Translate this page into:
Advancing and nurturing scientific writer in every resident (ANSWER) journal club module for mentored translation of critical appraisal into scientific writing: Description and preliminary observations
[To cite: Spoorthy MS, Malathesh BC, Tikka SK. Advancing and nurturing scientific writer in every resident (ANSWER) journal club module for mentored translation of critical appraisal into scientific writing: Description and preliminary observations. Natl Med J India. DOI: 10.25259/NMJI_1780_2025]
Journal clubs (JCs) form an integral part of medical postgraduate curricula, both globally and in India. The goals of JCs are to promote evidence-based medicine (EBM), enhance critical appraisal skills, promote shared learning with colleagues, provide a platform for academic debate, and create a lifelong learning model.1–3 However, underutilization, ineffective methodology, a lack of formal training in critical appraisal and ill-defined goals pose major threats to JCs, risking them becoming redundant.4,5 Several resident-friendly innovative models like ‘the resident run JC’,6 utilizing social media for JCs,7 ‘the flipped JC’,8 the ‘e-Journal clubs’,9 the ‘no-prep’ JC,10 etc., have been developed in order to make JCs more effective and sustainable. However, the utility of JCs is still under scrutiny with high resident dissatisfaction, low engagement, and a lack of measurable outcomes.11
While on the one hand, there is a growing emphasis on publishing papers during residency,12,13 on the other hand, there is a certain lack of structured training in scientific writing. JCs have the potential to integrate both of these aspects and, as a consequence, set well-defined goals for JCs that align with competency-based postgraduate curricula. With this background, we developed an innovative module (Table 1 and Fig. 1)14 for departmental JC for medical postgraduates—‘Advancing and nurturing scientific writer in every resident (ANSWER)’ that incorporates well-defined goals, a tiered approach, Bloom’s hierarchy for learning scientific skills and a formative assessment. The aim of each JC in this module is to mentor the resident through the process of translating critical appraisal of the chosen journal article into a manuscript submitted for publication, thereby digitizing it for the benefit of the medical community. We describe the module and present a 2-year experience of implementing it in the psychiatry department of our institute.
| Module structure/aspects | Description |
|---|---|
| A Target population | Postgraduate medical residents (R). The module seems applicable to undergraduates and students of other streams based on its set structure, but this must be determined independently. We deem this module applicable not only to departments of medical institutes/colleges but also to specialty hospitals involved in specialty training. |
| B Mentors | •Mentor 1—Chairperson (C)—faculty •Mentor 2—Moderator (M)—senior resident •Other department faculty and senior residents. Mentoring shall be offered at every step. It is individualized, considering the residents’ knowledge. |
| C Duration | Entire duration of the academic course (3-years for MD/MS courses). Beginning in the first semester itself and proceeding with a tiered approach |
| D Progression or course | The course shall progress according to a learning model that is based on the ‘EBM’ pyramid. In this model, a ‘Tiered’ approach (Fig. 1) is followed, where the residents present journal articles of increasing hierarchy of study design every semester. In the first semester, the study design chosen for the JC is a case-report or case series, followed by a cross-sectional, case-control, cohort, randomized-controlled study in the second to fifth semesters, respectively. Progressing in this tiered manner, in the last semester, they will choose a systematic review and a meta-analysis (SRMA). In a typical 3-year postgraduate course, every resident will present six JCs, one in each semester, by proceeding in a tiered manner. Moreover, a tiered approach will also be followed with respect to the choice of journals. For the first 3 semesters, journals ranking Q3 or Q2 will be chosen, and for the last 3 semesters, Qljournals will be chosen. The departmental academic roster, which is determined for one-year every time, will ensure the resident (R) and the JC are matched with that specific study design and the journal rank (Q1/Q2/Q3) for those two semesters in that year. |
| E Goals (SMART format) | Specific goalsCritical appraisal and scientific writing—translated into a journal manuscript submission (publication is dependent upon other factors). Measurable goalsA customized assessment method is devised (K of this table) Achievable goalsSeveral journals accept comments on recently published articles from unsolicited authors. Our experience of implementing this module (described later in this letter) presents the number of submissions/publications from the JCs conducted in a department. Relevant goalsBuilding research capacity is part of the overall purview of the competency-based curriculum. Moreover, learning critical appraisal and scientific writing equips residents to be actively involved in research in their careers ahead. The relevance of and need for this module have been described in the introduction as well. Time-based goalsSubmissions to journals are time-bound in many cases; even if not, submissions are to be done within 3 months of the JC presentation. |
| F Resources | Three resources form the main pool. 1. A predetermined list of journals and timelines for submitting comments on a published article shall be made available. This list shall contain the following information: Journal name, journal rank (Q1-4), specialty, number of issues per year, article type and time allowed for submitting comments. 2. Openly available reporting guidelines/checklists corresponding to various study designs. https://www.equator-network.oeg/repo/ting-guiOelines/ 3. Access to journals provided through the ONOS, available to most institutes in India. https://enes.oev.in |
| G Basic training in scientific writing | The entire department, including faculty, senior and junior residents, will be trained in the basic principles of scientific writing with emphasis on communicating critical appraisal to the original authors in a peer-learning-based session. Refresher sessions are conducted every 6 months by the faculty. The book ‘Writing Science’ by Joshua Schimel is the primary reference source. Basic concepts of scientific writing, like the PEEL framework and signposting, IMRaD structure of manuscript preparation, and Sandwich and the TEI techniques of communicating criticism, will be covered. All junior and senior residents also undergo a mandatory course in research methodology conducted by the institute and are also encouraged to attend advanced courses elsewhere. |
| H Operational rules for choosing an article for JC | 1 Review all available articles of the study design intended for that particular tier from the most recent issues of the listed journals in the proposed rank tier. Passive mentoring by the moderator (M) and chair (C). 2 Shortlist 3-5 articles based on novelty, relevance to the departmental clinical, academic and research practices and interests. The moderator (M) mentors shortlisting actively. 3 Resident (R) to review all relevant documents, such as supplementary materials and similar papers by the same authors/study group, of all shortlisted articles. The final choice is made based on the subjective perception of being able to raise the most critical issues. The onus of this lies completely on the resident (R). |
| I Operational rules for preparing for the JC presentation (Bloom’s hierarchy is followed) | 1 State adherence to the items on the quality checklist for the corresponding study design 2 Formulate strengths and limitations 3 Compare it with author endorsed strengths and limitations 4. Emphasize both method factors and substantive factors 5 Conduct a review of your own on the subject 6.Examine the most critical ones, especially those not listed by the authors 7.Assess the basic principles of scientific writing, such as the IMRaD, PEEL structure and signposting 8.Organize the presentation 9 Note the discussion points raised. Additional points raised to be reviewed/evaluated again with the core team. |
| J Operational rules for preparing the comment or letter to the editor writeup | 1 Review author guidelines of the corresponding journal: word count, format, references limit, etc. 2 Follow the sandwich method of communicating: start with strengths, have the main text emphasizing the critical aspects, and then end with constructive positive comments. 3 Also follow the TEI model and not being overly critical principles 4 Have at least 5-6 iterations from the mentors, senior resident moderator, and the faculty chair of the JC. 5 Make sure your critical evaluation is directed to the authors and not questioning the editorial/peer review process of the journal 6 Comments on the letter/comment to be sent to other department colleagues for their comments. Department colleagues to be acknowledged in the manuscript. This step may be evaded in cases where the submission timeline is too close. 7 All three members of the team must be involved in approving the final draft. 8 The resident remains the first author, the senior resident/moderator will be the second, and the faculty will be the senior and last author in the list. 9 Any one of them may submit and be the corresponding author. If asked to revise the submission after review, the response and rebuttal are to be supervised by the moderator and the faculty. |
| K Assessment and evaluation |
1 Both presentation and submission evaluation scores are summated with equal weightage. 2 Presentation scores are contingent upon the submission. If the submission does not happen, these marks arenull and void. This rule makes an exception only in cases where submission is not possible due to unavoidable circumstances, which are endorsed by the faculty chair of the JC. Presentation 1. Ability to review and shortlist articles for JCs and seek support from mentors—30% 2 . Ability to independently raise critical concerns and assess the strengths and limitations of the paper—50% Organization and presentation skills—20% Submission 1 Ability to write the first draft within the stipulated time (depending upon journal timelines: 2 days to 2 weeks) after the JC presentation, so that enough time is available for iterations—20% 2 Adhering to standards of scientific writing, structure, PEEL and signposting, in the first draft—20% 3 Adhering to standard methods of communicating critical comments (sandwich, TEI, etc.) in the first draft—50% Adhering to journal guidelines in the first draft—10% |
JC journal club IMRaD introduction, methods, results and discussion SMART specific, measurable, achievable, relevant, and time-based EBM evidence-based medicine ONOS one nation one subscription PEEL point, evidence, explanation, and link SRMA systematic review and meta-analysis TEI transparency, engagement, and improvement
Preliminary observations
This module was implemented at the department of psychiatry of one of the Institutes of National Importance in India that became functional from March 2021. Postgraduate courses began in January 2024. With a yearly intake of 2 residents, we currently have 4 postgraduate residents. The implementation of this module has now completed four semesters. The department has three faculty, with 12, 10 and 8 years postgraduate teaching experience respectively. The number of senior residents when the implementation of the module began was 3, and now there are 4 senior residents.
In the period of 2 years, we conducted 12 JCs. Remarkably, 11 of the 12 comments on JC articles were submitted to the journals. Of the 11 submitted comments, 7 (64%) have been published/accepted and 1 (10%) is under review. Three (27%) were rejected, with ‘not a substantial addition’ being the reason in all cases. With many journals accepting only a small percentage of unsolicited comments, these results are encouraging.
The module is structured in a way that it is not unique to a discipline, hence it is applicable across specialties. It also helps in inculcating continued motivation towards scientific writing and critical thinking. This is achieved through translation of JCs into publications early in their career, which is usually unprecedented in India. However, it is not without limitations. The module assumes adequate knowledge and experience of faculty in statistics, research methodology and scientific writing. Moderators for conducting the JCs, i.e. senior residents, may quit prematurely due to the tenure-based nature of their job, hampering their supervisory role across the tiered framework. In addition, the letters to editors published because of JCs do not fit into the criteria required for promotions in India, which might dampen their motivation. In case of departments with a greater number of trainees, implementation of a tiered approach should be tailored to the setup.
Implementation of the ANSWER module for JCs will help in building research aptitude among postgraduate students early in their careers and the development of a professional bond among residents and faculty.
Conflicts of interest.
None declared
References
- The importance of appraising articles and conducting psychiatric journal clubs. Australas Psychiatry. 2023;31:725-9.
- [CrossRef] [PubMed] [Google Scholar]
- Promoting the conduct of medical education journal clubs in teaching medical institutions. Avicenna J Med. 2021;11:156-9.
- [CrossRef] [PubMed] [Google Scholar]
- The impact of journal clubs on postgraduate medical education in China. BMC Med Educ. 2023;23:683.
- [CrossRef] [PubMed] [Google Scholar]
- Resident run journal club: A model based on the adult learning theory. Med Teach. 2009;31:e156-e161.
- [CrossRef] [PubMed] [Google Scholar]
- Journal clubs in the digital age: Twitter for continuing professional development. Future Healthc J. 2017;4:160-6.
- [CrossRef] [PubMed] [Google Scholar]
- Electronic journal clubs for capacity building: A case study in psychiatry as a model for medical disciplines in developing countries. Asian J Psychiatr. 2018;34:93-7.
- [CrossRef] [PubMed] [Google Scholar]
- No prep? No problem: Making journal club accessible. Acad Psychiatry. 2025;49:405-6.
- [CrossRef] [PubMed] [Google Scholar]
- The current state of journal clubs in psychiatry residency programs: Results from a national survey of program directors. Acad Psychiatry. 2022;46:605-10.
- [CrossRef] [PubMed] [Google Scholar]
- Publishing a paper during residency for specialists: How should we deal with it? JMA J. 2023;6:337-8.
- [CrossRef] [Google Scholar]
- Medical residents: Research and publication priorities/confusions. J Fam Med Prim Care. 2020;9:2583-4.
- [CrossRef] [PubMed] [Google Scholar]
- Writing science: H0ow to write papers that get cited and proposals that get funded Oxford: Oxford University Press; 2012.
- [Google Scholar]