3 Mar 2017
In a new series, RCVS Knowledge writers are to offer advice and ideas to VNs on how to ensure evidence-based veterinary medicine is adopted in clinics.
Jackie Belle
Job Title
Coffee and biscuits.
In a new series, RCVS Knowledge writers are to offer advice and ideas to VNs on how to ensure evidence-based veterinary medicine is adopted in clinics.
Kicking things off, RVN Jackie Belle shares 10 tips on how to run a successful journal club.
By meeting regularly in a journal club, your nursing team will have an opportunity to explore their work-based activities, consider veterinary literature and develop critical appraisal skills in a structured way.
It is also a useful way to fulfil criteria for CPD and, of course, really great fun, too. So, how do you go about it?
It is usually best for one or two people to take responsibility for the club. They should be interested and committed to its concept, and willing to organise it.
Although the leader can rotate among members, having an educator-mentor who is knowledgeable is essential to validate the journal club’s importance and provide support when the group needs guidance.
It is essential to have some clarity of purpose for the meeting so you are able to achieve the best possible outcome during the session. Identify the problem or topic you are considering and place it in a nursing context, and/or think of a concern or patient condition you would like to explore further.
An example could be a recent case – perhaps a cat with a urethral obstruction. So, what is the evidence on nursing hospitalised cats with urethral obstruction?
If the group is inexperienced, or this is your first meeting, participants could then critique the same article and have a shared discussion.
As staff members may differ widely in their knowledge and skills, consider access to basic courses on literature searching or critical appraisal – these will increase confidence, as well as enable active participation.
For example, a student journal club is a useful way of involving students in reflective learning, with the session being led by the clinical coach who, depending on the subject matter, may select specific papers for students to review.
Remember, physical space is just as important as the timing of the meeting, as it needs to be held in a room that facilitates learning.
It sounds silly, but think about it – anything too noisy, or a room likely to be required during the session, is just not going to work.
Also, consider staff shift patterns when scheduling appropriate times and meeting lengths. A monthly lunch and learn, or an early evening, usually allows maximum staff attendance.
Try to alternate the day, too, so part-time staff can also participate without attending on a day off. Meetings can be face to face or online using Skype, webinars or Twitter, so all branches of the practice can join in.
Some other points to consider are:
When choosing a paper, consider what you want to achieve. In getting there, a “question book” can be useful to record questions from consultations and ward rounds.
Once the articles are chosen, participants should have access to them about one to two weeks prior to the meeting, so they can gather materials and evidence.
If you cannot find an article for your topic, contact the RCVS Knowledge library – we might be able to help you with your search. Also, if you require help with information gathering, consider our free literature workshop, which can be run face to face or online to suit your needs.
Examples for a topic-based journal club are:
Use one form to summarise the article and another form for critical appraisal. Also consider how to appraise and which checklists to use. How do you measure outcomes, too?
See RCVS Knowledge Evidence-based Veterinary Medicine Toolkits 6 to 11 for critical appraisal checklists.
The facilitator should welcome staff and set out the agenda for the meeting, and a checklist or slideshow prompt should be followed.
The first half of the meeting could go like this:
In the second half of the meeting, the discussion could centre on whether the design and results justify their conclusions and what to do with the patient concerned.
Active discussion should be encouraged by using pre-planned questions. Someone should be recording minutes, with action points and recommendations, and a record of these meetings should be kept for reflection and as a resource tool for future events.
The most important part of the journal club discussion is the “bottom line”, so make sure you leave enough time for this. If the journal club started with an actual case, go around the room and see whether the article has changed how people would manage that case. If you don’t have a specific case in mind, make one up.
For example, at the end of a journal club discussion on the nutritional considerations of raw food diets, the conversation could go like this:
Facilitator: “You get a telephone call from the owner of a 12-year-old domestic shorthaired cat that had dental surgery. On reading a newspaper article about raw foods, the owner would like to start Toby on a raw meat diet.
“Let’s discuss what you would advise, with a show of hands. How many would advocate use of raw foods? How many would discourage use?”
Afterwards, you can spend five minutes or so having people justify their answers, followed by consideration of:
Modified from RCVS Knowledge, 2017; Mair, 2016; Swift, 2004).
After your club meetings are done – be it the first or a few months in – consider what went well and what could have been better.
From staff attendance and location or timing of meeting, to the article type and form design – everything needs to be discussed. Adopt new ideas, alter existing ones or abandon what did not work.
Make a recording or take notes during the meeting so this information is available to all staff to view. They can also be a useful review tool for managing future meetings if you used evaluation forms.
Also, your journal club can be used to demonstrate evidence of an activity undertaken to further your professional competence – log them online on your CPD record.
You can also attach the journal club minutes/record and reflection on what you have learned from the meeting as part of your evidence.
VNs play an important role in the daily care of their patients, so their ability to find, retrieve and evaluate veterinary literature is an important asset to any vet clinic wishing to implement evidence–based practice (Fausak, 2014).
One element of this – a successful journal club – is often measured by staff engagement through regular attendance, active participation, staff camaraderie and subsequent team development.
Remember, many of your discussions from the club may lead to changes in your nursing practice protocols, which could lead to a significant improvement in clinical outcome and patient care. Journal club examples can be viewed at the following websites:
For more help on running a journal club, visit http://knowledge.rcvs.org.uk for checklists and information. There’s also the Centre for Evidence-Based Medicine at The University of Nottingham, under the “BestBETS for Vets” initiative (https://bestbetsforvets.org).
