Annals Journal Club Selection:

Nov/Dec 2007

The Annals Journal Club is designed to encourage a learning community of those seeking to improve health care and health through enhanced primary care. Additional information is available on the Journal Club home page.

The Annals of Family Medicine encourages readers to develop the learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club, and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for: Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care, and then acting on those discussions.¹

Article for Discussion

Johnson BJ, Mold JW, Pontious JM. Reduction and management of no-shows in family medicine residency program practice exemplars. Ann Fam Med. 2007;5(6):534-539.

Discussion Tips

Consider the articles in the context of your own practice and patient population. Also consider the pros and cons of the novel method of identifying and studying exemplars.

Discussion Questions

What questions are addressed by the article? Why do they matter?
What purpose is served by the 2-stage sampling design of the study? Are there better alternatives for answering the research questions?
What are the main findings?
To what degree can the findings be accounted for by:
1. How participants were selected?
2. How critical variables were measured?
3. Confounding (false attribution of causality because 2 variables discovered to be associated actually are associated with a 3rd factor)?
4. How participant responses were interpreted?
5. Chance?
How transportable are the findings to your practice setting? How might they be adapted?
What are the challenges in disseminating findings from a study of exemplars?
How might the information be used to change practice or policy?
How do these findings relate to what already is known about methods to reduce no-show rates and enhance patient volume?
What questions do you have for further research or application?

Reference

Stange KC, Miller WL, McLellan LA, et al. Annals journal club: It�s time to get RADICAL. Ann Fam Med. 2006;4:196-197. Available at: http://annfammed.org/cgi/content/full/4/3/196.

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