FOAMed Primer for Emergency Physicians
What is FOAMed?FOAM stands for Free, Open Access Meducation (medical education). It is an umbrella term used to describe any and all online, freely accessible medication education content. Content may be in the form of social media, blog, podcast, website or app. It may be generated by an individual, group or be freely available materials released by traditional publishers. As long as it is free to access, widely available and conveys medical knowledge, it’s FOAM.
FOAM is the brainchild of Mike Cadogan (@sandnsurf), an Australian EP and co-founding of the phenomenal website, Life in the Fast Lane. He realized that, despite his best efforts, doctors, conservative bunch that we are, did not respond well to “social media.” FOAM was born as a means of making education and knowledge sharing through social media palatable.
I see it referred to as FOAM and #FOAMed. What’s the difference?FOAM is the concept and the movement. #FOAMed is the discussion. Specifically, #FOAMed refers to the Twitter hashtag used to identify FOAM content on Twitter. #FOAMed exists because searching Twitter for FOAM will lead you astray. And may burn your retinas.Why should I use FOAM?Because it’s awesome. And because your friends are doing it. And because if you don’t, you won’t get to hang out with the cool kids.
Reduce Activation Energy of Learning: Learning is hard. It always has been, but the older we get, the more life comes between us and Annals or Tintanelli’s. By making content available on phones, tablets and computers, we can access FOAM anywhere any time, even in queue at the coffee shop or on the bus. Further, widely available podcasts allow time previously spent cursing traffic to be made productive. FOAM makes learning easier, and certain tools can make FOAM even more accessible.
Gather the wisdom of the masses: None of us has time to read everything, but collectively we can and we can sort diamonds from the rough. The idea is that, through FOAM and crowdsourcing, the cream naturally rises to the top.
Group Discussion: The FOAM community is geographically diverse and experientially rich. Participants are global, and come from all fields, including nursing, prehospital medicine, physicians and administrators. Pose a question on Twitter, and you may stimulate an international discussion involving experts in multiple disciplines from varied backgrounds. Use what you hear online as a jumping off point for discussions with colleagues at your institution.
Post Publication Review: FOAM is an incredible place to discuss original research published in the traditional press. The debates are open for all to see and engage. The peer review process is transparent, reactive, robust and ongoing. Skepticism is appropriately rampant.
Decrease knowledge translation time: The 10 year knowledge translation window is simply unacceptable. FOAM helps to spread the word, increase knowledge uptake and reduce the time it takes for science to enter practice.
FOAM is up to the minute: Textbooks are decades out of date, Journals years, conferences months, but FOAM is up to the minute. Not only that, but FOAM is great at deconstructing old myths in medicine. Cliff Reid calls this “Dogmalysis” (dogma-lysis).
FOAM covers the “soft” topics: Knowing ACLS is one thing, running a code a different. Telling a family they have lost a love one is difficult, processing that emotion yourself is equally challenging. FOAM has evolved a strong ethos for teaching the intangibles and discussing the “softer,” but probably equally important, parts of our jobs.All drugs have side effects and limitations, FOAM is no exception.FOAM can make us lazy! Relying on someone else to peruse the journals, read the literature, break down the studies and then read the executive summary is fraught with danger. We risk losing critical appraisal skills, the ability to sort good from bad, and evening finding content interesting to just to us individually. I also worry about Evidence by Eminence or by Eloquence with social media. There are FOAMed superstars, but no one is bulletproof so question everything.
To combat this, we still need to look through the journals, and when you come across a paper getting a lot of online play, read the article and then check your conclusions against those of the online reviewers. Teach yourself to be better!
Quality is Inconsistent: True. Just as with traditional press, not all content is created equally. We must guard against blind trust and, as Ken Milne suggests, always be skeptical. There is only starting to be a pre-publication peer review process, and without a critical mass of active commenters, the post-publication review for social media lacks vigor.
No Curriculum: Those involved in resident education worry that there is no curriculum and that residents may over-rely on FOAMed but fail to learn the basics from the texts. FOAM also tends to over-represent the sexy topics in medicine, like difficult airway and resuscitation, but given scant attention to more mundane crucial topics like radiology or a good orthopedic exam. Finally, FOAM can lack context. Being current with the latest stroke paper does not afford the perspective that understanding the evolution of stroke care might.
If that wasn't enough on the history, benefits and limitations of FOAMed, more can be found across the internet.
Taming the SRU: Social Media Primer
Tim Leeuwenburg: FOAMed - a Primer for Physicians
Todd Raine: UBC EM Social Medical Primer
Before you join the discussion though, a word of caution: Consider anything you say or do online not only to be public, but the equivalent of shouting it to the waiting room of your ED. Farris Timimi at the Mayo Clinic has a great post on the maxims of social media which can be summed up in 12 words.
FOAM is the brainchild of Mike Cadogan (@sandnsurf), an Australian EP and co-founding of the phenomenal website, Life in the Fast Lane. He realized that, despite his best efforts, doctors, conservative bunch that we are, did not respond well to “social media.” FOAM was born as a means of making education and knowledge sharing through social media palatable.
I see it referred to as FOAM and #FOAMed. What’s the difference?FOAM is the concept and the movement. #FOAMed is the discussion. Specifically, #FOAMed refers to the Twitter hashtag used to identify FOAM content on Twitter. #FOAMed exists because searching Twitter for FOAM will lead you astray. And may burn your retinas.Why should I use FOAM?Because it’s awesome. And because your friends are doing it. And because if you don’t, you won’t get to hang out with the cool kids.
Reduce Activation Energy of Learning: Learning is hard. It always has been, but the older we get, the more life comes between us and Annals or Tintanelli’s. By making content available on phones, tablets and computers, we can access FOAM anywhere any time, even in queue at the coffee shop or on the bus. Further, widely available podcasts allow time previously spent cursing traffic to be made productive. FOAM makes learning easier, and certain tools can make FOAM even more accessible.
Gather the wisdom of the masses: None of us has time to read everything, but collectively we can and we can sort diamonds from the rough. The idea is that, through FOAM and crowdsourcing, the cream naturally rises to the top.
Group Discussion: The FOAM community is geographically diverse and experientially rich. Participants are global, and come from all fields, including nursing, prehospital medicine, physicians and administrators. Pose a question on Twitter, and you may stimulate an international discussion involving experts in multiple disciplines from varied backgrounds. Use what you hear online as a jumping off point for discussions with colleagues at your institution.
Post Publication Review: FOAM is an incredible place to discuss original research published in the traditional press. The debates are open for all to see and engage. The peer review process is transparent, reactive, robust and ongoing. Skepticism is appropriately rampant.
Decrease knowledge translation time: The 10 year knowledge translation window is simply unacceptable. FOAM helps to spread the word, increase knowledge uptake and reduce the time it takes for science to enter practice.
FOAM is up to the minute: Textbooks are decades out of date, Journals years, conferences months, but FOAM is up to the minute. Not only that, but FOAM is great at deconstructing old myths in medicine. Cliff Reid calls this “Dogmalysis” (dogma-lysis).
FOAM covers the “soft” topics: Knowing ACLS is one thing, running a code a different. Telling a family they have lost a love one is difficult, processing that emotion yourself is equally challenging. FOAM has evolved a strong ethos for teaching the intangibles and discussing the “softer,” but probably equally important, parts of our jobs.All drugs have side effects and limitations, FOAM is no exception.FOAM can make us lazy! Relying on someone else to peruse the journals, read the literature, break down the studies and then read the executive summary is fraught with danger. We risk losing critical appraisal skills, the ability to sort good from bad, and evening finding content interesting to just to us individually. I also worry about Evidence by Eminence or by Eloquence with social media. There are FOAMed superstars, but no one is bulletproof so question everything.
To combat this, we still need to look through the journals, and when you come across a paper getting a lot of online play, read the article and then check your conclusions against those of the online reviewers. Teach yourself to be better!
Quality is Inconsistent: True. Just as with traditional press, not all content is created equally. We must guard against blind trust and, as Ken Milne suggests, always be skeptical. There is only starting to be a pre-publication peer review process, and without a critical mass of active commenters, the post-publication review for social media lacks vigor.
No Curriculum: Those involved in resident education worry that there is no curriculum and that residents may over-rely on FOAMed but fail to learn the basics from the texts. FOAM also tends to over-represent the sexy topics in medicine, like difficult airway and resuscitation, but given scant attention to more mundane crucial topics like radiology or a good orthopedic exam. Finally, FOAM can lack context. Being current with the latest stroke paper does not afford the perspective that understanding the evolution of stroke care might.
If that wasn't enough on the history, benefits and limitations of FOAMed, more can be found across the internet.
Taming the SRU: Social Media Primer
Tim Leeuwenburg: FOAMed - a Primer for Physicians
Todd Raine: UBC EM Social Medical Primer
Before you join the discussion though, a word of caution: Consider anything you say or do online not only to be public, but the equivalent of shouting it to the waiting room of your ED. Farris Timimi at the Mayo Clinic has a great post on the maxims of social media which can be summed up in 12 words.
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Twitter
Twitter is the cornerstone of - and the proverbial water-cooler for - FOAM. It came first and it is where the discussion and interaction takes place. For me, Twitter is most valuable for its community, vibrant discussion and as an "early warning system" for what is coming in medicine. However, as a learning tool or a place for nuanced discussion, I find it lacking. I use Twitter, but I do not find it integral to passive learning from the FOAM community. However, it is essential to be an active part of the conversation.
Because of its ubiquity in the FOAMed world, it is worth taking a minute to understand the basics. Twitter is a online platform for discussion in which you post a thought or question, called a Tweet. The past tense is "tweeted," (not twit)! Tweets are composed of 140 characters or less and what you say is public for all to read. Users of Twitter are identified by their "Handle," which is their name on Twitter. Handles are denoted by the "@" sign. For instance, my Twitter Handle is @FOAMddm. Discussions on twitter are public for all to see. However, they can be directed at an individual by adding their handle to your tweet. Further, a tweet can be tagged or categorized by adding a "hashtag" to the tweet. For example, the FOAM discussion on Twitter is trackable using the hashtag #FOAMed. Hashtags can also be used to express emotion. Do not search for "FOAM" on Twitter, you won't like what you find. You can "follow" other people on Twitter, and items which they post will show up in your feed, much like with friends on Facebook. You can use the people I follow as a jumping off place, or scroll through those posting regularly with the #FOAMed hashtag to find what may be valuable to you. If you get into Twitter, using an application such a TweetDeck is exceptionally helpful. Rob Rogers has an excellent series of videos on how to use Twitter. Getting Started with Twitter Twitter Video Series: Part 2 The Twitter App Tweeting and Hashtagging |
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Blogs
Blogs, for me, are where the real learning happens. There are hundreds of them. They range widely in quality and topic, but the best provide regular, timely, insightful analysis of articles, dogmalysis, procedural explanations or practice advice.
Because there are so many, it would be very challenging and time consuming to follow each of them individually. Instead, it is much more efficient to use an RSS aggregator. This tool will compile many blogs and resources in a single place for easily access any time, any where. For me, the best in breed is Feedly. It is free, easily to use and available for all browsers and has iOS and Android apps. Use it to follow medicine, or anything else you might be interested in. It is worth figuring out which blogs you like and want to follow. Everyone has their favorites. Here is a list of mine. I have shared my Feedly collection so you can add it directly to yours. Daniel Cabrera from Mayo has also been generous enough to share his Feedly file. Brent Thoma put together a brief but very helpful video on using Feedly Brent Thoma: How to Use Feedly |
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Podcasts
I love podcasts. They are great. They allow you to learn or stay current with extreme ease and at times when it would otherwise be inconvenient or impossible to do so. You can listen to podcasts at the gym, in the shower, or while you drive.
Again, there are many, many podcasts available in the FOAMed world. I have my favorites, which may represent a good jumping off point to get into it, but choose your own. Like with blogs, because you are likely to follow more than one or two, it is best to use an aggregator or app of some sort to collect all your podcasts in one place, and do the work of keeping them updated for you. Most medical people seem to use Apple products, so iTunes makes it very easy to collect and subscribe. For Android users, there are several apps available. Personally, I use Pocket Casts, but Beyond Pod is a good choice too. |