Clesham Kevin, Piggott Robert P, Sheehan Eoin
Specialist Registrar in Trauma & Orthopaedic Surgery, Midlands Regional Hospital, Tullamore, Co Offaly, Ireland.
Specialist Registrar in Trauma & Orthopaedic Surgery, Midlands Regional Hospital, Tullamore, Co Offaly, Ireland.
J Surg Educ. 2020 Jan-Feb;77(1):115-123. doi: 10.1016/j.jsurg.2019.08.018. Epub 2019 Sep 18.
Journal clubs are useful for teaching critical appraisal skills and maintaining contemporary knowledge in orthopedics. The didactic format is most common; however, work commitments can pose difficulty in full attendance. Also with the current legislative working time restrictions for residents in Europe and North America, work and training time require separation with times that may not suit all attendees. Online forums such as "Twitter" have recently been used to accommodate various journal clubs. We aimed to establish a journal club using smartphone messaging application "WhatsApp" to discuss key orthopedic papers and teach critical appraisal skills to residents.
A prospective cohort study including all residents and attendings in the department. A research practice questionnaire, the "Evidence-based Practice Questionnaire" and a 28-question MCQ on research methods from the American Academy of Orthopedic Surgeons resident question database was completed by all participants prior to the study. A paper was uploaded each Friday, and discussed the following Tuesday through Friday for 6 consecutive weeks. The original questionnaire and MCQs were again completed after the 6-week study period.
A Trauma & Orthopedic residency unit.
All orthopedic residents, from PGY1-4 and attendings.
An average of 22 questions were asked (min 13, max 28), and 55 responses per week (min 30, max 88). In the EBPQ questionnaire, an example question of "how often you critically appraised a paper you have discovered" improved from an average score of 2.45 to 5.4. Self-rating of research skills improved from a score of 3.27 to 5.9. MCQ scores improved from an average of 48.2% among the group to 69%.
Residents' critical appraisal skills were improved while providing adequate time and flexibility to reflect on questions. Subspecialty topic discussions led by attendings, stimulated discussion of clinical pearls of interest to all participants. The simplicity of this method, and its widespread availability potentiates the implementation by any specialty looking to educate its residents.
期刊俱乐部有助于教授批判性评估技能，并使骨科医生掌握最新知识。讲授式形式最为常见；然而，工作安排可能会导致难以全程参与。此外，鉴于当前欧洲和北美的住院医师立法工作时间限制，工作时间和培训时间需要分开，而这可能并不适合所有参与者。诸如“推特”之类的在线论坛最近已被用于开展各类期刊俱乐部活动。我们旨在利用智能手机即时通讯应用程序“WhatsApp”建立一个期刊俱乐部，以讨论骨科关键论文，并向住院医师传授批判性评估技能。
一项前瞻性队列研究，纳入该科室所有住院医师和主治医生。在研究开始前，所有参与者均完成一份研究实践问卷，即“循证实践问卷”，以及一份来自美国骨科医师学会住院医师问题数据库的关于研究方法的28道选择题。每周五上传一篇论文，并在接下来的周二至周五连续六周进行讨论。在为期六周的研究期结束后，再次完成原始问卷和选择题。
一个创伤与骨科住院医师培训单元。
所有骨科住院医师，从PGY1 - 4年级以及主治医生。
平均每周提出22个问题（最少13个，最多28个），每周有55条回复（最少30条，最多88条）。在循证实践问卷中，“你多久批判性评估一次你发现的一篇论文”这一示例问题的平均得分从2.45分提高到了5.4分。研究技能的自我评分从3.27分提高到了5.9分。选择题得分从该组平均48.2%提高到了69%。
住院医师的批判性评估技能得到了提高，同时提供了充足的时间和灵活性来思考问题。由主治医生主导的亚专业主题讨论激发了所有参与者对感兴趣的临床要点的讨论。这种方法的简单性及其广泛可用性有利于任何希望对其住院医师进行教育的专业采用。
