The concept of Emergency Medicine Journal Club was first described by William Osler as a means for busy clinicians to maintain proficiency with ever evolving medical science. Today, over 5000 biomedical publications appear every day. Obviously, keeping current has not become any easier. Developing a skill set to find, appraise, and implement practice-changing advancements in the medical literature is fundamental to a successful residency.
On the third Thursday of every month, the Washington University Emergency Medicine attending physicians, faculty, residents, fellows, nurses and medical students meet at a local restaurant for journal club. During these three hour meetings the group, lead by the Journal Club Director, critically analyze recent literature using Evidence Based Medicine principles: patient preferences, clinician expertise, and scientific findings each weighted equally.
The Washington University Department of Emergency Medicine Journal Club has been published and presented at a variety of North American EM and non-EM academic programs. Residents receive a Journal Club Toolbox CD during their first days of residency. Each month’s event is a focused question revolving around a single therapeutic, diagnostic, prognostic, or cost effectiveness topic. A vignette and search strategy are circulated electronically at least three weeks before the Journal Club evening along with critical appraisal forms derived from the User’s Guide to the Medical Literature. After the Journal Club event, residents turn their completed appraisal form in for constructive feedback and additional instruction if concepts remain unclear. Faculty organize and administer this experience, not the residents.
As important as the intellectual considerations, however, are the social considerations. Journal Club provides an opportunity for residents and attendings physicians to interact in a relaxed setting away from the framework of medicine, patients, and academic rounds. Such interactions are well-catalyzed by good food and drink free of industry sponsorship.
Every December, the usual Journal Club is replaced by a well-attended and hotly contested faculty vs. resident trivia contest.