club (by a senior trainee) was 
shown to lead to high attendance rates. 
* Having a trainee as a club leader may 
make the fellow trainees feel less 
intimidated in asking questions. 
* Senior trainees, rather than the faculty, 
may be more attuned to the needs of their 
junior colleagues. 
* Having journal clubs early in the 
morning before the work day or 
in the evenings is more convenient 
for all involved.
FOOD
FOOD 
* The regular provision of food has been associated with 
successful journal clubs. 
* In orthopedics, 87% of meetings provide some sort of 
food. 
* Longevity and high attendance rates are correlated 
with the provision of food. 
* Funding journal club meals may be provided by 
individual faculty or by divisional or departmental 
support.
NUMBER OF PAPERS TO REVIEW 
* A range of three to 10 papers seems to be a 
reasonable 
* Too many articles (limiting valuable discussion) 
* Too few articles (limiting the breadth of 
information). 
* Be individualized by each training program.
LINKING JOURNAL CLUB TO THE CURRICULUM 
* Many authors have studied the educational 
effects of journal clubs in residency training 
programs. 
* Study of emergency medicine residents 
* Study of two pediatric training programs 
There were no significant differences between the 
two groups of residents in objective testing of 
knowledge of epidemiology, biostatistics, nor 
critical evaluation.
IMPACTS OF JOURNAL CLUB ON READING 
HABITS, KNOWLEDGE AND SKILLS 
* Parkes et al revealed a small evidence base that journal 
clubs probably do improve knowledge in biostatistics and 
clinical epidemiology in a Cochrane review. 
* Conflicting evidence exists on whether they enhance 
critical appraisal skills. 
* The impact of journal clubs on patient outcomes has 
not yet been investigated in a well-designed trial, as there 
is difficulty in measuring this process.
TYPES OF JOURNAL 
CLUBS
1. EVIDENCE-BASED JOURNAL CLUBS 
2. JOURNAL CLUBS BASED ON CRITICAL APPRAISAL 
3. JOURNAL CLUBS BASED ON KNOWLEDGE 
TRANSMISSION 
4. THE NO PREPARATION JOURNAL CLUB 
5. INTERNET-BASED JOURNAL CLUBS
Just deviating from the core journal to understand… 
Evidence based Medicine. 
Will cover…. 
1. Levels od Evidence based medicine.
Level of evidence Source of evidence Grades of recommend. 
I SR, RCTs A 
II Cohort studies 
B 
III Case-control studies 
IV Case series C 
V Expert opinion D
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Journal of 
the AAOS. 
April 2013 
Vol 21, No 4
Understandi 
ng 
Systematic 
Reviews and 
Meta-analysis 
in 
Orthopedics
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Executing and planning Orthopedic journal clubs- A Journal review
Evaluation Of The Journal Club 
* Periodic Restructuring Of The Club Will Be Necessary To 
Meet New Goals. 
* This Will Help To Maintain Enthusiasm And Effectiveness. 
* Periodically Asking The Attendees About Their Satisfaction 
With The Club Is One Way To Modify The Meeting If Needed. 
* Anonymous Feedback From The Residents May Alert 
Organizers About Strengths And Weaknesses And Potentials 
For Improvement. 
* These Periodic Evaluation Methods Will Aid In Improving 
The Educational Experience Of The Journal Club, Regardless 
Of Its Format.
Conclusions 
* Journal Clubs Are Integral To Graduate Medical 
Education, Including Most Orthopedic Training Programs. 
* Factors Associated With High Attendance And 
Longevity Of The Club Include 
- Mandatory Attendance, 
- Availability Of Food, 
- Perceived Educational Value Of The Program 
Director, 
- Having A Committed Leader, 
- Good Faculty Participation, 
- Formal Instruction In Epidemiologic Principles.
By evaluating the journal club and 
responding to the needs of the 
participants, journal clubs can continue 
to evolve and improve to remain as a 
valuable part of the orthopedic residency 
training program.
THA 
NK 
YOU

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Executing and planning Orthopedic journal clubs- A Journal review

  • 1. “A JOURNAL ON A JOURNAL CLUB!” Dr. Madhusudhan NC Resident-Dept. of Orthopaedic Surgery Bangalore Baptist Hospital
  • 2. Planning and executing orthopedic journal clubs
  • 3. 1. Journal Topic: Planning and executing orthopedic journal clubs. 2. Publication: Indian Journal of Orthopaedics. 3. Year: 2007. 4. Volume: 41. 5. Issue: 41. 6. Page: 47-54
  • 4. Authors: Jaydeep K Moro Mohit Bhandari Division of Orthopedic Surgery, McMaster University, Hamilton, Ontario Canada.
  • 6. Purpose of the Article? “ To provide organizers with tools to plan and execute successful journal clubs in Orthopedic surgery training programs”
  • 7. PURPOSE AND GOALS OF JOURNAL CLUBS 1. Keeping abreast with the current literature. 2. Unfortunately., has become an unrealistic goal-why? 3. So, the current goals include. “promoting Evidence-Based Orthopedics and learning general critical appraisal skills for Residents.” Thus, Journal clubs are the Ideal vehicle for Evidence based orthopedic surgery Topic
  • 8. What others have to say about this? 1. Greene surveyed 149 North American Orthopedic surgery training programs. 1. 99% included a regularly scheduled journal clubs. 2. Most important goal – Teaching critical appraisal skills to surgical residents. 2. General Surgery journal clubs in American Institutions: 1. 64% - directors thought their journal club was important or very Important to the educational mission . 2. 87.5% - Learning Literature Review Skills. 3. 52.9% - Provide training in research education. 4. 52.4% - Research design.
  • 9. 3. Survey of Hand Surgery fellowship directors: * 57 Hand Surgery fellowship directors. * Felt- Very Important for Fellowship training. Secondary Goals:  Increasing Reading Comprehension.  Fostering Resident- Faculty relations.  Learning Orthopaedics in an alternative manner.
  • 10. PREVALENCE AND CHARACTERISTICS OF ORTHOPEDIC JOURNAL CLUBS 1. Greene study: “ The Role of journal clubs in Orthopedic surgery Residency Programs” Findings: * 161 North Americn Orthopedic training programs. * 99% - Regularly scheduled journal clubs. * 78% - Once a month. * 9% - Twice a month. * 82% - More than 1 scientific journals were reviewed. * 38% - Designated faculty member. * 17% - Chairman of the Orthopedic program. * 32% - Rotating faculty. * 13% - Chief Resident.
  • 11. * 50% - Departmental Office. * 31% - Home of a Faculty member. * 18% - Restaurant. * 68% - Evening. * 29% - At the start of the work day. * 59% - (80-100%) attendance. * 36% - (60-80%) attendance. * 4% - (40-60%) attendance. * 50% - Full meal. * 37% - Light Snack. Top 3 Goals: 1. Teaching Orthopedic Residents how to evaluate scientific articles. 2. Instilling a habit of reading scientific journals. 3. Facilitating Residents learning about current research.
  • 13. PLANNING AND ORGANIZATIONAL ISSUES 1. Not all journal Clubs are successful. 2. Sidorov et all., - Successful journal clubs means- *Those that meets the educational objectives. *Those that continually promote and maintain resident interest. 3. Jones et all., - Regularly revise their selection of journals in order to increase the value of this important educational process.
  • 15. LEADERSHIP 1. Designated leader. * Effective journal clubs are correleted with having a designated leader. 2. Essential attributes of a leader. * An interest in medical education. * A belief that the journal club is important. 3. Responsibilities * Planning. * Execution of the club. * Evaluation of the club. 4. Use of having a skilled Moderator. * Adds value to the discussion. * Attendance of the club.
  • 17. ENVIRONMENT 1. Maintaining boundaries is important to the success of the club. 2. Thus Trainees should be relieved from clinical duties, except Emergency patient care. 3. This aids the session to start and stop on time. 4. Room should be comfortable. 5. Papers to be distributed well in advance to attendees. 6. Environment should have a sense of security and thus allow creative thinking.
  • 19. AUDIENCE 1. Crucial to the success of journal clubs, unlike traditional teaching conferences. 2. The educational value of the meeting is optimized by the interactions of the attendees and the dynamic exchange of opinions and ideas. 3. Mandatory attendance 4. Continuity is promoted by having a regular group of attendees. 5. On the other hand, trainees may feel attendance is imposed on them rather than viewing the club as an educational opportunity. 6. This may be addressed by allowing residents to set their own rules such as journal club presenter opportunities and participating in choosing papers to discuss.
  • 20. * Faculty support with independent running of the journal club (by a senior trainee) was shown to lead to high attendance rates. * Having a trainee as a club leader may make the fellow trainees feel less intimidated in asking questions. * Senior trainees, rather than the faculty, may be more attuned to the needs of their junior colleagues. * Having journal clubs early in the morning before the work day or in the evenings is more convenient for all involved.
  • 21. FOOD
  • 22. FOOD * The regular provision of food has been associated with successful journal clubs. * In orthopedics, 87% of meetings provide some sort of food. * Longevity and high attendance rates are correlated with the provision of food. * Funding journal club meals may be provided by individual faculty or by divisional or departmental support.
  • 23. NUMBER OF PAPERS TO REVIEW * A range of three to 10 papers seems to be a reasonable * Too many articles (limiting valuable discussion) * Too few articles (limiting the breadth of information). * Be individualized by each training program.
  • 24. LINKING JOURNAL CLUB TO THE CURRICULUM * Many authors have studied the educational effects of journal clubs in residency training programs. * Study of emergency medicine residents * Study of two pediatric training programs There were no significant differences between the two groups of residents in objective testing of knowledge of epidemiology, biostatistics, nor critical evaluation.
  • 25. IMPACTS OF JOURNAL CLUB ON READING HABITS, KNOWLEDGE AND SKILLS * Parkes et al revealed a small evidence base that journal clubs probably do improve knowledge in biostatistics and clinical epidemiology in a Cochrane review. * Conflicting evidence exists on whether they enhance critical appraisal skills. * The impact of journal clubs on patient outcomes has not yet been investigated in a well-designed trial, as there is difficulty in measuring this process.
  • 27. 1. EVIDENCE-BASED JOURNAL CLUBS 2. JOURNAL CLUBS BASED ON CRITICAL APPRAISAL 3. JOURNAL CLUBS BASED ON KNOWLEDGE TRANSMISSION 4. THE NO PREPARATION JOURNAL CLUB 5. INTERNET-BASED JOURNAL CLUBS
  • 28. Just deviating from the core journal to understand… Evidence based Medicine. Will cover…. 1. Levels od Evidence based medicine.
  • 29. Level of evidence Source of evidence Grades of recommend. I SR, RCTs A II Cohort studies B III Case-control studies IV Case series C V Expert opinion D
  • 35. Journal of the AAOS. April 2013 Vol 21, No 4
  • 36. Understandi ng Systematic Reviews and Meta-analysis in Orthopedics
  • 54. Evaluation Of The Journal Club * Periodic Restructuring Of The Club Will Be Necessary To Meet New Goals. * This Will Help To Maintain Enthusiasm And Effectiveness. * Periodically Asking The Attendees About Their Satisfaction With The Club Is One Way To Modify The Meeting If Needed. * Anonymous Feedback From The Residents May Alert Organizers About Strengths And Weaknesses And Potentials For Improvement. * These Periodic Evaluation Methods Will Aid In Improving The Educational Experience Of The Journal Club, Regardless Of Its Format.
  • 55. Conclusions * Journal Clubs Are Integral To Graduate Medical Education, Including Most Orthopedic Training Programs. * Factors Associated With High Attendance And Longevity Of The Club Include - Mandatory Attendance, - Availability Of Food, - Perceived Educational Value Of The Program Director, - Having A Committed Leader, - Good Faculty Participation, - Formal Instruction In Epidemiologic Principles.
  • 56. By evaluating the journal club and responding to the needs of the participants, journal clubs can continue to evolve and improve to remain as a valuable part of the orthopedic residency training program.