Modernizing Journal Club to Teach Evidence‐Based Practice

Effective critical appraisal of published literature is a fundamental competency needed for residents' educational growth and transition to practice. While journal clubs (JCs) are a cornerstone for learning critical appraisal and evidence-based practice (EBP), traditional JCs are often ineffective in maintaining trainees' interest and achieving the targeted educational objectives. JCs curricula face important challenges: poor sustainability over time, inconsistent participant preparation and lack of trainee skills and perceived self-efficacy with critical appraisal. A flipped classroom model for JCs might make it possible to teach EBP in a more modern and effective way. We propose a novel and easy-to-implement educational activity to teach critical appraisal. This 60-minute session requires no advanced preparation by the trainees. Sessions are tailored to cover three educational activities and are adaptable to in-person, virtual or hybrid contexts. To set the stage, the session facilitator presents a clinical scenario that highlights a ‘conundrum’ or an ‘area of controversy’ in the field. Participants, placed in groups of three to five trainees of various training levels, are first given time to highlight and discuss conundrums related to the case topic. This activity would usually take 10 minutes, with around 4 minutes of independent work to identify the conundrums. As a second activity, participants are asked to identify two or three clinical guidelines that relate to the case topic and then compare and contrast them. Participants were given 25 minutes to complete this task, with the last 10 minutes reserved for group discussions. For the third activity, participants were tasked with finding a recent article regarding the scenario's topic and then presenting it briefly. This last activity usually takes 15 minutes, with an initial 5 minutes for the literature review. During each group discussion, the facilitator ensured that the participants discussed the resources they used and their approach to searching the literature. All trainees rotating on the inpatient unit at Montréal Children's Hospital were invited to participate. Sessions were conducted monthly as a part of an existing weekly academic activity during the spring of 2022. Sessions were facilitated by paediatricians with experience in critical appraisal. Participants' evaluation was gathered using a non-mandatory anonymous evaluation survey at the end of each session. While the traditional approach to JCs is fraught with challenges, our educational session inspired by the flipped classroom model demonstrates that they can still play a meaningful role in teaching critical appraisal and EBP. Our sessions were short and easy to fit into a busy inpatient unit's protected teaching time. As they required no advanced preparation, the busy senior trainees' attendance was maximised. McGill University provides full-text access to major health care journals, which facilitated the activities. The session's activities fostered active participation, near-peer collaborative learning, experiential learning and the utilisation of modern technology. Participants felt that these sessions were helpful in learning EBP and that they represented “real-life” practice. Case scenarios were relatively easy to create, and although we did not encounter this issue, session success likely depends on choosing the right topic for the participant audience. Ebtehal Qulisy: Conceptualization; data curation; investigation; project administration; writing original draft. Geoffrey Dougherty: Conceptualization; methodology; project administration; review and editing; supervision. Kholoud Hothan: Project administration; review and editing. Mylene Dandavino: Conceptualization; methodology; project administration; review and editing; supervision.

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