Home-grown approach to journal clubs helps clinicians translate evidence into practice

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One of CKN’s primary aims is to support the work of Queensland researchers by providing access to high quality medical and health journals. Information literacy and critical evaluation skills are necessary for expanding our body of knowledge aimed at improving patient care. Journal clubs offer clinicians an opportunity to not only hone their research skills, but also keep abreast of the latest evidence and incorporate it into their practice. Journal clubs are not new, and have historically had mixed results. However a home-grown approach from a team at the Gold Coast HHS, TREAT Journal Clubs www.treatjournalclubs.com, offers to increase their effectiveness through an innovative process-driven format. 

Co-developer of TREAT Journal Clubs is Dr Rachel Wenke PhD. Dr Wenke is a Principal Research Fellow (Allied Health and Rehabilitation Services) at Gold Coast Health where she has co-designed, implemented, and evaluated a number of initiatives to build research capacity for allied health professionals, and mentored over 30 clinicians undertaking research projects across allied health. She concurrently works as a Senior Speech Pathologist in the area of rehabilitation at Gold Coast University Hospital. CKN spoke with Dr Wenke to learn more about what TREAT Journal Clubs have to offer.

Pictured L-R: Dr Caitlin Brandenburg, Dr Sharon Mickan, Dr Jodie Wiseman, Dr Janice Yeung and Dr Rachel Wenke

 

Dr Rachel Wenke PhD 
 

As a clinician you are always looking for ways to ensure you are providing best possible care to your patients and part of this is about staying current with the latest evidence. I have a passion for helping clinicians answer clinically important research questions whilst building their confidence and skills in using and participating in research to ultimately improve patient outcomes.

Journal clubs are a really useful way that a team can come together to discuss, in a meaningful way, new research evidence that’s been published in journal articles, with the aim to enhance the way we deliver care or confirm that what we are doing is based on best practice. They not only offer a means to help integrate the best available evidence into practice to optimise patient and service outcomes, but also help maintain and/or develop skills in evidence based practice (EBP) including searching the literature and critical appraisal. They can also count towards CPD points.

Journal clubs are widely used across health professions including medical, allied health and nursing staff, across multidisciplinary teams, and can include staff in roles that may not directly see patients (e.g., public health). 

Journal clubs have been part of my clinical role for over a decade, but for the last seven years I have also focussed on researching them. Back in 2015 around 14 allied health journal clubs were running at Gold Coast Hospital, but a local survey of EBP champions showed they were having little impact on clinical practice or EBP skills development. Dr Sharon Mickan (then Professor of Allied Health) and I wanted to explore how to make running a journal club more effective. A literature search found two key systematic reviews about the effective ingredients for a journal club. We synthesised those into eleven key components, tailored them to the allied health setting and the resulting structure became what is called the TREAT journal club format. TREAT stands for “Tailoring Research Evidence and Theory”, which is exactly what we did to design this format. TREAT was born out of the clinical problem of clinicians wanting to make the most of their existing journal clubs, which at the time they felt were having little impact.

Traditional journal clubs typically lack most of the components we’ve identified for effective operation. They mostly involve health professionals taking turns choosing a journal article of personal interest and presenting an appraisal of it. That includes its strengths and weakness, discussing the key results and how they could be applied into practice.

The TREAT journal club contrasts this by using a more structured group based approach to selection of the articles and its appraisal and application to practice to enhance relevance and engagement of those involved. 

After our success with the TREAT Journal Club format with allied health staff at Gold Coast University Hospital (outlined in the follwing papers, (here and here) we wanted to spread the format more widely across Queensland, nationally and internationally, and beyond allied health to also include medicine and nursing.  In January 2022 the TREAT Journal Club website https://www.treatjournalclubs.com/ was launched, in association with Bond and Griffith universities, with funding from a Gold Coast Hospital Foundation Collaborative Research grant.

The TREAT Journal Club website contains free resources to either start or revamp an existing journal club, with templates, videos and critical appraisal tools. Registering a journal club provides free access to extra resources including a tailored implementation plan based (using a web-based expert logic system tailored to each journal club’s context), step-by-step facilitator and presenter guides, quick reference guides for statistical concepts and implementing TREAT journal clubs (e.g., using telehealth, finding a mentor), and interactive EBP training modules.

Queensland Health staff can access databases to perform their search through CKN as well as with support through their local HHS library (where available). 

In spite of COVID a number of journal clubs have already registered, from Australia and internationally. 

Our research has shown that clinicians were significantly more satisfied with the TREAT format than standard journal club formats. It helped in their skill development and engagement in the journal club and led to improved EBP skills and confidence in our outcome measures. We also found from research that clinicians reported participating in the journal club helped change practice including reports of 88 new treatments/resources adopted and 64 clinical procedures updated. Managers have also reported that the structured nature of the format makes it easy for staff.

The website is currently being evaluated within a research framework until late 2023 and is freely available nationally and internationally. We are trying to spread its use far and wide, and encourage as many people as possible to use it.

Over the last seven years, the research team, led by me, has grown across three phases of research – a true collaboration between clinicians and researchers across Gold Coast University Hospital, Bond University and Griffith University.

Anyone working in Queensland Health thinking of starting or revamping their journal club is encouraged to visit www.treatjournalclubs.com (follow us on twitter @journalclubs). We’ve tried to make it as easy as possible for health professionals to start and run their own structured journal club with everything that’s needed on the website.