However, a pedagogical disservice is given to learners every time they are asked, "Would this evidence change your clinical practice?" This is a rhetorical question...they must NEVER let one piece of evidence change their clinical practice! This is especially true if the journal club topic that week focuses on observational or quasi-experimental designs!
The famous text by Straus et al.* stipulates that the individual trial or observational study is the LEAST FAVORABLE type of evidence to be sought out in applied clinical medicine. Systematic reviews, synopses of syntheses, and summaries are the most tangible and relevant pieces of clinical evidence when it comes to real-life patient populations.
A better use of a graduate level practitioner's time would be to seek out the highest levels of evidence in journal club, all the time. Observational studies are much more feasible for busy residents and fellows to conduct for academic requirements. But when it comes to teaching residents how to apply clinical evidence to their practice in the journal club environment, the highest levels of evidence should be used by faculty to correctly model reality-based clinical practice.