title: Journal clubs most effective if tailored to learner needs.
abstract: METHODS
  The search strategy was developed using Medline and adapted for the requirements of other databases. The strategy included all study types, enabling the retrieval of qualitative research. Databases searched were; Australian Education Index, ACP Journal Club, British Education Index, Cochrane Library, CINAHL, Embase, Eric, LISA Medline, metaRegister of Controlled Trials, National Research Register, Psychinfo, REFER, Sociological Abstracts, Web of Knowledge. Bibliographies of relevant publications and review articles were scanned and relevant references were retrieved. No language restrictions were applied. Information on databases searched provided by original authors as not included in published article.
  
  
  METHODS
  All study designs which evaluated whether clubs promote changes in learner reaction, attitudes, knowledge, skills, behaviour or patient outcomes in undergraduate, postgraduate and practice settings. Studies evaluating video/internet meetings or single meetings were excluded.
  
  
  METHODS
  Each article was reviewed by two authors independently with pilot-tested data collection forms. No quality assessment was pre-specified.
  
  
  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: Department of Dental Clinical Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.
authors: Debora C
authors: DC
authors: Matthews