Making Better Physicians Through Journal Clubs
At National University, teaching students how to access, interpret and apply the latest health science research is part of preparing them to be better doctors. Journal club is part of the required clinical curriculum for ninth and tenth trimester DC students. However all faculty, staff and students from any NUHS program are invited to participate in regular weekly journal club meetings.
Small groups of DC interns are assigned to choose a topic and lead the discussion for each week’s journal club meeting. They must pick a topic that applies to a current patient case they are treating in the clinic – a case that has unanswered clinical questions. They then search for and select the best example of current peer-reviewed research that applies to that patient’s condition. At the journal club meeting, they present their research, along with their evaluation of its merits and shortcomings, for discussion among the journal club participants.
Most of the topics taken up by the journal club are non-musculoskeletal. For example, recent journal topics include: acupuncture and infertility; vitamin D and multiple sclerosis; or how the paleo diet affects weight loss and mood disorders.
NUHS started its journal club in 2005, when the National Institutes of Health – National Center for Complementary and Alternative Medicine awarded NUHS a grant to implement an enhanced evidence-based practice curriculum.
Christopher Wolcott, DC, instructor and research department faculty member says that staying on top of the current literature makes for a better and more informed physician. “Patients now have access to the Internet and the health research that turns up on lots of news sites. Unfortunately, it’s often presented by a reporter who might not be an expert. We need our graduates to be experts for their patients.”
“Discussing research in a group dynamic provides a much richer understanding of the literature,” says Dr. Wolcott. “A group discussion may identify researcher bias that might not be noticed at first reading. For example, an author might conclude that spinal manipulation was no more effective than NSAIDs for headaches and thus conclude that spinal manipulation was ineffective. Yet looking at the same information, one could interpret the same research and conclude spinal manipulation is just as good as NSAIDs (the gold standard) for headache and is much safer, and therefore a better option.”
There’s also an added benefit to journal club according to Dr. Wolcott. “It’s fun! We do student surveys at the end of the term and these show that journal club is very well received. Of the clinical requirements at NUHS, this is one of the interns’ favorites.”