INTRODUCTION:

Nursing research is a vital component to the health care field. Nursing research helps implement new changes in the lifelong care of individuals and is used to develop treatments that provide the most optimum level of care. Hence, it is essential for nurses in research and nursing students in general to be able to find the research articles in various nursing specialization and topics and to update their knowledge to the current research and latest trends in the nursing research. There is growing interest in various methods of teaching critical appraisal skills at undergraduate and postgraduate levels of nursing. Learning to critically read, write, and evaluate scientific papers is one of the most important long-term skills required for success in science, both during and after graduate training. In this perspective, journal club approach is an innovative and enjoyable method for teaching in nursing. This article describes an approach using the journal club to teach critical appraisal and writing skills to nursing students.

Definition:

Journal club is defined as “A group of individuals who meet regularly to discuss critically the clinical applicability of articles in the current medical journals”.1 Journal club is effective in teaching critical evaluation of clinical literature in an evidence-based environment.2 Journal clubs are a critical way to help clinical nurses make the connection between their practice and how to use evidence in practice.3

History:

The earliest reference to journal club is found in a book of memoirs and letters by the late Sir James Paget, a British surgeon and one of the founders of modern pathology. He describes a group at St. Bartholomew's Hospital in London in the mid-1800s with 'a kind of club ... a small room over a baker's shop near the Hospital-gate where we could sit and read the journals'. It is believed that Sir William Osler established the first formal journal club at McGill University in Montreal in 1875, though Osler himself might have been aware of similar gatherings that were taking place elsewhere. The purpose of Osler's early journal club was 'for the purchase and distribution of periodicals to which he could ill afford to subscribe”.4 Nowadays, the aims have changed but essentially the practice remains as an excellent way to keep abreast with developments in your field.

Goals:

To develop skills in critically assessing the primary literature, verbally presenting the findings of clinical research, and scientific writing for the graduate thesis/dissertation and publication of the research results in journals.

Objectives:

• To become familiar with scientific literature and with different styles of scientific writing.

• To become familiar with the components of a good abstract, introduction, methods, results and discussion section of a paper.

• To develop skills in critical reading and evaluation of scientific writing.

• To learn about the scientific method and its application to solving a variety of current problems.

• To become comfortable with presenting, questioning and discussing scientific information with their peers, including other students, faculty and the general public.

• To keep abreast of current research in areas of new methodological approaches, and major advances in health care knowledge and thinking.

• To foster intellectual curiosity and excitement about health research in general.

Types of journal club:

Two types of clubs exist, critical appraisal club and evidence based medicine club. Critical appraisal clubs systematically weigh up evidence, and evidence based medicine clubs are concerned with the astute appraisal and conscientious use of current evidence in steering clinical decisions.5

Critical appraisal clubs are more appropriate to students because their primary focus is the methodological understanding of medical literature. Participating in a critical appraisal club as a medical student equips you well for participation later in evidence based medicine club.5

The latter is more relevant at a clinical level, where it can be integrated into tutorial-like scenarios to encourage students to think through clinical case studies with greater scientific rigour.

Members of the journal club and their roles:

The members of the journal club are Director/Moderator, Co-ordinator/Facilitator and Presenter. Roles of each member are described here.

Director or moderator :–

Director is the administrative head of the journal club, someone who is committed to the idea and importance of a Journal Club and is willing to spend the necessary time in the overall organization of the club. Evidence shows that the most successful clubs are those with strong committed leadership. The director does not need to be present in every meeting of the journal club. However, it is essential for this person to direct the identify the relevant papers for discussion

Co-ordinator / facilitator: –

Co-ordinator is the person presiding every meeting of the journal club. The role of the coordinator will be to organize date, time and facilities for the meeting, record attendance and maintain administrative records of the meeting. The coordinator will also facilitate discussion during the journal club meeting. The coordinator role may be rotated but for continuity each co-ordinator should facilitate a few meetings before handing over the role to the next person.

Presenter: –

The presenter is the person that presents a chosen article in the meeting. The presenter can be any person of the group; in nursing colleges, any of the students or faculty; in hospitals, the staff nurses. The presenter will be rotated each meeting and their role will involve locating an article for the meeting presentation and organizing distribution of the article to all group members.

An additional person filling the role of administrative/secretarial support may also be needed. They will support the journal club by providing write-up and circulate notes to help effective management of the club. Also, preparing role outlines might help to ensure that each person is aware of their responsibilities. It may help the group to draw up a timetable so that roles are rotated fairly.

Format for Journal Club Presentations:

There are many different ways to lead a journal club. The format suggested by Jeanee St.Pierre here is aimed at helping participants learn how to read articles critically.6

1. Introduction of the topic and presenter (by Nursing Journal Club planning committee member).

2. Polling (optional)

• Test baseline knowledge and/or seek opinions, attitudes of audience.

3. Give brief synopsis of following parameters:

• Title of article

• Study’s purpose

• Setting

• Population

4. Discuss major findings of study.

5. Discuss other relevant research that supports/does not support this study.

6. Discuss implications of article in terms of impact on nursing practice

• Documentation

• Delegation

• Patient education

• Patient satisfaction

• Patient/Family-centered care

• Interdisciplinary collaboration

What is the relevance of this article to our practice?

Should we change our practice based on this information? If yes, discuss next steps.

7. Group discussion/Questions

8. Evaluations

Suggestions for a dynamic presentation:

• Audience participation

• Role-playing

• Invite other experts/disciplines to do a portion of the presentation

• Videotape

• Case studies

Changing nursing practice through a nursing journal club:

The nursing profession has been slow to adapt journal clubs, but the momentum is growing as the volume and relevance of nursing research studies increases and evidence-based practice becomes more widely accepted.3 As hospitals seek to promote evidence-based nursing practice and improve the quality of bedside nursing care, formation of a nursing journal club can be one strategy to accomplish both goals.6 A hospital-based nursing journal clubs can be a fun and interesting way to improve the quality of nursing care by providing the impetus to change practice. Traditionally, the journal club has been used by health care disciplines to foster knowledge, teach critical thinking, and learn about research methods. By emphasizing practice implications and following up with an action plan, a nursing journal club can go beyond information-sharing to having an impact on patient care.6

Benefits of journal club in nursing:

Journal clubs are also an accessible way of supporting lifelong learning. They help to keep up to date with relevant literature and give you the confidence to formulate your own opinion on topics through critical analysis of the literature. Discussions and questions that may arise as a result can help you to understand scientific concepts and relate them to clinical practice, both essential to optimize patient care.5

The following are the benefits of Journal club in Nursing: 7,8

• Improve critiquing skills

• To provide a bridge between research and practice and foster an application of research to the clinical setting9

• Locate the best evidence on which to base your practice

• Helping research awareness

• Keeping abreast of current research

• Strengthening critical appraisal skills

• Understanding of biostatistical and epidemiological methods

• Increasing confidence in dealing with evidence/research

• Improving professional reading habits

• Develop team/multidisciplinary relationships

• Fulfill requirements for Continual Professional Development

• To maintain and improve professional knowledge and competence which impacts on quality of care

• To develop local guidelines

CONCLUSION:

A journal club is a medium for teaching, professional development and networking. To fill up the gap between researches and practice every nursing educational institution can start journal club. Nursing practice requires the application of current, health-related research. Nurses are expected to employ evidence-informed practice in making decisions about the clinical care of their clients. A journal club is one method that can help promote an increased awareness of research, educating students to critique and use research findings.

REFERENCES:

1. Linzer, M. (1987). The journal club and medical education: Over 100 years of unrecorded history. Postgraduate Medical Journal, 740(6), 475-478.

2. Letterie, G.S. and Morgenstern, L.S. (2000). The Journal Club, Teaching critical evaluation of clinical literature in an evidence-based environment. Journal of Reproductive Medicine, 45,299-304

3. Krugman M. Barriers to successful journal club outcomes. Journal of Nurses Staff Development. 2009 Mar-Apr; 25(2):100-1.

4. Deenadayalan, Y., Grimmer-Somers, K., Prior, M. and Kumar, S. (2008). How to run an effective journal club: a systematic review. Journal of Evaluation in Clinical Practice, 14: 898–911.

5. Hellmich, Cand, Bugeja, L. Journal Clubs: Not Just an Essential Tool for Lifelong Learning: Types of Journal Club available at http://www.medscape.com/viewarticle/714407_3. Retrieved on 22 July 2011.

6. St. Pierre, J. (2005). Changing nursing practice through a nursing journal club. Medical Surgical Nursing, 14(6), 390-392.

7. Journal club support service. Available at www.btuheks.nhs.uk/publications/journal_club_leaflet.pdf. Retrieved on 22 July 2011.

8. Thompson, C.J. (2006) ‘Fostering skills for evidence-based practice: the student journal club’, Nurse Education in Practice, 6: pp.69-77.

9. Lindquist R, Robert RC, Treat D. (1990). A clinical practice journal club: bridging the gap between research and practice, Focus Critical Care. 17(5):402-6.

10. Hammick,M.(1995), A research and journal club: a medium for teaching, professional development and networking. European Journal of Cancer Care, 4: 33–37.

11. Steenbeek, A., Edgecombe, N., Durling, J., LeBlanc, A. and Bainbridge, R. (2009). Using an interactive journal club to enhance nursing research knowledge acquisition, appraisal, and application. International Journal of Nursing Education Scholarship 6(1): 12.

Received on 19.08.2011 Modified on 10.10.2011

Asian J. Nur. Edu. and Research 1(4): Oct-Dec. 2011; Page 117-119