NEW N E W H O R I Z O N S

Empowering change
with traditional or
virtual journal clubs

By Gina Dovi, MSN, RN, CPHON

“IS THE CARE I PROVIDE to my patients based on current evidence? Do my

colleagues provide care in the same way? How can I make a change that will
improve my patients’ outcomes?” Nurses may ask themselves these questions
to assess their own use of evidence-based practice (EBP). Using EBP can
empower nurses, improve patient outcomes, and increase patient safety.1
This article describes the impact a journal club can have on promoting EBP
and positive change, as well as best practices for successful journal clubs.

Take a closer look

A journal club is a gathering of colleagues to discuss relevant professional ar-
ticles about a clinical practice topic.2 One of its purposes is to increase health-
care professionals’ knowledge of practice changes, leading to improved pa-
tient outcomes.
Reviewing and critiquing research in journal clubs isn’t a new idea; this
teaching method has long been employed by medical schools to share current
knowledge and translate it into EBP.3 Journal clubs have gained popularity
within the nursing field as one way to bridge gaps in nurses’ knowledge of EBP.4
Journal clubs can also contribute evidence for components of the
Magnet® program, including new knowledge, innovation and improve-
ment, exemplary professional practice, and structural empowerment.3,5 For
nurses, reading, critiquing, and discussing journal articles helps to fulfill a
commitment to lifelong learning and meet a recommendation set forth by
the Institute of Medicine.6

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 Journal club participation helps Turning on the power Although some institutions have
nurses develop a positive attitude Nurse empowerment is having the formed journal clubs to meet criteria
toward research and improves their clout to improve care for patients in for Magnet status, the journal club
ability to interpret and critically ap- an environment that fosters profes- may be more successful if it’s formed
praise articles.2,7 These clubs provide sional practice.9 To most effectively because of the interest of those
an avenue for active learning experi- create change and promote research involved.12 To engage nursing staff
ences in which nurses interact, dis- use, journal clubs should be con- who may be unfamiliar with critiqu-
cuss, and evaluate current practices nected to structured systems for ing research and using EBP, a first
and new innovative EBP.3 Professional practice change, such as nursing meeting of a journal club may
development also occurs as nurses practice councils.4 The nursing include a discussion of the basic
question traditional practice and seek council structure at my facility in- principles of EBP as well as the
research-based solutions to clinical cludes unit-based councils and an process of initiating practice changes
problems.8 Promoting evaluation of institution-wide professional practice at the institution.3 Articles chosen to
research and awareness of practice council that reviews all policies and review may discuss research, EBP,
through journal clubs can lead to develops new policies based on EBP. clinical care, or quality improve-
nurse-driven practice assessments One pilot study of journal clubs ment.12,13 (See How participants can
and changes that may contribute to and EBP concluded that participation prepare for a meeting.)
improved patient outcomes. in a journal club was an effective Journal club leaders can make
My Magnet-designated facility, catalyst to EBP initiatives.1 In another sure that the club’s goals and objec-
Hackensack University Medical Cen- survey, journal clubs were found to tives are met. Leaders may choose
ter, is a nonprofit, teaching, and re- make a difference in attitudes and articles, create guidelines for read-
search hospital with over 700 beds. reduce perceived barriers to research ing, encourage reading the articles
Its allergy center conducts bimonthly usage in nursing practice.7 Other before the meeting, and plan incen-
journal clubs to discuss current lit- nurses have reported that journal tives, such as continuing nursing
erature relevant to its patients. In club participation caused them to education credits or food. Creating
these journal club meetings, clinical question their standards of practice an agenda for the meeting is one
nurses can seek ways to integrate a and explore best practices.10 way to make certain the group’s
new idea, process, or treatment to goals and objectives are achieved.11
improve patient outcomes. For ex- Forming traditional Leaders may develop PowerPoint
ample, after reading an article from journal clubs presentations to provide a visual
the New England Journal of Medicine, Preliminary steps to take when approach to learning and discussion.
the nurses learned that omalizumab planning a traditional journal club These presentations may include
not only treats asthma, but it can meeting include developing a pur- information about the clinical issue,
also diminish clinical signs and pose for the club, deciding on a current practice, prior studies, sug-
symptoms of chronic idiopathic urti- time and place to meet, advertising gestions for practice changes, and
caria. This new knowledge helped the meeting, selecting a relevant impact on patient care.3
nurses collaborate with physicians to topic, and choosing a leader to To encourage full participation, a
improve patient care and outcomes. guide the group.11,12 different person can be chosen to
lead the club each time. Tapping
nurses with advanced education in
How participants can prepare for a meeting research and experience in critiquing
Providing questions and guidelines to consider while reading the article can help to strategies can also help.4 However,
facilitate active discussion and participation. Here are some examples: nurses at all levels should be includ-
• What’s the question to be answered or purpose of the article? ed in journal clubs and mentored for
• Is the literature comprehensive, and does it provide a rationale for the article? professional development.7
• What’s the study’s design?
• What are the main findings? Overcoming barriers
The participants can be asked to think about the article’s relevance to their practice For a journal club to be successful,
and policies. The discussion may empower nurses to seek further education on the nurses must find ways to overcome
topic, implement quality improvement projects, or conduct their own research.13 barriers.12 For instance, nurses may
Questions include:
not know how to lead a journal
• What does the article recommend for the future? club discussion. To address this at
• What did you like about the article?
my facility, the clinical level IV
• How does the article relate to your current practice?
nursing committee conducted a lit-
• How can you change your current practice or unit policies to reflect the findings of
this article?
erature review and created a tem-
plate for journal club leaders to use

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during meetings. To help select an
article, the leader can survey staff
for topics of interest or choose a
topic from a journal specific to
their area of practice. Nurses,
especially those with advanced
degrees who know how to use
library databases, can help search
for articles.
Dedicating time to attend meet-
ings is another common barrier.
Repeating sessions at various times
may help to boost participation.12
Another idea is integrating the
journal club meeting into the unit-
based council meeting. The heart
failure unit at my facility conducts its
journal club during monthly unit-
based council meetings. The discus-
sion is then summarized in the unit’s
monthly newsletter, which is shared
throughout the unit and the entire
institution. This summary makes all
nurses aware of research, new treat-
ment modalities, and EBP discussed
during the meeting. The clinical
education department conducts its
journal club meeting after its depart-
ment meeting.
The meeting’s goals are twofold:
to earn continuing nursing educa-
tion credits toward the department’s
specialty certification in nursing
professional development and to
discuss how the article can be inte-
grated into practice. As the journal
club evolved, they transitioned from
continuing education articles to
focus on research articles.
Virtual approaches
Increasing journal club participation
by using online technology such as
blogs, discussion postings, wikis,
and e-mails can help to overcome
workday time barriers and incorpo-
rate nurses who work on all shifts.13
(A wiki is a web-based program in
which many people can add content,
allowing for collaboration among a
group.) These asynchronous meth-
ods let participants independently
access the journal club, meet its ob-
jectives, and interact as they wish.13
Virtual journal clubs allow nurses to
access the club at their convenience,
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reducing time spent away from
patient care.8,14
These clubs are similar to face-to-
face journal clubs in that they bring
current articles to nurses to review,
critique, and discuss.5 The format
provides a nonthreatening learning
environment, the chance to engage
with nurses from other units or
shifts, and a format for nurses who
prefer to blog.8
Online social media programs
such as Twitter can also be used
to facilitate colleagues’ discussion
about journal articles. Some nursing
journals host regular Twitter journal
clubs about current articles and in-
vite nurses to discuss and analyze
practice articles. To prevent a serious
confidentiality breach, avoid refer-
ring to any identifiable patient when
using social media.
Online options for virtual journal
clubs can provide just as many
benefits as face-to-face clubs. Take
these steps to develop an online club.
• Develop a clear objective and pur-
pose for the club.
• Decide on the journal club’s
participants. Will the club involve
nurses on one unit or throughout
an institution?
• Choose a journal club facilitator.
Facilitators may change with each
journal club virtual meeting.
• Meet with representatives from the
information technology department
to determine the online format that
will work best. For example, will
specific software, if required, be ac-
cessible to all nurses interested in
participating? Or can discussion
boards be linked to the institution’s
intranet?
• Choose an article that meets the
audience’s educational needs. De-
velop and provide guidelines for
reading the article.
• Advertise the journal club, includ-
ing its purpose, how nurses can par-
ticipate, and the topic that will be
discussed.
• Develop a timeframe for nurses to
participate in the online discussion.
• Measure outcomes based on the
purpose of the club.
Deeper understanding
Journal clubs can provide the moti-
vation needed to empower changes
that lead to improved patient out-
comes. Nurses like you who are
reading Nursing2014 demonstrate
your motivation to keep abreast of
current nursing knowledge. The time
for you to be the change agent at
your institution is now. Start a face-
to-face or online journal club, or
both! Let this article empower you to
incorporate lifelong learning and
positive change through journal
clubs at your institution. ■
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Gina Dovi is a clinical level III staff nurse at Hacken-
sack University Medical Center in Hackensack, N.J.
The author has disclosed that she has no financial
relationships related to this article.
DOI-10.1097/01.NURSE.0000453727.94778.00
October l Nursing2014 l 53