The learning does not stop when that hard-earned diploma is in your hand—our responsibility is to provide current, evidence-based care for our patients throughout our careers. One way to keep our scientific-literacy muscle active is through journal clubs.
Typically, journal clubs are more formal during the student intern or resident years. But, if you can rally a group of two to six interested colleagues over video chat or bites, this can be a great reason to meet up post-graduation. Journal clubs are a great space to dig deep into usually one topic in the optometry or ophthalmology literature to guide clinical practice.
Journal club article preparation
As a journal club presenter, you curate, summarize, and evaluate someone else's work. There are several considerations for selecting and analyzing your article to help capture high-level points and sift through relevant details. In addition to the presenter role, you can assign a moderator to partner with you to field questions and drive discussion of the bigger picture.
Journal club article selection
If the article is not already selected for you, consider the following guidelines to start on the right foot.
1) Journal impact factor
A journal's impact factor (IF) is one of many proxies to weigh publication quality. The IF is related to a journal's frequency of citations over a period of time.1 Built into IF is the assumption that higher quality articles are usually found in higher impacted journals; however, there are critics of leaning too heavily on IF.2 One index for ophthalmology journal impact factors can be found on the SCImago Journal and Country Rank site.
2) Level of evidence
Article type should be prioritized in selection criteria, with more robust data coming from randomized controlled trials (RCTs). Even though systematic reviews and meta-analyses are at the top of the hierarchy of evidence, they may not be your first choice because they are summaries by nature and not "original research" in the truest sense. Case reports and case series have value in developing hypotheses and clinical pictures; however, they are generally considered less usable for journal clubs.3
Figure 1 shows a pyramid of the hierarchy of evidence for cited sources in a journal club presentation.
Figure 1: Image is taken from Hierarchy of Evidence: From Case Reports to Randomized Controlled Trials
Ask yourself what value the article adds to the journal club's clinical question—the answer can often serve as a good introduction to your presentation for why you chose the paper. Is it challenging old truths? Is it highlighting a new treatment? Another factor to consider is the timeliness of the publication. In rapidly changing spaces, it is imperative to tighten the publication date window with a general recommendation of the last 3 to 5 years.
Download the Optometry Journal Club Presentation Template
Optometry Journal Club Presentation Template
Use this slide deck as a template for your next optometry journal club presentation.
Analyzing the structure of a scientific paper
Understanding the anatomy of a scientific paper will help you develop your major points. We will review the different sections of a scientific paper and how to use them to develop your journal club presentation.
Introduction and background
This is where you prime yourself on the disease burden, historically or currently available treatment options, and the purpose of the study. Consider doing an independent literature search in tandem, so you can speak with confidence about the landscape of the subject area and be able to simplify unfamiliar or complex topics. Additionally, as mentioned earlier, make sure you plan to highlight the value of the study in relation to the background information.
Even though this section is easy to skim over with its small print, the methods section needs some of your synthesis as you prepare. The study design, population, and outcome measures are essential points to highlight. A bigger question to ask is whether the population captured in the study's inclusion and exclusion criteria can be generalized to a larger, real-world population.
You do not need to be a statistician, but you need some statistical fluency to understand the data and the bigger message. Focus on the results from the primary outcomes and statistically significant data, and digest the tables and figures to complete your understanding.
Though the author's conclusions seem sound, you can give the article more color by critiquing or reviewing the various components of the study design. Consider commenting on the strength or validity of the intervention and endpoints or pointing out unexplained conclusions.
The discussion section can be broken down into four main sections:
- Author’s conclusions
Journal club presentation pointers
After going over the presentation's content, the journal club transitions from a monologue to hopefully a lively forum for discussion. Areas to explore would be how the study conclusions can affect clinical decision-making and directions for further research. This should stir up a conversation; however, prepare questions to target points of interest for your journal club members.
The delivery of your presentation can be supplemented with a print-out or a slide deck. If you are using visuals, use them effectively to convey your point quickly.
These visuals should be an aid, not a script, so do not let a crowded slide or handout overshadow the main points. Whether or not you supplement your journal club with a visual, remember you are the article's tour guide. Help the audience stay on track by outlining the goals of each section, recapping often, and connecting ideas. Because science is constantly changing, keeping to a sample schedule like the ones below can keep everyone up-to-date.
Tables 1 and 2 outline sample schedules for organizing optometry journal club presentations.
Sample Schedule 1 (Comprehensive)
Table 1: Courtesy of Courtesy of Tiffany Yanase Park, OD
Sample Schedule (Sub-specialty: Pediatrics)
|Quarter 1||Myopia control|
|Quarter 3||Specialty/Ocular disease|
Table 2: Courtesy of Tiffany Yanase Park, OD
Don't forget to download the Optometry Journal Club Presentation Template!
Having a cadence of journal clubs could be a great next step to rotate others as presenters and cover a breadth of topics. A well-done journal club will be a productive time for both you as the leader and all the audience members.