The Evidence-Based Study Club: A Practical Means to Facilitate EBD Awareness and Implementation

Description 

Three key concepts for developing and facilitating a successful evidence-based study club are reviewed: (1) keep it simple, (2) implement EBD before teaching EBD, and (3) begin the study club soon after EBD implementation.

Keep it Simple 

A busy clinician who seeks members for a study club needs the process to be simple and effective. Clinicians will find less resistance and higher acceptance by reaching out to dentists who they know, respect, and care about. Consideration should be given to how EBD implementation is presented to prospective audiences. Better EBD awareness, adoption, and implementation occur when grassroots clinicians are approached from the perspective of the benefits the advantages of the EBD approach are emphasized. When introducing EBD advantages to clinicians, it is often best to first address the clinician benefits, then the patient benefits, followed by the dental team and practice benefits3 (please see Sidebar 1 in reference 7). When addressing the dental team, better outcomes can be achieved by first presenting the benefits for the patient and then the benefits for the dental team and practice.

When new information is organized into a few conceptual building blocks, information overload risks decrease and learning outcomes increase.3, 4, 5 Preventing information overload for prospective study club members as well as the study club leader is critical for successful outcomes. Study club leaders are encouraged to first communicate with prospective study club members by e-mail and to make efforts to minimize e-mail content (see Table 1). A small group format of up to 8 members is recommended. Groups up to this size provide ample diversity and appropriate shared responsibility. Small group format also benefits the study club leader because of fewer administrative demands, easier facilitation, and less management effort. Additionally, with a small group format, the study club leader has greater opportunities to fully participate and engage in the learning process. The introductory meeting for prospective study club members should be limited to 90 minutes and focused on the benefits of study club membership and EBD implementation (see Table 2). Clinicians intending to establish a study club are encouraged to review additional study club implementation information before the introductory meeting.2

Table 1. The first contact e-mail to prospective study club members

	Limit the text box to 3 to 4 short paragraphs. Content should include:
	1. Invite prospective member to an introductory meeting for your EB Champions Study Club.
	2. Describe the your experience with EBD and the benefits.
	3. Refer to www.ada.org/prof/resources/ebd/ for further information.
	4. Give RSVP detail.

Provide 1 e-mail attachment: The Evidence-Based Dental (EBD) Practice Advantage.3 Follow-up with a telephone call.

Table 2. The introductory meeting for prospective study club members

	Provide
	The Evidence-based Dental (EBD) Practice Advantage3
	Dental Evidence Locator-EBD Resources12
	Study club registration form
	Display
	Three evidence-based clinical decision support (EB-CDS) Tools6, 7
	Review
	Study club logistics2

Implement EBD Before Teaching EBD 

Although study club leaders need not be EBD experts or teachers, it is best if they have some prior experience with implementing EBD in practice. The dental practice team plays a critical role in the EBD implementation process and great care should be taken with EBD introduction and training. Reference articles on EBD implementation should be reviewed before introducing the concept to the dental team.3, 5, 6, 7, 8, 9, 10, 11, 12 Suggested topics to include for the first team meeting on EBD approach implementation are reviewed in Table 3.

Table 3. The first dental team meeting on EBD approach implementation: Topics to include

	□What is the EBD Approach, why is it different from what we are doing? 7, 8, 9, 10
	□EBD Practice Advantage benefits review3
	□Introduction to the 3 evidence-based clinical decision support (EB-CDS) tools6, 7, 11
	□Online review of a preselected sampling of easy-to-understand evidence-based, and clinical decision support resources12
	□Review of practice mission/purpose statement9, 10
	□Develop an EBD Implementation team task list (weekly, monthly)
	□Agree on achievable homework assignment for developing familiarity with EB-CDS online resources

It is essential to establish realistic and achievable team goals for the first few months during the EBD implementation process (see Table 4). One option is to focus the team on using the 3 Evidence-based clinical decision support (EB-CDS) tools as soon as possible.6, 7, 11 Clinician follow-up and assessment are critical to a successful EBD implementation program. On a monthly basis it is recommended to review case acceptance rate and procedure analysis for changes that can be attributed to the EBD approach (eg, topical fluoride applications, dental sealant procedures). Also review dental team and patient feedback and adjust implementation plans as needed.

Table 4. Develop realistic and achievable team goals for the first month

	□Establish dental team consensus on achievable weekly goals
	□Focus on EBD approach benefits for patients and the dental team3
	□Schedule short weekly check-in meetings
	□Listen for questions and obstacles
	□Inspire and motivate

Begin the Study Club Soon After EBD Implementation 

Both the study club leader and members benefit from sharing experiences and information regarding the EBD implementation process. Therefore, study club leaders should start their study clubs very early on in their own EBD implementation process.

After the study club is established and members are enrolled, the first formal meeting of the new club should be dedicated to an overview and orientation of the EBD approach and to strategies for in-office EBD implementation. An example is provided in Table 5. Quarterly meetings are appropriate for an evidence-based study club. The format that I have used and found successful for ongoing EB study club meetings is presented in Table 6. This unique hands-on approach is enjoyable and stimulating, keeps interest levels high, and encourages participation and sharing among members.

Table 5. The first EB study club meeting: Topics to include

	□What is the EBD Approach, why is it different from what we are doing? 7, 8, 9, 10
	□The EBD Practice Advantage benefits review3
	□Introduction to the 3 evidence-based clinical decision support (EB-CDS) tools6, 7, 11
	□Online review of a preselected sampling of easy-to-understand evidence-based, and clinical decision support resources.12
	□Review in-office EBD implementation strategies

Table 6. The 4-part format for ongoing EB study club meetings

	1. Review the most recent Journal of Evidence-Based Dental Practice.2
	2. Compare and share office EBD implementation and outcomes data and experiences.
	3. Visit and review online evidence-based clinical decision support (EB-CDS) sites.12
	4. Present one clinical case review per study club session with simultaneous study group EB-CDS online support for research and problem solving.

Conclusion 

Using 3 key concepts for developing and facilitating a successful evidence-based study club provides a practical approach for grassroots clinicians who want to disseminate EBD awareness and facilitate implementation in their community by way of the study club approach.

These concepts are intended to augment the clinician's professional expertise, not replace it. Although the information provided may not apply in every situation, the intention of this article is to provide supplemental material to assist in EBD implementation and dissemination. As dentistry's evidence base continually improves and knowledge transfer methodology advances, EBD implementation and knowledge sharing must continually be brought up-to-date to reflect these developments.