Journal Club Research Articles

Evidence-Based Medicine Within Surgical Practice and Training: A Scoping Review.

Evidence-based medicine (EBM) is a fundamental element of modern surgical practice. However, its integration into surgical training remains challenging. Through a scoping review, this study mapped existing evidence on the practice of EBM in surgery, focusing on knowledge, attitudes, barriers, and curricula. The literature was systematically searched through 3 databases and 2 registers. Fifty articles published over a 22-year period (2001-2023) were identified based on predefined eligibility criteria. These were reviewed using Arksey and O'Malley's methodological framework. The review was checked against the PRISMA 2018 checklist for scoping reviews. There is evidence of awareness and appreciation of EBM principles among surgeons and surgical trainees. However, the understanding of EBM terminology is varied. Attitudes toward EBM were predominantly positive yet reliance on clinical experience over evidence-based guidelines was noted. Key barriers to EBM practice included time constraints, lack of structured training, and methodological challenges in surgical research. The review highlighted the lack of validated competency assessment tools and the need for structured EBM curricula. Various educational strategies, such as journal clubs and courses, were found to improve EBM knowledge, albeit with limited evidence on long-term practice change. This scoping review underscores the need for a more detailed understanding of stakeholder views of EBM in surgical practice, the development, implementation, and assessment of educational interventions in this field, and tailored strategies to assess EBM competency in surgery.

Modeling the Mottled Child: Evaluating a Pediatric Septic Shock Predictive Modeling Screening Tool: February 2025 Annals of Emergency Medicine Journal Club.

Modeling the Mottled Child: Evaluating a Pediatric Septic Shock Predictive Modeling Screening Tool: February 2025 Annals of Emergency Medicine Journal Club.

PRS Journal Club: Optimizing the Aesthetic Outcomes of Reconstructive Surgery and Avoiding Patient Abandonment.

PRS Journal Club: Optimizing the Aesthetic Outcomes of Reconstructive Surgery and Avoiding Patient Abandonment.

P-949. The Success of Rapid-Fire Journal Club in Achieving Doctor of Pharmacy Educational Outcomes

Abstract Background Rapid-fire journal club is an activity in the infectious diseases elective for pharmacy students in their third professional year. In small groups, students were tasked with completing a journal club on an assigned study evaluating new antibiotics for treatment of resistant gram-negative infections. Students were given 1 week to prepare their presentation, and 10 minutes deliver their presentation. The goal of rapid-fire journal club was to engage pharmacy students in primary literature relating to new antibiotic agents and differentiate how each of the agents is best used in practice. The purpose of this study was to assess the impact of rapid-fire journal club on achieving Curriculum Outcomes and Entrustable Professional Activities (COEPA) within a Doctor of Pharmacy Program. Methods Student feedback was anonymously collected via an electronic survey. Students evaluated the impact of rapid-fire journal club across the 3 domains of the American Association of Colleges of Pharmacy (AACP) COEPA educational outcomes (Knowledge, Skills, and Attitudes) on a Likert scale from strongly disagree (1) to strongly agree (5). Student perceptions and feedback on the activity were also collected. Results 29 of the 38 students who participated responded. Majority strongly agreed or agreed that rapid-fire journal club allowed them to build foundational knowledge of antibiotics for resistant gram-negative infections (27/29, 93.1%), solve problems (21/29, 72.4%), improve communication among colleagues (24/29, 82.7%), understand the role of primary literature in improving antibiotic use (26/29, 89.7%), support shared goals on a team (25/29, 86.2%), and build and maintain trust among colleagues (25/29, 86.2%). Majority of students rated the activity a 3 out of 5 in difficulty, found the activity engaging, and enjoyed participating. Conclusion Rapid-fire journal allowed pharmacy students to achieve key Doctor of Pharmacy educational outcomes across the 3 COEPA domains. The activity was positively received by students and provided them with a unique activity within the classroom. Disclosures All Authors: No reported disclosures

Effectiveness of Different Intervention Modes in Lifestyle Intervention for the Prevention of Type 2 Diabetes and the Reversion to Normoglycemia in Adults With Prediabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Lifestyle interventions have been acknowledged as effective strategies for preventing type 2 diabetes mellitus (T2DM). However, the accessibility of conventional face-to-face interventions is often limited. Digital health intervention has been suggested as a potential solution to overcome the limitation. Despite this, there remains a significant gap in understanding the effectiveness of digital health for individuals with prediabetes, particularly in reducing T2DM incidence and reverting to normoglycemia. This study aimed to assess the effectiveness of different intervention modes of digital health, face-to-face, and blended interventions, particularly the benefits of digital health intervention, in reducing T2DM incidence and facilitating the reversion to normoglycemia in adults with prediabetes compared to the usual care. We conducted a comprehensive search in 9 electronic databases, namely MEDLINE, Embase, ACP Journal Club, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Clinical Answers, Cochrane Methodology Register, Health Technology Assessment, and NHS Economic Evaluation Database through Ovid, from the inception to October 2024. This review included randomized controlled trials (RCTs) that studied the effectiveness of lifestyle interventions in adults with prediabetes. The overall intervention effect was synthesized using a random-effects model. The I² statistic was used to assess heterogeneity across the RCTs. We performed a subgroup analysis to explore the effectiveness of digital health, face-to-face, and blended interventions compared with the control group, which received usual care. From an initial 7868 records retrieved from 9 databases, we identified 54 articles from 31 RCTs. Our analysis showed that face-to-face interventions demonstrated a significant 46% risk reduction in T2DM incidence (risk ratio [RR] 0.54, 95% CI 0.47-0.63; I²=43%; P<.001), and a 46% increase in the reversion to normoglycemia (RR 1.46, 95% CI 1.11-1.91; I²=82%; P=.006), when compared with the control group. On the other hand, digital health interventions, compared with the control group, were associated with a 12% risk reduction in T2DM incidence (RR 0.88, 95% CI 0.77-1.01; I²=0.6%; P=.06). Moreover, the blended interventions combining digital and face-to-face interventions suggested a 37% risk reduction in T2DM incidence (RR 0.63, 95% CI 0.49-0.81;I²<0.01%; P<.001) and an 87% increase in the reversion to normoglycemia (RR 1.87, 95% CI 1.30-2.69; I²=23%; P=.001). However, no significant effect on the reversal of prediabetes to normoglycemia was observed from the digital health interventions. Face-to-face interventions have consistently demonstrated promising effectiveness in both reductions in T2DM incidence and reversion to normoglycemia in adults with prediabetes. However, the effectiveness of digital health interventions in these areas has not been sufficiently proven. Given these results, further research is required to provide more definitive evidence of digital health and blended interventions in T2DM prevention in the future. PROSPERO CRD42023414313; https://tinyurl.com/55ac4j4n.

Peer-Led or Faculty-Led? Investigating the Best Approach to Journal Clubs for Postgraduation Trainees, A Quasi Experimental Study.

Introduction: Journal clubs are essential in postgraduate education. They promote critical appraisal and understanding of research articles. Faculty-led journal clubs offer structured guidance, while peer-led models emphasize collaboration and engagement. Understanding which approach better supports trainees’ learning can inform educational strategies in postgraduate training programs. Objective: To compare the perceived effectiveness of peer-led versus faculty-led journal clubs in enhancing postgraduate trainees’ understanding of research articles. Methodology: A quasi-experimental study was conducted with 60 postgraduate trainees randomly assigned to peer-led (n=30) or faculty-led (n=30) journal clubs. Identical articles were discussed in standardized sessions. A validated post-session questionnaire using a 5-point Likert scale assessed trainees’ perceptions of clarity of article content, confidence in interpreting results, and ability to identify key findings. Data were analyzed using descriptive statistics and independent samples t-tests. Results: The faculty-led group reported higher clarity of content (4.4 ± 0.5 vs. 3.8 ± 0.6, p=0.02) and confidence in interpreting results (4.3 ± 0.5 vs. 3.9 ± 0.7, p=0.04). Both groups scored similarly on identifying key findings (4.1 ± 0.6 vs. 3.9 ± 0.6, p=0.15). Overall, both groups provided positive feedback, with faculty-led sessions praised for structure and peer-led sessions valued for promoting collaboration and engagement. Conclusion: Both peer-led and faculty-led journal clubs effectively enhance trainees' understanding of research articles, with faculty -led sessions excelling in clarity and confidence. A hybrid model combining the strengths of both approaches may maximize learning outcomes. Future research should explore objective measures of learning and test these models in diverse educational settings.

A case study of establishing a foundation year engineering and physical science journal club as a means for developing confidence in academic skills and socialisation to academia

ABSTRACT An implementation of the journal club model to develop confidence in academic skills across speaking, writing and integrity domains, as well as socialising journal club members to academia, is reported. A journal club was established in a Foundation Year (Pre-undergraduate) context for ten physical scientists. A mixed-methods approach was used to measure self-reported confidence upon entering the university, contrasted after attending three, one-hour, journal club meetings, where contemporary literature across diverse subjects was discussed through the lens of ‘academic themes’ to scaffold discussions and support specific skill development. Self-reported confidence was captured through questionnaires and unpacked through semi-structured interviews, the themes of which were generated through qualitative reflexive analysis. Increased confidence in academic speaking was a notable result; interviewed journal club members valued the opportunity to present in small, regular, and informal meetings where discussions were appreciated between members. Exposure to subject domains outside of physical sciences where members were confronted with topics for which there is no clear answer, was uncovered as the impetus to disrupt members’ thinking, facilitated by the conversational medium of the journal club. The implementation reported here likely represents the scenario many professionals will find themselves in when considering establishing a journal club.

Psychometric Properties of the Critical Appraisal Tool for Anatomical Meta-Analysis.

The hallmark of evidence-based anatomy (EBA) is the anatomical meta-analysis (AMA). The Critical Appraisal Tool for Anatomical Meta-Analysis (CATAM) was recently published to enable users to appraise AMAs quickly and effectively. The tool is valuable for students and clinicians who need to judge the quality of AMAs, which informs clinical decision making and results in better patient care. Subjective measures of the tool's face and content validity have been established, but establishing its reliability provides a more objective measure of the instrument's dependability. This study investigated the interrater reliability (IRR) of the CATAM between novice and expert raters. Three graduate students and three professors (two anatomists and one pharmacist) read the original CATAM paper, and then had a post hoc meeting to discuss scoring with the tool. Three recent AMAs (published between 2017 and 2022) were randomly chosen from PubMed, and all six raters scored the papers blindly. The intraclass correlation coefficient (ICC) statistic was used to calculate the interrater reliability (IRR) between all scores, and then the ICCs between novice and expert scores were compared. Cronbach's alpha (internal consistency) of the CATAM was also calculated (SPSS 25, Armonk, NY). ICC for AMA-1 was 0.999 (95% CI, 0.997-0.999), p = 0.000, and alpha was 0.999. ICC for AMA-2 was 0.994 (95% CI, 0.988-0.998), p = 0.000, and alpha was 0.994. ICC for AMA-3 was 0.998 (95% CI, 0.995-0.999), p = 0.000, and alpha was 0.998. ANOVA showed no significant differences (p > 0.05) in mean ICCs between raters. The CATAM is a robust tool with excellent IRR (ICC > 0.990) and internal consistency (alpha > 0.990). No significant difference in ICC scores between novices and experts suggests the tool does not require prior expert knowledge to be effective. Now that the reliability of the CATAM is established, it can be more widely adopted by students and physicians worldwide to evaluate the quality of AMAs. The CATAM offers widespread applicability, and can be adopted in medical education, journal clubs, and clinical seminars to critically evaluate AMAs.

Early Exposure to Research: Its Impact on Medical Students’ Educational Experience and Interest in Future Research

Introduction: Integration of research into medical education is crucial for cultivating physician-scientists capable of advancing medical breakthroughs. It is imperative to take these measures for early medical students to establish a strong research foundation for future healthcare professionals. Methods: This study investigated the impact of early research exposure on pre-clinical medical students at Gulf Medical University (GMU). A sample size of 85 MD students participated in the study, which spanned six months. In GMU, early exposure to research begins with sessions integrated into the Medical Education and Lifelong Learning (MEL) course during the first year, covering the structure and function of different sections of a research paper and practical application through Journal Article Discussions (JADs) in journal clubs in the 2nd year. Results: The intervention involved the evaluation of these measures through pre-validated MCQs and a self-administered questionnaire. MCQ results revealed that over 70% of students scored above 40% on research knowledge assessments. Additionally, a questionnaire comprising open and close-ended questions revealed that most of the students reported a positive agreement in understanding research structures. Conclusion: The findings underscored the necessity of incorporating research into medical curricula to enhance students' research competencies and foster a positive attitude toward research. This study highlighted the importance of early research exposure in developing future physician-scientists.

Clinical Confidence, Certification, and Connectedness: Impact of a Journal Club for Inpatient Psychiatry Faculty.

Inpatient psychiatry faculty manage complex clinical, administrative, and legal issues amid increasing mental health service utilization rates, limiting time for (1) focusing on lifelong learning and (2) connecting. We examined the impact of a monthly journal club on inpatient psychiatry faculty's (1) confidence that their practice is evidence informed, (2) stress related to board recertification, and (3) sense of connectedness with peers. We employed a primarily qualitative approach using semi-structured interviews and brief survey questions to elicit input from inpatient psychiatry faculty at an academic medical center on their experience participating in a monthly journal club, including perceived changes in one's practice of evidence-based medicine, recertification stress, and connectedness with peers. Thirteen faculty who participated in the journal club responded to at least one survey or interview. Many faculty reported feeling more confident that their clinical practice was evidence informed, less stressed about board recertification, and more connected to peers at 6 and 12 months following the commencement of the journal club. Following in-person attendance, video-based learning (an innovative method of participating in the journal club) was found to be the second most preferred method of participation among respondents. All respondents noted that the journal club was a valuable use of their time and enjoyable. A monthly journal club has the potential to increase hospital psychiatry faculty confidence in evidence-based clinical practice, reduce board recertification stress, and improve sense of peer connectedness. Future research should examine the journal club experience and impact among a larger number of faculty and incorporate additional measures of learning outcomes.

PRS Journal Club: Breast Augmentation Plane Selection, Bleeding in Rhinoplasty, and Medical Spa Practitioner Trends.

PRS Journal Club: Breast Augmentation Plane Selection, Bleeding in Rhinoplasty, and Medical Spa Practitioner Trends.

Online Education in Orthopaedic Surgery: A Current Concept Review

This allows for blended learning and flipped classroom opportunities for the reduced in-person didactic time that orthopaedic surgical faculty have with residents today. Exam preparation for the Orthopaedic In-Training Exam (OITE) and the American Board of Orthopaedic Surgeons (ABOS) is now very commonly done with online platforms. Journal club activities have also shifted to the virtual space; podcasts provide a new way to learn when on the go, and virtual and augmented reality technologies are starting to make their way into surgical training. Evidence for these learning methods is steadily growing, although more extensive studies are needed to determine their efficacy. This review will assess the evidence available for these online education methods in orthopaedic surgery.

Practice Brief: Academic Research Supports Translation Pathways for Clinical Impact in Structured Journal Clubs

Academic research plays a pivotal role in creating and sustaining pathways for clinical impact. Over nine years, a series of collaborative research projects informed the translation pathway for structured journal clubs within a tertiary health service. This pathway included conceptualisation, implementation, sustainability and spread of research evidence into practice within the innovative journal club initiative. This brief identifies four key stages of the pathway, summarising the contribution of research to support ongoing practice transformation.

Current trends of postgraduate presentation in medical school: Is it beneficial for presenter and listeners?

Abstract Postgraduate presentation is a Socratic method, also known as two-way communication, where the audience takes an active part in asking questions and adding points to the presentation. When a presentation is a one-way communication, no matter how to the point the presentation was or how beautiful diagrams were included in the presentation, listeners are not attracted unless and until they are called to communicate. From choosing the topic for the journal club or seminar, the journey started which passed through the topic selection, finding an appropriate review of literature material, searching the historical moments of the topic, past development, current trends, recent advances, and prospects they try to cover during the presentation. Current trends of presentation can be made more beneficial if scheduled and implemented practical way. It also needs support from the listeners given attention, input, and appreciation.

EP111 Setting up and running a journal club in the OMFS department – A contemporary approach

EP111 Setting up and running a journal club in the OMFS department – A contemporary approach

Intraoperative use of processed electroencephalogram in a quaternary center: a quality improvement audit.

Although intraoperative electroencephalography (EEG) is not consensual among anesthesiologists, growing evidence supports its use to titrate anesthetic drugs, assess the level of arousal/consciousness, and detect ischemic cerebrovascular events; in addition, intraoperative EEG monitoring may decrease the incidence of postoperative neurocognitive disorders. Based on the known and potential benefits of intraoperative EEG monitoring, an educational program dedicated to staff anesthesiologists, residents of Anesthesiology and anesthesia technicians was started at Cleveland Clinic Abu Dhabi in May 2022 and completed in June 2022, aiming to have all patients undergoing general anesthesia with adequate brain monitoring and following international initiatives promoting perioperative brain health. All the surgical cases performed under General Anesthesia at 24 daily locations were prospectively inspected during 15 consecutive working days in March 2023. The use or absence of a processed EEG monitor was registered. Of 379 surgical cases distributed by 24 locations under General Anesthesia, 233 cases (61%) had processed EEG monitoring. The specialty with the highest use of EEG monitoring was Cardiothoracic Surgery, with 100% of cases, followed by interventional Cardiology (90%) and Vascular Surgery (75%). Otorhinolaryngology (29%), Gastrointestinal Endoscopy (25%), and Interventional Pulmonology (20%) were the areas with the lowest use of EEG monitoring. Of note, in the Neuroradiology suite, no processed EEG monitor was used in cases under General Anesthesia. We identified a reasonable use of EEG monitoring during general anesthesia, unfortunately not reaching our target of 100%. The educational and support program previously implemented within the Anesthesiology Institute needs to be continued and improved, including workshops, online discussions, and journal club sessions, to increase the use of EEG monitoring in underused areas.

First step to environmentally sustainable endoscopy practice: a prospective study of minimizing multiple device use during screening colonoscopy at a large tertiary center.

The healthcare sector generates 8% of greenhouse gas emissions in the USA, of which gastrointestinal (GI) endoscopy is the third largest contributor. Single-use tools are a major contributor to modifiable waste generation during GI endoscopy. Through a quality improvement initiative, we aimed to reduce endoscopy waste by urging gastroenterologists to be mindful of tools used during polypectomies by avoiding using multiple tools. We discussed green endoscopy initiatives in monthly journal club and business meetings. Over 14 weeks, 210 patients were included in the pre-intervention group and 112 in the post-intervention group. At baseline, 34% of colonoscopies required no intervention, 32% required one tool (either biopsy forceps or a snare), and 33% required multiple tools. After the intervention, the use of just one tool increased (17 percentage point increase; P=0.003) and the use of multiple tools decreased significantly (16 percentage point decrease; P=0.002). The odds ratio for use of a single tool compared with multiple tools after the intervention was 3.0 (95%CI 1.6 to 5.5; P=0.005). This single-center quality improvement study noted a significant change in practice patterns favoring the use of a single tool over multiple tools during colonoscopies after an environmentally conscious practice intervention was applied. This intervention can be readily applied to reduce endoscopy-related waste.

Journal Club: PET Imaging in Multiple Sclerosis and Its Prognostic Implications.

Journal Club: PET Imaging in Multiple Sclerosis and Its Prognostic Implications.

Gynecologic Pathology Journal Club: A 2-year, Worldwide Virtual Learning Experience With a Focus on Mentorship and Inclusion.

Journal clubs (JCs) are a common format used in teaching institutions to promote trainee engagement and develop skills in seeking out evidence-based medicine and critically evaluating literature. Digital technology has made JC accessible to worldwide audiences, which allows for increased inclusion of globally diverse presenters and attendees. Herein we describe the experience of the first 2 years of a virtual gynecologic pathology JC designed with the goal of providing mentorship and increasing inclusivity. JC began in a virtual format in April 2020 in response to the need for remote learning during the coronavirus disease 2019 pandemic. Each JC had 1 moderator, lasted 1 hour, featured up to 3 trainees/early-career pathologists, and covered articles on gynecologic surgical pathology/cytopathology. Trainees were recruited through direct contact with moderators and advertising through social media (eg, Twitter). A template was used for all presentations, and before presenting, live practice sessions were conducted with the moderator providing constructive feedback and evaluations were provided to presenters and attendees for feedback. Recordings of the meetings were made publicly available after the event through YouTube, a society website, and emails to registrants. Fifty-nine presenters participated, covering 71 articles. Most were trainees (53/59; 89%) from North America (33/59; 56%), with additional presenters from Asia (14/59; 24%), Australia/Oceania (5/59; 8%), Africa (4/59; 7%), and Europe (3/59; 5%). An average of 20 hours were spent per month by moderators on the selection of papers, meeting preparation, and provision of mentorship/feedback. Live events had a total of 827 attendees, and 16,138 interactions with the recordings were noted. Among those who self-identified on provided surveys, the attendees were most commonly from Europe (107/290; 37%) and were overwhelmingly practicing pathologists (275/341; 81%). The experience, including mentorship, format, and content, was positively reviewed by attendees and presenters. Virtual JC is an inclusive educational opportunity to engage trainees and early-career pathologists from around the world. The format allowed for the JC to be widely viewed by attendees from multiple countries, most being practicing pathologists. Based on feedback received, virtual JC appears to expand the medical knowledge of the attendees and empower presenters to develop their expertise and communication skills.

A Pilot Project to Promote Research Competency in Medical Students Through Journal Clubs: Mixed Methods Study.

Undergraduate medical students often lack hands-on research experience and fundamental scientific research skills, limiting their exposure to the practical aspects of scientific investigation. The Cerrahpasa Neuroscience Society introduced a program to address this deficiency and facilitate student-led research. The primary goal of this initiative was to enhance medical students' research output by enabling them to generate and publish peer-reviewed papers within the framework of this pilot project. The project aimed to provide an accessible, global model for research training through structured journal clubs, mentorship from experienced peers, and resource access. In January 2022, a total of 30 volunteer students from various Turkish medical schools participated in this course-based undergraduate research experience program. Students self-organized into 2 groups according to their preferred study type: original research or systematic review. Two final-year students with prior research experience led the project, developing training modules using selected materials. The project was implemented entirely online, with participants completing training modules before using their newly acquired theoretical knowledge to perform assigned tasks. Based on student feedback, the project timeline was adjusted to allow for greater flexibility in meeting deadlines. Despite these adjustments, participants successfully completed their tasks, applying the theoretical knowledge they had gained to their respective assignments. As of April 2024, the initiative has culminated in 3 published papers and 3 more under peer review. The project has also seen an increase in student interest in further involvement and self-paced learning. This initiative leverages globally accessible resources for research training, effectively fostering research competency among participants. It has successfully demonstrated the potential for undergraduates to contribute to medical research output and paved the way for a self-sustaining, student-led research program. Despite some logistical challenges, the project provided valuable insights for future implementations, showcasing the potential for students to engage in meaningful, publishable research.