Education Research: A Mixed-Methods Analysis of Journal Club Formats to Enhance Evidence-Based Practice Through Social Cognitive Learning Theory.

Abstract

Background and objectives: In an era of rapid advances in research, it is imperative for residents to develop the skills for evidence-based practice. Alternative journal club formats grounded in active learning strategies may be better suited to address this need, although evidence is lacking. A theoretical framework of social cognitive learning theory (SCLT) may provide insight into how journal clubs can be better designed to teach residents how to evaluate research. Using a sequential, explanatory mixed-methods design and SCLT framework, we compared 2 different journal club formats for teaching methodology and clinical application. We also explored neurology resident experiences with both formats using a qualitative approach.

Methods: We conducted 4 alternating journal clubs: 2 active learning and 2 traditional. In the quantitative phase, we compared resident performance on presession and postsession assessments for the 2 different journal club formats. We designed parallel pretest and posttest forms and analyzed the change in scores using a linear mixed-effects model with fixed effects for the test type and pretest score. In the qualitative phase, we explored neurology resident experiences with both formats through the lens of SCLT. We observed the journal club sessions through an ethnographic lens and conducted semistructured one-on-one interviews with residents. The data were mixed during analysis of interview data.

Results: Resident participants (n = 18 active learning, 18 traditional) of each journal club completed pretests (n = 16 active learning, 11 traditional) and posttests (n = 8 active learning, 5 traditional). There were statistically significant increases in total (estimate = 18.03%, SD = 6.9, p = 0.028) and clinical application (estimate = 48.40%, SD = 6.6, p < 0.0001) pretest and posttest scores with the active learning format. There was no difference in methodology subscores (estimate = 5.84%, SD = 11.8, p = 0.63). Regarding the active learning format, observations noted more demonstrations of retention, reproduction, and motivation during the sessions than a traditional format. Interviews highlighted 4 main themes: the burden of preparation, the importance of clinical relevance, preference for organic discussion, and the value of faculty expertise.

Discussion: These results highlight the strengths and disadvantages of a more discussion-based journal club format. Further altering the design to a "no-prep" approach and emphasizing the faculty facilitator's role may further optimize teaching of evidence-based practice.