Before June 2010, a single M.D. faculty managed a JC with regular meetings, food, and mandatory attendance. Articles were chosen and presented monthly by a resident. However, timelines were not defined; discussion goals were unclear; and explanation of research methods and statistics was limited.
In June 2010, we instituted three major changes to the structure and organization of the JC. First, a Ph.D. facilitator was appointed to increase discussion of research methods and statistics. Second, a self-directed, structured summary format was incorporated to standardize the curriculum, clarify methodology, and increase critical appraisal skills. A resident was assigned to choose an article to be approved by the facilitator and chief resident 6 weeks before presentation. The resident created a one-page, self-directed, structured summary, using a facilitator-designed template to report the background, purpose, research question, hypotheses, data and methods, findings, and conclusion, and report compliments or critiques (Table 1). The resident critiqued the article and presented core concepts in one page. Two weeks before the presentation, the facilitator provided feedback, and the resident revised the summary. The final summary was distributed on the presentation day and was used to facilitate discussion. The resident analyzed the article and described key points with considerable self-directed learning. The expectations for presentation were explained to the residents in the first session. All residents were expected to attend and to have read the article. Lunch is served. Finally, we involved a rotating clinical psychiatrist faculty member to enhance the clinical relevance of the discussion and provide multiple viewpoints.