Journal Club

Abstract

We are about to introduce a new feature called ‘Journal Club’, to continue the push started by our previous editor-in-chief Frank Oberklaid, to improve the educational value of the Journal of Paediatrics and Child Health. Like many other medical journals, we recognise the importance of clinical problems and the importance of considering the evidence for clinical decisions. Our intention is that articles for ‘Journal Club’ should reflect what happens at evidence-based journal clubs all over the world, where doctors come with a clinical question, search for evidence, critically appraise the best evidence and then apply it to their patient while reflecting how the research could have been conducted better. Journal clubs have been around for at least 135 years, and some illustrious thinkers have been instrumental in their development.1 A forerunner developed at St Bartholomew's Hospital, London (Bart's), where Sir James Paget worked from 1835 to 1854. The small hospital library had no reading room, so some students started a club which met in a small room over a baker's shop near the hospital gate, where they sat and read the journals and, in the evening, some played cards.2 In his biography of Sir William Osler, Harvey Cushing describes Osler's first journal club in Montreal in 1875, ‘for the purchase and distribution of periodicals to which he could ill afford to subscribe as an individual’, and its successful reincarnation as a weekly journal club when Osler moved to Johns Hopkins Hospital in Baltimore in 1889.3 Recent journal clubs have often focused on evidence-based medicine. Is there evidence that journal clubs are educational, or do they just provide a social function: the ABC of journal clubs, ambience, breakfast and collegiality? Mark Linzer not only researched the history of journal clubs,1 he also performed the only randomised controlled trial, in which medical interns received a mean of five journal club sessions or a control seminar series.4 Attendance at journal club improved reading habits and knowledge significantly. A systematic review of what factors contributed to a successful journal club found that the characteristic features were regular meetings, mandatory attendance (!), clear short-term and long-term purpose, appropriate meeting times and incentives, a trained journal club leader, prior circulation of papers, use of the Internet, and use of critical appraisal processes and summaries.5 The review did not look at nutrition, but there is little doubt that good food improves attendance at meetings. The junior medical officer journal club at the Children's Hospital at Westmead was started by Professor Craig Mellis in 1998. It had all the key elements of a successful journal club: a dynamic leader with clinical and research expertise and a core group of keen young trainees meeting weekly, around food (provided by the junior staff and not a pharmaceutical company), to review current and interesting medical literature while learning critical appraisal and research design skills and improving clinical practice in an era when ‘evidence-based medicine’ became vogue. The journal club continues meeting weekly to this day. Our first published article in ‘Journal Club’ was the result of one of the junior medical officer journal club meetings which has led to the conduct of a Cochrane Systematic Review by one of the trainees who also won the Wiley-Blackwell New Investigator Award in the Paediatrics and Child Health Division at the World Congress of Internal Medicine recently for his work.6 The success of the ‘Journal Club’ feature depends on keen young trainees and their supervisors and on others who want an opportunity to share what they have learnt when they ‘searched for evidence’ to interesting clinical questions. We urge you to write up your journal club presentations and submit them to us, on the web site http://www.wiley.com/bw/submit.asp?ref=1034-4810&site=1. If you want advice on any aspect of writing or submitting a paper, please email Patrina Caldwell on [email protected]. Your ‘Journal Club’ needs you.