Correspondence: Dr E Leung, Women's Health Research Unit, Centre of Public Health and Primary Care, Yvonne Carter Building, 58 Turner Street, Queen Mary, University of London, London E1 2AB, UK. Email firstname.lastname@example.org
Journal clubs have been around for over a century. They inform clinicians, instill research literacy and embed evidence-based practice. BJOG articles are read in journal clubs around the world, but rarely is this discussion fed back to the journal for reflection from editors and authors. Social media has the capacity to connect readers, authors and editors without the delay of traditional journal correspondence. BJOG is moving ahead to incorporate this idea in its dissemination strategy.
BJOG believes strongly in post-publication peer review and we have a strong track record of promoting evidence-based medicine. In contrast to the format used in the past,[2, 3] journal clubs based on clinical scenarios, structured questions and focused on learning needs have practice changing potential.[4-6] They support development of research literacy, prepare trainees for their assessments and provide continuing education to journal club members. These learning activities can be enhanced by immediate access to a varied range of clinicians, including authors and editors, to answer questions and to explore practical implications. BJOG is determined to challenge the status quo.
Recently, a number of online journal clubs using social media platforms (e.g. LinkedIn and Twitter) have generated immense interest. Supported by BJOG, the Katherine Twining (KT) Network (http://www.ktnetwork.org/; @kt_network on Twitter), a multidisciplinary collaboration to promote research engagement and literacy, has developed a Twitter-based journal club. This commentary officially launches this exciting initiative.
How BJOG supported journal clubs until now
Since 2008, selected BJOG papers have been accompanied by questions, discussion points and, more recently, PowerPoint slide sets, prepared by authors and BJOG’s journal club editor, for use in journal clubs. In collaboration with the authors of the selected paper, the editorial team summarise the study in a slide set for presentation and provide questions to encourage discussion and debate. This is a framework for critically appraising the paper, stimulating discussions on study design, analysis and interpretation. Journal club leaders download these to run their sessions. Until recently discussion from these sessions was only available to authors and the BJOG readership if the journal club hosts decided to write a letter to the editor, published in the correspondence section.
#BlueJC: how BJOG will support journal clubs from now on
BJOG has developed this new initiative in collaboration with the KT Network. A schematic overview is summarised in Figure 1. BJOG's existing journal club resources will be developed further, with a slide set and a journal club guide suitable for both Twitter-based and conventional journal club discussions available for each selected paper. These will be prepared by the authors with input from BJOG editors and journal club coordinator, using structured templates provided by BJOG. The material will be written using well-established critical appraisal tools incorporating the Graphic Appraisal Tool for Epidemiology (GATE) approach to facilitate participation and engagement of researchers and clinicians. This approach spurs critical thinking, focussing on key concepts for appraisal of research methods, results and applicability by visual means, avoiding reliance on number crunching.
All journal club materials will also be suitable to use in the conventional face-to-face sessions. BJOG's new approach will be to encourage and support online discussion along side this, through social media platforms such as Twitter and LinkedIn. Public platforms may encourage multidisciplinary and multinational input with the potential to promote discoverability of the discussions and engage people interested in the subject, who are not necessarily medical professionals.
BJOG will announce a scheduled time for an online discussion session on Twitter, usually to last for 1 hour, shortly after the print publication of the selected paper and materials. Conversations can be searched, tracked and followed using hashtags. Twitter journal club discussions for BJOG papers will use the hashtag #BlueJC (see Figure 2 for illustration). Therefore each Tweet (comment) posted on Twitter must include ‘#BlueJC’ in order for us and others to see which users are engaged in the discussions. All relevant discussions using #BlueJC will be captured by the BJOG journal club host for up to 1 week after the initial fixed-time #BlueJC session. The aim is to include all responses from the journal club participants. For those unfamiliar with Twitter, a user guide is available at www.bjog.org.
After the capture period, a transcript of the Twitter discussions will be summarised and published online using Storify (a web-based tool that will allow the journal club hosts to collate #BlueJC Tweets into a concise summary). A short summary will subsequently be submitted to BJOG to be considered for publication in its correspondence section, BJOG Exchange.
These developments and activities will be accessible via www.bjog.org under its ‘Journal Club’ tab.
Social media: new frontier or Pandora's box?
Social media has become an important, almost unavoidable, platform for disseminating information; just look at how sports, news and political media are changing. There are concerns within medical and research communities about the use of social media for information dissemination. However, we believe most of these concerns are due to a lack of familiarity, particularly among older members of the profession. Social media has spread like wild fire among younger people, including medical students and trainee doctors. Unprofessional use of social media can be a threat, but this risk should not be blown out of proportion. Chretien et al. analysed over 5000 Tweets from 260 high-profile physicians on Twitter (defined as those with >500 Twitter followers). They found that 97% of Tweets raised no concerns. Using Twitter for journal clubs does not pose problems related to patient privacy, as published papers have already complied with journals' ethical considerations. Moderation of social media comments by a journal club host will minimise the risk of disproportionate and unfair criticism of the research appraised. Therefore social media is an unavoidable method of communication that can be used sensibly to benefit research and the health profession.
With the more sophisticated use of virtual learning environments at higher education institutes worldwide, trainee doctors and young researchers are increasingly accustomed to digital learning and immediate feedback and appraisal. Medical educators are increasingly keen to use social media to supplement the formal curriculum, in a useful way for learners.[12, 13] In addition, for those in developing countries and remote areas, access to online real-time interactive discussions and other digital material could transform the appraisal experience and provide knowledge of evidence-based practice.
Authors cannot ignore the exponential rise of social media usage. Presence of a research study on social media is positively associated with traditional metrics such as citation rates. Communications via social media were regarded as informal. Now it is considered an inescapable part of research dissemination for the future. This is exactly what BJOG is planning to do. The new #BlueJC aims to compile summaries of Twitter-based discussion on selected studies, and submit them for assessment by editors and feedback by authors.
How to get involved
Further information on joining Twitter, taking part in the #BlueJC and hosting your own journal club is available on www.bjog.org and collaborating websites, including the KT Network website. Alternatively, just email email@example.com@rcog.org.uk or Tweet us @BJOGTweets for assistance. To accommodate time and language differences, collaborators abroad may wish to hold separate sessions during the week after the official time, using the same hashtag #BlueJC. Follow @BJOGTweets for notification of the next #BlueJC and join the discussion.
What happens after you have hosted a #BlueJC? Your summaries will be considered for publication in our BJOG Exchange section, alongside regular correspondence. The key roles of a journal club host are summarised in Table 1. We hope these BJOG resources will allow for international discussion and that the learning outcomes will be shared through the journal.
Table 1. The key roles of a #BlueJC host
Prepare your modified discussion guides using templates and material provided by BJOG
Advertise locally and via social media platforms the fixed-time discussion session
Stimulate and moderate #BlueJC discussion during fixed-time session
Capture ongoing discussions (via #BlueJC) for 1 week after the fixed-time session
Summarise #BlueJC discussion using Storify
Provide an edited summary of these Storified discussions to BJOG for publication
What is unique about #BlueJC?
#BlueJC has a few key differences from other Twitter-based journal clubs. To our knowledge, we are to first to: (i) have linked a Twitter-based journal club with an international peer-reviewed medical journal; (ii) publish edited summaries of the Twitter-based discussions in print to complete the post-publication peer-review loop; (iii) have attempted to engage authors with readers directly. In addition, the flexibility afforded by the 7-day capture period for initial discussion avoids the restrictions inherent in traditional fixed-time discussions on existing Twitter-based journal clubs. Ours is not just an educational exercise. Strengthened by our link to an already established traditional journal club and an active network (KT network), #BlueJC is well positioned to inform practice and further research.
Pilot journal club
We have held three pilot sessions, including one in conjunction with the Trainee Association of the Study of Medical Education (http://www.asme.org.uk/tasme). In this pilot, the Twitter journal club discussed a study by Fransen et al. on the effects of high-fidelity obstetrics team training. Approximately 200 Tweets were captured using #ktjc as hashtag (hashtag for pilot only), and, after removing duplicates and probing Tweets from the KT team, 88 Tweets were of interest and summarised using Storify (see Figure 3). This discussion will be published in a future issue of BJOG.
Our latest pilot discussed a systematic review by Professor Baaqeel based in Saudi Arabia on the use of prophylactic antibiotics at caesarean sections. During the session, Professor Baaqeel actively interacted with other participants, including trainee doctors, statisticians, editors, other health-allied professionals and senior clinical academics. The paper discussed can be found in this issue on page 661, as well as the summary of the discussion in BJOG Exchange.
The research dissemination landscape of the 21st century is increasingly embracing the use of technology for both authors and readers. #BlueJC aims to provide the much needed immediacy for post-publication peer review, which would be a valuable extension of the current correspondence format. We believe the flexibility and public nature of this exciting initiative will stimulate discussions of research studies in women's health and ultimately achieve the goal of improving research literacy and research-based practice.
We are grateful for the contributions of Mr Patrick Chien, Miss Elizabeth Hay and Miss Louisa Waite.
Disclosure of interests
Contribution to authorship
EYL and SAT contributed significantly in planning #BlueJC and acted as moderators on behalf of the KT network. DS contributed significantly to the collaboration between #BlueJC and KT Network. KSK supervised the process of planning and implementation of this idea. All authors contributed to the manuscript.