Abstract
Boreens (from the Gaelic bóthairín meaning little road) are the narrow roads that twist through the Irish countryside. Travel is slower than the busy major roads that cut straight through, but these routes enable the traveller to easily change course as options arise and to discover hidden opportunities for exploration. It is in this context that we share how we moved from the idea of a journal club for health librarians to the reality of an active knowledge sharing group. Through the story of the governing committee and our first three presenters, we explain what is required to drive this kind of club. At the beginning there were so many options and decisions it felt like moving quickly along a busy motorway, often changing lanes to avoid snarl-ups, and watching out for tolls. However, as we settled in for the long haul, we decided to take our own quieter but ultimately more interesting route. We found that if you are clear about your destination, ensure you have sufficient resources, plan carefully but are flexible about how you get there, then you may just enjoy the journey.
Journal clubs
A journal club is a group of individuals who meet regularly to discuss, and critically evaluate, academic articles. Groups commonly share an interest in a topic, and often consist of members of a specific profession or sector, such as health. Journal clubs come in many forms. Sir William Osler started the first recorded medical journal club at McGill University in 1875 (Barsky et al., 2009). Traditionally, members would meet in-person to discuss a chosen article that would be critically analysed to improve understanding of research design, statistics and critical appraisal methods (Barskey et al., 2009). Meetings would also provide an opportunity to network with peers. More recently, online and social media–facilitated clubs, usually using Twitter, have become popular (Chan et al., 2015; Lin & Sherbino, 2015; Roberts et al., 2015; Topf et al., 2017). Developing critical appraisal skills and enabling knowledge translation from research to policy and practice are often the key aims.
Journal club meetings generally involve a presentation by a volunteer or invited speaker who provides a short summary of key points addressed in an article and then leads a discussion (Schwartz, 2007). The goals of the club determine the direction of discussion. Many journal clubs adopt a process-focused approach, with the aim to improve critical appraisal skills. Tools or templates (such as CONSORT or AMSTAR 2) can be used to assess if the evidence presented in the article is true, relevant and sufficient (Chetlen, 2017). Other clubs engage more with outcomes where although the quality of the article is important it is not the focus of the discourse. Members are primarily interested in the findings and what they mean for their context or profession. In either case, evidence-based learning, critical thinking, knowledge sharing and debate is encouraged (Aronson, 2017).
Numerous components of a successful journal club have been proposed, including having designated, trained, and committed leaders; regular and anticipated meetings at appropriate times; literature aligned with clear, long- and short- term goals; allowing participants to select articles that are of special interest, timely, or controversial; circulation and review of materials prior to the meeting; mandatory or incentivized attendance; formalised structures; summarising findings; and, using the internet for wider dissemination (Chetlen et al., 2017; Deenadayalan et al., 2008). The process begins with one or more motivated individuals who take responsibility and drive initial decisions.
A HSLG journal club
The Health Sciences Libraries Group (HSLG) is a special interest group of the Library Association of Ireland. The HSLG committee manages governance and activities on behalf of members. We have an annual conference, annual general meeting, email discussion list, e-newsletter, continuing professional development and networking events. Activities have generally taken place in-person, and we enjoy high attendance from a core group of active health librarians. The idea of a HSLG journal club was mooted in 2018 and a brief literature search was undertaken by our research officer. A heavy workload meant it went no further. However, when a virtual journal club (VJC) was proposed by a member again in 2020, the committee, led by our new communication’s officer, was keen to make it happen. This was an ideal opportunity to create an informal network to support, encourage and learn from one another. A regular VJC would have social and educational benefits for us all.
There is a great deal of literature available on setting up a VJC (Chan et al., 2015; Kean, 2013; Lizarondo et al., 2010; Aronson, 2017). A common theme is the need for active, committed leadership and organisation (Chetlen et al., 2017). It was essential that the HSLG committee and potential members had defined roles, and that the VJC had clear and agreed terms. As host, the committee considered some practical and resource issues, such as:
• Who can join the journal club?
• How can they join?
• Are members willing to join a club working group to help facilitate the club?
• Would members be willing to present (and how often)?
• What is the best day and time for a virtual chat? And how long should the chat be for?
• What topics would members like to cover?
• Do we only accept open access articles to enable free and easy access to everyone?
• Should we make the website VJC page private (password protected) so people can feel freer to comment?
• Are members happy for a summary of the comments/conversation, without names, to be made available on the public website and/or in our newsletter, HINT?
• Would members be willing to participate in a short research survey at the beginning of the club to evaluate if the club is meeting personal and overall goals?
Each issue that we considered was weighed, and decisions made based on our goal to have a well-attended, long-term VJC where participants could learn in a relaxed, inclusive environment. For example, we believed that although some members would inevitably miss meetings, we should not record sessions in case it discouraged volunteers and stifled free interaction. Similarly, to maintain an informal atmosphere, we thought we should (at least initially) limit participants to those on our email discussion list (which includes members of the HSLG and other health librarians). Although the committee was keen to initially take the driving seat and to host the club, we believed that members must ultimately take responsibility. Therefore, we organised a virtual coffee morning for potential members and sent invitations to our email list.
Our communications officer led the discussion, proposing ideas by the committee but seeking views and agreement from participants. A modified hybrid journal club model (Chetlen et al., 2017) was suggested to the group. In our case, we would use virtual meetings for presentations and discussion, and our website blog to upload pre-meeting information, questions and documents, and post-meeting comments. We would meet for 45 minutes during a workday morning about once every six-weeks. A volunteer would be recruited at the end of each meeting to present for ten minutes and lead discussion at the next. To encourage presenters, they could choose their topic and date of their meeting. The article(s) and discussion questions were to be submitted to the committee at least 14 days prior so they could be uploaded to the website and details sent to members. A buddy-system was proposed to help those presenting to monitor time and the questions that arose in the chat.
Perhaps the biggest decision to make was the aim of the VJC. This would affect everything from the choice of topics, the content of discussions, and even why people would join. The committee proposed an outcomes-focused approach which would entail some appraisal of the quality of the study, but primarily focus on the outcomes and improving our knowledge-to-action skills. That is, we would learn from the findings of each article, and the related experiences of fellow members, with the ultimate aim of improving our skills and practice. This approach also broadened the scope beyond academic literature to more informal articles of relevance to the group.
Having a plan to present to potential members provides a map of options. Perhaps because we restricted the invitation to our local network of health librarians, we found easy consensus in agreeing our direction. Everyone was in favour of an informal style which could help create new ideas and spark innovation we could apply to practice. We took the decision not to wait and specify the route exactly, but to begin immediately with a pilot approach. We would hold our first few meetings and reassess. That way we could change course as the need arose. Following our coffee morning in February 2021, the committee developed a guidance document outlining the agreed terms of the club (HSLG committee, 2021). This was sent to the email list and uploaded on to a new section of our website for the VJC. We specifically noted that this was to be a ‘living’ guide and that it should evolve organically over time through collaboration. Having set the wheels in motion, it was now time for the members to take charge.
Presenter case studies
Presentation one: Exploring the ‘librarian’ Wikipedia trail, by Anne Madden
As the first presenter, I thought long and hard about what topic to choose as an ice-breaker, eventually selecting the Wikipedia article on “Librarian” (2021). This would be freely available to all prospective participants.
Would it fit with the general aims and scope of our VJC? After a thorough read of the article including the “Talk” section, a number of interesting questions arose that should generate some lateral thinking about who we were and what we do. On that basis, and after a quick chat with the committee, it got the green light.
The next step was to prepare a short presentation, and more importantly, a set of questions to engage participants. The topic and the questions were then circulated to health librarians via the email discussion list. Limiting participants to the list ensured I didn’t suffer from presenter nerves, instead an almost festive atmosphere prevailed as we all caught up with each other’s lockdown stories. Technology also behaved and my short PowerPoint presentation was soon completed. I had provided ten questions for discussion, but the participants opted for three that resonated most, including highlighting the very meagre health librarian section in the article. As our VJC focus is on outcomes, we made great plans to edit the piece in the not-so-distant future. Another piece of the learning curve was that keeping to the allotted time meant that fewer, more in-depth questions would work best.
This article choice was without doubt a thoughtful meander down a boreen but based on attendance and the liveliness of the ensuing discussion, it fulfilled a need to take an overview of health librarians, our actual and perceived roles, and where our profession was heading.
Presentation 2: Taking a reflective journey, by Breeda Herlihy
Our second virtual journal club was delayed by the cyber-attack on the Irish health system. Nevertheless, once I had been tracked down, I was able to identify an article and send it with associated questions to the committee. An article on reflective practice in librarianship piqued my interest as I had heard the term used frequently by learning and teaching colleagues when I worked in a university library. I had recently changed roles to work in the library of a teaching hospital and now encountered entire books written on the topic for healthcare professionals. As well as satisfying my own self-interest, I felt the article: “Elevation through reflection: closing the circle to improve librarianship” (Miller et al., 2020) would nicely match the scope of the club. During the coffee morning, many of us had said that they were interested in practical applications for our working lives.
The prominence of reflective practice in education and now in health and social care was something that I had never quite fully understood. Surely everyone thinks about their work, reflects on where they might have gone wrong with something, learns along the way and tries to modify appropriately for the future? It turns out this does encapsulate reflection, but it is the intentional use of reflection in work life which can really improve performance. While this solved the mystique of reflective practice for me, I felt that a short presentation on the article would be beneficial for introducing this topic to the journal club. Preparing the slides also enhanced my understanding because I really had to dig into the article and another related article by the same author. In fact, I probably would have posed different questions after preparing the presentation rather than the set I had sent on to the committee and journal club members in advance of the meeting. Even so, the questions I had devised got discussion moving and participants already versed in reflective practice were able to share their experiences and resources. I felt this was really useful because it showed I wasn’t introducing a spurious topic to the club. This sharing of experiences and knowledge facilitated by the journal club is really useful for a nationally distributed group of librarians who are often the only library professional in their organisation.
My presentation of this article to the club certainly helped deepen my understanding of the relevance of reflection to my professional practice. Even though I too wandered down a boreen to explore a topic of personal interest, it turned into a nice segue to an online course I signed up for. This course, designed by the National Forum for the Enhancement of Teaching and Learning and the Library Association of Ireland Career Development Group, leads to a digital badge, L2L Joint PACT Digital Badge, and has definitely been more like a reflective practice motorway.
Presentation 3: Traversing the misinformation superhighway, by Niamh O’Sullivan
Going third was an advantage as I could follow the lead of the presenters who had gone before. Choosing a topic to discuss was an easy choice for me as I had attended an excellent webinar series earlier in 2021 on the growing issue of misinformation entitled: “Shining a light in the Post Truth Era”. My interest was piqued by excellent speakers such as Lord David Puttnam and I wanted to know more about the Covid -19 infodemic.
So with my topic chosen, I just had to find two open access articles to discuss. I decided to choose one article that had more of a theoretical focus and the other one with a more practical lean. The theory article I chose was: “The Covid‐19 ‘infodemic’: a new front for information professionals” (Bin Naeem & Bhatti, 2020) and the second more practical article was by a fellow Irish librarian “Infodemic in a pandemic – critical thinking needed” (Patton, 2020).
I created a short presentation with slides on the following topics:
• Infodemics, types of mis/dis information and the consequences of all three.
• The role health sciences librarians can play, if any, to stem the flow of misinformation.
• The best tools and resources to combat fake news and mis and dis information.
I sent article links to the VJC group along with these three questions:
1. How much impact can health sciences librarians realistically have on the spread of fake news?
2. What resources and tools do you currently use to help users find authoritative information?
3. How can we, in the health science libraries community, better prepare ourselves for the next infodemic?
In my presentation, I also included these two quotes that I found in the articles and they set the tone well: “We need a vaccine against misinformation”– Dr Mike Ryan, World Health Organization (Ryan, 2020, as cited in Patton, 2020, p.35) and “A lie can run round the world before the truth has got its boots on” (Pratchett, 2013, as cited in Bin Naeem & Bhatti, 2020, p. 233). I like to use quotes in a presentation as they can provide short dramatic talking points very suitable for an interactive club meeting such as this. They can also sum up a feeling or spark a conversation and can offer a kind of social proof to support what you are saying. As well as being inspiring, quotes from well known and respected people can help to make your message more credible.
I found that the journal club is a really useful forum for highlighting and disseminating the tools and resources found within articles. The part I learned the most from was the list of ‘Useful websites and tools for evaluating health information’ in the Patton article:
• Informed Health Choices: https://www.informedhealthchoices.org
• iHealthFacts: https://ihealthfacts.ie/
• Be Media Smart: https://www.bemediasmart.ie/
• CRAP: https://sites.google.com/site/crapcraaptest/
• SPAT: http://www.spat.pitt.edu/
• DISCERN: http://www.discern.org.uk/
Health sciences librarians have the knowledge, skills and experience to play an important role in the fight against fake news. It is worth bearing in mind that since the 1980s they have played a leading role in educating people (through information literacy programmes) about how to evaluate facts and how to check the authenticity of information. There is a need now for us, as librarians, to promote dialogue amongst ourselves about how best to develop mechanisms to prevent mis and disinformation and help counteract the spread of fake news.
Challenges
Challenges have largely related to the busy nature of our working lives. As suspected, not all members can attend every meeting, and instead of ten meetings per year, they have been held on average every two to three months. We had also thought that providing a website space for post-meeting comments could extend discussion beyond the meeting, but this has not been the case.
There was also enthusiasm during meetings to follow up with practical activities, such as updating the librarian Wikipedia entry. However, it appears that it is hard to translate this enthusiasm to active change. We may need to focus on defining specific actions and follow-up if we want to have a real impact.
Being evidence-focused we had hoped to undertake a prospective evaluation of the VJC, which would require setting of goals by individuals before we began, with progress in achieving these assessed after a year. Only some members noted their goals in their club registration email so any evaluation may rely on a retrospective approach.
Conclusion
So perhaps our story will eventually take us from our narrow boreen back towards the motorway as we look at elements that could expand our remit and membership, but for the moment we are happy to explore the more informal, close, collegial approach. We have learned that it takes people with responsibility to drive the project forward. However, although leaders are required to steer, it should be the members who navigate the way. Are we there yet? Perhaps not but we are certainly enjoying the journey.
Key learning
A VJC needs to be:
• clear about its aims
• adaptable and inclusive
• led by motivated, active people
• relevant and interesting
• fun
No known conflicts of interest. No source of funding.
References
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