Development and Implementation of a Hospital Pharmacy Journal Club: Our Experience at the Children’s and Women’s Health Centre of British Columbia

Abstract

INTRODUCTION

The medical literature has expanded greatly in the past few decades. The National Library of Medicine currently indexes more than 4000 medical journals in MEDLINE, a database of more than 12 million articles and abstracts.1 The utility of the journal club as a forum for participants to keep abreast of the medical literature has been documented for over 150 years. The first journal club in North America was instituted at McGill University in Montreal in 1875.2 Since then, the journal club has been an established teaching modality in the medical education system. Although the goals of a journal club are typically to encourage participants to keep up with the peer-reviewed literature and to teach them to critically evaluate the literature, other goals have been described. Simpson and others3 described a regular meeting to which participants would bring their unread stack of journals to review and share with other participants. Hartlaub4 developed a format whereby the selected article is not distributed in advance of the meeting. Instead, during the session, the leader of the group gives a brief description of the research question and participants are asked to suggest appropriate study designs for addressing the research question. Other nontraditional goals of journal clubs include to discuss controversies, to practise teaching skills, to prepare for board examinations, and to build a database of reviewed material for a particular group.5 Issues related to the format or organization of journal club sessions that have been addressed in the literature include the value of having a leader or coordinator, the ideal number of participants, and the frequency and place of meetings.5 Sidorov,6 in a review of journal clubs for internal medicine residents, found that most designated an individual to be responsible for coordinating the sessions. In fact, journal clubs with a designated leader have higher participant satisfaction ratings than those without.5 Although there does not appear to be agreement as to the ideal number of participants, it has been suggested that a group size of 12 or fewer may be most conducive to valuable participation, exchange of ideas, and teaching.5 Regular meetings appear to be more successful than sporadic ones; however, there is less agreement as to whether one time of day is preferable over another, and this variable seems to be discipline-specific. For example, many surgical journal clubs meet in the early evening, whereas internal medicine sessions are most commonly held during the lunch hour.5 Although, for practical reasons, most journal clubs meet in the hospital setting, some have suggested that meeting at one of the participants’ homes or at a nearby restaurant may create a positive social environment that could increase appeal.5 Despite these differences in format, all agree on the value of the journal club as an educational tool. Pharmacists face the challenge of keeping up with the ever-changing drug information that is available, so that they can help prevent and resolve patients’ drugrelated problems. They face the added challenge of using appraisal skills in reviewing and applying the information available. A review of the medical literature (MEDLINE 1966 to 2004 and EMBASE 1980 to 2004) using the search term “journal club” yielded over 150 articles in the medical and nursing literature. However, there appears to be a lack of published experience in the implementation of journal clubs in pharmacy. A brief description of a 4-participant pharmacy journal club at a psychiatric hospital was published as a letter,7 but, to our knowledge, there is a shortage of published information on how to initiate and implement a journal club in hospital pharmacy. Some of the issues related to the implementation of a journal club in pharmacy may be similar to those associated with journal clubs in other disciplines. Hospital pharmacists can learn from other disciplines’ experiences in determining the basic organization of the sessions (e.g., frequency and duration of meetings, selection of a discussion leader). However, the goals of a hospital pharmacy journal club may be different from those described for nursing or medical journal clubs, particularly because many of the latter are part of residency or training programs. In some cases, the main goals of the journal clubs may be the same, but the priority accorded to each goal may vary among disciplines.5 In this paper we describe our experience in developing and implementing a journal club in the Pharmacy Department at Children’s and Women’s Health Centre of British Columbia.