#FOAMed Movement: Winner #hesawards 2013 Global Medical Collaboration

When we spoke with Perth-based Emergency Physician and blogger Mike Cadogan earlier this year, it was clear that ‘conventional’ models of medical information were changing among healthcare professionals (HCPs) worldwide who are active in social media.

Cadogan told us about his work to revolutionise the way emergency care and critical care topics are discussed and shared by experts and HCPs across the globe. His online movement, FOAMed, which stands for ‘Free Open Access Medical Education’, promises to be one of the most inclusive repositories for international medical education resources on the web.

The online community behind FOAMed collaborates to ensure the free flow of knowledge between medical peers worldwide. Its primary objective, says Cadogan, is to make the world a better place through the sharing of the latest cutting edge medical education resources, be they podcasts, presentations, tweets, or other platform-independent formats.

According to Cadogan, FOAMed plays a big role in fostering meaningful real-time discussions about critical topics in emergency medicine, dermatology, cardiology, and other therapy areas. The movement seeks to provide a level playing field where HCPs with as much as over 20 years’ experience can share best practice across a range of platforms and countries within a meritocratic community that doesn’t just ‘take’, but shares up-to-date knowledge and strives to question medical dogmas that may cause certain systems of epidemiology to be overlooked.

In terms of platforms, the FOAMed community uses a number of channels, with active groups and conversations on Facebook, LinkedIn and Slideshare. On Twitter, however, the conversation is happening constantly. This is a key element of the FOAMed concept, as it allows for potentially urgent medical questions to be answered within minutes of posting.

Below is an example of a conversation started by a Manchester-based HCP on a medical topic. Within 6 minutes, Simon Carley had already received a reply from another HCP, in addition to the fact that his tweet was re-tweeted 16 times.


Bringing Together Like Minded HCPs

The term ‘FOAM’ was coined at the International Conference of Emergency Medicine in Dublin in 2012, where Dr Cadogan spoke about the significance of digitally active HCPs putting their virtual networks to good use and letting other people engage with, and benefit from, their ideas and resources. Today, the FOAMed movement has expanded to include the creation of GMEP, a global medical education project in the form of a media library that has over 3,200 members, including 169 universities. Bloggers and HCPs who are registered with GMEP can upload various media to the appropriate folders, from photos of intriguing ophthalmology cases to descriptions of cardiology emergency situations, complete with EKG information. The aim of the website is to have all resources uploaded and managed on a single platform rather than resorting to managing multiple accounts, which can lead to fragmentation and incoherence when sharing resources with other HCPs around the world.

Social Peer Reviews

“…they’ve all got something quirky to add, to create contextual in-line learning for the asynchronous platform that we’re creating”, says Dr Cadogan. “We are now able to stand up and say, this is an enormous technological advancement and we can take control of it for ourselves, using free APIs.”

According to Dr Cadogan, one of the worries that has been voiced in the past is that HCPs are “just reading a blog post and going and doing something stupid”.

One way to address this, he says, is to conduct in-depth peer reviews once several HCPs have come together and collated similar materials and resources. For example, says Dr. Cadogan, we can consider an obscure but cutting edge treatment or procedure that is not being spoken about in wider medical circles or on closed HCP networks. With the help of other #FOAMed members, HCPs will contribute to creating a mini-portal of information around the topic, but not before community members have conducted thorough peer reviews.

Dr Cadogan explains the process that takes place once there is interest in a particular topic: “…and then someone else says, ‘that’s great, I’ll do a podcast on that’, and someone else says ‘I’ll do all the literature review’… We will then peel back the dogma, and just say, you know, we have been doing this now for 50 years, but no one’s actually gone back to the original paper…”

Although one of the principles FOAMed was built on is the ability to incorporate contributions from all categories of HCPs and the nature of the project is to provide open access to potentially life-saving medical information, Dr Cadogan maintains that the resources that are being shared are not only dependable, but come from healthcare professionals who have a wealth of medical experience and are at the forefront of important developments in medical procedures. Sometimes this experience is particularly useful to HCPs around the globe due to its specific nature, as was the case when a Pretoria-based healthcare professional shared his vast knowledge of gunshot wounds, having been treating this type of injury for many years.  

Lessons Learned and The Future of FOAMed

Stimulating educational frameworks

The FOAMed project has spawned numerous programmes and schemes, including aiding in the creation of emergency medicine syllabuses in countries where these are not currently put in place, such as Italy. Dr Cadogan explains that Italy did not have an emergency medicine college with a formal structure, but that FOAMed has helped enclaves of anaesthesiologists, pulmonologists and other medics engender the collection of discussions and resources into a reserve with a coherent framework. Furthermore, FOAMed was also a building block in jumpstarting similar systems for emergency medicine colleges in Sweden and the Netherlands.

Using open public networks for HCP collaboration

I sat next to a nurse I had been conversing with…whether she was a nurse, whether she wasn’t a nurse, we were able to discuss at exactly the same level everything we were dealing with during the conference, and it was enlightening.”

Dr Cadogan explains that collaborating openly on public social networks, rather than closed HCP-only communities, eliminates hierarchical tendencies and situations where members of the community try to “outdo” each other.

The FOAMed community collaborates not based on short-term incentives (which has happened in certain online environments that Cadogan says have contained elements of ‘one-upmanship’), but out of the genuine desire to advance medical concepts and techniques freely and easily, without feeling like they have to adhere to a benchmark set by the industry, or what we would have thought as ‘key opinion leaders’ a few years ago.

“A closed network feels, to me, like writing a letter to the editor after reading a journal article. It’s really cold, it doesn’t warrant engagement, it just doesn’t have the free-flowing ability of these guys, who are medical students, who are nurses, and they’re all able to make a comment. Nobody gets shot down in flames”, explains Dr. Cadogan.

Connecting HCPs offline

In March 2013, the FOAMed concept materialised in the form of SMACC13, a highly successful conference based around critical care that saw over 700 delegates come together to discuss clinical matters that spanned from anti-venom treatments to acute spinal cord injuries and beyond. The conference is happening again next year and aims to use the success of free online learning platforms to address crucial medical issues. The event is not for profit and all content is released through FOAMed and its affiliated channels post-conference.

FOAMed wins the #hesaward 2013 for Global Medical Collaboration

The FOAMed movement is a perfect example of harnessing the accessibility and ease of use of social media channels to form communities of HCPs who collaborate in an open and timely manner. Not only are these HCPs constantly learning from each other, they are also able to draw potentially life-saving insights from the lessons presented in the medical resources shared with them from across the globe. This renders the medical knowledge exponentially more useful.  FOAMed is not ‘reinventing the wheel’, but harnessing existing technology such as wiki pages, twitter chats and LinkedIn groups to create a more dynamic approach to medical education – one that is based on immediate, real time two-way interaction and continuous learning.


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