Improving Journal Clubs Through the Use of Positive Deviance: A Mixed-Methods Study

Anzarut, Alexander; Martens, Benjamin; Tredget, Edward E.

doi:10.1177/229255031101900307

Cited by 11 publications

(12 citation statements)

References 12 publications

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“…20 30–32 42 45 54 Conceptualisations of the approach also varied. Community involvement was central to Anzarut et al 's definition, 28 while Kennedy et al 33 emphasised that determinants of success do not necessarily oppose determinants of failure. Positive deviance was commonly used as a single improvement method, but 26 articles did not explicitly state which process had been followed (see online supplementary file 4).…”

Section: Resultsmentioning

confidence: 99%

“…Stage 2 was conducted using quantitative, routinely collected data and/or surveys in four projects. 22 23 28 33 Mixed methods were used in four additional projects, typically combining interviews, focus groups or DADs with surveys and routinely collected data. 11 21 35 37–39 Twelve projects included comparison groups to assess how positive deviants differed from others (see online supplementary file 4).…”

Section: Resultsmentioning

confidence: 99%

“…Limited staff involvement was facilitated through designing materials, 31 identifying positive deviants 24 30 32 52 and consulting on the success strategies identified. 28 41 Front-line staff were integral throughout four unique projects (12 articles) which used DADs to explore success. 34–40 43–47 These articles though lacked detail about how the DADs were conducted and tended to be of lower quality.…”

Section: Resultsmentioning

confidence: 99%

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What methods are used to apply positive deviance within healthcare organisations? A systematic review

et al. 2015

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BackgroundThe positive deviance approach focuses on those who demonstrate exceptional performance, despite facing the same constraints as others. ‘Positive deviants’ are identified and hypotheses about how they succeed are generated. These hypotheses are tested and then disseminated within the wider community. The positive deviance approach is being increasingly applied within healthcare organisations, although limited guidance exists and different methods, of varying quality, are used. This paper systematically reviews healthcare applications of the positive deviance approach to explore how positive deviance is defined, the quality of existing applications and the methods used within them, including the extent to which staff and patients are involved.MethodsPeer-reviewed articles, published prior to September 2014, reporting empirical research on the use of the positive deviance approach within healthcare, were identified from seven electronic databases. A previously defined four-stage process for positive deviance in healthcare was used as the basis for data extraction. Quality assessments were conducted using a validated tool, and a narrative synthesis approach was followed.Results37 of 818 articles met the inclusion criteria. The positive deviance approach was most frequently applied within North America, in secondary care, and to address healthcare-associated infections. Research predominantly identified positive deviants and generated hypotheses about how they succeeded. The approach and processes followed were poorly defined. Research quality was low, articles lacked detail and comparison groups were rarely included. Applications of positive deviance typically lacked staff and/or patient involvement, and the methods used often required extensive resources.ConclusionFurther research is required to develop high quality yet practical methods which involve staff and patients in all stages of the positive deviance approach. The efficacy and efficiency of positive deviance must be assessed and compared with other quality improvement approaches.PROSPERO registration numberCRD42014009365.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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What methods are used to apply positive deviance within healthcare organisations? A systematic review

et al. 2015

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“… 18 , 35 One study found that faculty mentorship for article selection significantly improved participant satisfaction. 38 Alternatively, faculty may select the articles for inclusion. This technique offers the advantage of ensuring high-quality article selection, while allowing the learners to focus on analyzing and applying the selected articles.…”

Section: Introductionmentioning

confidence: 99%

Journal Club in Residency Education: An Evidence-based Guide to Best Practices from the Council of Emergency Medicine Residency Directors

Gottlieb¹,

King²,

Byyny³

et al. 2018

WestJEM

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Journal clubs are an important tool for critically appraising articles and keeping up-to-date with the current literature. This paper provides a critical review of the literature on the design and structure of journal clubs in residency education with a focus on preparation, topic selection, implementation, and integration of technology. Recommendations for preparation include developing clearly defined goals and objectives that are agreed upon by all journal club participants; mentorship from experienced faculty members to ensure appropriate article selection, maintenance of structure, and applicability to objectives; distribution of articles to participants 1–2 weeks prior to the scheduled session with reminders to read the articles at predetermined intervals; and the use of a structured critical appraisal tool for evaluating the articles. Recommendations for topic selection include selecting a primary objective of either critical appraisal or informing clinical practice and ensuring that the articles align with the objective; involving learners in the topic- and article-selection process; and having the article selection driven by a specific clinical question. Recommendations for implementation include hosting sessions in the evening and away from the hospital environment; providing food to participants; hosting meetings on a monthly basis at regularly scheduled intervals; mandating journal club attendance; and using theories of adult learning. Recommendations for integration of technology include using previously established, effective strategies and determining the feasibility of creating an online journal club versus joining an established journal club. It is the authors’ intention that after reading this paper readers will have new strategies and techniques for implementing and running a journal club at their home institutions.

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“… 1 – 3 However, many challenges are encountered when designing an effective journal club structure that actively engages learners and accomplishes these objectives. 4 , 5 , 6 Most programs assign designated residents to deliver an oral presentation, 7 while the remainder of the participants have little motivation to prepare beforehand and risk becoming passive listeners. The traditional Socratic method of “calling on” residents may encourage participation, but may also conflict with the desire to create a collegial atmosphere.…”

Section: Introductionmentioning

confidence: 99%

The Flipped Journal Club

Bounds¹,

Boone²

2018

WestJEM

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IntroductionEducators struggle to develop a journal club format that promotes active participation from all levels of trainees. The explosion of social media compels residencies to incorporate the evaluation and application of these resources into evidence-based practice. We sought to design an innovative “flipped journal club” to achieve greater effectiveness in meeting goals and objectives among residents and faculty.MethodsEach journal club is focused on a specific clinical question based on a landmark article, a background article, and a podcast or blog post. With the “flipped” model, residents are assigned to prepare an in-depth discussion of one of these works based on their level of training. At journal club, trainees break into small groups and discuss their assigned readings with faculty facilitation. Following the small-group discussions, all participants convene to summarize key points. In redesigning our journal club, we sought to achieve specific educational outcomes, and improve participant engagement and overall impressions.ResultsSixty-one residents at our emergency medicine program participated in the flipped journal club during the 2015–2016 academic year, with supervision by core faculty. Program evaluation for the flipped journal club was performed using an anonymous survey, with response rates of 70% and 56% for residents and faculty, respectively. Overall, 95% of resident respondents and 100% of faculty respondents preferred the flipped format.ConclusionThe “flipped journal club” hinges upon well-selected articles, incorporation of social media, and small-group discussions. This format engages all residents, holds learners accountable, and encourages greater participation among residents and faculty.

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Improving Journal Clubs Through the Use of Positive Deviance: A Mixed-Methods Study

Cited by 11 publications

References 12 publications

What methods are used to apply positive deviance within healthcare organisations? A systematic review

What methods are used to apply positive deviance within healthcare organisations? A systematic review

Journal Club in Residency Education: An Evidence-based Guide to Best Practices from the Council of Emergency Medicine Residency Directors

The Flipped Journal Club

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