Every day in exam rooms and hospitals, patients ask clinicians about medical treatments they have heard about from the news, social media, or direct-to-consumer advertising. To address these questions, clinicians must often evaluate evidence from primary sources such as clinical trials. Historically, medical education has relied on activities such as journal club and ad hoc clinical teaching to train learners to critically appraise research. These traditions are cornerstones of medical education, but like many traditions they must adapt to a changing environment. Medical evidence is produced more rapidly than ever, clinical trials have become more complex, and classroom-based learning is increasingly compressed for both physician trainees and advanced practice clinicians. Thus, modernized didactic frameworks and new platforms for education and mentorship are needed. We propose a range of strategies to teach healthcare professionals to critically appraise and effectively communicate scientific findings to patients.

The COVID-19 pandemic laid bare the challenges clinicians currently face in translating published research to high-quality patient care. During the pandemic, there was an explosion of observational data and clinical trials examining COVID-19 therapeutics. Pharmaceutical companies and scientists often communicated results directly to the public via headlines and social media, sometimes ahead of confirmatory study or rigorous peer review. This phenomenon generated significant confusion among the public, who frequently turned to their healthcare providers for guidance.

As clinicians who practice in environments ranging from primary care to public healthcare system leadership, we drew from our shared experience in a two-year editorial fellowship at a medical journal to help our patients better understand the implications of COVID-19-related research. The fellowship involved participating in editorial meetings where experts critically appraised submitted research, learning to write peer reviews, and assisting with composing editorial commentaries. The experience was a transformative part of medical training for each of us, developing analytic skills that have enriched our clinical practice. While programs such as this are available to a select few, our experience has made us aware of the need to better prepare healthcare professionals to translate research into individualized, evidence-based patient care. To accomplish this goal, a spectrum of educational tools is required.

Several existing frameworks scaffold the process of efficiently discussing research articles. Most primarily focus on analyzing basic study design and outcomes.1 While these skills remain fundamental to understanding medical research, in many cases they are no longer sufficient. Clinical trial design has become more complex over time, generating more data and accounting for an increasingly intricate web of influences and contextual factors.2 Common features of contemporary trial design such as composite outcomes, surrogate endpoints, and specialized measurement scales may achieve statistical significance while maintaining a degree of abstraction from clinical decision-making and patient health. Modern observational research methods have also grown increasingly sophisticated, generating results that often require nuanced interpretation.3 Finally, although disclosure of conflicts of interest is of growing importance to medical journals and the public, commercial sponsorship continues to influence study design, results, and reporting.4 Clinicians must be able to recognize and weigh these factors when translating research findings to patient care.

Augmenting current methods of teaching engagement with medical research may help focus learners’ critical appraisal and communication skills. While existing tools such as the PICO (population studied, intervention, compared to…, outcomes) framework cover fundamental research methodology,1 an enhanced discussion framework would prompt learners to ask deeper questions about study design (e.g., How do aspects of study design influence the strength and generalizability of the conclusions?), sources of bias, relevant contextual factors, and implications for patient care. It would also ensure that study results and conclusions are analyzed through the lens of direct patient benefit and harms (e.g., Are the outcomes measured likely to be meaningful to patients? Is the magnitude of benefit likely to be noticeable by the patients or populations studied, even if statistically significant?). These skills help clinicians to translate medical research to the “real world” of patient care.

Additionally, an enhanced journal club format would stimulate and scaffold discussion around the best ways to communicate results to patients to foster evidence-based shared decision-making. This includes exercises that allow trainees to role play patient-physician communication about the implications of trial results in observed practice exercises. Opportunities for trainees to receive direct feedback on their communication skills to patients are relatively rare.5 Observed practice with feedback can empower trainees to engage their patients in discussions about evidence-based care, building confidence and habits over time that they will take with them throughout their careers. Journal club may provide a safe space for trainees to hone their skills with examples chosen to represent clinical scenarios that are influenced by a chosen research study.

Medical journals also play an important role in fostering a deeper understanding of the medical literature. Several journals have already made important contributions in this area. Resources such as visual abstracts, expert commentaries/editorials, and author interviews are all important ways journals help clinicians engage with current medical research in an efficient and curated manner. However, many of these platforms are designed to convey information unidirectionally, rather than guide critical appraisal. In addition to these useful tools, there are other ways in which journals can teach mastery of the medical literature.

First, medical journals could expand opportunities for direct mentorship. By increasing venues for medical trainees and early-career clinicians to receive the type of immersive training in medical writing and critical appraisal that we experienced, the number of local experts acting as mentors in diverse practice environments will grow. In addition to resource-intensive fellowships, hosting episodic workshops, continuing medical education courses, and social media–based didactics/discussions (e.g., Tweetorials, live Twitter Q&A) can all enhance the reach of expert instruction. Recruiting seasoned peer reviewers to provide feedback and/or mentorship to early-career reviewers within their respective areas of expertise may also help enhance critical appraisal and communication skills in an efficient manner.

Second, medical journals may prepare reading guides that facilitate richer discussion of select articles within a journal club format. These materials could provide instruction on important features of study design (e.g., What is propensity matching, and how does it influence the conclusions of the study?) and prompts that facilitate a clinically focused discussion of a study’s results and conclusions (e.g., Is a 2-point difference on an 18-point scale likely to be noticeable for patients, even if statistically significant?). These materials may also include short vignettes that can be used for role play and modeled discussions.

Third, medical journals can prepare simplified tools that guide clinicians through a well-rounded discussion of research findings with their patients. Such a tool might combine elements of a visual abstract, a clinical decision aid, and a patient page. These tools may not facilitate a critical appraisal of clinical research, but for busy clinicians with variable training in research methods, they can serve to facilitate patient-centered discussions of current evidence. Furthermore, these documents can be widely disseminated throughout health systems as a resource to promote evidence-based public health measures and equitable, high-value care.

As the volume, complexity, and public reach of research increase, new tools are necessary to help clinicians critically engage with the medical literature. By augmenting traditional learning structures such as journal club, as well as exploring new platforms for education and mentorship, we can empower clinicians to translate evidence from the journal page to the bedside.