Background
It is estimated that the doubling time of cumulative medical knowledge in 1950 was 50 years. In 2020 it is thought to be just 73 days. Good Medical Practice guidelines published by the General Medical Council require medical practitioners to keep their professional knowledge up to date. Research can be flawed and biased. Practitioners need to apply critical thinking and professional judgement to assess its usefulness, validity and applicability practice. Critical appraisal skills are implemented in curricula of doctors in training in the United Kingdom. However, compared to clinical skills, they may be underrepresented. Traditional journal clubs are considered an effective way of developing evidence-based medicine (EBM) skills, yet they frequently face challenge of low attendance. Online journal club might be a convenient alternative whilst preserving its educational value. 

Summary of Work
An online website titled Sceptical Medic was developed and launched in January 2020. It included guidelines on how to write critical appraisal and criteria needed to be met for publishing on the website. Invitations for participation had been disseminated to junior doctors and medical students at local NHS Trust. Before each session, critical appraisal and summary of the article had to be written by each host. Hosts then stimulated discussion with scripted open-ended questions on Twitter. Anyone was free to join and discuss using hashtag #ScepticalMedic. In March 2020 there were four critical appraisals published and three journal club sessions had been held on Twitter. Feedback was collected after each session with total of 15 questions on the topic, critical appraisal summary, Twitter session and the project in general. Likert five-point scale (fair to excellent; strongly disagree to strongly agree) had been used and each answer had allocated points (from 1 to 5, respectively). 

Summary of Results
Total of eight participants provided feedback. Answers to the statements ‘Session aided my learning about the topic’ and ‘[Sceptical Medic] is useful as educational platform’ on five-point Likert scale had identical means of 4.73 (95% CI 4.41 – 5.05). Statement ‘[Sceptical Medic] improved my evidence-based medicine skills’ had mean 4.86 (95% CI 4.62 – 5.11). Answers to all questions on five-point Likert scale had mean of 4.64 (95% CI 4.52 – 4.76). 

Discussion & Conclusion
Online journal club using social media platform Twitter has proposed a convenient and modern way to improve critical appraisal skills. This project has been welcomed by its participants and rated positively as an aid to improve learning, a useful educational platform and a way to improve evidence-based medicine skills. Its low feedback rate, however, puts these results at significant risk of bias. Objective methods to measure evidence-based medicine skills (e.g. Fresno test) need to be used to assess true impact on development of these skills. 

Take-Home Message
Online journal club can be a convenient way of developing critical appraisal skills of medical practitioners.