I. Select a provocative article

A. Try to select recent articles... search the specific journal's table of contents online, which sometime also give access to articles which "e-published ahead of print". Obviously it should be a peer-reviewed report of original research. Reviews are out -- the article needs to have a methods section.

B. Sometimes a pair of articles with opposite conclusions, as long as they are not too long or difficult makes a great journal club. (For example, back to back articles on coin ingestions with opposite conclusions and recommendations made a good journal club). Likewise, articles published in a similar time frame that support each other can give stronger credence to the author's conclusions.

II. Prepare yourself

A. Read the article critically. Write out what the authors did, what results they got, and what they concluded according to the outline below.

B. Think about each of the decisions they made in designing the study, and what they concluded from the results. Were these good design decisions? Were the conclusions reasonable? What are possible problems with the design, sampling, measurements, and so on? How likely are these problems? How would they impact on the results and conclusions?

C. Pick out a few MAIN POINTS OR CONCEPTS that you think are most important in reading this study critically.

D. Consider meeting with at least one other person (give them a copy of the article in advance) to discuss specific points of the article that are unclear to you.

III. Prepare the participants. A journal club is always better if people show up having read the article!

A. Distribute the article at least one week in advance. This is done by mailing the reference and/or pdf to: RNAclub@ucsf.edu.

B. Bring a few extra copies of the article to the session. Several people usually forget to bring it with them, even if they have read it, and it helps if everyone has a copy in front of them.

IV. Leading the discussion

A. Basic rules and tips

1. Start and end on time! (Of these, ending on time is most important!)

2. The more key points the participants make themselves (rather than you pointing them out) the better. Avoid lecturing and answering your own questions!

3. Try to make sure everyone is involved and interested. It is OK to call on people, including faculty members, if you do it in a nice way. If people fall asleep, it is perfectly acceptable to wake them up; it is distracting to others to have anyone clearly not participating. Similarly, if one or two people are dominating the discussion, say, "I want to hear from some other people now" and try to get others into the discussion.

4. Use the board. Many of us have much better visual than auditory memories--it really helps us to see things written down. Also, putting stuff on the board helps keep the people who come late from slowing things down by asking stuff that has already been covered. It also helps remind you to proceed in a systematic fashion. It is helpful to think in advance about what you will put where on the board. Otherwise you end up erasing stuff you wish was still up there. Write small and only put down key things. One good way to do this is to put the experimental design, reagents, etc. in order starting at the top left of the board, and leave the right side for issues that get brought up during the discussion

B. Do your homework! Read outward from your article, so that you have a good understanding of the topic or methodologies. Plan on giving a SOLID introduction to the group, of around 20 minutes. What were the papers that led up to your article? Why is your article worth discussing at a journal club?

C. Format for discussion: Just as with a clinical case presentation, it is helpful to review the factual information before proceeding to discussion of judgment and interpretation. Plan on spending the first few minutes reviewing the clinical case that led to your selecting the article, and maybe a minute or two on how you found this particular article. Then take about 20 minutes going through what the authors of the study did, what results they got, and what they think the implications of the findings are. Then the second half of the discussion can center on whether the design and results justify their conclusions.

D. Tips on timing: A common problem is to run out of time just as the discussion is getting interesting. This can result from spending too much time on the more boring stuff at the beginning. You don't want the discussion of what is in the article (as opposed to the interpretation part) to go on for more than half the session. You will want to mediate the amount of discussion to the parts of the paper you think are the most critical. If you get too flooded with questions, don't hesitate to suggest that you would like to move on, but that you would be happy to discuss the questions in more detail later.

V. Outline of the content of the article: The same sort of learning that allows one to get better at obtaining relevant information from your own experiments, organizing it, and presenting it to others applies to reading journal articles as well. After using the structure below to review the article yourself, lead the journal club participants through it. Write the main headings one at a time on the board, explain what they mean, and get the participants to fill in the data from the paper. The elements of a study can be considered:

A. Authors: Who are the authors? Do you know of any of their previous work, and has it been reliable?

B. Research Question: What is the question this study was designed to answer? Often these are stated in the abstract or the end of the last lines of the introduction.

C. Study Design: What type of study is this? Did they stumble upon an observation? Was their study designed to test a hypotheses? Was it biased? Was the experimental design set up in way to find an unbiased answer?

D. Results: What did they find? Usually the key results are summarized in tables or figures--it may be helpful to walk the group through the most important tables to make sure everyone can see what results were obtained.

E. Conclusions: What do the authors think the results mean? At this point don't discuss yet whether you agree with them.

VI. Discussing the validity of the study. The first part of the discussion dealt with facts, all of which were in the paper. The second half of the discussion deals with interpretation. There are no longer clear right and wrong answers--judgement comes into play.

A. Identify possible biases or flaws in the study. Consider the numbers. Is the sample size appropriate? Were the appropriate statistics performed? Was the sampling scheme reasonable? Were the measurements valid? Is the study design appropriate to answer the research question?

B. For each figure, consider the quality of the data. Ask yourself whether there are alternative interpretations to the data. Does each specific set of data contribute to the author's claims to the degree that is important in supporting their claims?

VII. Wrapping up: The most important part of the discussion is the "bottom line." MAKE SURE you leave enough time for this! Will this article change the direction in the field? What lines of study will need to be further investigated?