Journal clubs are a hallmark part of education in academic medical training programs. Historically this was a way to keep appraised of new articles in press as they were not as easily accessible. Now we use journal clubs to spur thoughtful discussion with critical appraisal of the article, diving into the research methods and whether this article can and should change current clinical practice.
The benefits of implementing a journal club in a respiratory therapy department mirror those of the medical divisions: to stay abreast of important new publications, gain clinically relevant knowledge to practice evidence-based medicine, learn to appraise an article critically, and understand research methodology. Typically, these skills are not part of the standard curriculum in respiratory therapy programs. Because of this, a Journal Club can be a low-cost and interactive way to provide professional development, stimulating new ideas for practice or research. It also encourages confidence in respiratory therapy staff to engage in discussions with the medical team when ordered therapeutics are not at an evidence-based medicine standard.
How to get started
The best chance for long-term success with a journal club is integrating it into the department’s culture and being staff-run. Create a committee to design and run the journal club, with leadership mentorship, ensuring that at least one committee member has access to a medical library. If a medical library is not easily accessed or is costly, remember that all AARC Members have access to RESPIRATORY CARE. Involve committee members in choosing articles and discussion topics. They can also lead the discussion during journal club meetings. Offer journal club meetings on both day and night shifts and that more than one person can lead the discussion and mentor others to do so. Provide training for the committee on facilitating journal club meetings and implement a train-the-trainer approach for new members. Ensure staff committee involvement gives credit to advance on a department clinical ladder to foster continued and new membership.
Consider offering Continuing Respiratory Care Education (CRCE) Credits for active journal club participation as a benefit for attendance. A past study of journal club participation from Washington state showed an increase in participation after CRCEs were offered with each journal club session. The number of CRCE hours awarded from reading the article and participating in the meeting is based on the amount of contact time in the discussion. The application for CRCE can be submitted quarterly or even bi-annually at a time to reduce the administrative burden. Individual session entries will be entered within the application with the article title and information on when your sessions will be held. Credit would be awarded at the end of your journal club series. The AARC staff can assist with the application process.
Use a structure and worksheet for critically appraising the articles as the format for the meetings. There are several options available, and your institution may have a preferred tool for use. Toolkits are available from Evidence-Based Medicine organizations such as the Johns Hopkins School of Medicine Center for Evidence-Based Medicine. Develop a timeline leading up to journal club and an outline using this structure for each meeting to follow that will include the topic of the article, appraisal of the article, and open discussion on the applicability of changes to clinical practice. The article should be sent out or posted at least a few days before the scheduled journal club meetings to allow participants time to read the article in advance.
How to choose articles
Articles can be chosen a variety of ways. An easy starting point can be to hold a journal club meeting to discuss one of the five the monthly articles in RESPIRATORY CARE that offers CRCE. These are free for all AARC members monthly. A local discussion of the article can occur with each individual going to the website and taking the quiz to earn the CRCE. The topics span the entire respiratory care profession and thus may not always be relevant to your staff.
Choosing articles in conjunction with local interest may assist staff engagement and knowledge of new research or practices. For example, choose articles published from a research study related to the hospital, used to develop a new protocol or pathway, or to act as a team refresher for diseases occurring cyclically each year. Provide a way for staff to submit topics or articles for future discussions, so they have an investment in the topics discussed. Also, consider choosing a variety of articles throughout the year to help satisfy state licensure requirements. For example, if the state requires safety, ethics, or diversity CEU’s, add one or all of the topics throughout the licensure cycle to assist staff with meeting this requirement.
Encouraging attendance
Structuring the day and time of the journal club can assist with long-term planning and scheduling. Be sure to choose a time for both day shift and night shift and ensure it is optimal for people to attend during a shift. Another option may be virtual meetings with live discussion and a forum for offline discussion and questions so all to gain knowledge. Offsite journal clubs have also been successful as everyone can focus on the discussion and not answer pages/calls/texts or need to leave for patient care needs. Offsite meetings can occur at restaurants and can also foster community within the department.
Consider having guest discussion leaders such as the article author if they are local or in town for other purposes. You can also hold journal club meetings in conjunction with local conferences for this purpose. Attendance at so many journal clubs can also be considered an aspect of advancement on the local clinical ladder.
In the end, the goal of a departmental journal club will be to assist in professional development of RTs and give them the tools to critically appraise and article, understand the ability to implement the results into clinical practice, and provide valuable resources to the clinical discussion in determining therapeutic options for patients ensuring the practice of evidence-based medicine.
References/Resources:
- Johns Hopkins Medicine Center for Evidence-Based Practice, Models and Tools. https://hopkinsmedicine.org/evidence-based-practice/ijhn_2017_ebp.html (Last accessed 18 July 2021)
- Phillips RS, Glasziou P. What Makes Evidence-Based Journal Clubs Succeed? Evid based Med 2004;9:36-37.
- Deenadayalan Y, Grimmer-Somers K, Prior M, Kumar S. How to run an effective journal club: a systematic review. Journal of Evaluation in Clinical Practice 2008;14:898-911.
- Turner A, Rosewall. Implementing an Innovative Journal Club in the Workplace: A beginners’ Guide. J Medical Imaging Radiation Science 2011;42:130-136.
- McGlacken-Byrne SM, O’Rahelly M, Cantillon P, Allen NM. Journal Club: Old Tricks and Fresh Approaches. Arch Dis Child Educ Pract Ed 2020;105:236-241.
- Hinkson CR, Kaur N, Sipes MW, Pierson DJ. Impact of Offering Continuing Respiratory Care Education Credit Hours on Staff Participation in a Respiratory Care Journal Club. Respir Care 2011;56(3):303-305.
Email newsroom@aarc.org with questions or comments, we’d love to hear from you.
Natalie is a registered respiratory therapist and neonatal pediatric specialist working at the Children’s Hospital of Philadelphia, Philadelphia. She is the Research Clinical Specialist guiding clinical and bench research in respiratory therapeutics and the practice of the respiratory therapist. She is also the vice president for the Pennsylvania Society for Respirator Care and serves as the co-chair of the Pennsylvania Respiratory Research Collaborative.
