Evidence-Based Medicine

Journal Club

Journal Club is an important vehicle for teaching residents how to critically evaluate and apply medical literature to answer a clinical question. At the University of Washington, the OB Gyn resident journal club is hosted in faculty homes which allow faculty and residents to interact in an informal dinner setting.

At the beginning of each academic year, Dr. Kristina Adams Waldorf provides an interactive workshop on evidence-based medicine where residents practice evaluating different types of journal articles and study designs. Residents then work with Dr. Caroline Mitchell, Journal Club Mentor, to pick a question of interest and choose articles relevant to that question. Residents often choose articles that both stimulate debate and a change in clinical practice. When the article is a randomized controlled trial, topics discussed include randomization, blinding, methods of analysis (e.g. intent-to-treat), and evaluation of the size of the treatment effect (e.g. number needed to treat). Articles related to a new diagnostic test may involve how to interpret positive and negative predictive values, the gold standard, pre- and post-test probabilities, and likelihood ratios. Ultimately, after evaluating the articles, there is a lively discussion by residents and faculty as to whether the findings presented are of sufficient quality to inform practice. Each member of the resident team has a specific role in the evaluation and discussion of the article. The R1 provides pertinent background information including other key studies on the topic, the R2 discusses the methods, and the R3 leads the discussion on results.

The Gyn Oncology divisions at University of Washington and Swedish Medical Centers hold their own joint journal club at faculty homes and are attended by the residents, fellows, and faculty. These are scheduled quarterly.