Fu Katherine A, Chan Joy M, Stepanyan Katelyn, Elting Sally, Manchanda Ashley, Zea Vera Alonso Gonzalo, Vermillion Michelle, Wilhalme Holly, Keener Adrienne M, Strowd Roy E
Department of Neurology, University of California, Los Angeles.
Department of Medicine, University of California, Los Angeles.
Neurol Educ. 2025 Feb 11;4(1):e200195. doi: 10.1212/NE9.0000000000200195. eCollection 2025 Mar.
In an era of rapid advances in research, it is imperative for residents to develop the skills for evidence-based practice. Alternative journal club formats grounded in active learning strategies may be better suited to address this need, although evidence is lacking. A theoretical framework of social cognitive learning theory (SCLT) may provide insight into how journal clubs can be better designed to teach residents how to evaluate research. Using a sequential, explanatory mixed-methods design and SCLT framework, we compared 2 different journal club formats for teaching methodology and clinical application. We also explored neurology resident experiences with both formats using a qualitative approach.
We conducted 4 alternating journal clubs: 2 active learning and 2 traditional. In the quantitative phase, we compared resident performance on presession and postsession assessments for the 2 different journal club formats. We designed parallel pretest and posttest forms and analyzed the change in scores using a linear mixed-effects model with fixed effects for the test type and pretest score. In the qualitative phase, we explored neurology resident experiences with both formats through the lens of SCLT. We observed the journal club sessions through an ethnographic lens and conducted semistructured one-on-one interviews with residents. The data were mixed during analysis of interview data.
Resident participants (n = 18 active learning, 18 traditional) of each journal club completed pretests (n = 16 active learning, 11 traditional) and posttests (n = 8 active learning, 5 traditional). There were statistically significant increases in total (estimate = 18.03%, SD = 6.9, = 0.028) and clinical application (estimate = 48.40%, SD = 6.6, < 0.0001) pretest and posttest scores with the active learning format. There was no difference in methodology subscores (estimate = 5.84%, SD = 11.8, = 0.63). Regarding the active learning format, observations noted more demonstrations of retention, reproduction, and motivation during the sessions than a traditional format. Interviews highlighted 4 main themes: the burden of preparation, the importance of clinical relevance, preference for organic discussion, and the value of faculty expertise.
These results highlight the strengths and disadvantages of a more discussion-based journal club format. Further altering the design to a "no-prep" approach and emphasizing the faculty facilitator's role may further optimize teaching of evidence-based practice.
在研究迅速发展的时代，住院医师掌握循证医学实践技能至关重要。基于主动学习策略的替代性期刊俱乐部形式可能更适合满足这一需求，尽管目前缺乏相关证据。社会认知学习理论（SCLT）的理论框架或许能为如何更好地设计期刊俱乐部以教导住院医师评估研究提供见解。我们采用序列式、解释性混合方法设计及SCLT框架，比较了两种不同的期刊俱乐部形式在教学方法和临床应用方面的情况。我们还运用定性方法探究了神经病学住院医师对这两种形式的体验。
我们开展了4次交替进行的期刊俱乐部活动：2次主动学习型和2次传统型。在定量阶段，我们比较了两种不同期刊俱乐部形式下住院医师在课前和课后评估中的表现。我们设计了平行的预测试和后测试表格，并使用线性混合效应模型分析分数变化，该模型将测试类型和预测试分数作为固定效应。在定性阶段，我们通过SCLT的视角探究了神经病学住院医师对这两种形式的体验。我们通过人种志视角观察期刊俱乐部活动，并与住院医师进行半结构化一对一访谈。在分析访谈数据时对数据进行了整合。
每个期刊俱乐部的住院医师参与者（主动学习组18人，传统组18人）完成了预测试（主动学习组16人，传统组11人）和后测试（主动学习组8人，传统组5人）。主动学习形式下，课前和课后测试的总分（估计值 = 18.03%，标准差 = 6.9，P = 0.028）和临床应用得分（估计值 = 48.40%，标准差 = 6.6，P < 0.0001）有统计学显著提高。方法学子得分无差异（估计值 = 5.84%，标准差 = 11.8，P = 0.63）。关于主动学习形式，观察发现与传统形式相比，活动期间更多地展示了记忆、再现和动机。访谈突出了4个主要主题：准备工作的负担、临床相关性的重要性、对自然讨论的偏好以及教师专业知识的价值。
这些结果凸显了基于更多讨论的期刊俱乐部形式的优缺点。进一步将设计改为“无需准备”的方法并强调教师引导者的作用，可能会进一步优化循证医学实践的教学。
