1. Identify a knowledge gap and formulate a structured clinical question
  2. Perform a literature search to answer the question
  3. Select a paper and appraise it using Critical Appraisal Skills Programme (CASP)
  4. Distribute the paper to the Journal Club members
  5. Prepare the presentation and present the findings at Journal Club

Identify a knowledge gap and formulate a structured clinical question
The first step in EBM is to define a structured clinical question. The question should arise from clinical practice. Using the PICO acronym will help you organize your query into a searchable question. In
addition to the PICO elements of your clinical question, it’s important to know the type of question you are asking and the best study design to search for in order to find evidence that answers your clinical
P.I.C.O. Model for Clinical Questions
Literature search for best evidence to answer the question

The second stage in EBM is a literature search to identify a study that will help answer the question. When searching for evidence use terms identified in PICO and consider an appropriate research design
(RCT, cohort study etc).

A literature search may include: • Electronic databases: Medline, Embase, Cinahl, Cochrane database, NICE available from
  • Hand search of journals
  • Grey literature: reports (government or academic), conference proceedings, internet, libraries, professional societies, Kings Fund, Nuffield.
  • Research registers: National Research Register, HTA database, Cochrane
  • Retrieved articles: bibliographies, search authors names, citation threads
  • Contact with researchers or “experts”

Ideally, evidence-based clinical practice guidelines relevant to your question will already exist. When this is not the case you need to seek out the best scientific evidence available to help inform the treatment decision.

Appraise the evidence
The next stage is to critically appraise the selected study. This can be done using an appraisal tool like CASP
The presentation should not last for more than 30 minutes
Recommended slide titles
  • Title
  • Aim
  • Objectives
  • Case Presentation
  • The Clinical Question
  • Literature Search
  • Journal Article Identified
  • Current Practice
  • Appraisal
  • Methods
  • Outcome/Measures
  • Appraisal
  • Conclusion

Critical Appraisal Skills Programme

Study Types

Randomized Controlled Trial
Case Control
Case Control
Cohort Study
Cohort Study
Cross-Sectional Study
Cross-Sectional Study
Qualitative Research
Qualitative Research
Systematic Reviews
Systematic Reviews
  1. Aveyard H (2017) A beginner's guide to evidence-based practice in health and social care professions 3rd ed OUP
  2. Bootland, D. (2017) Critical appraisal from papers to patient. CRC Press.
  3. Howlett, B. (2020) Evidence based practice for health professionals : an interprofessional approach. 2nd ed. Jones & Bartlett Learning
  4. Gosall N.K. and Gosal, G.S. ( 2015). The doctor's guide to critical appraisal. 4tg ed. PasTest 
  5. Greenhalgh T. (2019 ). How to read a paper : the basics of evidence-based medicine. Wiley-Blackwell.
  6. Moule,P. (2018) Making sense of research in nursing, health and social care. 6th ed. Sage
  7. Critical Appraisal Skills Programme (2019). CASP Checklist. [online] Available at: https://casp-uk.net/casp-tools-checklists/