#dontgetleftbehind: FOAMed and Social Media for EM Educators

On March 30th, 2014 at the CORD Academic Assembly, the first FOAMed and Social Media for EM Educators workshop was held. The goal of this half-day workshop was to introduce learners to the concepts of social media through interactive workshops.

I was privileged to take part in a FOAMed workshop at CORD 2014 along with innovators such as Joe Lex, Jan Shoenberger, Steve Carroll, and Michelle Lin. Instead of exclusively focusing on the importance of social media and education this workshop delivered a highly informative lecture and hands-on workshop describing how each of us can get involved with this digital movement.  It was very clever and very awesome. If you missed out, fret not; I’m here to give you the details.

It began with Dara Kass showing the audience that she is a #boss of social media. The short story is that she has used social media to spread word about her husband’s recent experience at a local movie theater in Brooklyn. Her husband, a Type 2 Diabetic, tried to watch a movie with a basket of strawberries purchased elsewhere. Despite his preference for healthy food options he was escorted out of the theater by NYPD. The story spread with the help of Dara Kass and her use of Facebook and Twitter, showing the power of social media to spread a message. (For more details on history go here, here, here, here, or here.)


Joe Lex then took the stage and, as always, rocked the house. He opened up explaining how FOAM is not a generational experience as much as it is an educational experience.

“Everyone should have a Twitter Account.”
-Joe Lex, a 66 year-old-M with Social Security, Medicare and Twitter

The idea of FOAM actually is not a new revelation. The Hippocratic Oath, over 2,000 years old, states that we should “teach them this art, if they require to learn it, without fee or indenture.” The idea of spreading knowledge without any price is not truly a modern principal.  However, it became a more digital process when Joe Lex first started Free Emergency Talks by recording lectures from conferences and posting them for free on his website. From there, blogs by Cliff Reid, Chris Nickson, David Newman, Scott Weingart, Mike Cadogan and Michelle Lin began to dominate social media. FOAM however became popularized as a concept in 2012, over a Guinness in Ireland. A detailed history of FOAM evolution can be found here.

During this CORD2014 workshop a discussion among participants was focused around the value of the peer-reviewing process of journals and textbooks versus FOAM. There are obviously arguments for and against the utility of pre-publication versus post-publication peer review. However the recurring conclusions were that there is no evidence that pre-publication peer-review eliminates errors.  The goal of FOAM is not to disregard the role of journals or textbooks. Those sources are still necessary as FOAM is less helpful in the earliest stages of a physician’s career. Early training still should incorporate reading a textbook from cover to cover. As one develops a skill set, FOAM becomes a more valued tool fine-tuning your already engrained knowledge.

So why use social media? Well, you are likely already doing the work required to become involved every time you prepare a lecture, workshop, or write a paper. Now, all you have to do is share that knowledge.


So how does one share? This workshop was divided into smaller focus groups on blog, podcasts, twitter, and wiki pages. For information on blogs, check out ALiEM’s summary page. Anand Swaminathan, John Greenwood and Rob Cooney had some amazing tips on podcasting, Twitter and wikis, which are found below.


Why create a podcast?

  • Residency programs should consider creating podcasts – this is a podcast not limited to individuals but rather to better development of program.
  • Lectures have inherent weaknesses – dictate “when to learn” to the learner, lectures reach few people and are dead after given.
  • Podcasting is lecture 2.0 – can reach thousands, consumed by learners when they are ready, immortalized and always available.

How to create and shape the theme?

  • Think about why you want to podcast and what unique message or viewpoint you have.
  • Develop a theme (critical care, pediatrics, education etc) for your podcast – the panel noted that there are very few EM pediatrics podcasts.
  • Along with theme you have to consider the layout (single voice, multiple voice and interview style) and the frequency.
  • While you don’t want to replicate another podcast, there’s always room for multiple podcasts with the same theme (i.e. the existence of EMCrit doesn’t obviate the need for other critical care podcasts).

What do you need?

  • Computer – nothing fancy needed here.
  • Microphone – We recommend the Blue Yetti ($97) or the Blue Nessi ($70).
  • Editing software – Audacity (free) or Garage Band.
  • Podcast host – We recommend Libsyn ($5/month for basic package, $20/month for advanced package).
  • Blog Host – We recommend WordPress but there are many out there.

What do you talk about?

  • The most important part of a podcast is the content. If the content is good, you will get listeners.
  • Speech/Voice is the second most important concept. The speaker should be clear, confident and expressive.
  • Select content that fits with the podcast’s theme and format.
  • The majority of time goes into creating the script/outline. Depending on the length of the podcast, this can take up to 10 hours. The time investment will pay off.

The most important thing with deciding to do a podcast is figuring out how much time you have to put in. This will dictate the theme, content, format, frequency etc.


What is Twitter?

It is a real-time social networking venue and educational exchange platform.  To understand it you must speak the language. Some basic terms are:

A 140 character or less message posted to Twitter. Tip: It gets tricky regarding who can see your tweet. Therefore the basic rule of thumb is to tweet as if the entire world is reading. You cannot edit a tweet. But you can delete them (this may take time to be deleted from Twitter’s servers).
Your name; begins with the “@” sign. Any individual, organization, journal or department can have a handle. For example:

Tips: If you begin a tweet that begins with a handle, it will only be seen by people who follow you AND that other person. If you want your tweet seen by everyone, start with anything BUT the handle.

  • Ex 1: “@MprizzleER how are you?” –Seen by only followers of @MprizzleER and my followers.
  • Ex 2: “.@MprizzleER how are you?” —Seen by everyone b/c of the “.” Placed before the “@” sign.
Hashtag (#)
Used as a topic label. There are two ways to use a hashtag (#):

  1. To tag a large conversation between multiple people.
    • Ex: If I type “#CordAA14” into the search bar (as below)—All of the Tweets are grouped because each person typed #CORDAA14 using part of their 140 characters.cordaa
  2. To give a category to a particular tweet.
    • Ex: For topics related to critical care you end tweet with #FOAMcc.salim
Retweet (RT)
An action that sends someone else’s tweets to all of your followers.
Modified Tweet (MT)
Means that you changed the original tweet in some fashion.
Hat-tip (HT)
A form of appreciation. Used to give credit to someone else’s tweet that may be helpful to you in some way.
Direct Message
Send a private message to only one individual. Cannot be seen by others.

How to get followers?

You choose your range of Twitter followers; some prefer an intimate group while others prefer to be known internationally. Probably the best advice is to keep your posts interesting and relevant to the topic at hand. Occasionally following others will help you get more followers.  Also, re-tweeting someone else’s comments can’t hurt, right?

Along the same token, follow people who post comments interesting to you. You have the control to decide which posts you want to read in your feed.

How much time does it take?

Up to you! Some people tweet when they are at national conferences, weekly residency conferences, or every ten minutes. Tweeting for the sake of accumulating followers will probably remove all the fun of using this medium. Try not to get overwhelmed and use it as an educational tool and not as the only means to build your career.


What is a Wiki?

While blogs are great platform to build your personal brand and are quite sexy in appearance, and podcasts play to our technophile geekiness, if you really want to build a collaborative online learning environment, you want to learn how wikis work.

The term “wiki” is derived from the Hawaiian term “wiki wiki” which means quick or fast. It’s an ample description of how wikis work. If you want a simplistic view of a wiki, consider it an online Word document linked to hundreds of other online Word documents.

How do I set one up?

What wikis lack in sexiness, they make up for in functionality. First, they are incredibly easy to use. Simply set up a wiki at one of the popular wiki hosts: PB works, Google sites, or Wikispaces. Once you’ve created your account, you’ll be taken to a homepage. To get started, you only need to know to buttons: edit and save.

The edit button opens up a world of possibilities. Click it, and the wiki takes on the appearance of a document editor. Just like a document, you can type, change fonts, alignment, and colors. You can also embed videos, other online documents, add photos, and all manner of widgets. Once you have the page looking somewhat like you would like it, click the save button in the page will turn back into a plain Jane wiki site.

So how is this different from a blog?

  • Security: There are three basic degrees of security:
    1. First, the security architecture of wiki will allow you to publish the wiki in an open format inviting anyone on the World Wide Web to help edit your “document.”
    2. Second, you can also publish in read-only format, yet allow a select group of editors to edit the document.
    3. Third, you can set the security high enough that people can only access the wiki with a password. This allows you to create a home base for your residency program behind lock and key, incredibly important when discussing sharing materials with copyright protection.
  • Collaborative work: easy incorporation of large groups of learners into the creation and editing process. If you are looking for a platform that allows true online collaboration, wikis are your tool. The ability to edit and quickly link to other existing pages or create new pages is a boon to those doing collaborative writing. The next time you have a scholarly article to write with the team of people, consider creating a wiki. Each section can have its own page and all of your references can be stored on the wiki for easy access.
  • Revert button: Wikis are programmed to store all prior revisions of itself for a preset number of days. This allows you, the administrator, the ability to go back and undo any mistakes that your collaborative learners may make. Simply click the prior version, ensure that it is the version that you want, and hit revert. Suddenly, all changes are undone. This feature alone should give peace of mind to anyone considering acting as administrator to a wiki. I will warn you, however, that you are more likely to need this feature when working with faculty members than learners!

As you can see, wikis offer a wide array of powerful tools. They are also incredibly easy to learn how to use. For your residency program, consider hosting all manner of information including flipped curriculum, journal clubs, residency handbook, quality improvement team projects, and a significant amount of reference material.

Special thanks to Drs. Rob Cooney, John Greenwood, Nikita Joshi, Dara Kass, and Anand Swaminathan for organizing this workshop. Be sure to check out ALiEM’s post on the blogging section of this session.

Edited by Alex Koyfman

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