Personal learning networks, remote learning and early access
Free Open Access Medical education (FOAM) has the power to facilitate global conversations about the latest medical practice and literature. It allows anyone to follow conferences remotely (but in real time), helps users develop professional networks and friendships and can consolidate information with colleagues at home and abroad. There are enumerate conferences and symposia to choose from these days, and that choice often becomes impossible due to the sheer diversity. Following attendees using meeting hashtags permits in real-time remote access to the meeting, viewed through their interest / opinion spectrum.
Such networks can permit parallel learning and discussion, for example with the running of remote journal clubs. Many major journals open up 1-2 hour long windows for free and unimpaired discussion of soon to be released papers, in order to scope responses from like minds prior to final peer review and release.
New and un-published innovations, upcoming trial ideas and recruitment to studies are often showcased. Innovative safety ideas and discussions thereon can often open doors to new and exciting practices, many promoting patient safety.
Appraisals, records and continuing medical education (CME)
With many of us now increasingly learning from blogs and podcasts, it is important to reference these resources for the purpose of appraisals. The problem is how best to record this activity. Some methods include the use of IFTTT or “If This Then That”. This is a web service that aggregates many other web apps into one place and can perform actions given a certain set of criteria. All you need to do is create your recipe and let it store all of your SoMe activity on Twitter and Facebook for you. Other more specific resources include an online zone for Association of Anaesthetists of Great Britain and Ireland (AAGBI) members that host a wealth of educational, learning and CPD resources. Here you can learn in your own time and keep a record of your completed CPD for use in appraisals and revalidation.
Policing, etiquette & caution
The Royal College of Anaesthetists (RCOA) in the UK encourages the use of SoMe and in its guidance states that SoMe use by doctors can benefit patient care, enhance learning and strengthen professional relationships. SoMe facilitates networking by linking like-minded people through tweets at conferences and meetings, and has enhanced communication between and within trainee research groups. As an educational resource, it encourages the use of open access journals (#FOAMed) and time-limited free access to articles in subscribed journals (Anesthesia journal free for a day articles, #FFAD) to further distribute new information.
Like any tool, there are risks and consequences of using SoMe. Communication and rapid dissemination of new information allows almost instantaneous access to the results of new trials, and allows for critical discussion when the information is fresh and without any traditional peer review process. Clearly, we need to be mindful that any information can be misinterpreted or distorted, especially when subjected to multiple layers of filtering through the SoMe channels (a broken telephone effect) and the unchecked dissemination of distorted information (grey evidence). Often, it can take some time to sift the so called, ‘wheat from the chaff’ and learn the patterns of ‘the good, the bad and the ugly’.
The General Medical Council (GMC) has issued specific guidance relating to the use of social media by doctors, stating that “the standards expected of doctors do not change because they are communicating through social media rather than face to face or through other traditional media”. It must be considered that if one is to place a message out into the vapor of SoMe, it should be done with exactly the same degree of caution, candor and humility one would exercise when orating it in person from a conference stage to friends, patients and strangers in the crowd. Disappearing behind a username should not be an excuse to abuse the privileged of freedom of speech, or indeed the privileged position of a medical professional.
More detailed guidance has been written as a collaborative publication of Australasian groups of doctors in training, illustrating the application of professional standards with examples both fictional and based on previous cases. Other guidance has been issued by the Medical Defence/Indemnity organisations and professional organisations.
The sheer volume of new medical knowledge and publications makes it nearly impossible to keep up to date with everything. Just 60 years ago, the answer would have been simple:
“All that is required is the current issue of The Journal, an easy chair, pencils, a pad of paper and postal cards, along with a genuine, sustaining interest in all fields of medicine”, N Flaxman, 1954
“If physicians would read two articles per day out of the six million medical articles published annually they would fall 82 centuries behind with their reading” – WF Miser, 1999
There are an estimated 6000 papers published every day at present, thus keeping up with recent and relevant advances in medicine is an enormous challenge. SoMe, when used correctly, can be an effective way of optimizing opportunities for self-directed learning, holding discussions with other health care professionals (commonly including the principal authors of landmark studies) and reflecting on newly-acquired knowledge. It is possible to document these learning experiences for your personal record and as evidence for appraisals and revalidation. There is a certain addictive appeal in having the power to consult such resources so readily and in such a structured fashion.
The growth of SoMe as a tool for improving access to medical education resources has been astronomical over recent years. Increasingly, health care professionals are using platforms such as Twitter to share and discuss papers and resources. The beauty lies within the fact that whatever is placed onto the SoMe platform for debate will reach thousands, if not millions of other like minds. Within minutes, people are able to pass comments, pontificate and offer their opinions on topics.
There is no doubt about the reach and immense power that social media and free open access medicine have over what we learn. It influences how we access information and how we spread important messages to millions of like-minded clinicians. It may indeed be one of the most effective and efficient platforms for publishers, researchers and clinicians alike. It allows us to rapidly disseminate ground-breaking results, new therapies and trial methodologies. Of course, the information must be used with due care, as peer review processes are not the same as those involved in major journals. One can become influenced by grey information, as well as by the biases of others. In our opinion, with due care and attention, it is one of the most exciting and promising areas to become involved in within critical care.