Just in time teaching through Journal Clubs

The COVID19 pandemic saw almost all education sessions at Gold Coast health be cut as staff went into a “all hands-on deck” situation in preparation for the pandemic. This meant that our planned workshops had to be put on hold. However, the deluge of new studies (many of them of poor quality and non-peer reviewed) made it clear that clinicians needed EBP skills now more than ever.

As a team, the Evidence Based Practice Professorial Unit (EBPPU) decided to host regular COVID19 Journal Clubs (JC) to help clinicians understand the literature as it comes out and provide just in time teaching of EBP concepts.

I used the TREAT format in setting up the Journal Club including involvement methodological, statistical, and clinical experts including senior clinical staff, choosing an article that has local interest and relevance, providing a structured framework for appraisal. JCs were held as requested by the clinicians (initially weekly, then fortnightly, then monthly/ad-hoc) via the EBPPU Teams group on Queensland Health MS Office. This ensured that all clinical staff can easily find and access the team and join. We also ask for participants to vote on when they can attend as initial feedback suggested that availably changes week to week.

In choosing articles that are clinically relevant, we engaged with clinical staff, including the director and senior staff specialists of the Infectious Diseases department, and all participants were free to nominate a paper.

In preparation of the JC, myself, and several of the EBPPU and IEBH staff meet before the JC to discuss the quality of the paper and opportunities for just-in-time teaching and to engage clinicians in the discussion. During the JC we guided clinicians through the article, providing explanations regarding key methodological considerations that may impact how to interpret findings. 

Throughout the JC we engage with the participants, calling on their expertise to help interpret the clinical impact of the paper findings. We also provides an annotated pdf of the article and slides (where appropriate), and one of the participants documented the discussion using a structured template, all of which is stored on Teams.

So far, we have >100 JC members and have held COVID19 JCs since early 2020 years with a regular attendance of 10-25 participants. Feedback received indicates that these sessions have aided clinical staff in their understanding and application of evidence in a rapidly changing field and have resulted in immediate practice change as evidence is evaluated.

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"Dr Paulina Stehlik has been running an educational journal club on COVID-19 for clinical and academic staff  since the beginning of the pandemic.

It has now become our primary source of independent analysis of the rapidly evolving literature in this field and influences our approach to managing patients with COVID-19 on a daily basis.

Dr Stehlik’s approach to analysis and teaching is very clear and logical.

She has significantly influenced the way in which I approach the medical literature.

Information that I might have taken at face value, I now approach with a more critical mind.

On the flip side, I feel that she helped me identify quality research and given me a greater sense of confidence in its application.

In short, Dr Stehlik is an outstanding teacher, whose pro-active initiative is significantly influencing the clinical approach to the COVID-19 pandemic in the region."

Dr John Gerrard
Director of Infectious Diseases and Immunology
Gold Coast University Hospital

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PUBLICATIONS

D. A. Henry, M. A. Jones, P. Stehlik and P. P. Glasziou, Effectiveness of Covid-19 Vaccines: Findings from Real-World Studies 2022. Medical Journal of Australia.;https://doi.org/10.5694/mja2.51479

R. Wenke, P. Stehlik, J. Gerrard, S. Mickan and D. Henry, Using a Journal Club to Navigate a Maze of Covid-19 Papers in a Front-Line Hospital Service2023. BMJ Evidence-Based Medicine. bmjebm-2022-112130;10.1136/bmjebm-2022-112130