title: Are journal clubs effective in supporting evidence-based decision making? A systematic review. BEME Guide No. 16.
abstract: BACKGROUND
  Journal clubs (JCs) are a common form of interactive education in health care aiming to promote the uptake of research evidence into practice, but their effectiveness has not been established.
  
  
  OBJECTIVE
  This systematic review aimed to determine whether the JC is an effective intervention in supporting clinical decision making.
  
  
  METHODS
  We searched for studies which evaluated whether clubs promote changes in learner reaction, attitudes, knowledge, skills, behaviour or patient outcomes. We included undergraduate, postgraduate and practice JCs and excluded studies evaluating video/internet meetings or single meetings.
  
  
  RESULTS
  Eighteen studies were included. Studies reported improvements in reading behaviour (N = 5/11), confidence in critical appraisal (N = 7/7), critical appraisal test scores (N = 5/7) and ability to use findings (N = 5/7). No studies reported on patient outcomes. Sixteen studies used self-reported measures, but only four studies used validated tests. Interventions were too heterogeneous to allow pooling. Realist synthesis identified potentially 'active educational ingredients', including mentoring, brief training in clinical epidemiology, structured critical appraisal tools, adult-learning principles, multifaceted teaching approaches and integration of the JC with other clinical and academic activities.
  
  
  CONCLUSIONS
  The effectiveness of JCs in supporting evidence-based decision making is not clear. Better reporting of the intervention and a mixed methods approach to evaluating active ingredients are needed in order to understand how JCs may support evidence-based practice.
authors.affiliation: School of Health and Related Research, University of Sheffield, UK. janet.harris@sheffield.ac.uk
authors.forename: Janet
authors.initials: J
authors.lastname: Harris
authors.forename: Karen
authors.initials: K
authors.lastname: Kearley
authors.forename: Carl
authors.initials: C
authors.lastname: Heneghan
authors.forename: Emma
authors.initials: E
authors.lastname: Meats
authors.forename: Nia
authors.initials: N
authors.lastname: Roberts
authors.forename: Rafael
authors.initials: R
authors.lastname: Perera
authors.forename: Katharine
authors.initials: K
authors.lastname: Kearley-Shiers
mesh_terms: D003657:Decision Making; D004501:Education, Medical; D019317:Evidence-Based Medicine; D006126:Group Processes; D006801:Humans