You want the best care for your patients and clients. We have been taught the value of evidence-based practice (EBP). You want to incorporate the most clinically relevant research into your practice to improve your quality of care. There is so much new information, from so many sources, that it seems impossible to stay up-to-date. Even the APTA acknowledges the obstacles to incorporating EBP, which involves discovering and utilizing research.1 How do you keep up? You try to read journals when you can. A quick search on the Internet might capture a few pertinent tidbits. You might even promise yourself that you will actually read those articles recommended from your last continuing education course. At times there does seem to be a divide between the research community and clinical practice. How do you create a bridge from all this research to your clinical practice? Some health care facilities have built-in mechanisms, which promote applying the best evidence to practice, but it's a daunting task to tackle on your own.
Integrating research into how you make clinical decisions requires the assimilation of high-quality suitable evidence as well as strategies for combining this new knowledge with the everyday world of patient care. In today's demanding health care environment, that may be too much for an individual to undertake. What you need is a forum for discussion where you can air your concerns and exchange ideas. Knowing when and how to implement research is made easier when you can talk it over with other knowledgeable clinicians. Journal clubs might offer a solution.
Journal clubs have been shown to be successful in converting evidence into practice. A recent literature review found 11 quantitative studies from 6 countries substantiating the effectiveness of journal clubs in establishing supportive environments to promote discussion, improving critical appraisal skills, increasing EBP knowledge, and influencing clinical practice.2 In a more specific approach, a journal club was used to improve a specific practice issue. A team of Australian physical and occupational therapists successfully used the journal club model to obtain and implement falls assessment tools and develop patient education materials.3 While all this sounds great, what do you do? How do you get started?
The inspiration for this editorial came from Beth Shelly, who contacted me about using articles from the Journal of Women's Health Physical Therapy (JWHPT) for her online journal club. I was so impressed that I wanted to tell you all about this amazing woman. Honestly, I had never heard of an online journal club. I was intrigued. In 2011, Beth was faced with the familiar dilemma of how to keep up with the literature. As an individual, she struggled to stay current with all the breaking research and wanted to maintain her relationships with leaders in the field (Beth Shelly, PT, DPT, WCS, BCB- PMD, e-mail communication, February 2020). So she started a journal club. And not just any journal club, the Pelvic Physiotherapy Distance Journal Club, with the following mission:
To provide a forum for discussion of current research and new ideas in the field of pelvic physiotherapy. Research in this area is occurring at a fast pace. It is nearly impossible to stay up to date alone. This format allows structured discussion of research and its application to practice.4
With the help of her “right-hand” Ann Dunbar, Beth has organized an online group, which meets once a month for an hour. Journal club members call in to listen and can participate. Each month 2 of her 10 experts or leaders choose an article to present and send it electronically to the club members 2 weeks before the meeting. If a member is not able to call into the meeting, they can find a link to the recorded presentation and discussion on the associated blog.5 Currently, there are 824 members in the English-speaking Pelvic Physiotherapy Distance Journal Club, with 12% of these members from outside the United States. In 2017, Beth started a Spanish-speaking journal club in coordination with a group in Argentina that has 256 members of which 17% are from the United States and the rest from South America and Spain.
What Beth has accomplished is amazing, but you can start small. Gather a group of clinicians with complementary interests, decide on a meeting schedule (maybe once a month), and assign a person responsible for running the meeting. Choose someone to present an article and designate about half of your meeting for discussion. You can find more tips on journal clubs from the American Physical Therapy Association's PTNow website.6
If you are looking for articles to discuss, perhaps one of the thought-provoking topics presented in the JWHPT will spark your interest. In this issue, Dr Mannen and associates examined the biomechanics of holding infants under different conditions. Dr Bonis and colleagues performed a quantitative longitudinal study evaluating the effects of exercise and behavioral modifications on women with pelvic floor dysfunction and lumbopelvic pain. Dr Rudolphi's group presented a retrospective case series on children with daytime incontinence who benefited from a comprehensive physical therapy program. In a qualitative study, Dr Happel-Parkins prompts us to be sensitive to the sociocultural and religious backgrounds of women with dyspareunia.
I hope that Beth Shelly's initiative serves as a catalyst for you to develop your own journal club. After all, what is the point of clinical research if it is not put into practice? Happy reading!
—Cynthia M. Chiarello, PT, PhD
1. American Physical Therapy Association. Evidence-Based Practice & Research. https://www.apta.org/EvidenceResearch/
. Updated December 11, 2017. Assessed February 24, 2020.
2. Al Saif AN, Johnson JM, Munir S, Ammal K, Forgrave D. Effectiveness of journal clubs in translating knowledge into practice: a literature review. J Nurs Educ Pract. 2019;9(5):87–94. doi:10.5430/jnep.v9n5p87.
3. Bernhardsson S, Lynch E, Dizon JM, et al. Advancing evidence-based practice in physical therapy settings: multinational perspectives on implementation strategies and interventions. Phys Ther. 2017;97(1):51–60. doi:10.2522/ptj.20160141.
4. Shelly B. Pelvic physiotherapy distance journal club. https://www.bethshelly.com/dist-journal.html
. Updated 2017. Accessed February 24, 2020.
5. Shelly B. Pelvic physical therapy distance journal club blog: a discussion of current literature in the field of pelvic physical therapy. https://pelvicptblog.wordpress.com
. Updated February 2020. Accessed February 24, 2020.
6. American Physical Therapy Association. Nine hot tips for running a successful journal club. PTNow: Tools to Advance Physical Therapist Practice. https://www.ptnow.org/blog/detail/9-hot-tips-running-successful-journal-club
. Updated October 14, 2014. Assessed February 27, 2020.