Abstract
1997). Although this view is gaining ground, journal clubs remain a fundamental part of postgraduate education, both from the point of view of continuing medical education for con sultants and the education of trainees. There are problems with the traditional journal club format: the paper may be selected ad hoc and may not be the most suitable to cover the topic in question; the trainee may have no say in the choice of paper, not know why the paper has been chosen and have little interest in the topic; often, trainees prA©cisa paper, and offer an unstructured and poorly performed critique; trainees get no experience of reviewing a ques tion or undertaking a literature search. For these reasons, the whole process can be very boring for the audience and presenter alike, and limited in terms of learning. In an attempt to overcome these difficulties, an alternative approach would be to adopt the evidencebased medicine (EBM) paradigm (Gilbody, 1996; Sackett et al, 1997). Evidence-based medicine, defined as the conscientious, explicit and judi cious use of current best evidence in making decisions about the care of individual patients (Sackett et al 1996), has been suggested as a new approach to teaching the practice of medicine (Evidence-Based Medicine Working Group. 1992). From the point of view of an academic programme, the EBM approach could involve integrating the case conference with the journal club; the paper presented at the latter chosen to address a question or topic arising from the case.
Highlights
From the point of view of an academic programme, the evidencebased medicine (EBM) approach could involve integrating the case conference with the journal club; the paper presented at the latter chosen to address a question or topic arising from the case
When preparing for the EBM sessions, the presenters of the case and the journal were invited to meet with a member of the academic staff at least a week beforehand
A question raised by the case conference was idenUfied by the trainees as the focus of the EBM session
Summary
The weekly postgraduate meeting in our depart ment used to begin with a one-hour case presentation, followed by an unrelated journal club. These meetings are generally attended by around 30 people including consultants, trainee psychiatrists and medical students. Trainees were offered guidance about literature searching, statistical analysis and critical ap praisal techniques. Examples in these sessions so far have included: Is cognitive - behavioural therapy useful in an older depressed patient?; What is the evidence to support the use of clozapine in a patient with treatment resistant stocmhiozogprahprhenyia?;aid Dthoees dsiainggnloesisphootfonAlzehmeiimsseior'ns disease? The paper(s) are presented at the journal club
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