There's No Place Like FOAM

Editor's Notes

1. It’s important that we clarify that FOAM is not social media Social media is the delivery method and it takes many forms (twitter, facebook, google plus, linked in) FOAM is the community of practitioners concerned with creating free-open access medical education resources, predominantly in emergency medicine, prehospital and retrieval medicine and critical care but also in acute medicine, paediatrics, geriatrics, radiology, dermatology and other specialties, as well as across disciplines including nursing and paramedic practice. FOAM is an adjective; the FOAM community is a noun. FOAM reflects the fact that we spend a lot of time educating and reflecting; its (informal) aims are to make us better practitioners by sharing resources which have already been created (as well as creating resources expressly for the purpose of sharing) and engaging in group reflection and development while reducing knowledge translation time (that is, the amount of time taken for new medical knowledge to reach the patient’s bedside - traditionally this has been 14 years)
2. Like all unfamiliar lands, the world of FOAM can appear scary. I hope by explaining a few of the benefits of participation in this community we can start to understand it better and be less afraid - and maybe take a step into the unknown.
3. We rarely talk about FOAM without embracing its history. It originated in Aus - but the one on the other side of this planet, rather than a fictional place. Mike Cadogan, cofounder of LiTFL, coined the phrase in Ireland in 2012 to describe what he and Chris Nickson have been doing for more than ten years - making educational resources available for free. This was primarily through a blog, available to access online, and through subsequent sharing of this resource and conversations through twitter and other social media.
4. We should probably think about what FOAM is and isn’t. You may remember these three characters from the other Oz - each was in search of something in particular. I think that the FOAM community can give us these things in a way other modes of learning can’t.
5. Courage: In the film, the Wizard recognises that the Cowardly Lion’s desire to run away actually represents wisdom - so I’m going to talk about wisdom The FOAM community will help you restructure your approach to clinical uncertainty, encouraging you to not ask your neighbour “what do you do? I’ll do that” but instead to formulate a three part question, to seek and appraise relevant evidence, to evaluate how and if you should apply that evidence to your practice and to seek immediate peer review. This is the way FOAM resources are structured. Many have pre-publication peer review but post-publication peer review is one of their greatest strengths. In that regard, FOAM can give you brains - exposing areas of unconscious incompetence and utilising the psychological spacing effect through spaced repetition to encourage more effective learning. This additional reflection on your current practice is the marker of higher level learning. FOAM resources can make you a better learner, which makes you a better teacher, which makes you a better learner and a better doctor And thirdly, the FOAM community gives you heart. This is a community with a strong identity, with a markedly reduced power gradient and flattened hierarchy, enabling junior doctors and medical students to ask questions of renowned experts Welfare matters here too, and there is a huge emphasis on taking care of one another, on discussing mental health and wellbeing (including resources on resilience, coping with error, sleep hygiene and other often forgotten aspects of our clinical lives)
6. FOAM is not a replacement for textbooks - it’s not designed to be Also not a replacement for primary research, but as a supplement to both A way of disseminating and applying ideas To get the most out of the FOAM community, know why you are there and what you want To avoid overload, set clear boundaries
7. In terms of twitter, start small, avoid lots of meaningless following Have a professional account, start small and share things which you are interested in or have learned from. Engage and interact. Good starting resources;
8. FOAMstarter twitter account (high yield tweeters, few tweets with good quality resources.
9. LiTFL review - best of the FOAM resources (blogs, podcasts etc) Weekly
10. LiTFL R&R - best of the published literature with miniature reviews
11. Cultivate your personal learning network - identify people and resources you can learn from More at St Emlyn's
12. Rather than just following, remain skeptical! Engage in critical appraisal, think carefully about what you read. If you come across witches and flying monkeys - think twice! There is a lot of information out there and not all of it is good quality (or worthy of your attention). Many resources detail their prepublication peer review processes. Know who you trust and be discerning - but remember these resources aren’t intended to be complete, so be polite!
13. Don’t be anonymous. Hiding behind a mask, like the Wizard did, might seem like fun but there are downsides. It’s off-putting for people engaging with you, it’s tempting to say things you might not otherwise say, and for us in the UK it goes against the GMC guidance. Be open, be transparent, be kind. Remember there is a person behind whatever is posted.
14. Professional behaviour matters online whether or not you are identifying yourself as a healthcare professional. Behave sensibly online and you won’t get into trouble. Farris Timimi of the Mayo Clinic published this 12-word social media policy back in 2012 which sums up sensible online behaviour. Of course we know we shouldn’t reveal identifiable patient information online but the boundaries have been stretched more than once; be wary, be alert, ask a trusted colleague if unsure whether you should be sharing something.
15. So the FOAM community contributes to our teaching and learning in emergency medicine medical education in new ways, many of which feed our educational needs for belonging and community. It’s more fun to learn together; it saves time and energy and, given appropriate stewardship, can be tremendously rewarding.
16. So if you haven’t tried it yet, climb into the hot air balloon, click your heels together three times and say with me - there’s no place like FOAM.