REVIEW
How to run an effective journal club: a systematic review
Y. Deenadayalan BPT IMMP BEHM (MBA),
1
K. Grimmer-Somers PhD MMedSci BPhty,
2
M. Prior BPhty (Hons)
1
and S. Kumar PhD MPT BPT
3
1
Researcher, Centre for Allied Health Evidence, University of South Australia, City East Campus, Adelaide, Australia
2
Director, Centre for Allied Health Evidence, University of South Australia, City East Campus, Adelaide, Australia
3
Deputy Director, Centre for Allied Health Evidence, University of South Australia, City East Campus, Adelaide, Australia
Keywords
effectiveness, evidence-based, format,
health, journal club, processes
Correspondence
Professor Karen Grimmer-Somers
Centre for Allied Health Evidence
University of South Australia
Division of Health Sciences
GPO Box 2471
Adelaide
SA
Australia 5000
E-mail: karen.grimmer-somers@unisa.edu.au
Accepted for publication: 18 April 2008
doi:10.1111/j.1365-2753.2008.01050.x
Abstract
Background Health-based journal clubs have been in place for over 100 years. Partici-
pants meet regularly to critique research articles, to improve their understanding of research
design, statistics and critical appraisal. However, there is no standard process of conducting
an effective journal club. We conducted a systematic literature review to identify core
processes of a successful health journal club.
Method We searched a range of library databases using established keywords. All research
designs were initially considered to establish the body of evidence. Experimental or
comparative papers were then critically appraised for methodological quality and informa-
tion was extracted on effective journal club processes.
Results We identified 101 articles, of which 21 comprised the body of evidence. Of these,
12 described journal club effectiveness. Methodological quality was moderate. The papers
described many processes of effective journal clubs. Over 80% papers reported that journal
club intervention was effective in improving knowledge and critical appraisal skills. Few
papers reported on the psychometric properties of their outcome instruments. No paper
reported on the translation of evidence from journal club into clinical practice.
Conclusion Characteristics of successful journal clubs included regular and anticipated
meetings, mandatory attendance, clear long- and short-term purpose, appropriate meeting
timing and incentives, a trained journal club leader to choose papers and lead discussion,
circulating papers prior to the meeting, using the internet for wider dissemination and data
storage, using established critical appraisal processes and summarizing journal club
findings.
Background
Journal clubs are a well-recognized quality improvement strategy
used by health practitioners to critique and keep up-to-date with
relevant health literature [1]. A number of authors [2,3,1] report
that Sir William Osler started the first recorded journal club in
Britain in 1875, as a way of sharing scant educational resources.
He encouraged journal club attendees to apply their updated
knowledge from attending the journal club to relevant patient cases
[3]. Thus the philosophy of journal club from its inception was to
share current knowledge, and translate it into evidence-based
patient care.
While there is considerable published literature describing
journal clubs conducted in different settings and for different
health consumers, there appear to be no ‘Gold Standard’ processes
for conducting a journal club, or to evaluate journal club effective-
ness in assisting practitioners translate knowledge into practice. It
is therefore an ongoing challenge for clinicians to design and
maintain a stimulating, educational and sustainable journal club
format that assists the participants to stay up to date with the
literature, and to translate journal club activities into evidence-
based practice [2]. Thus for clinicians wishing to initiate a journal
club in their workplace, reading and evaluating the volume of
literature on how to conduct a journal club presents a substantial
barrier to establishing the activity.
This paper presents the findings of a systematic review from
which information on how to conduct a journal club was extracted.
This paper provides recommendations for establishing and con-
ducting journal clubs in a health care setting in a manner which is
likely to be effective and sustainable.
Method
Process of systematic review
We first scanned the literature using broad inclusion/exclusion
criteria for any peer-reviewed published literature reporting on
journal clubs conducted in health environments. From this body of
Journal of Evaluation in Clinical Practice ISSN 1356-1294
? 2008 The Authors. Journal compilation ? 2008 Blackwell Publishing Ltd, Journal of Evaluation in Clinical Practice 14 (2008) 898–911898

evidence, after a series of steps, we included in our review those
papers which reported on comparative studies and/or controlled
trials of the journal club activity, which established measures of its
effectiveness. We extracted information from these papers on how
journal clubs were conducted, with the aim of developing recom-
mendations regarding the process of running an effective and
sustainable journal club in a health setting.
Search strategy
The search was formulated using the following broad parameters:
Population health practitioners of any discipline
Intervention any form of journal club
Comparison any comparator
Outcomes any outcome measure relating to journal club
effectiveness, including but not limited to,
knowledge, attitudes, skill acquisition,
practice behaviours, satisfaction.
Databases and search terms
We searched all available health databases in an attempt to identify
relevant journal club literature. These included CINAHL, Psy-
cINFO, PsychARTICLES, ERIC, Medline, AMED, Embase,
AARP ageline, Google. For the search we used variations on
keywords including ‘Journal club’, ‘health’, ‘effectiveness’ and
‘Evidence-based’.
Inclusion criteria
No date limit was set for the search. Articles included in the review
were primary research only, available in full text, and written in
English. Included papers should reflect the processes of running a
health-based journal club (as opposed to journal clubs conducted
in other settings), they should report on the health discipline(s)
involved in the club as well as the methods/processes by which the
journal club was conducted.
Hierarchy of evidence
We searched initially for any article of any research design to
establish the size and strength of the body of evidence in this area.
We used the CEBM (Oxford Centre for Evidence-based Medicine
Levels of Evidence) hierarchy of evidence for intervention studies
[4]. We then narrowed our search to only those experimental
studies which directly and concurrently compared outcomes from
journal club activities with outcomes from other forms of educa-
tion, or to quasi-experimental or comparative studies which
assessed outcomes pre- and post journal club inception.
Search validation
Potentially relevant articles were independently assessed by the
authors, who then met to agree on article inclusion.
Additional references
We searched the reference lists of identified articles for other
pertinent references that had not been identified during the primary
search (Pearling). If secondary evidence was found, the reference
list of included primary research papers would be used rather than
the individual secondary evidence reference.
Analysis of the selected articles
The included articles were critically appraised with the McMaster
University instrument [5]. This is a generic critical appraisal
instrument relevant to any quantitative study. Equally weighted
scores are given to 14 criteria, providing a quality rating reflecting
how well the authors considered internal and external validity
issues in their study design, and reporting.
A purpose-built analytical instrument was then constructed for
the review, seeking details on the processes of conducting the
journal club, and how the effectiveness of the journal club had
been evaluated. This instrument was collated using the range of
information found on journal club processes when reading the
identified studies in this area. The components of the analytical
instrument are provided in Table 1. This instrument underpinned
data extraction, as well as a secondary quality evaluation of the
included studies. Each element listed in Table 1 was given an
equally weighted score, thus studies which reported in detail on
journal club processes and evaluation were rated more highly than
studies that reported few details.
Results
Search findings
The search yielded 101 articles in the first step of the review. All
these articles came directly from searching the listed library data-
bases, and all but one article [6] reflected primary research evi-
dence. This article was a review paper [6] which was not directly
relevant to the objective of this review; however, its reference list
contained four of the primary articles which had already been
identified in our search.
Table 1 Criteria for analysis
Participants Number of participants
Field of health of participants
Intervention Group leader
Preparation (pre-reading)
Frequency of meeting
Setting
Mandatory attendance
Article choice
Clinical focus
Format Case-based format
Structured evaluation processes
Faculty supervised
Internet-based
Time of day noted
Formal process
Food provided
Results Results reported
Specific outcomes tested
Statistical significance
Y. Deenadayalan et al. How to run an effective journal club
? 2008 The Authors. Journal compilation ? 2008 Blackwell Publishing Ltd 899