Is FOAM at fault?
A medical practitioner learns something from FOAM, puts it into practice and things go wrong…
Who is at fault?
Is there something intrinsically wrong with FOAM? Is ‘the Internet’ not to be trusted?
These issues are being explored at StEmlyns in When FOAM Doesn’t Wash and at ALIEM in Is FOAM to blame when a medical error occurs?. I highly recommend you read these two posts.
I’m aware of situations where trainees have performed modified procedures learned from FOAM — that were successful — that have still brought criticism amid concern that the methods were not validated. In such situations it is not FOAM per se that is at fault — as such techniques could be learnt from anyone (ever seen two consultants do things completely differently based on received wisdom?) or any non-peer reviewed textbook or even a peer-reviewed case report in a respected journal — instead this reflects a breakdown in the chain of command and supervision. The senior clinician is ultimately responsible, what he or she says goes when a patient is listed under his or her name.
The ease of access and speed of dissemination of FOAM is undoubtedly both a blessing and curse. Yet nothing changes. Regardless of the source of information, we need to think critically and take responsibility for our actions. Context is everything. Importantly, we must respect the supervision hierarchy and those who carry the can.
When in Rome…
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC