1. DR ROSS FOWLER DR DEVANG DESAI DR PETER MACTAGGART Establishing a monthly bi-national online video conference Journal Club for USANZ Trainees

2. Background  Journal club is invaluable source of PDL 1-3  keeping up to date with literature.  Improve reading habits and behaviour  Increase understanding of research design, statistics and critical appraisal  Increased ability to search relevant literature  Potential to transfer the evidence to clinical practice  Two systematic review showed that no paper yet published specifically on this topic 2,3

3. Background  Increased use of online technology SoMe /Twitter /Teleconference  #urojc more familiar to us 4  Expanding avenue to foster professional interaction and disseminate information on global scale. Shown to be viable and sustainable - Thangasamy et al. European Urology 4  Systematic review: microblogging on global scale – can interact directly with authors, increasing establishment of active online based journal clubs - Roberts et al 5  Great opportunity but equally can be daunting and intimidating to comment on global scale as a trainee

4. Aims  “Shot gun Effect”  Establish a common USANZ journal club for trainees  Non on threatening forum for open discussion  Meet monthly to critically appraise an article using EBM tools  Cover “landmark papers” critical to the curriculum and practice  Cover more contemporary papers  Specific paper used to teach different critical appraisal techniques  Answer a specific question and apply it to patients we treat  Challenge the results presented in papers  Calculate NNT, ABSOLUTE Risk, interpret Power  Leave a useful Toolbox of resources that trainees can draw on at leisure  Journal articles  Appraisal  Video of webinar

5. Methods  Getting Setup  Board Approval  Secure Sponsorship  Source Video Conferencing Host  Redback Conferencing  Financially Viable  Excellent tech Support / available 24-7  Abundant features  Video : via online webinar. Sign in online at website  Audio : Via toll free telephone call  Bank of resources at DiscussUrology.com  Appraisal Tools and EBM “how to “ papers  Article available online at least 2 weeks prior to event –”fair use policy”  PowerPoint of presentation/ critical appraisal  Link to recorded Webinar for Trainees who could not attend

8. Methods  Execution  Rotating Roster between section  Moderator / Expert opinion invited  Communication  Official emails from Trainee Education Manager  Twitter @ #UJC reminders of event /banter - changed to #UTJC  Whatsapp  Read and appraise paper before attending  PowerPoint presentation  Interactive conversation. Q & A time. Input from moderator  Polling ability, sketching, desktop sharing – underutilised  All info available on DisscusUrology.com

9.  Execution  Rotating Roster between section  Moderator / Expert opinion invited  Communication  Official emails from Trainee Education Manager  Twitter @ #UJC reminders of event /banter - changed to #UTJC  Whatsapp  Read and appraise paper before attending  PowerPoint presentation  Interactive conversation. Q & A time. Input from moderator  Polling ability, sketching, desktop sharing – underutilised  All info available on DisscusUrology.com

10. Results  60 / 120 Trainees signed up to DisscusUrology.com  5 presentations by 4 states  QLD – MTOPs Trial  QLD – RCT of TVT vs Pelvicol vs AFS by Guerrero et al.  SA - PSA Validity by Gann et al  NSW – SUSPEND trial by Pickard et al  VIC – EORTC Partial vs Radical Nephrectomy low stage RCC by Van Poppel et al  NZ – “ ABC” meta- analysis Adjuvant chemotherapy for MI UC - next event  Attendance  QLD > other states. WA = 0  Numbers 14 – 33 at event

11. Results – Relevance  78% - acknowledge benefit of journal club  88% - strongly agree cover relevant core topics  75% - strongly agree had opportunity to be involved in discussion  Only 22% agree more beneficial to local events

12. Results - Quality  Audio – main problem >70% had some issues  77% pre-read but only 33% appraise it before event  22% use the EBM tool on website  11% read the ppt or watch the recording  62.5% recommend the resources &attendance

13. Limitations  Equipment  Audio - telephone quality, echo’s, back ground noise, -can discourage contribution to conversation  Visual – unfamiliar program interface to learn. Need extra person to control  Solution -conference quality conference polycom phones. -mute microphones when not talking -trial run. Contact tech support early  Participant Contribution  Voluntary – 7pm, On call commitments, Moderator availability  Time zones – WA, NZL, attendance  Presenters knowledge of EBM and appraisal skills.  Solution - available for down load at leisure. - ongoing development of critical appraisal skills -negotiation, forethought and planning

14. Conclusion Characteristics of successful journal club 2  regular and anticipated meetings  mandatory attendance  clear long- and short-term purpose  appropriate meeting timing and incentives  a trained journal club leader to choose papers and lead discussion  circulating papers prior to the meeting  using the internet for wider dissemination and data storage  using established critical appraisal processes and summarizing journal club findings.

15.  References  1) Ahmadi N 1, McKenzie ME, Maclean A, Brown CJ, Mastracci T, McLeod RS; Evidence-Based Reviews in Surgery Steering Group. Teaching evidence based medicine to surgery residents-is journal club the best format? A systematic review of the literature. J Surg Educ. 2012 Jan-Feb;69(1):91-100  2) Y. Deenadayalan BPT IMMP BEHM (MBA) 1, K. Grimmer-Somers PhD MMedSci BPhty 2,*, M. Prior BPhty (Hons) 1 and S. Kumar PhD MPT BPT 3. How to run an effective journal club: a systematic review. Journal of Evaluation in Clinical Practice.Volume 14, Issue 5, pages 898–911, October 2008  3) Harris J, Kearley K, Heneghan C, Meats E, Roberts N, Perera R, et al. Are journal clubs effective in supporting evidence based decision making? A systematic review. BEME guide No. 16. Medical Teacher 2011;33:9-23.  4)Linzer M, Trig Brown J, Frazier LM, DeLong ER, Siegel WC. Impact of a medical journal club on house staff reading habits, knowledge, and critical appraisal skills. JAMA 1988:260;2537-41. Smith R. Strategies for coping with information overload. BMJ 2010;341:7126.  5)Isaac A. Thangasamy a, Michael Leveridge b, Benjamin J. Davies c, Antonio Finelli d, Brian Stork e and Henry H. Woo f. European Urology, Volume 66 Issue 1, July 2014, Pages 112-117  6)Roberts MJ 1, Perera M, Lawrentschuk N, Romanic D, Papa N, Bolton D. Globalization of Continuing Professional Development by Journal Clubs via Microblogging: A Systematic Review. 23.04.15 in J Med Internet Res 2015;17(4):e103  7)Survey Monkey @ surveymonkey.com