FOAM NOT FLUFF
Michael Burk , MD
Research surrounding the outcomes from implementing technology in medical education is a fast-growing area of publication and there is an expanding body of research to support its validity . 1 – 5 The use of technology and FOAM ( Free Open Access Medical Education ) as integral or primary teaching modalities for medical education has only come to broad adoption in any specialty in less than a decade , and has only become prominent in the past six to seven years . 3 , 6 – 8
Every year there are more papers published on the improvements in outcomes from the implementation of these modalities and the size of the samples and scope of the projects has increased similarly . A landmark study from 2013 reviewed project implementation from 14 studies using various social media tools and helped legitimize the topic as not only an idea for educators , but also as an area for significant research investment for academicians . 9 The most consistent result was a statistically and educationally significant increase in learner engagement . This review showed an indication of improvement in learning retention in various areas and at minimum , no reduction in test scores for the studies reviewed . 9
The adoption of technology as a primary educational modality in medicine , at all levels of training , has been swift . 3 , 8 – 13 In graduate medical education , the fields of emergency medicine and critical care have led with over 300 online blogs , podcasts and resources . 8 At the medical school level , the University of Vermont has become the first allopathic medical school to change its entire educational course structure , based on the evidence behind using online teaching modalities , to facilitate a flipped classroom model . 10 , 13 In Louisville , we have led the field of internal medicine with the creation of Louisville Lectures ( www . LouisvilleLectures . org ), a project that provides free access to lectures on core medicine topics from the faculty and specialists from the University of Louisville . 14 For those practicing physicians creating the educational resources , there is a massive international conference , Social Media and Critical Care ( SMACC ), to facilitate networking , debate best practices , and work to expand the horizons of the concept of FOAM .
A major concern for many educators and learners revolves around the reliability of online educational resources . While it is absolutely true that any person could create a blog , claim to be a physician expert , and begin posting resources that would be detrimental to patient care , it is unlikely that these efforts would be able to persist . Medicine has historically relied on peer review by an editorial board for scientific work to be published . However , a significant number of the findings produced by these studies are eventually overturned
15 – 17 or are unable to be replicated .
Anyone who has seen a news story about a celebrity or company taken to task on social media for posting incorrect , biased or unsubstantiated information has seen the ruthless efficiency of Cunningham ’ s Law . This states , “ The fastest way to find the answer to a question on the internet is to post the wrong answer .” In application , a significant benefit of using online and FOAM resources is the nearly real-time peer review by physicians in all levels of training and in multiple fields . Just as well established journals such as the New England Journal of Medicine are more trusted than smaller pay-to-publish resources , large , reputable , and highly reviewed online resources are able to provide high quality educational content .
The concept of doctors creating educational resources and offering a helping hand to other physicians is not new . The concept of using the internet as a home for these resources is hardly new , either , with the first blogs that could be considered FOAM ( even before the term existed ) starting in 2002 . 8 By 2009 this had increased to over 100 websites , blogs and podcasts . 8 The most popular resources now have well over a million visitors per month . 18 If this shift to using technology and FOAM for education sounds like an overnight success , the stories behind it are remarkably similar to that of other overnight successes ; that is , years of work by hundreds of people have culminated in the resources we use today . 6 , 7 , 19
Louisville Lectures has grown out of this international movement to provide high quality educational resources . In 2014 there were essentially no FOAM resources dedicated to internal medicine . 20 I began working with the administration and faculty at the University of Louisville to take the faculty lectures given to the residency program , edit them , and publish them online . With the help and advice of the FOAM community , I recruited a team and we built a YouTube channel , website and podcast to host these lectures . In less than two years after launching , our lectures have been viewed more than 800,000 times by over 16,000 subscribers in 170 countries . Our lectures have been used in a variety of ways ; we have had internists tell us they used our website to review for recertification and we have had a physician request a lecture to help assess and treat back pain in rural Pakistan . We now offer CME on several of our lectures to allow physicians to receive credit for the time they are spending on education . 14
In Louisville , we have taken a slightly different approach to providing FOAM . While we seek to lead the field of internal medicine into this new frontier , we have maintained focus on providing a broad and comprehensive curriculum . Consistent with the exponential growth of FOAM resources , there are often resources that are duplicative , and even in well-established resources , gaps in topic coverage exist . 1 We have worked to overcome gaps in education for our residents ( and our larger audience ) by working with faculty and residents to build a comprehensive medicine curriculum . 20 Our lectures are reviewed by the residents in the live audience , content
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