An investigation was made as to whether studies have found journal clubs for physicians in training to be effective for improving patient. care, teaching critical appraisal skills, improving reading habits, increasing knowledge of clinical epidemiology and biostatistics, and increasing the use of medical literature in clinical practice. A literature search was undertaken using 10 databases and retrieval systems and hand searches of journals, conference proceedings and personal files. The rigor of studies meeting the inclusion criteria was analyzed using a protocol based on methods established by the Cochrane Collaboration. One randomized controlled trial found an improvement in knowledge of clinical epidemiology and biostaristics, reading habits, and the use of medical literature in practice, but no improvement in critical appraisal skills. Six less methodologically rigorous studies found possible improvement in critical appraisal skills. It is concluded that journal clubs may improve knowledge of clinical epidemiology and biostatistics, reading habits, and the use of medical literature in practice. A multi-center, randomized controlled trial of journal clubs is needed to assess whether journal clubs improve critical appraisal skills.

In a subset of internal medicine residents in the class of 2004, career decisions changed late into residency training and enthusiasm for careers in general internal medicine remained low.

Conscientious sign-out between medical interns is important for the continuity of care of hospitalized patients. We developed a standardized sign-out card that prompted the intern going off duty to transmit patient care information to the inter on call. The card was tested in a prospective, randomized, controlled trial in which one group of interns used the card, and another group did not. Any instance of poor sign-out was reported on a questionnaire completed by the intern who had been on call the previous night. The group using the sign-out cards reported poor sign-out on 8 nights (5.8% of questionnaires), and the control group reported it on 17 nights (14.9% of questionnaires, p = .016). The card was time-effective and inexpensive, resulted in more complete data recording, and possibly decreased the morbidity associated with poor sign-out.

No abstract