The journal club. Teaching critical evaluation of clinical literature in an evidence-based environment

To develop a curriculum in epidemiology, biostatistics and experimental design that uses a journal club format for resident instruction and to assess participants' response to this format.

A curriculum over 12 months included 24 concepts descriptive of topics considered critical in the assessment and evaluation of literature descriptive of clinical practice and patient care. There was one two-hour session per month for 12 months. Two sets of articles were distributed for each session. The first set consisted of literature on the topics of epidemiology, biostatistics and experimental design. These concepts increased in complexity throughout the academic year, starting from simple concepts, such as P values, and progressing to more-involved and complicated concepts, such as meta-analysis. The second set of articles consisted of literature on clinical topics. It was intended to illustrate and emphasize the concepts of experimental design and statistical analysis presented in the first set of articles. These clinical articles were both contemporary and historical and were from a variety of medical disciplines, including internal medicine, obstetrics and gynecology, orthopedics, infectious disease, anesthesiology, pediatrics and psychiatry. A questionnaire was distributed to the students at the conclusion of the curriculum.

This format was well received by both residents and staff. Eighty-five percent of the residents expressed interest in continuing the format without a major change. Fifteen percent requested restricting the clinical literature to obstetrics and gynecology.

This format proved an excellent method of training residents in evaluating clinical literature and providing familiarity with concepts in epidemiology, biostatistics and experimental design.