Teaching practicing surgeons critical appraisal skills with an Internet-based journal club: A randomized, controlled trial

Background The effectiveness of interventions for developing critical appraisal skills in practicing physicians has not been studied, despite the documented importance of reading the literature in caring for patients and in continuing professional development. The objective of this study was to evaluate whether an Internet-based intervention would lead to enhanced critical appraisal skills in practicing surgeons. Methods General surgeons who agreed to participate were randomized into 2 groups. The intervention was a curriculum in critical appraisal skills that included a clinical and methodologic article, a listserve discussion, and clinical and methodologic critiques. The control group received only the clinical articles. The primary outcome measure was a previously validated 2-hour test of critical appraisal. Results Of the 55 surgeons who completed the examination, subjects in the intervention group performed better on the test of critical appraisal skills than those in the control group (mean score: intervention group, 58% ± 8 vs control group, 50% ± 8), with a large effect size of 1.06 standard deviation units (t+3.92, P < .0001). Training conditions accounted for 22% of the variance in total scores. Conclusions A multifaceted, Internet-based intervention resulted in improved critical appraisal skills of practicing general surgeons.