Social media in critical care: what’s all the fuss about?

The way we communicate and learn has been revolutionized by technology. Almost all of us carry a smartphone these days, so we are never more than a phone call, message or text away from family, friends and colleagues. This blog is the first of three from the authors examining how social media (SoMe) transgresses the usual borders and may, in the future, play an important role in communication, learning, teaching and peer review in anesthesia and critical care. Part 2: Free Open Access Medical education (FOAM): the new way to keep up-to-date  
Part 3: Using social media in medicine to your advantage, with care!


The Digital Revolution!

The wealth of knowledge traditionally stored in books, articles or other printed media is increasingly being digitalized. In fact, reading a journal, picking up a textbook, or carrying around paper manuscripts is becoming so rare these days, it could be viewed as rather a, ‘Do you remember when…’, sort of reminiscence. Whether researching for a manuscript, preparing for a lecture, constructing a teaching session or simply keeping yourself up-to-date, you need not leave the comfort of your office chair.

We are never more than a click/tap away from almost everything we require. Shelves of textbooks previously stored in libraries can now be accessed as digital downloads and journals can be accessed within their own websites, whether free open access or subscription based. When faced with a knowledge deficit, whilst the library still exists, most learners would sooner consult the Internet on their mobile device. This may be even before consulting the textbooks sitting on their own book shelves. All of this has vastly improved productivity and may indeed be part of the reason why the flow of new publications seems endless. As sad as it may be, libraries are also becoming the victims of their own definition – quiet places.

SoMe, FOAM & #

SoMe describes the myriad of cloud- and web-based applications that allow people to create and exchange content. The UK’s General Medical Council guidance use the term to include blogs and microblogs (such as Twitter), internet forums (such as, content communities (such as YouTube and Flickr), and social networking sites (such as Facebook and LinkedIn). This term however is very broad and is constantly evolving.

Closely related to SoMe is the concept or principle of Free Open Access Medical education (FOAM), where online resources (articles, videos, podcasts, etc) are shared freely and openly to the wider audience. It forms a collection of resources, a community and an ethos. The FOAM community spontaneously emerged from the collection of constantly evolving, collaborative and interactive open access medical education resources being distributed on the web with one objective — to make the world a better place! It is independent of platform or media and has a personalized, continuously expanding database of resources for medical education: it includes blogs, podcasts, tweets, Google hangouts, online videos, text documents, photographs, Facebook groups, and a whole lot more.

Placing a hashtag (#) symbol before an item being described allows every Twitter user rapid access anything associated with it. It has become a rapid way of filtering the relevant cohorts of information on Twitter, and here is where FOAM comes in. Anything related to Ultrasound (#FOAMus), anything relating to Emergency medicine (#FOAMem), and anything critical care (#FOAMcc) and so on (Table 1). A revolution has also occurred in the area of point of care ultrasound (#POCUS), where live ultrasound clips are posted promoting remote learning and discussion.

Table 1 – Relevant hashtags and their descriptors

Hashtag term Specialty or subject
#FOAMed Anything medical
#FOAMcc Critical care
#FOAMem Emergency medicine
#FOAMim Internal medicine
#FOAMped Pediatrics
#FOAMres Resuscitation
#FOAMsim Simulation
#FOAMtox Toxicology
#FOAMus Ultrasound
#FOANed Nursing
#MedEdFOAM Medical education
#POCUS Point of care ultrasound

How to start in social media

  • Find what you are interested in, activate Twitter

Twitter forms a fabulous platform from which to access a vast amount of information. Set up an account and pick a catchy username. This may or may not relate to what you do from day-to-day, or it may simply be your name.  Be identifiable, don’t be anonymous and be professional. We must mention caution over the use of pseudonyms or false identities, as it has been known for people to hide behind such aliases when *trolling others. (*A troll is someone who sets out to pass deliberate and controversial, often inflammatory comments on other users and their opinions). Using a short number of lines to let people know who you are, with a nice image of yourself, travels miles. One could view it in the same way you would introduce yourself at a meeting; after all, merely stating your name probably will not stimulate much interest. Those without a descriptor paragraph tend to pick up fewer followers. People want to know who you are and what you are about. Register as a FOAM user and promoter.

  • Search the hashtags (#)

This is similar to searching for a generic term in a search engine and forms an excellent filter. As mentioned above, there are many identifiable hashtags out there. Searching for #FOAMed will highlight anything to do with Free Open Access Medicine, #POCUS, point of care ultrasound related posts and so on (see Table 1). You can also have a look at the Symplur Healthcare Hashtag project to see what is trending.

  • Follow people

Look for people within the hashtag searches who seem to be putting information out there that appeals to you (Table 2). In this way, you form a link and others can find you. The person who you follow can then follow you and so on, until a multiplicative effect occurs whereby a network is formed and you are reaching out to many more people than you first started with. Personal learning/social media groups have thus been created, paving the way to extremely useful networking, learning and productivity.

  • Download or subscribe to a podcast

Podcasts are audio recordings that can be downloaded and listened to at a later date. They are very useful when travelling, biking, running or generally passing time. Some find this an excellent medium for learning. They can be found on each user platform, whether Android or Apple on various stores, or by following links on sites that provide the casts themselves.

  • Follow or subscribe to a blog

There are many out there to choose from, over 300 within critical care alone. Look for a RSS feed icon and use this to alert/stream appropriate material to you. Perhaps an easier way is to look for the ‘subscribe’ button on the site itself. Most will have these enabled and you can then receive brand new updates/news/blogs direct to your inbox, rather than checking each day and missing new posts. Apps such as Feedly will help you to filter what you want to look at. If you find you are enjoying this side of FOAM, then perhaps start your own website/blog and accrue followers of your own.

  • Subscribe to video channels

There are many video feed channels readily available, such as YouTube and Vimeo. Simply search for interesting topics and save them into your own playlists. These can be embedded into any website, should you start your own. You can also subscribe to selected users and their content, again, with alerts on release of new material. Videos offer an immersive and intricate learning platform and many come highly recommended.

  • General rules

Be generous with your criticism and with what you share. The more you put in, the more you get out. Use filters to beat information overload, and be a filter yourself. Have fun and don’t take it too seriously

Table 2 – Key people to follow on Twitter (not exhaustive)

Name Twitter Name Affiliation
Aarti Sawal @aartisarwal ICM / Anaesthesia Consultant
Adrian Wong @avkwong ICM / Anaesthesia Consultant
Anna Batchelor @AnnaBatchelor ICM / Anaesthesia Consultant
Aoife Abbey @WhistlingDixie4 ICM Anaesthesia Trainee
Ashley Miller @icmteaching ICM / Anaesthesia Consultant
Cian McDermott @cianmcdermott EM Consultant
David Lyness @Gas_Craic ICM Anaesthesia Trainee
Deb Chalmers @viridescentFrog ICM Consultant
Duncan Chambler @DuncanChambler ICM / Anaesthesia Consultant
John Myburgh @JAMyburgh ICM / Anaesthesia Consultant
Jonathan Downham @ccpractitioner Critical Care Practitioner
Jonny Wilkinson @wilkinsonjonny ICM / Anaesthesia Consultant
Justin Kirk-Bailey @PARADicmSHIFT ICM / Anaesthesia Consultant
Kylie Baker @Kyliebaker88 EM Consultant
Laura Duggan @drlauraduggan Anaesthesia Consultant
LJ Mottram @ljmottram  ICM / Anaesthesia Consultant
Manu Malbrain @manu_malbrain ICM / Anaesthesia Consultant
Marcus Peck @ICultrasonica ICM / Anaesthesia Consultant
Matt Rowland @matthewjrowland ICM / Anaesthesia Trainee
Michelle Johnston @Eleytherius EM Consultant
Mika Hamilton @ICUwalker ICM / Anaesthesia Consultant
Nitin Arora @Aroradrn ICM / Anaesthesia Consultant
Rob Mac Sweeney @CritCareReviews ICM / Anaesthesia Consultant
Rosie Baruah @rosieICM ICM / Anaesthesia Consultant
Rupert Pearse @rupert_pearse ICM Consultant
Salim Rezaie @srrezaie EM Consultant
Segun Olusanya @iceman_ex ICM / Anaesthesia Trainee
Steve Mathieu @stevemathieu75 ICM / Anaesthesia Consultant
Victoria Stephen @EMcardiac EM Consultant
Vicki Noble @nobleultrasound EM Consultant


In part 2 of this series, the authors discuss the FOAM resources available and whether, ultimately, it could even replace peer review.

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Ken Milne

Great post. I will share via my social media network.

Would you consider including the Skeptics’ Guide to Emergency Medicine (@TheSGEM) in your twitter recommendation? I think it is very important clinicians develop critical appraisal skills so they can interpret the literature.

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