Guidelines For Conducting Journal Club For AP/GP Residents

Goals and Objectives

Goals of a Journal Club

Anatomical and General Pathology

  • Teach Critical Appraisal
  • Keep current with the medical literature
  • Provide a foundation for evidence‐based practice
  • Review landmark or controversial papers

Characteristics of successful Journal Clubs

  • Presented by residents or fellows and actively supervised by a Staff
  • Attendance is mandatory
    • Residents and Fellows
  • Meeting lasts for less than 60 minutes
    • Protected time (pager off!)
  • Supported and endorsed by Program Director and departmental leaders

Problem‐Based Learning

  • Choose 2 relevant journal articles that:
    • related to the specialty
    • 20 minutes for presentation followed 10 minutes of critiques for each paper
    • topics for discussion may be:
      • Ask, “so what?”
      • Will it change my practice?
      • Is the question important?


  • Research question, study objective, and specific hypothesis:
    • Do the authors provide a clear and specific question and hypothesis?
    • Is the research objective clear and unambiguous?

Critically Reviewing Articles

  • Methodology:
    • Is the study design appropriate for the research question?
  • Pros and cons of this design
  • Pros and cons of alternative methodologies
    • Advantages and disadvantages of chosen methodology
  • Level of evidence
  • Confounding, bias, and validity

Study Population

  • Characteristics of the study population:

Who are the participants?

  • Time and place?
    • Is the study population appropriate?

Characteristics of the sample

  • Random versus convenience sampling
  • Is the population similar to my patients?
    • Specific inclusion and exclusion criteria
  • Are these appropriate?
  • Selection bias?

Measurement Issues and Bias

  • How are variables measured?
    • Misinformation bias?
    • Detection bias?
    • Masking or blinding?

Statistical Analysis

  • How were the data analyzed?
    • Appropriate tests
    • P values versus sizes and 95% confidence intervals (more informative)
    • NS versus actual P values
    • Multivariable methods
  • Regression analysis?

Sample Size and Power

  • Sample size calculation done a priori?
  • Did the investigators specify a clinically important difference they would like to detect?
  • Type I (α or alpha) and Type II (ß or beta) errors Power=1‐type II error


  • What are the results?
    • Are they clearly presented and understandable?
  • How were the results interpreted?
    • Are the interpretations appropriate?
  • Threats of validity
    • Loss to follow‐up
    • Missing information
    • Control of confounding
    • Issues of bias


  • Are the conclusions supported by the data?
  • Relate findings to other studies in the medical literature
  • Do the authors “stretch” too far?
  • What are the strengths of the study?
  • What are the study weaknesses or flaws?
    • Do the authors recognize them?
  • Come back to the key question: So what?
    • Will it change how we practice?
    • Will it change how we counsel patients?


  • Where to from here?
  • Do the findings contribute to our knowledge of the subject?
  • How could we do better?
  • What additional questions does the study raise?
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