Radiologic Education Should Radiology Residents Be Taught Evidence- Based Radiology? An Experiment with ‘‘The EBR Journal Club’’ 1 Marta E. Heilbrun, MD Rationale and Objectives. Introduce radiology residents to evidence-based radiology (EBR) using a journal club format based on the Radiology Alliance for Health Services Research/American Alliance of Academic Chief Residents in Radiology (RAHSR/ A3CR2) Critical Thinking Skills sessions and EBR series of articles published in Radiology in 2007. Materials and Methods. The club began with a presentation outlining the process that would occur in an alternating format, with topics and articles chosen by residents. In session A, questions were rephrased in a Patient/Population, Intervention, Comparison, Outcome format, and a literature search was performed. Articles were discussed in session B, with residents assigned by year to the tasks of article summary, technology assessment, and comparison to checklists (Standards for Reporting of Diagnostic Accuracy, Consolidated Standards of Reporting Trials, or Quality of Reporting of Meta-analysis). The residents collectively assigned a level of evidence to each article, and a scribe provided a summary. Results. Twenty-two residents participated, with 12/22 (55%) of residents submitting any question, 6/22 (27.3%) submitting more than one question, and 4 residents submitting questions in more than one session. Topics included radiation risk, emergency radiology, screening examinations, modality comparisons, and technology assessment. Of the 31 articles submitted for review, 15 were in radiology journals and 5 were published before 2000. For 2/9 topics searched, no single article that the residents selected was available through our library’s subscription service. The maximum level of evidence assigned by residents was level III, ‘‘limited evidence.’’ In each session, the residents concluded that they became less confident in the ‘‘right answer.’’ They proposed that future reading recommendations come from attendings rather than literature searches. Conclusion. A journal club format is an effective tool to teach radiology residents EBR principles. Resistance comes from the difficulty in accessing good literature for review and in constructing good review questions. Key Words. Critical thinking; evidence based radiology; journal club; resident education. ª AUR, 2009 The significant evolution, explosion, and significance of medical imaging in today’s practice of medicine has made the process of both teaching and learning clinical and nonclinical radiologic skills a formidable task to accomplish during 4 years of residency (1,2). Practice-based learning and im- provement is one of the Accreditation Council for Graduate Medical Education’s six general competencies (3) that is particularly relevant to training today’s residents in diag- nostic radiology, both because of the growth of medical imaging and the cost associated with this imaging (4,5). An introduction to the tools and process of evidence-based ra- diology (EBR) provides a forum for teaching and promoting practice-based learning in a diagnostic radiology curricula. A resident journal club facilitates the introduction of EBR into a diagnostic radiology resident education program (2,6). However, for such a curriculum to be successful, because it represents a change from traditional didactic and view-box teaching in radiology, it requires significant buy-in from program directors, faculty, and residents. At the 2007 Asso- ciation of University Radiologists (AUR) meeting sessions on journal clubs, led by the late Ed Staub, MD, two main points were emphasized regarding journal clubs—the first Acad Radiol 2009; 16:1549–1554 1 From the Department of Radiology, University of Utah, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140. Received February 6, 2009; accepted June 17, 2009. Supported by GE-AUR Radiology Research Academic Fellowship. Address correspondence to: M.E.H. e-mail: marta.heilbrun@ hsc.utah.edu ª AUR, 2009 doi:10.1016/j.acra.2009.06.013 1549