I was pleasantly surprised and excited when I first heard about the citywide Chicago PGY1 journal club. This journal club was funded by the Robert Bucholz Resident Journal Club Grant through The Journal of Bone and Joint Surgery. The premise of this program was for all of the orthopedic surgery PGY1s from around the city to meet and discuss landmark articles specific to a certain orthopedic topic. The event that I attended was the first meeting of the program, and the focus of our discussion revolved around four orthopedic trauma articles. I recognized all of the articles as the guidelines established from these papers are still used in our trauma practice every day.
Although I knew the general principles derived from this literature, I found reading the full text beneficial as it helped provide a more thorough background into the reasoning behind the decisions we make in the management of various fracture patterns. What I found most educational however was the discussions we had with residents at various programs, specifically in regards to our institutions’ management of common orthopedic fractures. We each went around the table and discussed our ED management of injuries including humeral shaft fractures, femoral shaft fractures, open fractures, and our intraoperative technique for intramedullary nailing of tibial shaft fractures.
While there were small differences in our management of these injuries, we all seemed to abide by the general guidelines that were set into motion after the publication of these landmark articles. It brought into focus how influential this literature has been, and also gave me additional insight into possible alternative management algorithms that could produce similar outcomes. When working at one institution throughout your residency, that institutions protocols often become the “normal” for you. I now better recognize that it is important to keep an open mind and that there can be many methods to achieve a desired result.
Our meeting allowed for a low stress environment to both appreciate and constructively criticize how we think about orthopedic trauma. At our specific institution the discussion of articles occurs in a large group setting with attendings and senior residents, and usually focuses on more recent literature. I think it is essential to understand where we came from, and this citywide journal club provides that history while also encouraging open critical discussion. I think any junior resident would benefit from this type of educational open forum with their colleagues.
You can apply for your own Robert Bucholz Resident Journal Club Grant by clicking this link.
Orthopaedic Surgery, PGY-2
University of Chicago
Medical education is a constant need, but how it’s delivered is always changing. When my grandfather was a surgeon, medical trainees brought their dusty textbooks and print journals to “fireside chats” at an attending’s home. Today, we have online journals, tablets and smartphones, podcasts, and “virtual” discussions on social media platforms. Although the technologies evolve, the need to discuss present and past literature remains constant.
These discussions often taken place nowadays through journal clubs. Medical residents across the continent routinely get together in formal or informal settings to discuss journal articles, not only to acquire the knowledge contained in the articles themselves, but also to learn how to properly read, critique, and digest the information.
JBJS provides medical education across multiple platforms, several of which I participate in. I strongly encourage residency programs to submit an application for the 2019-2020 JBJS Robert Bucholz Resident Journal Club Grant Program before the deadline of September 30, 2019. The grant allows medical educators to support their journal clubs in many ways:
- Investigating new and innovative alternatives to the traditional journal club.
- Bringing an author to your institution to discuss his or her articles.
- Hosting a virtual journal club with multiple authors via teleconference or social media.
- Purchasing food and refreshments within the “old school” method of a fireside chat at an attending’s home.
No matter the platform or methodology, journal clubs are a vital part of orthopaedic education, not only for interpreting literature, but also for incorporating knowledge into future clinical practice and for the joy and excitement of lifelong learning.
Matthew R. Schmitz, MD, FAOA is an orthopaedic surgeon specializing in adolescent sports and young adult hip preservation at the San Antonio Military Medical Center in San Antonio, TX. He is also a member of the JBJS Social Media Advisory Board.
Editor’s Note: The Journal of Bone and Joint Surgery’s Robert Bucholz Resident Journal Club Grant provides selected orthopaedic surgery residency programs with funds that facilitate career-long skills in evaluating orthopaedic literature and its impact on clinical decision-making. The Journal is always interested in hearing how those funds have been used to enhance orthopaedic education. Here, Michael Perrone, MD describes how the University of Chicago’s Department of Orthopaedic Surgery and Rehabilitation Medicine used its grant this past academic year.
Our residency hosted Dr. Mohit Bhandari for two days. Dr. Bhandari is widely recognized as the world’s foremost authority in the translation of orthopaedic research into clinical practice. On the first day, he joined us for dinner at a local Chicago pizzeria, where we had a “Deep Dish-cussion” about several landmark articles within the orthopaedic literature. He provided his insights on the design, merits, and limitations of each paper, while also discussing each study’s clinical impact. Both residents and faculty alike found the discussion enlightening and educational.
The following morning, Dr. Bhandari delivered Grand Rounds to the entire department. His talk, “Fear Less, Do More,” gave us an inside look at the trials and tribulations of conducting large, multicenter studies and bringing them to publication. Throughout the talk, he encouraged residents and faculty to be ambitious in their pursuit of research and evidence-based practice.
There are few people with more experience or expertise within orthopaedic research than Dr. Bhandari, and his visit to our residency program was inspirational and enlightening. Such an experience would not have been possible without the generous support from JBJS.
Michael Perrone, MD
University of Chicago
Depending on which historical account you read, journal clubs have been a staple of medical education since around 1875. Still ubiquitous within medical education today, journal clubs help educators and students alike stay current on medical literature, provide a vehicle for teaching how to critically appraise medical studies, and convene a forum in which respectful debate can occur among colleagues. Journal clubs constitute a medical-education practice that almost no one questions, probably because they are so effective.
But that doesn’t mean journal clubs can’t be improved. As the September 30, 2018 deadline approaches to submit applications for the JBJS Robert Bucholz Journal Club Grant Program (click here for the application form), I encourage medical-education leaders to envision new ways in which journal clubs could further orthopaedic education. That might include various iterations of “virtual” journal clubs over the internet. For example, the Journal of Hand Surgery recently hosted a journal club on Twitter. Another intriguing possibility would be to invite authors of journal articles with conflicting conclusions about the same research question to discuss their findings in a point/counterpoint format over teleconference. (Today’s teleconferencing platforms are not hard to set up, are relatively low-cost, and could broaden journal-club participation to anyone with a suitable device and a high-speed internet connection.)
The traditional face-to-face journal club provides many unique benefits, but creating new, innovative platforms for using departmental or grant-based journal-club funds could increase their impact and help ensure the sustainability of these educational programs. It will also be important for everyone to share their experiences with alternative journal-club formats. It behooves the orthopaedic community to continually envision how to integrate the journal-club component of medical education into new technologies as they evolve.
Chad A. Krueger, MD
JBJS Deputy Editor for Social Media
No matter how you look at it, orthopaedic residency is a relentlessly challenging five or six years. The Journal of Bone & Joint Surgery offers the following special services to make life and learning a little easier for orthopaedists in training:
- Complimentary access to all JBJS journals via the AOA’s Council of Orthopaedic Residency Directors (CORD)
- Guidance for getting the most out of your Journal Club
- Annual grants ($2,500) to support Journal Club activities
- Free access to JBJS Podcasts, Videos, and Webinars
- Opportunities to participate in the JBJS blog, OrthoBuzz
Residents who connect now with JBJS establish a solid foundation for a career of lifetime orthopaedic learning. Click on the “Residents” button under “Editorial Resources” at www.jbjs.org to find out more.