Medical Journal Clubs Shift Online During Pandemic

By Carolyn Crist

September 08, 2020

NEW YORK (Reuters Health) - The longstanding tradition of hosting journal clubs for medical residents and fellows to review the latest research has shifted to a virtual setting during the pandemic and could lead to a more permanent change in the future, according to a group of radiologists.

Attendees adjusted the format, content and "ground rules" for meetings, which caused some issues at first, but at the same time, more residents and staff were able to attend sessions, the group writes in the Journal of the American College of Radiology.

"The COVID-19 pandemic challenged educators to find innovative ways to preserve critical components of residency and fellowship training, including regular journal clubs," said lead author Dr. Priscilla Slanetz of the Boston University School of Medicine.

"Ultimately, the best care for our patients stems from a command of existing evidence to support medical practice," she told Reuters Health by email.

Dr. Slanetz and radiology colleagues in Massachusetts, North Carolina and Pennsylvania describe their experiences of moving journal clubs online during the pandemic - and what did and didn't work. Even before the pandemic, in-person journal clubs posed scheduling challenges for busy attendings and residents, notes co-author Dr. Harprit Bedi, vice chairman of radiology education at Boston University. Physical distancing created a new challenge.

The Boston University Neuroradiology department created a virtual journal club to discuss two articles on strokes. The meeting started with reactions from the residents, and then Dr. Bedi arranged for one of the article authors to join the conversation by surprise. He also invited clinicians to join sessions and give insights based on their experience.

"These Zoombombing guests gave amazing additional insights, answered questions and facilitated much deeper conversations," he writes in the report. "Having guests during the session would be impossible with an in-person journal club."

At the University of North Carolina at Chapel Hill, the breast-imaging division quickly moved to a virtual journal club, and the online format created an interactive space to offer discussion questions and invite doctors from different disciplines to attend, according to Dr. Thomas Kesler, a breast-imaging fellow. Members paired up to present articles together, and they used a template for each session to streamline the process.

"The fellows stated that the journal club strengthened their knowledge base and enhanced communication and teaching skills," Dr. Kesler explains. "The attendings learned from the frank discussions of differing practice patterns."

At Penn State Health, several divisions pivoted to a virtual journal club as well. They created ground rules for discussions, turned on their video cameras and muted themselves while others talked. Residents prepared short presentations of the articles and shared personal updates with photos of their family, pets, hobbies and previous vacations, writes Dr. Alison Chetlen, vice chair of education.

"Our virtual journal clubs are full of new knowledge, healthy controversy, and most importantly, laughter and camaraderie," she says.

In recent years, some journal clubs began to shift online through social media or blogs. Free virtual chats have opened up conversations for global audiences and various viewpoints, the authors write. Residency programs will likely continue to adapt their journal club practices for residents, fellows and doctors to connect on the latest research, they add.

"Online journal clubs are a great way to facilitate critical thinking and evaluation," Dr. Matthew Roberts of the University of Queensland, in Brisbane, Australia, told Reuters Health by email. Dr. Roberts, who wasn't involved with the article, has written about microblogging trends and Twitter-based journal clubs.

"Personal touch also allows others to relate to people, rather than papers," he said.

As the medical literature around coronavirus data and other disciplines grows daily, virtual journal clubs are "crucial" for adapting practices, said Tushar Garg, a medical student at Seth GS Medical College and King Edward Memorial Hospital in Mumbai, India, who was not involved with the new paper. Garg has written about journal clubs on Twitter.

"A lot of journal clubs are usually conducted in the silos of their respective specialties," he told Reuters Health by email. "This is a great time to organize interdisciplinary and global journal clubs, where doctors from different specialties and countries can chime in and we can have a more fruitful discussion."

SOURCE: Journal of the American College of Radiology, online August 23, 2020.