Abstract
INTRODUCTION: Journal clubs are established pedagogical tools that enhance pharmacy students' critical appraisal and evidence-based practice skills. However, few studies have examined longitudinal changes following repeated exposure to such activities. This study assessed the outcomes, perceptions, and engagement of pharmacy students after two sequential journal club experiences within an Evidence-Based Medicine course. METHODS: A cross-sectional comparative study was conducted among fifth-year undergraduate pharmacy students at Umm Al-Qura University, Makkah, Saudi Arabia. The second journal club experience occurred 3 months after the first one and used the same validated survey to measure three domains: learning outcomes, perceptions and attitudes, and feedback and future improvements. Descriptive statistics, Wilcoxon rank-sum, and chi-squared/Fisher's exact tests were used to compare scores between cycles, with significance set at p < 0.05. RESULTS: seventy seven students participated in each experience. Reliability improved across all domains (learning outcomes α = 0.666 → 0.774; perceptions α= 0.782 → 0.813; feedback α= 0.647 → 0.710). Significant gains were observed in critical thinking (77.9% vs. 58.4%, p = 0.009) and data analysis (59.7% vs. 42.9%, p = 0.036). However, satisfaction and willingness to participate again declined (68.8% vs. 84.4%, p = 0.022), and mean feedback scores decreased (3.6 ± 1.5 vs. 2.7 ± 2.2, p = 0.005). No significant differences were found in overall learning outcome or perception scores. CONCLUSION: Repeated exposure to journal club activities enhanced students' analytical and critical thinking skills but reduced their satisfaction and enthusiasm for future participation. While the intervention strengthened cognitive learning domains, declining affective engagement suggests the need for curricular adjustments such as varied formats, reflective components, and diversified facilitation to sustain motivation and optimize educational impact in longitudinal learning designs.