Friday, 26 January 2018

The School Research Lead and making the most of journal clubs - recommendations from a systematic review

In this week’s post, I will be taking a further look at the research on journal clubs and in particular a systematic review by (Deenadayalan, Grimmer-Somers, Prior, & Kumar, 2008)

The systematic review

(Deenadayalan et al., 2008) over identified 101 articles, of which 21 comprised the body of evidence, with 12 describing journal club effectiveness within healthcare settings.  Over 80% of the papers noted that journal clubs were effective in improving participants’ knowledge and critical appraisal skills.  Nevertheless, none of the papers reported on how this then manifested itself in changes in practice.

Findings

Although the articles reviewed often differed in terms of participants, processes and evaluation, (Deenadayalan et al., 2008) argue that there were a range of consistent findings vis a vis the effectiveness of journal clubs in developing participant’s knowledge and critical appraisal skills.  As such, Deenadayalan et al have been able to identify a number of recommendations for the conduct of a journal club, which if adopted, increases the journal club’s chances of succees

Journal club attendance
  • Establish a journal club group of members of the same discipline, or similar interests within a clinical specialty. 
Journal club purpose
  • Have an established and agreed overarching goal for the long-term journal club intervention. The overarching journal club purpose should be reviewed regularly, and agreed by participants
  • Establish the purpose of each journal club meeting, and link this to the paper being read, or the skill acquisition being addressed.
Structure of an effective journal club
  • Regular attendance should be expected and recorded. Attendance may be mandatory, particularly if the journal club has a curriculum-based format
  • Conduct journal clubs at regular predictable intervals (suggest monthly)
  • Conduct journal club at an appropriate times of the day for all participants
  • Provide incentives to attend such as food (which is shown to increase attendance as well as the conviviality of the occasion).
Leading journal club
  • Journal clubs appear to be more effective if they have a leader. The journal club leader should be responsible for identifying relevant articles for discussion, however the final choice needs to be decided by the journal club members
  • Train the leader/facilitator of the journal club in relevant research design and/or statistical knowledge so as to appropriately direct group discussions and assist the group to work towards its goals
  • The leader can change from meeting to meeting, however he/she needs to have the skills to present the paper under discussion and lead the group adequately. It is a fine balance between choosing a leader of high academic standing whose expertise may stifle discussion,
  • or choosing a leader from peers who may not have the requisite understanding of the paper under discussion
  • Provide access to a statistician to assist the leader in preparing for journal club, and to answer questions that may arise from the journal club discussion.
Choosing articles for discussion
  • Choose relevant case-based or clinical articles for discussion. These papers should be of interest to all participants. Articles should be chosen in line with the overarching purpose of the journal club
  • Identify one journal club member (either the designated leader or a member) who has the responsibility for identifying the literature to be discussed for each meeting. This person should also lead the discussion on the article at the journal club. 
Circulating articles for discussion
  • Provide all participants for each journal club (in addition to the leader) with pre-reading at a suitable time period prior to the journal club (may be up to a week prior). Participants should agree to the time frame for pre-reading. In some curriculum-based situations, assessment of whether pre-reading has occurred may be appropriate
  • Use the internet as a means of distributing articles prior to the meeting, maintaining journal club resources and optimizing use of time and resources. 
Efficiently running the journal club
  • Use established critical appraisal approaches and structured worksheets during the journal club session, which leads to healthy and productive discussion
  • Formally conclude each journal club by putting the article in context of clinical practice.

Journal club effectiveness
  • Depending on the journal club purpose, it may be appropriate to evaluate knowledge uptake formally or informally
  • Evaluation should specifically relate to the article(s) for discussion, critical appraisal, understanding of biostatistics reported in the paper and translating evidence into practice. (Deenadayalan et al., 2008) p 905-6

How relevant are these findings to schools?

It seems to me, that these findings are broadly applicable to school-based research clubs, and could be easily adapted to meet the needs of individuals schools.   Nevertheless, there are a number of points which are worth further consideration.

First, depending on the nature of journal being reviewed, it makes a lot of sense to get an expert in statistics involved.  Anyone who has read (Gorard, See, & Siddiqui, 2017) recent book will be aware of some of the challenges in the correct use and interpretation of p values, statistical significance and confidence interval.  As for effect sizes, (Simpson, 2017) provides an interesting survey of the problems associated with effect sizes and subsequent use in ‘meta-analyses’.

Second, whoever leads the journal club will need to be viewed as credible by colleagues, not just in being able to find, select and understand and apply research.  The journal clubs leader also need to have ‘high-level’ interpersonal skills, so that they can skilfully navigate discussions, where colleagues disagree, or where colleagues have had deeply held values and beliefs challenged by the literature.  Indeed, it could be be argues that unless the research is ‘challenging’ if not controversial, then it is unlikely to provoke deep reflection on practice

Finally, given the workload pressures on teachers, and the relatively scant if non-existent evidences of journal clubs impacting upon day-to-day decision-making, very real consideration needs to be given to the reasons, why a journal club is being established.  As a mechanism to get ‘research’ into the classroom it is unlikely to have any impact whatsoever on teachers’ teaching and pupils’ learning.  If on the other hand, it is seen as an integral part of a wider process of building social capital (Hargreaves & Fullan, 2012) and developing a collaborative culture amongst teachers and other colleagues, it will be of some value.


Next week I’ll be looking at some school-based research by (Sims, Moss, & Marshall, 2017) into whether journal clubs can work and can they increase evidence-based practice.

Reference

Deenadayalan, Y., Grimmer-Somers, K., Prior, M., & Kumar, S. (2008). How to run an effective journal club: a systematic review. Journal of Evaluation in Clinical Practice, 14(5), 898-911. doi:10.1111/j.1365-2753.2008.01050.x
Gorard, S., See, B., & Siddiqui, N. (2017). The trials of evidence-based education. London: Routledge.
Hargreaves, A., & Fullan, M. (2012). Professional capital: Transforming teaching in every school. New York: Teachers College Press.
Simpson, A. (2017). The misdirection of public policy : Comparing and combining standardised effect sizes. Journal of Education Policy.
Sims, S., Moss, G., & Marshall, E. (2017). Teacher journal clubs: How do they work and can they increase evidence-based practice? Impact, 1(1).


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