Re-Thinking Journal Club to Enhance Evidence-Based Practice
by Katherine Fu, M.D. | April 30, 2025
Article Citation: Fu KA, Chan JM, Stepanyan K, et al. Education Research: A Mixed-Methods Analysis of Journal Club Formats to Enhance Evidence-Based Practice Through Social Cognitive Learning Theory. Neurol Educ. 2025;4(1):e200195. Published 2025 Feb 11. DOI: 10.1212/NE9.0000000000200195
What is this article about?
This article describes a quasi-experimental, sequential, explanatory mixed-methods study comparing a traditional journal club format with an active learning, flipped-classroom style format to teach neurology residents evidence-based practice (EBP) at the University of California, Los Angeles (UCLA). In the traditional journal club format, a resident facilitator was assigned to present an article while a faculty facilitator offered their expertise. Facilitators were instructed to welcome comments or questions during the journal club itself, while also dedicating at least 10 minutes at the end for discussion. In the active learning format, the resident facilitator created a discussion guide, which consisted of an article summary and 1–3 discussion questions for each section of the research article (Introduction, Methods, Results, Discussion). To minimize preparation burden, each postgraduate year class was assigned to prepare a specific section of discussion questions. Discussion items and the journal article were assigned by email to participating residents 1 week before the journal club session.. During the session, the resident and faculty facilitator guided the large group discussion. Multiple-choice based pre- and post-tests were administered for each journal club. There were statistically significant increases in the total (estimate = 18.03%, SD = 6.9, p = 0.028) and the clinical application (estimate = 48.40%, SD = 6.6, p < 0.0001) pretest and posttest scores with the active learning format, but no difference in the research methodology subscores (estimate = 5.84%, SD = 11.8, p = 0.63). Although the active learning format demonstrated benefits, the qualitative interviews revealed that residents were challenged by the burden of preparation in both formats. They also mentioned the importance of clinical relevance, preference for organic discussion, and the value of faculty expertise as critical elements of journal club.
Why should you read the article?
Evidence-based practice (EBP) and the ability to apply advances in research to patient care is a critical skill that both the AAMC and ACGME recognize as an important process in educating healthcare professionals. In the context of a digital era with large volumes of information, and at times misinformation, the ability to rapidly and efficiently critique research, summarize the findings, and recognize study limitations becomes ever more paramount. Journal clubs have served as a historically long-standing approach to teach critical appraisal of research. However, the traditional format, which lends itself to a more passive didactic approach, has limitations. This article therefore explores an alternative active learning format and shares lessons learned from this approach.
How can you use this article?
This article aims to serve as an impetus for medical educators to re-examine how they currently conduct journal clubs at their own institutions and programs. Although the study population was neurology residents, there are likely implications for residents of other disciplines as well as medical students. Medical students are increasingly faced with competing professional commitments and so improving the learning efficiency around evidence-based practice (EBP) is of benefit. This article highlights the key elements of what residents found most beneficial from the two journal club formats, while also acknowledging some of the existing challenges and proposing future directions and ways to circumvent these, such as with a “no-prep” journal club format. Educators can integrate these results when considering how they may choose to revise or adapt journal clubs to improve the learning of EBP.
Review Author: Katherine Fu, M.D., Assistant Professor of Neurology and Associate Residency Program Director, University of California Los Angeles, Los Angeles, CA. Organization: Consortium of Neurology Clerkship Directors