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Journal Club Resident Spotlight: Abdulaziz Ahmed

JBJS is pleased to highlight the orthopaedic residents who help implement the Robert Bucholz Resident Journal Club Grants at their institutions. The grant program promotes career-long skills in evaluating the orthopaedic literature. Click here for more information.

Name: Abdulaziz Ahmed, MD

Affiliation: Hamad Medical Corp., Doha, Qatar

What was the topic of the most “dynamic” journal club meeting you have had so far this year?

One distinctive journal club evaluated two Level-I studies that addressed common sports-medicine procedures. One article was a randomized clinical trial (RCT) that evaluated the effectiveness of acromioplasty when added to full-thickness rotator cuff tear repair (Abrams GD, et al. Arthroscopic Repair of Full-Thickness Rotator Cuff Tears with and Without Acromioplasty: Randomized Prospective Trial With 2-Year Follow-up. Am J Sports Med. 2014 Jun;42[6]:1296-303). The second article was a trial that compared hip arthroscopy versus nonoperative treatment for femoroacetabular impingement (Griffin DR, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome [UK FASHIoN]: a multicentre randomized controlled trial. Lancet. 2018 Jun 2;391[10136]:2225-2235). By completing systematic critical-appraisal forms, the residents were able to dissect and digest complex methodology and statistics. Both articles provided high-value learning points on evaluating the mechanics and limitations of randomized trials.

What are the top 3 characteristics of an engaging, enlightening journal club presentation?

First, audience preparedness is essential to an engaging journal club. Thus, articles should be distributed in advance for prereading. In our program, we circulate articles 4 weeks in advance. In addition, we highlight important educational objectives for each article. This allows residents to concentrate on crucial elements of selected articles, especially when analyzing several articles in one sitting. Second, selected articles have to be pertinent to the residents’ curriculum and clinical exposure. Our journal club articles are hand-picked jointly by senior residents and research-oriented faculty. The senior residents ensure the article’s relevance to residents, while experienced faculty provide oversight and refine article selection. Third, a systematic approach maximizes the beneficial value of the journal club. We provide participants with a systematic critical-appraisal checklist that not only enhances the residents’ critical appraisal, but also helps them adopt efficient lifelong reading tactics.

Aside from orthopaedic content, what have you been reading lately?

I have been reading the book Deep Work by Cal Newport. The book teaches valuable strategies for optimizing productivity and getting the most out of our cognitive abilities—a much-needed skill in our currently fast-paced, distracted world.

How has the COVID-19 pandemic affected your journal-club activities?

The COVID-19 pandemic has profoundly affected residency training around the globe. Although the pandemic limited our in-person journal club format, like many others, we have transitioned to virtual education. Currently, our journal club is conducted through online meetings. As much as we loved the in-person format, the online format made the journal club more accessible to faculty members. Moreover, the virtual setting motivated us to invite experts in the field. Recently, Dr. Bashir Zikria from Johns Hopkins moderated an exciting journal club on the long-term outcomes of matrix-induced autologous chondrocyte implantation.

How has free access to JBJS Clinical Classroom benefited you and your journal club?

JBJS Clinical Classroom has been a useful source for article selection in our journal club. It also provides an exciting opportunity to evaluate our knowledge by strengthening deficient areas and steering us away from mastered topics. The recharge feature provides a time-efficient way to reinforce knowledge.  Clinical Classroom presents questions that are based on the best available evidence, and cited references feature both classic and most recent articles.

 

Journal Club Resident Spotlight: Praharsha Mulpur

JBJS is pleased to highlight the orthopaedic residents who help implement the Robert Bucholz Resident Journal Club Grants at their institutions. The grant program promotes career-long skills in evaluating the orthopaedic literature. Click here for more information.

Name: Praharsha Mulpur, MD

Affiliation: Sunshine Bone and Joint Institute, Hyderabad, India

What was the topic of the most “dynamic” journal club meeting you have had so far this year?

Tuberculosis (TB) of the hip joint is still prevalent in India. We are often faced with situations of advanced destruction of the hip joint requiring total hip replacement (THR), but THR is usually delayed until the disease condition becomes quiescent. However, TB is known to persist subclinically and to reactivate after surgery. One of the journal club articles we discussed was a “practice changer” as far as THR in active TB was concerned: Kim et al. Total hip replacement for patients with active tuberculosis of the hip. Bone Joint J, 2013; 95-B:578-82.

What are the top 3 characteristics of an engaging, enlightening journal club presentation?

The most important characteristics include: (1) Clinical relevance: The article chosen should generate discussion on a topic that is clinically relevant and not one that has already been “settled” or “dismissed.” Not all “historical” articles are clinically relevant in the 21st century. (2) Participation: Participants should be well-versed with the topic prior to the meeting, which allows detailed discussion with different perspectives. (3) Brevity: Presentations of the article(s) being discussed should be clear and concise.

Aside from orthopaedic content, what have you been reading lately?

I am following several podcasts, both clinical and nonclinical. I am also reading articles from the Farnam Street blog by Shane Parrish, The New York Times, and a nonfiction book titled Nothing to Envy by Barbara Demick.

How has the COVID-19 pandemic affected your journal-club activities?

Unfortunately, our in-person journal clubs have been halted due to the ongoing risk of COVID transmission, and our institute and department have adopted a completely virtual academic program. This has advantages and disadvantages. On the positive side, we are able to involve senior faculty, both national and international, to participate in the journal club discussions. Apart from our monthly internal journal club, we have an ongoing academic relationship with the department of orthopaedics at the University of Miami for a monthly journal club. With this, our residents and fellows gain international perspectives on topics of clinical significance. On the downside, nothing beats an in-person meeting. Group dynamics and participation are always better in a room than on a Zoom screen.

How has free access to JBJS Clinical Classroom benefited you and your journal club?

JBJS Clinical Classroom is a valuable educational resource and is highly recommended for orthopaedic residents. The content is excellent and helped me cover a lot of topics without having to go back to a reference textbook. The progress meter is useful to assess personal progress. One of the best features is the JBJS Clinical Classroom Library. Every topic has links to the best or most-cited references, which makes studying easy.

Journal Club Resident Spotlight: Agustin Albani Forneris

JBJS is pleased to highlight the orthopaedic residents who help implement the Robert Bucholz Resident Journal Club Grants at their institutions. The grant program promotes career-long skills in evaluating the orthopaedic literature. Click here for more information.

Name: Agustin Albani Forneris, MD

Affiliation: Hospital Italiano de Buenos Aires, Argentina

What was the topic of the most “dynamic” journal club meeting you have had so far this year?

Many articles presented in our journal club ignited debate, not only about their findings but also their design and methodology. One standout was the article by Matsunaga et al. (Minimally Invasive Osteosynthesis with a Bridge Plate Versus a Functional Brace for Humeral Shaft Fractures: A Randomized Controlled Trial. J Bone Joint Surg Am. 2017 Apr 5;99[7]:583-592), which is a prospective randomized study comparing minimally invasive osteosynthesis vs functional bracing for the treatment of humeral shaft fractures. It is quite unusual that a Level-I prospective study like this was designed in Latin America. Our debate focused primarily on identifying which patients in our population would benefit from one treatment or another, in order to apply specific indication criteria to our daily practice. In turn, several hypotheses were raised that stimulated ideas for future projects.

Based on your journal club experiences, what are the top 3 characteristics of an engaging, enlightening journal club presentation?

(1) The commitment of the participants. We encourage all of our 43 residents to not only read the article in advance but also to write a critical review as if they were reviewers of a journal.

(2) Selection of the article. We encourage residents to select controversial studies that trigger debate about results and methodology. It is often valuable to criticize an article whose methodology is controversial to analyze which aspects would make the same study more solid (i.e., selection bias, randomization, data collection, statistical analyses, etc.)

(3) Inviting an experienced faculty surgeon. This is always inspiring to all residents, helping us to write and review articles and transmitting to us their passion for research.

Aside from orthopaedic content, what have you been reading lately?

I am a technology fan, so I usually read specialized magazines on electronic devices and reviews about new gadgets on the market. During holidays, I love to read historical novels that transport me to another place and time. Reading about the achievements of people living at a time when life expectancy did not exceed 30 years amazes me.

How has the COVID-19 pandemic affected your journal-club activities?

Paradoxically, the pandemic empowered our journal-club activities. The substantial decrease in elective surgery to prioritize medical resources for Covid-patients, in addition to the proliferation of virtual applications, gave residents more accessibility to and availability for academic activities. The pandemic also enabled several staff surgeons to join our program, and that enriched the discussions.

How has your free access to JBJS Clinical Classroom benefited you and your journal club?

JBJS Clinical Classroom provides us the opportunity to link one of our most valuable learning tools with the journal club by synchronizing the topics from the resident program classes with the selected journals. JBJS Clinical Classroom also enables us to individualize each resident’s progress and to reinforce the areas that present the greatest difficulty.

Journal Club Resident Spotlight: Brian Goh

JBJS is pleased to highlight the orthopaedic residents who help implement the Robert Bucholz Resident Journal Club Grants at their institutions. The purpose of this program is to promote career-long skills in evaluating the orthopaedic literature as it relates to practice decision making among orthopaedic residents. Click here for more information about the grant program.

Name: Brian Goh, MD

Affiliation: Harvard Combined Orthopaedic Residency Program, Boston, MA

What was the topic of the most “dynamic” journal club meeting you have had so far this year?

One of the most dynamic and engaging journal clubs we have had centered around both residency [1] and fellowship [2] selection – a topic of universal interest for both residents and faculty. This journal club was particularly interesting in the setting of the recent changes to the USMLE Step 1 and how the assessment of medical students will change in the future. We analyzed the merits of these manuscripts, and our discussion led to commentary on the current state of the residency and fellowship selection process.

[1] Trikha R, Keswani A, Ishmael CR, Greig D, Kelley BV, Bernthal NM. Current Trends in Orthopaedic Surgery Residency Applications and Match Rates. J Bone Joint Surg Am. 2020 Jan 6:10.2106/JBJS.19.00930. doi: 10.2106/JBJS.19.00930. PMID: 31904608.

[2] Krueger CA, Helms JR, Bell AJ, Israel H, Cannada LK. How the Reputation of Orthopaedic Residency Programs Is Associated with Orthopaedic Fellowship Match Results. J Bone Joint Surg Am. 2020 Jan 8:10.2106/JBJS.19.00750. doi: 10.2106/JBJS.19.00750. PMID: 31913867.

Based on your journal club experiences, what are the top 3 characteristics of an engaging, enlightening journal club presentation?

Our journal clubs usually consist of manuscript topics that directly impact clinical practice and demonstrate clear, foreseeable patient application. Another characteristic is inviting faculty who are engaged in similar areas of research and can comment on the merits of the manuscripts discussed. Lastly, our journal clubs have been fortunate to receive visits from JBJS Editor-in-Chief, Dr. Marc Swiontkowski. He provides unique insight into the review process of manuscripts and how these articles have contributed to the broader musculoskeletal literature.

What advice about running a top-notch journal club program do you have for residents who will manage a Robert Bucholz Resident Journal Club Grant next year?

Our journal clubs are structured so that each article is jointly presented by a junior and senior resident. The junior resident presents the article and study design, while the senior resident provides context of the research and the strengths and weaknesses of the manuscript. Our discussions typically follow Dr. Seth Leopold’s framework [1] on thoughtful analysis of orthopaedic literature. To allow more residents to participate, we also have our journal clubs streamed to our off-site residents. As residency training evolves to include more off-site rotations, finding a mutual time and place is increasingly difficult. We have found videoconferencing to be immensely beneficial to include all of our residents, near and far. Good food and beverage also help maximize attendance!

[1] Leopold SS. Editorial: Getting the Most from What You Read in Orthopaedic Journals. Clin Orthop Relat Res. 2017;475(7):1757–1761. doi:10.1007/s11999-017-5371-0

Aside from orthopaedic content (journals and otherwise), what have you been reading lately?

I recently took a course in Value-Based Health Care Delivery at Harvard Business School that is based on the research of Dr. Michael Porter. I am now reading Redefining Health Care: Creating Value-Based Competition on Results by Drs. Michael Porter and Elizabeth Teisberg to better understand how health care delivery is changing and how we can maximize value in patient care.

Journal Club Resident Spotlight: Elizabeth Scott

JBJS is pleased to highlight the orthopaedic residents who help implement the Robert Bucholz Resident Journal Club Grants at their institutions. The purpose of this program is to promote career-long skills in evaluating the orthopaedic literature as it relates to practice decision making among orthopaedic residents. Click here for more information about the grant program.

 

Name: Elizabeth Scott, MD

Affiliation: University of Iowa

What was the topic of the most “dynamic” journal club meeting you have had so far this year?

We were fortunate to host this year’s Arthur Steindler Award recipient, Dr. Margaret McQueen at our journal club when she visited our department earlier this year. We had a lively discussion regarding the diagnosis of compartment syndrome, and the use of continuous compartment pressure monitoring. We discussed the pros and cons of our current practices and how they could be improved. Having the original author present was extraordinarily valuable!

McQueen MM, Duckworth AD, Aitken SA, Court-Brown CM. The estimated sensitivity and specificity of compartment pressure monitoring for acute compartment syndrome. J Bone Joint Surg Am. 2013;95(8):673–677. doi:10.2106/JBJS.K.01731

Based on your journal club experiences, what are the top 3 characteristics of an engaging, enlightening journal club presentation?

There are a few characteristics of a good journal club. The first is the most obvious – attendees actually have to read the articles in advance. Limit the number of articles you choose, and send them out well in advance so everyone has time to prepare. The second is a clear structure – we allot a certain amount of time to each article and guide junior residents on how to present an article succinctly. Lastly, you must have faculty commitment. Letting faculty approve or suggest articles, as well as the meeting venue, can help.

What advice about running a top-notch journal club program do you have for residents who will manage a Robert Bucholz Resident Journal Club Grant next year?

Come up with a system for how things are done, and stick to it! Everyone (staff, residents, students) should know exactly what to expect and feel prepared. Avoid pressured “pimp sessions” and focus on group learning and discussion. Journal club should be something residents and staff look forward to.

Aside from orthopaedic content (journals and otherwise), what have you been reading lately?

I’m a fan of audiobooks – easy to listen to in the car or walking home – and particularly nonfiction. If you’re looking for some motivation, check out “Can’t Hurt Me” by David Goggins, a Navy Seal and elite ultramarathoner. I’m currently listening to Greg McKeown’s “The Disciplined Pursuit of Less,” which tackles the idea of essentialism.

Journal Club Resident Spotlight: Carl Herndon

JBJS is pleased to highlight the orthopaedic residents who help implement the Robert Bucholz Resident Journal Club Grants at their institutions. The purpose of this program is to promote career-long skills in evaluating the orthopaedic literature as it relates to practice decision making among orthopaedic residents. Click here for more information about the grant program.

Name: Carl Herndon, MD

Affiliation: Columbia University Medical Center, New York, NY

What was the topic of the most “dynamic” journal club meeting you have had so far this year?

We recently had a journal club focusing on adult joint reconstruction, and discussed different fixation strategies of implants (broadly cement vs cementless fixation). We evaluated the following 3 studies:

Stea S, Comfort T, Sedrakyan A, Havelin L, Marinelli M, Barber T, Paxton E, Banerjee S, Isaacs AJ, Graves S. Multinational comprehensive evaluation of the fixation method used in hip replacement: interaction with age in context. The Journal of bone and joint surgery. American volume. 2014 Dec;96(Suppl 1):42-51.

Khanuja HS, Vakil JJ, Goddard MS, Mont MA. Cementless femoral fixation in total hip arthroplasty. JBJS. 2011 Mar 2;93(5):500-9.

Nam D, Lawrie CM, Salih R, Nahhas CR, Barrack RL, Nunley RM. Cemented versus cementless total knee arthroplasty of the same modern design: a prospective, randomized trial. The Journal of bone and joint surgery. American volume. 2019 Jul 3;101(13):1185.

Based on your journal club experiences, what are the top 3 characteristics of an engaging, enlightening journal club presentation?

1. Hand-on activities: We always lead off our journal club with a sawbones exercise where senior residents, fellows, and attendings lead junior residents through a topical saw bones. Great to get everyone thinking and a chance for everyone to learn.

2. Multilevel involvement: Having everyone there from interns all the way to senior attendings is critical as we evaluate the literature with different biases and can all learn together.

3. Atmosphere: Reading these articles and discussing them doesn’t have to be boring! Having food or snacks and scheduling it at the end of the day allows for a more laid-back vibe to learning that is conducive to discussion.

What advice about running a top-notch journal club program do you have for residents who will manage a Robert Bucholz Resident Journal Club Grant next year?

Plan it out in advance, and put dates on the calendar for everyone to know when it’s happening. Nothing worse than trying to do all this work and having no one show up!

Aside from orthopaedic content (journals and otherwise), what have you been reading lately?

Once a Runner by John L. Parker Jr. One of my favorite books.