The road ahead for FOAM

Guest post: Aidan Baron, aka @ALittleMedic, student-prehospitalist, one of the youngest FOAMers around

Explosive growth. Ever increasing content. Trailblazing innovations. FOAM is undoubtedly going places: the question is, where? What does the future hold for the FOAM movement? Only time will tell And that’s the most exciting part.

Our FOAM world has come a very long way, though there are still challenges ahead.

There is an inherent risk of information overload, the ongoing process of developing a distinct identity and a steady stream of critiques; ranging from reflective self-evaluation to fear-mongering by the often technophobic.

One thing is for sure; the way we access medical education will continue to evolve over time.

Will #FOAMed endure as a distinctive force? Or will it simply dissipate into generic online learning?

What is it that distinguishes #FOAMed from soft copy e-textbooks and narcolepsy-inducing online lectures? Is it simply the free access? I would hope that our online evolution represents something greater.

Will the pain of information overload and substance heterogeneity outweigh the pleasure of instantaneous collaboration, inspiration and innovative learning?

We have witnessed how FOAM translated from a niche group of primarily critical care physicians, to a mainstream paradigm embraced by a range of diverse clinicians. It could be said that in the process it has lost some, though not all, of its loveable quirkiness in exchange for wider-spread recognition and uptake.

So, Where to from here?

Contribution vs Consolidation:

One of the biggest challenges facing FOAM is the management of information overload – a problem common to many aspects of the online world. Likely you too have recognised how near impossible a task it is to keep abreast of the horde of enthusiastic contributors who have taken a seat at the FOAM table. Luckily, a trend of content consolidation has gained momentum and many blog writers and clinicians have begun synchronising and summarising the information out there. The creation of these reviews and bite-sized tasters has allowed readers to benefit from maximal exposure with minimal exertion. Even so, this process is relatively inconsistent and many times is duplicated by multiple authors. (Personally, I’m of the opinion that this is actually a strength, though that might just be the Darwinian in me) Could a large part of the future of FOAM lie in consolidation and organisation rather than the explosive content-driven growth of the past half-decade?

Could Social media become a ‘Source Engine’?

A paradigm shift might be in order. Why are we using Search Engines such as Google to find educational content? Quality, usefulness and impact are easily distinguishable. The ‘better’ a resource, the more likely one is to remember and then recommend it when asked. This is a truly underappreciated strength of FOAM that sails beneath the radar – we are a collaborative network who aid each other in sourcing content! We are not discussing peer reviewed evidence here, rather the impact of educational content on people – who better to adjudicate this than other people!? Let’s stop using search engines to find content that drives humans, and instead start using humans who’ve already experienced that content, and been driven by it, to recommend it to us! Could Social media become a ‘Source Engine’? Should we be ‘Sourcing’ quality content rather than ‘Searching’ for it?

A Question of Quality

“But what about quality control?” is the cry sounded again and again by the rightfully sceptical. First, let’s consider that #FOAMed is a movement built on the sharing of knowledge for the mutual benefit of our practice and thus ultimately our patients. Stringent critical analysis is applied by FOAMed readers in the form of post-publication comments and critiques, and more importantly, by content creators themselves. The best content is thoroughly researched, meticulously referenced and openly discloses the strengths and weaknesses of its arguments Fortunately, good quality, high impact, clinically useful content stands out from the crowd. The best FOAM bubbles to the surface. SoMe (Social Media) is how we interact and share – we are all our own independent review process – highly shared content is thus far more likely (even though not guaranteed) to be of superior quality. The Internet is a ‘quality democracy’. As with any new information, the onus is on the learner to evaluate the quality and trustworthiness of the source. In this, reputation is just as important in the online world as in any other teaching environment. After all, when was the last time you recall seeing poorly evidenced, low quality educational content from a well-regarded FOAM contributor? With this in mind, there is the potential for quality content from newer sources to go under appreciated, though FOAMed’s welcoming and egalitarian ethic makes this far less likely than in almost any other field! There is no question in my mind that the benefits to our education and, most importantly; to patient care, outweigh the thus far theoretical risks.

Diversity in Delivery:

It has become apparent that trying to create an online one-stop-shop for all interests is both unrealistic and undesirable, and that a diversity of both contributors and consumers is healthy. As learners, we have different needs. Students are in search of entirely different content to residents, and in turn, to faculty. Content creators and online educators shouldn’t attempt to be ‘all things to all people’ but rather pitch to a target within the FOAM spectrum of users. There is a noticeable trend of increasing content relevance (e.g. Foamcast, CCH journal, LITFL R&R) with resources that target different audiences. Perhaps this will become even more apparent in the future as more individuals from different career stages turn to FOAM for their learning needs.

As the FOAMed spreads

Social Media can be intimidating and FOAM shouldn’t necessarily be synonymous with it. Does FOAM exist without mainstream social media platforms? In my opinion: Yes! I prefer to view FOAM as a Tao. A way. An ethos. As much as it pains me to admit, one does not need twitter to support or use FOAM. Part-and-parcel of our global expansion is accepting that many find social media confronting or confusing. You wouldn’t throw a medical student into a resus room and shout “intubate!” Let’s not apply a similar pressure to the more technologically conservative amongst us. In order to assist our colleagues, we can encourage them to start gradually, perhaps with an email subscription to a few high output blogs relevant to their area of interest.

Having said that, I truly believe that the connectedness that occurs through social media is one of the greatest strengths of FOAM.

What began as a small and tight knit circle of content creators in the critical care arena – the original pioneers of FOAM, has become a diverse and vibrant community – branching off into; paediatrics, general practice, family medicine, toxicology, wilderness medicine, ultrasound, ICU and many more: each with their own focus, leaders, memes, subcultures and hashtag !

The essential component remains that through Social Media, these offshoots and diverse threads of #FOAMed are able to constantly interact. With this comes a cross-pollination. We are maintaining a refreshing and innovative culture which encourages interdisciplinary collaboration and the breaking down of silos, rather than the tribal mentality of many modern medical institutions.

Information Overload
Content Consolidation
Sourcing Quality
Delivering Diversity

Just a few of the many tribulations and triumphs we have to look forwards to.

I see a bright future reflected in the glimmering surface of #FOAMed

Watch this space. With Special thanks and gratitude to Dr Michelle Johnston (@Eleytherius) and Dr Penny Wilson (@NomadicGP) for their advice, input and editing.

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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