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Journal clubs in Australian medical schools: prevalence, application and educator opinion.

ABSTRACT: PURPOSE:Medically-focused journal clubs have been used as an educational tool for over 100 years with research indicating that they improve knowledge, reading behaviour, and critical appraisal skills. However, it is not known how widespread their use is among Australian medical schools, nor the opinions of medical education leaders as to their value. METHODS:A nationwide cross-sectional study was performed on academic leaders from every Australian medical school. Individuals were asked to complete a survey detailing their attitudes towards journal clubs using single or multiple answer questions, Likert scales, and ranked data. They were asked whether students at their institutions were able to partake in journal clubs, and if so, details of their implementation. RESULTS:At least one response was collected from 18 of 19 Australian medical schools. This represented 60 responses of a possible 147 (40.8%), the vast majority of whom were heads of clinical schools, 36 (60.0%). The prevalence of journal clubs among medical institutions was high, with 15 of 18 (83.3%) stating that they had a journal club. Of these 23 (65.7%) were metropolitan and 12 (34.3%) were rural institutions. Most were clinician-led, 18 (51.4%), run through specific hospital departments, 13 (37.1%), and most frequently occurred during clinical years, 23 (65.7%). The vast majority stated that the primary aim of the journal club was to develop critical appraisal skills, 20 (57.1%). CONCLUSION:Journal clubs are a highly regarded educational tool in the armoury of medical school educators, with significant heterogeneity in their structure, geographic prevalence and intended purpose. Further studies into their efficacy in teaching evidence-based medicine is warranted in the medical student cohort.

SUBMITTER: Ianno DJ

PROVIDER: S-EPMC7365995 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Journal clubs in Australian medical schools: prevalence, application and educator opinion.

Ianno Damian James DJ Mirowska-Allen Kelly K Kunz Stephen Anthony SA O'Brien Richard R

Journal of educational evaluation for health professions 20200101

<h4>Purpose</h4>Medically-focused journal clubs have been used as an educational tool for over 100 years with research indicating that they improve knowledge, reading behaviour, and critical appraisal skills. However, it is not known how widespread their use is among Australian medical schools, nor the opinions of medical education leaders as to their value.<h4>Methods</h4>A nationwide cross-sectional study was performed on academic leaders from every Australian medical school. Individuals were ...[more]

PMID: 32106214

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Project description:BackgroundThe Australian Medical Council, which accredits Australian medical schools, recommends medical leadership graduate outcomes be taught, assessed and accredited. In Australia and New Zealand (Australasia) there is a significant research gap and no national consensus on how to educate, assess, and evaluate leadership skills in medical professional entry degree/programs. This study aims to investigate the current curricula, assessment and evaluation of medical leadership in Australasian medical degrees, with particular focus on the roles and responsibilities of medical leadership teachers, frameworks used and competencies taught, methods of delivery, and barriers to teaching leadership.MethodsA self-administered cross-sectional survey was distributed to senior academics and/or heads or Deans of Australasian medical schools. Data for closed questions and ordinal data of each Likert scale response were described via frequency analysis. Content analysis was undertaken on free text responses and coded manually.ResultsSixteen of the 22 eligible (73%) medical degrees completed the full survey and 100% of those indicate that leadership is taught in their degree. In most degrees (11, 69%) leadership is taught as a common theme integrated throughout the curricula across several subjects. There is a variety of leadership competencies taught, with strengths being communication (100%), evidence based practice (100%), critical reflective practice (94%), self-management (81%), ethical decision making (81%), critical thinking and decision making (81%). Major gaps in teaching were financial management (20%), strategic planning (31%) and workforce planning (31%). The teaching methods used to deliver medical leadership within the curricula are diverse, with many degrees providing opportunities for leadership teaching for students outside the curricula. Most degrees (10, 59%) assess the leadership education, with one-third (6, 35%) evaluating it.ConclusionsMedical leadership competencies are taught in most degrees, but key leadership competencies are not being taught and there appears to be no continuous quality improvement process for leadership education. There is much more we can do as medical educators, academics and leaders to shape professional development of academics to teach medical leadership, and to agree on required leadership skills set for our students so they can proactively shape the future of the health care system.

Project description:BackgroundResearch into how medical schools support students who are pregnant or with current parental responsibilities has been mostly limited to the US context.ObjectivesTo review pregnancy and parental leave policies for students at Australian/New Zealand medical schools.DesignA cross-sectional survey.MethodsData were collected between June and September 2021. Websites of Australian/New Zealand medical schools (n = 23) were searched for freely available information on pregnancy and parental leave policies. Each school was contacted to provide supplementary information on the processes to support students who apply for pregnancy and/or parental leave. Outcome harvesting techniques were used to analyse the key attributes and processes used by medical schools.ResultsNone of the 23 accredited Australian/New Zealand medical schools had specific pregnancy and/or parental leave policies. Fourteen of the 23 Australian/New Zealand medical schools responded to the request for more information. All confirmed, beyond their University's general student leave policies, they had no additional pregnancy and parental leave policy. Analysis of each school's processes identified the following themes: lack of school specific pregnancy and/or parental leave policies; lack of public statements of support for medical students who are pregnant and/or with current parental responsibilities; and lack of attention to the specific needs of medical students who are pregnant and/or with current parental responsibilities, including those with pregnant partners or are a birth support person.ConclusionThere was a lack of documentation and formalized processes related to the support of this group of students. By creating easily accessible information on pregnancy and parental leave which is nuanced to the challenges of medical school and clinical placements, medical schools and medical education accreditation bodies in Australia/New Zealand can address the needs of medical students who are pregnant and/or with current parental responsibilities and normalize pregnancy and parental status within entry-to-practice medical courses.

Project description:BackgroundMedical student journals (MSJs) help to introduce the fundamentals of academic research and publication to future doctors. It has recently been shown that MSJs can influence doctors' future academic and professional success, however these findings have not been replicated in an Australian cohort. The aim of this study was to examine the association between publication in the Australian Medical Student Journal (AMSJ) and markers of a student's future academic trajectory, including future publication, attainment of higher academic degree or entry into specialist training.MethodsArticles authored by medical students in the AMSJ from 2010 to 2015 were retrospectively identified. A list of these student authors was made, with university- and year- matched control students randomly selected from university graduation databases. For all students, data related to academic success were obtained from multiple sources including PubMed®, Google, university databases and author affiliation information from publications. A multivariable conditional logistic regression model was used to assess correlation between variables. The primary outcome measure was the number of postgraduate PubMed®-indexed publications. Secondary outcome measures included attainment of higher degree or faculty position. Clinical speciality was also recorded.ResultsFifty-five AMSJ authors (14 case reports, 17 original research, 21 review articles) from 14 Australian universities were included. Publication in the AMSJ was associated with future PubMed® indexed publications (OR 3.43, 95% CI 1.74-6.77, P < 0.001) and higher degree attainment (OR 4.05, 95% CI 1.99-8.22, P = 0.0001). AMSJ authors were also significantly more likely to enter into surgical training (OR 2.53, 95% CI 1.10-5.84, P = 0.029). A multivariable conditional logistic regression model demonstrated that publication in the AMSJ was predictive of future PubMed indexed publication, independent of higher degree or faculty position attainment (OR 2.56, CI 1.22-5.39, P = 0.01).ConclusionWe have shown that publication in a MSJ is associated with markers of academic success in an Australian cohort. PubMed®-indexed publications, attainment of a Masters degree, and entry in to surgical training were all significantly correlated to AMSJ publication. A conditional logistic regression model demonstrated that medical student publication in the AMSJ influences the number of future PubMed®-indexed publications, independent of major academic confounding variables.

Project description:BackgroundStructured journal clubs are a widely used tool to promote evidence-based practice in health professionals, however some journal clubs (JC) are more effectively sustained than others. To date, little research has provided insights into factors which may influence sustainability of JCs within health care settings. As part of a larger randomised controlled study, this research aimed to gain understanding of clinicians' experiences of sustaining a structured JC format (TREAT- Tailoring Research Evidence and Theory) within their clinical context. The study also aimed to identify which strategies may assist longer term sustainability and future implementation of the TREAT format.MethodsWe employed a qualitative methodology, informed by behaviour change theory. Clinicians (n = 19) from five different JCs participated in focus groups to explore their experience in sustaining the JC format six months after the formal trial period had completed. Clinicians were asked to describe factors which they perceived helped or hindered sustaining components of the JC format within their local context. Following a descriptive summary of the data, barriers and enablers were thematically analysed according to behaviour change theory domains: capability, motivation and opportunity and further mapped to targeted implementation strategies.ResultsParticipants reported perceived benefits of maintaining the TREAT format and described several components that promoted its sustainability. Sustaining factors linked to individuals' capability included building research knowledge and skills and having access to research experts. Sustaining factors that enhanced opportunities for behaviour change included management expectation to attend and a team culture which values evidence based practice, while factors found to enhance individuals' motivation included the JC having close application to practice and clinicians sensing ownership of the JC. Several implementation strategies to enhance these factors are described including graduated support to clinicians in facilitation of JCs and greater engagement with managers.ConclusionsLong-term sustainability of a structured JC is dependent on both individual and service level factors and a balance of implementation strategies that enhance capability, opportunity and motivation. Consideration of how clinicians can be engaged to take ownership and build their own capability from the commencement of the JC is important.Trial registrationACTRN12616000811404 .

Project description:BackgroundThis pilot study aimed to test the potential effectiveness and acceptability of an intervention to support the implementation of 16 recommended policies and practices to improve the health promotion environment of junior sporting clubs. Reported child exposure to health promoting practices at clubs was also assessed.MethodsA cluster randomised trial was conducted with eight football leagues. Fourty-one junior football clubs belonging to four leagues in the intervention group received support (e.g. physical resources, recognition and rewards, systems and prompts) to implement 16 policies and practices that targeted child exposure to alcohol, tobacco, healthy food and beverages, and participation in physical activity. Thirty-eight clubs belonging to the four control group leagues did not receive the implementation intervention. Study outcomes were assessed via telephone interviews with nominated club representatives and parents of junior players. Between group differences in the mean number of policies and practices implemented at the club level at follow-up were examined using a multiple linear regression model.ResultsWhile the intervention was found to be acceptable, there was no significant difference between the mean number of practices and policies reported to be implemented by intervention and control clubs at post-intervention (Estimate - 0.05; 95% CI -0.91, 0.80; p = 0.90). There was also no significant difference in the proportion of children reported to be exposed to: alcohol (OR 1.16; 95% CI 0.41, 3.28; p = 0.78); tobacco (OR 0.97; CI 0.45, 2.10; p = 0.94); healthy food purchases (OR 0.49; CI 0.11, 2.27; p = 0.35); healthy drink purchases (OR 1.48; CI 0.72, 3.05; p = 0.27); or participation in physical activity (OR 0.76; CI 0.14, 4.08; p = 0.74).ConclusionsSupport strategies that better address barriers to the implementation of health promotion interventions in junior sports clubs are required.Trial registrationRetrospectively registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12617001044314 ).

Project description:BACKGROUND:People with intellectual disability (ID) have multiple and complex health needs, more frequent healthcare episodes, and experience poorer health outcomes. Research conducted two decades ago showed that medical professionals were lacking in the knowledge and skills required to address the complex needs of this patient group. The aim of the current study was to determine whether Australian undergraduate medical schools that offer ID health education content had changed the amount and nature of such teaching over this period. METHODS:Identical or equivalent questionnaire items were compared across eight Australian medical schools that participated in curricula audits conducted in 1995 (referred to as T1) and 2013/14 (T2). The audits were of the nature of the ID content, methods used to teach it, and who taught it. RESULTS:There was no significant difference in the number of hours of compulsory ID content offered to medical students at T2 (total?=?158.3?h; median?=?2.8?h per ID unit) compared with T1 (total?=?171?h; median?=?2.5?h). At T2 compared with T1, units with ID content taught in the area of general practice had increased (2?units; 3.6% to 7?units; 16.3%), while decreases were seen in paediatrics (22?units; 40.0% to 10?units; 23.3%) and psychiatry (10?units; 18.2% to 4?units; 9.3%). The number of schools using problem- and/or enquiry-based learning rose to six at T2 from one at T1. Inclusive teaching practices (people with ID develop or deliver content) in compulsory/elective units had increased at T2 (10?units; 23.3%) compared with T1 (6?units; 10.9%), but direct clinical contact with people with ID had decreased (29?units; 52.7% to 11?units; 25.6%). CONCLUSIONS:Overall, little progress has been made to address the gaps in ID education for medical students identified from an audit conducted in 1995. Renewal of ID content in medical curricula is indicated as a key element in efforts to improve workforce capacity in this area and reduce barriers to care, with the aim of reversing the poor health outcomes currently seen for this group.

Project description:BackgroundAllied Health Professionals (AHPs) commonly use journal clubs (JCs) to support Evidence-Based Practice (EBP). There is however little research regarding implementing and sustaining JCs in the long term, and their impact on EBP use and skills in AHPs. This study investigated the impact of implementing a structured JC format, called "TREAT" (previously only investigated across 6 sessions), over a longer period of 16 sessions for AHPs in a public health service. The study also investigated AHP's attendance, adherence, satisfaction and barriers and enablers to implementing the format.MethodsA mixed methods hybrid-effectiveness implementation design was employed, guided by the Knowledge-to-Action cycle. EBP skills, confidence, use, and attitudes were assessed (Adapted Fresno Test, EBPQ, tailored journal club culture questionnaire) at baseline, and after 10 and 16-monthly sessions. Satisfaction and impact on clinical practice were explored using questionnaires at 10 and 16-months, with free-form responses identifying enablers and barriers to EBP culture and implementation. Data on attendance and adherence to the TREAT format were also collected.ResultsSix JCs comprising a total of 132 unique participants from seven Allied Health professions were assessed across three time points. EBP skills improved on the Adapted Fresno Test after 10-monthly (6.6 points: 95% CI, 0.43 to 12.7) and 16-monthly sessions (7.8 points, 95% CI, 0.85 to 14.7), and on self-reported total EBPQ ratings of confidence at 10-months (4.9 points: 95% CI, 2.2 to 7.5) and 16-months (5.7 points: 95% CI 2.7 to 8.7). Of 132 AHPs, 88 reported adopting new treatments/resources and 64 reported updating clinical procedures. Mean attendance was 5.7 sessions (SD = 3.8). Adherence to TREAT components in each session was 86% (95% CI, 83% to 89%). Most participants recommended the format and reported a desire to continue. Enablers to the JC included using clinically relevant topics and active participation while reported barriers included limited time to prepare.ConclusionsDespite variable attendance, TREAT JCs can continue to be implemented within a service for 16 monthly-sessions, and may contribute to improved EBP skills and confidence and changes in clinical practice over time. Tailoring of implementation strategies was shown to be important to address local enablers and barriers.

Dataset Information

Journal clubs in Australian medical schools: prevalence, application and educator opinion.

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Journal clubs in Australian medical schools: prevalence, application and educator opinion.

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