Monday, June 13, 2016

Journal Club Curriculum to Teach Evidence Based Medicine to Pediatric Residents

Ajit Sarnaik
Children’s Hospital of Michigan/Detroit Medical Center
Introduction: Evidence-based medicine (EBM) is increasingly valued among clinicians due to its potential to improve patient care and contain costs. Journal Club is a teaching modality that has been effective in teaching EBM to medical trainees. The present study evaluates effectiveness of a Journal Club curriculum to teach EBM to pediatric residents, and identifies barriers to learning and practice of EBM.

Methods: A Journal Club curriculum was designed in which second-year pediatrics residents selected an article, performed a critical appraisal, and gave a 10 minute presentation to colleagues. A test consisting of multiple-choice knowledge items, Likert-style items evaluating self-efficacy and attitudes, and free-text items was administered to the residents prior to and after undergoing the curriculum.

Results: Twelve pre-tests and 3 post-tests were returned. There was no difference in knowledge before and after undergoing the curriculum (68 ± 17 vs. 57% ± 12 respectively). There was no difference between Likert scores of self-efficacy and attitudes (40 ± 4 vs. 38 ± 2 respectively), how the trainees accessed literature (27 ± 2 vs. 38 ± 2 respectively), or confidence appraisal (18 ± 3 vs. 19 ± 4 respectively) before and after undergoing the curriculum. Themes emerging from free-text comments identified barriers to learning and practice of EBM including insufficient time, emphasis, and formal instruction.

Conclusions: In the present study, a journal club curriculum given to second-year pediatric residents did not show statistical improvements in knowledge, skills, or attitudes. However, the study was limited by very small sample size.